Search results for: health risk factors

Authors: Joseph K. A. Johnson

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Hypertension affects 20 percent of the people within the ages 55 upward in Ghana. Of these, almost one-third are unaware of their condition. Also at the age of 55, more men turned to have hypertension than women. After that age, the condition becomes more prevalent with women. Hypertension is significantly more common in African Americans of both sexes than the racial or ethnic groups. This study was conducted to determine the causes of high blood pressure in Ashanti Region, Ghana. The study employed One Hundred and Seventy (170) respondents. The sample population for the study was all the available respondents at the time of the data collection. The research was conducted using primary data where convenience sampling was used to locate the respondents. A set of questionnaire were used to gather the data for the study. The gathered data was analysed using principal component analysis. The study revealed that, personal description, lifestyle behavior and risk awareness as some of the causes of high blood pressure in Ashanti Region. The study therefore recommend that people must be advice to see to their personal characteristics that may contribute to high blood pressure such as controlling of their temper and how to react perfectly to stressful situations. They must be educated on the factors that may increase the level of their blood pressure such as the essence of seeing a medical doctor before taking in any drug. People must also be made known by the public health officers to those lifestyles behaviour such as smoking and drinking of alcohol which are major contributors of high blood pressure.

Keywords: high blood pressure, principal component analysis, hypertension, public health

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Authors: David J. Thomson, Joshua C. J. Chew

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Background: Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) is a rare complication of lithium toxicity that typically causes irreversible cerebellar dysfunction. These patients may require hemodialysis and extensive supports in the intensive care. Methods: A review was performed on the available literature of SILENT with a focus on current pathophysiological hypotheses and advances in treatment. Articles were restricted to the English language. Results: Although the exact mechanism is unclear, CNS demyelination, especially in the cerebellum, was seen on the brain biopsies of a proportion of patients. There is no definitive management of SILENT but instead current management is focused on primary and tertiary prevention – detection of those at risk, and rehabilitation post onset of neurological deficits. Conclusions: This review draws conclusions from a limited amount of available literature, most of which are isolated case reports. Greater awareness of SILENT and further investigation into the risk factors and pathogenesis are required so this serious and irreversible syndrome may be avoided.

Keywords: lithium toxicity, pathogenesis, SILENT, syndrome of irreversible lithium-effectuated neurotoxicity

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Authors: Claudia Seabra, Elisabeth Kastenholz, José Luís Abrantes, Manuel Reis

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In a world of increasing mobility and global risks, terrorism has, in a perverse way, capitalized on contemporaneous society’s growing interest in travel to explore a world whose national boundaries and distances have decreased. Terrorists have identified the modern tourist flows originated from the economically more developed countries as new appealing targets so as to: i) call attention to the causes they defend and ii) destroy a country’s foundations of tourism, with the final aim of disrupting the economic and consequently social fabric of the affected countries. The present study analyses sensitivity towards risk and travel behaviors in international travel amongst a sample of 600 international tourists from 49 countries travelling by air. Specifically, the sample was segmented according to the Global Peace Index. This index defines country profiles regarding the levels of peace. The indicators used are established over three broad themes: i) ongoing domestic and international conflict; ii) societal safety and security; and iii) militarisation. Tourists were segmented, according to their country of origin, in different levels of peacefulness. Several facets of travel behavior were evaluated, namely motivations, attitude towards trip planning, quality perception and perceived value of the trip. Also factors related with risk perception were evaluated, specifically terrorism risk perception during the trip, unsafety sensation as well as importance attributed to safety in travel. Results contribute to our understanding of the role of previous exposure to the lack of peace and safety at home in the international tourists behaviors, which is further discussed in terms of tourism management and marketing implications which should particularly interest tourism services and destinations more affected by terrorism, war, political turmoil, crime and other safety risks.

Keywords: terrorism, tourism, safety, risk perception

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Authors: Dedjo Yao Simon, Takahiro Saito, Norikazu Inuzuka, Ikuo Sugiyama

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Abidjan city (Republic of Ivory Coast) is an emerging megacity and an urban coastal area where the number of floods reported is on a rapid increase due to climate change and unplanned urbanization. However, comprehensive disaster mitigation plans, policies, and financial resources are still lacking as the population ignores the extent and location of the flood zones; making them unprepared to mitigate the damages. Considering the existing condition, this paper aims to discuss an approach for flood risk reduction in Cocody Commune through value capture strategy and flood risk communication. Using geospatial techniques and hydrological simulation, we start our study by delineating flood zones and depths under several return periods in the study area. Then, through a questionnaire a field survey is conducted in order to validate the flood maps, to estimate the flood risk and to collect some sample of the opinion of residents on how the flood risk information disclosure could affect the values of property located inside and outside the flood zones. The results indicate that the study area is highly vulnerable to 5-year floods and more, which can cause serious harm to human lives and to properties as demonstrated by the extent of the 5-year flood of 2014. Also, it is revealed there is a high probability that the values of property located within flood zones could decline, and the values of surrounding property in the safe area could increase when risk information disclosure commences. However in order to raise public awareness of flood disaster and to prevent future housing promotion in high-risk prospective areas, flood risk information should be disseminated through the establishment of an early warning system. In order to reduce the effect of risk information disclosure and to protect the values of property within the high-risk zone, we propose that property tax increments in flood free zones should be captured and be utilized for infrastructure development and to maintain the early warning system that will benefit people living in flood prone areas. Through this case study, it is shown that combination of value capture strategy and risk communication could be an effective tool to educate citizen and to invest in flood risk reduction in emerging countries.

Keywords: Cocody-Abidjan, flood, geospatial techniques, risk communication, value capture

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

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

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

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Authors: Mukesh A. Modi

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High-nitrate concentration in groundwater of unconfined aquifers has been a serious issue for public health risk at a global scale. Various anthropogenic activities in agricultural land and urban land of alluvial soil have been observed to be responsible for the increment of nitrate in groundwater. The present study was designed to identify suitable denitrification strategies to minimize the effects of high nitrate in groundwater near the Mahi River of Vadodara block, Gujarat. There were 11 wells of Jal Jeevan Mission, Ministry of Jal Shakti, along with 3 observation wells of Gujarat Water Resources Development Corporation have been used for the duration of 21 years. MODFLOW and MT3DMS codes have been used to simulate solute transport phenomena along with attempted effectively for optimization. Current research is one step ahead by optimizing various denitrification strategies with the simulation of the model. The in-situ and ex-situ denitrification strategies viz. NAS (No Action Scenario), CAS (Crop Alternation Scenario), PS (Phytoremediation Scenario), and CAS + PS (Crop Alternation Scenario + Phytoremediation Scenario) have been selected for the optimization. The groundwater model simulates the most suitable denitrification strategy considering the hydrogeological characteristics at the targeted well.

Keywords: groundwater, high nitrate, MODFLOW, MT3DMS, optimization, denitrification strategy

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Authors: M. V. Shivaani, P. K. Jain, Surendra S. Yadav

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Public Sector Undertakings (PSUs), being government-owned organizations have commitments for the economic and social wellbeing of the society; this commitment needs to be reflected in their risk-taking, decision-making and governance structures. Therefore, the primary objective of the study is to suggest measures that may lead to improvement in performance of PSUs. To achieve this objective two normative frameworks (one relating to risk levels and other relating to governance structure) are being put forth. The risk index is based on nine risks, such as, solvency risk, liquidity risk, accounting risk, etc. and each of the risks have been scored on a scale of 1 to 5. The governance index is based on eleven variables, such as, board independence, diversity, risk management committee, etc. Each of them are scored on a scale of 1 to five. The sample consists of 39 PSUs that featured in Nifty 500 index and, the study covers a 10 year period from April 1, 2005 to March, 31, 2015. Return on assets (ROA) and return on equity (ROE) have been used as proxies of firm performance. The control variables used in the model include, age of firm, growth rate of firm and size of firm. A dummy variable has also been used to factor in the effects of recession. Given the panel nature of data and possibility of endogeneity, dynamic panel data- generalized method of moments (Diff-GMM) regression has been used. It is worth noting that the corporate governance index is positively related to both ROA and ROE, indicating that with the improvement in governance structure, PSUs tend to perform better. Considering the components of CGI, it may be suggested that (i). PSUs ensure adequate representation of women on Board, (ii). appoint a Chief Risk Officer, and (iii). constitute a risk management committee. The results also indicate that there is a negative association between risk index and returns. These results not only validate the framework used to develop the risk index but also provide a yardstick to PSUs benchmark their risk-taking if they want to maximize their ROA and ROE. While constructing the CGI, certain non-compliances were observed, even in terms of mandatory requirements, such as, proportion of independent directors. Such infringements call for stringent penal provisions and better monitoring of PSUs. Further, if the Securities and Exchange Board of India (SEBI) and Ministry of Corporate Affairs (MCA) bring about such reforms in the PSUs and make mandatory the adherence to the normative frameworks put forth in the study, PSUs may have more effective and efficient decision-making, lower risks and hassle free management; all these ultimately leading to better ROA and ROE.

Keywords: PSU, risk governance, diff-GMM, firm performance, the risk index

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Authors: Jose A. Diaz-Olivares, Nafise Mahdavian, Farhad Abtahi, Kaj Lindecrantz, Abdelakram Hafid, Fernando Seoane

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Despite new recommendations and guidelines for the evaluation of occupational risk assessments and their prevention, work-related musculoskeletal disorders are still one of the biggest causes of work activity disruption, productivity loss, sick leave and chronic work disability. It affects millions of workers throughout Europe, with a large-scale economic and social burden. These specific efforts have failed to produce significant results yet, probably due to the limited availability and high costs of occupational risk assessment at work, especially when the methods are complex, consume excessive resources or depend on self-evaluations and observations of poor accuracy. To overcome these limitations, a pervasive system of risk assessment tools in real time has been developed, which has the characteristics of a systematic approach, with good precision, usability and resource efficiency, essential to facilitate the prevention of musculoskeletal disorders in the long term. The system allows the combination of different wearable sensors, placed on different limbs, to be used for data collection and evaluation by a software solution, according to the needs and requirements in each individual working environment. This is done in a non-disruptive manner for both the occupational health expert and the workers. The creation of this solution allows us to attend different research activities that require, as an essential starting point, the recording of data with ergonomic value of very diverse origin, especially in real work environments. The software platform is here presented with a complimentary smart clothing system for data acquisition, comprised of a T-shirt containing inertial measurement units (IMU), a vest sensorized with textile electronics, a wireless electrocardiogram (ECG) and thoracic electrical bio-impedance (TEB) recorder and a glove sensorized with variable resistors, dependent on the angular position of the wrist. The collected data is processed in real-time through a mobile application software solution, implemented in commercially available Android-based smartphones and tablet platforms. Based on the collection of this information and its analysis, real-time risk assessment and feedback about postural improvement is possible, adapted to different contexts. The result is a tool which provides added value to ergonomists and occupational health agents, as in situ analysis of postural behavior can assist in a quantitative manner in the evaluation of work techniques and the occupational environment.

Keywords: ergonomics, mobile technologies, risk assessment, smart textiles

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Authors: Renae McNair

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Subjective well-being levels were assessed in individuals diagnosed with an autoimmune disease. The current exploratory analysis sought to examine two factors that impact subjective well-being in individuals diagnosed with a chronic health condition. The two factors, resilience, and rumination, were assessed as possible moderators in self-reported levels of subjective well-being were measured. The importance of understanding the psychological state of perceived well-being in an individual diagnosed with an autoimmune disease is important given the impact of the level of subjective well-being on life longevity. In previous research, higher levels of subjective well-being are correlated with longer life longevity, including those individuals who have been diagnosed with an autoimmune disease. Conversely, individuals who report higher levels of negative affect have a shorter length of life longevity. According to the Center for Disease Control (CDC) and a report from the National Health Council, currently, 8-10% of individuals in the United States have been diagnosed with at least one autoimmune disease. Although treatment plans are in place to help manage the physical effects of disease, the psychological state of the person impacts life longevity. Resilience and rumination impact subjective well-being as an outcome in individuals diagnosed with an autoimmune disease. Resilience is the ability to adjust or adapt effectively and positively to unfavorable life conditions or events. Resilience acts as a protective factor in life, allowing those who face adversity to successfully adapt, regardless of the health diagnosis. Rumination is the worry or dwelling on the negative aspects of a given situation. Rumination interrupts the adaptive response, leading to a decrease in well-being. The relationship between resilience and subjective well-being were examined correlated with higher levels of resilience and higher levels of self-reported subjective well-being.

Keywords: subjective well-being, rumination, resilience, autoimmune disease

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Authors: Ahmed O. Babaleye, Rafet E. Kurt

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The global oil and gas industry is beginning to witness an increase in the number of installations moving towards decommissioning. Decommissioning of offshore installations is a complex, costly and hazardous activity, making safety one of the major concerns. Among existing removal options, complete and partial removal options pose the highest risks. Therefore, a dynamic risk model of the accidents from the two options is important to assess the risks on an overall basis. In this study, a risk-based safety model is developed to conduct quantitative risk analysis (QRA) for jacket structure systems failure. Firstly, bow-tie (BT) technique is utilised to model the causal relationship between the system failure and potential accident scenarios. Subsequently, to relax the shortcomings of BT, Bayesian Belief Networks (BBNs) were established to dynamically assess associated uncertainties and conditional dependencies. The BBN is developed through a similitude mapping of the developed bow-tie. The BBN is used to update the failure probabilities of the contributing elements through diagnostic analysis, thus, providing a case-specific and realistic safety analysis method when compared to a bow-tie. This paper presents the application of dynamic safety analysis to guide the allocation of risk control measures and consequently, drive down the avoidable cost of remediation.

Keywords: Bayesian belief network, offshore decommissioning, dynamic safety model, quantitative risk analysis

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Authors: Kemal Izci

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Assessment forms an important part of instruction. Assessment that aims to support learning is known as formative assessment and it contributes student’s learning gain and motivation. However, teachers rarely use assessment formatively to aid their students’ learning. Thus, reviewing the factors that limit or support teachers’ practices of formative assessment will be crucial for guiding educators to support prospective teachers in using formative assessment and also eliminate limiting factors to let practicing teachers to engage in formative assessment practices during their instruction. The study, by using teacher’s change environment framework, reviews literature on formative assessment and presents a tentative model that illustrates the factors impacting teachers’ adoption of formative assessment in their teaching. The results showed that there are four main factors consisting personal, contextual, resource-related and external factors that influence teachers’ practices of formative assessment.

Keywords: assessment practices, formative assessment, teacher education, factors for use of formative assessment

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Authors: Md. S. Sabuz

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Bangladesh, a South Asian developing country, has achieved a remarkable breakthrough in health indicators during the last four decades despite immense income inequality. This phenomenon results in the mystical exclusion of marginalized people from obtaining health care facilities. However, the persistence of exclusion of the disadvantaged remains troubling. Exclusion occurs from occupational inferiority, pay and wage differences, educational backwardness, gender disparity to urban-rural complexity and eliminate the unprivileged from seeking and availing the health services. Evidence from Bangladesh shows that many sick people prefer to die at home without securing medical services because in previous times they were not treated well, not because the medical facilities were inadequate or antediluvian but the socio-economic class allows them to receive obdurate treatment. Furthermore, government and policymakers have given enormous emphasis on infrastructural development and achieving health indicators instead of ensuring quality services and inclusiveness of people from all spheres. Therefore, it is high time to address the issues concerning this and highlight the impact of economic status on health status in a sociological perspective. The objective of this study is to consider ways of assessing and exploring the impact of economic status for instance: occupational status, pay and wage variable, on health status in the context of Bangladesh. The hypotheses are that there are a significant number of factors affecting economic status which are impactful for health status eventually, but acute income inequality is a prominent factor. Illiteracy, gender disparity, remoteness, incredibility on services, superior costs, superstition etc. are the dominant indicators behind the economic factors influencing the health status. The chosen methodologies are a qualitative and quantitative approaches to accomplish the research objectives. Secondary sources of data will be used to conduct the study. Surveys will be conducted on the people who have ever been through the health care facilities and people from the different socio-economic and cultural backgrounds. Focus group discussions will be conducted to acquire the data from different cultural and regional citizens. The findings show that 48% of people who are from disadvantaged communities have been deprived of proper health care facilities. The general reasons behind this are the higher cost of medicines and other equipment. A significant number of people are unaware of the appropriate facilities. It was found that the socio-economic variables are the main influential factors that work as the driving force for both economic dimension and health status. Above all regional variables and gender, dimensions have an enormous effect on determining the health status of an individual or community. Amidst many positive achievements for example decrease in the child mortality rate, an increase in the immunization programs of the child etc., the inclusiveness of all classes of people in health care facilities has been overshadowed in Bangladesh. However, this phenomenon along with the socio-economic and cultural phenomena significantly demolishes the quality and inclusiveness of the health status of people.

Keywords: cultural context of health, economic status, gender and health, rural health care

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Authors: Semaw A., Awet H., Yohannes M.

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Background: Hepatitis B Virus (HBV) is a major global public health problem. Individuals living in Sub-Sahara Africa have 60% lifetime risk of acquiring HBV infection. Evidences showed that 80-90% of those born from infected mothers developed chronic HBV. Perinatal HBV transmission is a major determinant of HBV carrier status, its chronic squeal and maintains HBV transmission across generations. Method: Institution based cross-sectional study was conducted among 406 pregnant mothers attending Antenatal clinics at Mekelle and Ayder referral hospital from January 30 to April 1/2014. Epidata version 3.1 was used for data entry and SPSS version 21 statistical software was used for data cleaning, management and finally determine associated factors of hepatitis B surface antigen adjusting important confounders using multivariable logistic regression analysis at 5% level of significance. Result: The overall prevalence of hepatitis B surface antigen among pregnant women was 33 (8.1%). The socio-demographic characteristic of the study population showed that there is high positivity among secondary school 189 (46.6%). In the multivariable logistic regression analysis, history of a contact with individuals who had history of hepatitis B infection or jaundice and lifetime number of multiple sexual partners were found to be significantly associated with HBsAg positivity at AOR = 3.73 95%C.I (1.373-10.182) and AOR = 2.57 95%C.I (1.173-5.654), respectively. Moreover, Human Immunodeficiency Virus (HIV) and HBV confection rate was found 3.6%. Conclusion: This study has shown that HBV prevalence in pregnant women is highly prevalent (8.1%) in the study area. Contact with individuals who had a history of hepatitis or have jaundice and report of multiple lifetime sexual partnership were associated with hepatitis B infection. Education about HBV transmission and prevention as well as screening all pregnant mothers shall be sought to reduce the serious public health crisis of HBV.

Keywords: HBsAg, hepatitis B, pregnant women, prevalence

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Authors: Sulasmi Sudirman, Rachmadanty Mujah Hartika

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Traffic violence is currently a big issue in Indonesia. However, the road users perceived risk that is caused by traffic violence is low. The lack of safety driving awareness is one of the factors that road users committed to traffic violence. There are several lists of common traffic violence in Indonesia such as lack of physical fitness, not wearing helmet, unfasten seatbelt, breaking through the traffic light, not holding a driving license, and some more violence. This research sought to explore the perception of road users toward traffic violence. The participants were road users in Makassar, Indonesia who were using cars and motorbikes. The method of the research was a qualitative approach by using a personal interview to collect data. The research showed that there three main ideas of perceiving traffic violence which are motives, environment that supported traffic violence, and reinforcement. The road users committed traffic violence had particular motive, for example, rushing. The road users committed to traffic violence when other road users and significant other did the same. The road users committed traffic violence when the police were not there to give a ticket. It can be concluded that the perception of road users toward traffic violence determined by internal aspect, the social aspect, and regulation.

Keywords: perception, road users, traffic, violence

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Authors: Varangkana Thaotumpitak, Jarukorn Sripradite, Saharuetai Jeamsripong

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Environmental contamination from wastewater discharges originated from anthropogenic activities introduces the accumulation of enteropathogenic bacteria in aquatic animals, especially in oysters, and in shellfish harvesting areas. The consumption of raw or partially cooked oysters can be a risk for seafood-borne diseases in human. This study aimed to evaluate the relationship between the presence of Salmonella in oyster meat samples, and environmental factors (ambient air temperature, relative humidity, gust wind speed, average wind speed, tidal condition, precipitation and season) by using the principal component analysis (PCA). One hundred and forty-four oyster meat samples were collected from four oyster harvesting areas in Phang Nga province, Thailand from March 2016 to February 2017. The prevalence of Salmonella of each site was ranged from 25.0-36.11% in oyster meat. The results of PCA showed that ambient air temperature, relative humidity, and precipitation were main factors correlated with Salmonella detection in these oysters. Positive relationship was observed between positive Salmonella in the oysters and relative humidity (PC1=0.413) and precipitation (PC1=0.607), while the negative association was found between ambient air temperature (PC1=0.338) and the presence of Salmonella in oyster samples. These results suggested that lower temperature and higher precipitation and higher relative humidity will possibly effect on Salmonella contamination of oyster meat. During the high risk period, harvesting of oysters should be prohibited to reduce pathogenic bacteria contamination and to minimize a hazard of humans from Salmonellosis.

Keywords: oyster, Phang Nga Bay, principal component analysis, Salmonella

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Authors: Ahmad Shanei, Milad Baradaran-Ghahfarokhi

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This study aimed to investigate testicular dose (TD) and the associated risk of heritable disease from common pelvis radiotherapy of male patients in Iran. In this work, the relation between TD and changes in beam energy, pelvis size, source to skin distance (SSD) and beam directions (anterior or posterior) were also evaluated. The values of TDs were measured on 67 randomly selected male patients during common pelvis radiotherapy using 1.17 and 1.33 MeV, Theratron Cobalt-60 unit at SSD of 80 cm and 9 MV, Neptun 10 PC and 18 MV, GE Saturne 20 at SSD of 100 cm at Seyed-Al Shohada Hospital, Isfahan, Iran. Results showed that the maximum TD was up to 12% of the tumor dose. Considering the risk factor for radiation-induced heritable disorders of 0.1% per Sv, an excess risk of hereditary disorders of 72 per 10000 births was conservatively calculated. There was a significant difference in the measured TD using different treatment machines and energies (P < 0.001). The TD at 100 cm SSD were much less than that for 80 cm SSD (P <0.001). The Pearson Correlation test showed that, as expected, there was a strong correlation between TD and patient’s pelvis size (r = 0.275, P <0.001). Using the student’s t-tests, it was found that, there was not a significant difference between TD and beam direction (P = 0.231). Iranian male patients undergoing pelvic radiotherapy have the potential of receiving a TD of more than 1 Gy which might result in temporary azoospermia. The risk for induction of hereditary disorders in future generations should be considered as low but not negligible in comparison with the correspondent nominal risk.

Keywords: pelvis radiotherapy, testicular dose, infertility, hereditary effects

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Authors: Thachamon Sinsoongsud, Noppawan Piaseu

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This predictive study was aimed to 1) describe self efficacy for risk reduction and preventive behavior for osteoporosis, and 2) examine factors predicting preventive behavior for osteoporosis in nursing students. Through purposive sampling, the sample included 746 nursing students in a public university in Bangkok, Thailand. Data were collected by a self-reported questionnaire on self efficacy and preventive behavior for osteoporosis. Data were analyzed using descriptive statistics and multiple regression analysis with stepwise method. Results revealed that majority of the students were female (98.3%) with mean age of 19.86 + 1.26 years. The students had self efficacy and preventive behavior for osteoporosis at moderate level. Self efficacy and level of education could together predicted 35.2% variance of preventive behavior for osteoporosis (p< .001). Results suggest approaches for promoting preventive behavior for osteoporosis through enhancing self efficacy among nursing students in a public university in Bangkok, Thailand.

Keywords: osteoporosis, self-efficacy, preventive behavior, nursing students

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Authors: Zainab Alghali Elsaid Muhammed

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Background : IBS is a gastrointestinal disorder characterized by a variety of symptoms that occur concurrently. It is very common and is associated with high levels of psychiatric comorbidities, all of which have a negative impact on the patient's quality of life. Abdominal pain, diarrhea, constipation, excess gas, and bloating are common symptoms of IBS. Objectives : The purpose of this study is to determine the prevalence of IBS among medical students and intern doctors in Sudan, as well as the risk factors associated with it. Study design: This cross-sectional study was carried out in Sudan from April to July 2022. All participants completed a six-part online questionnaire. The ROME IV criteria questionnaire was used to make an IBS diagnosis. Participants completed the hospital anxiety and depression questionnaire in order to be diagnosed with anxiety and depression. Results : 600 participants filled out the questionnaire. The overall prevalence of IBS was found to be 42%, with females being the most affected. Intern doctors had higher IBS rates (30.0%) than medical students, but this was not statistically significant. Single status (p =0.079), good GPAs (p =0.00), had significant associations with IBS occurrence. Other significantly associated habits were sleeping less than 8 hours (p =0.013), two cups or less of coffee per day (p = 0.109), No smoking (p =0.001), and No exercise (p =0.00, IBS participants were also found to have a significant relationship with abnormal anxiety (p =0.00) and borderline depression (p=0.0156). Conclusion : The high prevalence of IBS in this study suggests that medical students and interns are unable to recognize their symptoms. The main IBS predictors in this study were suffering from anxiety or depression, having an insufficient income, sleeping less than 8 hours per day, working/ studying more than 8 hours per day, and not performing any type of exercise.

Keywords: irritable bowel syndrome, sudan, HADS, rome IV, medical students

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Authors: Chunhua Ma

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Background: There is a relationship between cultural identity and psychological health. Resilience is an important factor of psychological health, and cultural identity will protect the resilience. The research showed that the cultural identity, resilience, and self-concordance of students from different cultures. It should be a theoretical basis to improve mental health of different nationalities students. And the role of resilience factors for adults’ cultural identity and self-concordance was deserve studied. Aims: The current study aimed to examine the relationship between cultural identity and self-concordance among Chinese academician from 3 minorities, postulating mediating by resilience. Methods: This study used cross-sectional and correlational design. Participants were 328 Chinese aged between 18 and 25 years. Data was collected via self-reports including both closed and opened questions. Results: Linear regression analysis controlling for age, gender, the result showed that: (a) Cultural identity was related to self-concordance, resilience was related to self-concordance and cultural identity was related to resilience, (b) Resilience mediated the link between cultural identity and self-concordance, respectively. Discussion: Our findings suggested that resilience and cultural identity are important factors in self-concordance. If minority college students realized the heterogeneous culture, it would alleviate their psychological conflict, stimulate their strength potential and improve their self-concordance.

Keywords: cultural identity, resilience, self-concordance, mediating effect

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Authors: Cátia Regina Branco da Fonseca, Maria Wany Louzada Strufaldi, Lídia Raquel de Carvalho, Rosana Fiorini Puccini

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Background: Birth weight reflects gestational conditions and development during the fetal period. Low birth weight (LBW) may be associated with antenatal care (ANC) adequacy and quality. The purpose of this study was to analyze ANC adequacy and its relationship with LBW in the Unified Health System in Brazil. Methods: A case-control study was conducted in Botucatu, São Paulo, Brazil, 2004 to 2008. Data were collected from secondary sources (the Live Birth Certificate), and primary sources (the official medical records of pregnant women). The study population consisted of two groups, each with 860 newborns. The case group comprised newborns weighing less than 2,500 grams, while the control group comprised live newborns weighing greater than or equal to 2,500 grams. Adequacy of ANC was evaluated according to three measurements: 1. Adequacy of the number of ANC visits adjusted to gestational age; 2. Modified Kessner Index; and 3. Adequacy of ANC laboratory studies and exams summary measure according to parameters defined by the Ministry of Health in the Program for Prenatal and Birth Care Humanization. Results: Analyses revealed that LBW was associated with the number of ANC visits adjusted to gestational age (OR = 1.78, 95% CI 1.32-2.34) and the ANC laboratory studies and exams summary measure (OR = 4.13, 95% CI 1.36-12.51). According to the modified Kessner Index, 64.4% of antenatal visits in the LBW group were adequate, with no differences between groups. Conclusions: Our data corroborate the association between inadequate number of ANC visits, laboratory studies and exams, and increased risk of LBW newborns. No association was found between the modified Kessner Index as a measure of adequacy of ANC and LBW. This finding reveals the low indices of coverage for basic actions already well regulated in the Health System in Brazil. Despite the association found in the study, we cannot conclude that LBW would be prevented only by an adequate ANC, as LBW is associated with factors of complex and multifactorial etiology. The results could be used to plan monitoring measures and evaluate programs of health care assistance during pregnancy, at delivery and to newborns, focusing on reduced LBW rates.

Keywords: low birth weight, antenatal care, prenatal care, adequacy of health care, health evaluation, public health system

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Authors: Kebret Kebede, Anthony Scinta

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Obesity is the most prevalent global problem that continues to rise at alarming rates both in the industrialized and developing countries. Adipose tissue is an endocrine tissue that secretes numerous chemical signals, hormones, lipids, cytokines and coagulation factors as well as prompting insulin resistance which is a primary contributor to Type II Diabetes- one of its most common adverse effects on health. Other hormones whose levels are linked to obesity and nutritional state are leptin, IGF-1, and adiponectin. Several studies indicate that obesity is the leading cause of high levels of cholesterol that leads to fatty liver disease, gallstones, hypertension, increased risk for cancer and degenerative joint disease that primarily affects the weight bearing joints of the lower extremities. The activation of inflammatory pathways promotes synovial pathology that results in accelerated degeneration of the joints. The study examines the prevalence of obesity in the US female population in comparison to that of the developing world and its emergence as a significant and potentially modifiable risk factor in degenerative disease of the hip and knee joints that has resulted in staggering healthcare cost. Studies have shown that as the prevalence of obesity rises, we continue to see a rise in degenerative joint disease. The percentage of arthritis cases linked directly to obesity has risen from 3 percent in 1971 to 18 percent in 2002. A person with obesity is around 60 percent more likely to develop arthritis than someone of normal body weight. In women, obesity is associated with increased mortality from breast, cervical, endometrial and ovarian cancer that may accompany debilitating joint diseases and restricted mobility.

Keywords: obesity, endocrine, degenerative, mortality, joint diseases, cancer, debilitating, mobility

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Authors: Renny Wulandari

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This study aims to determine how the influence of Non Performing Financing, Financing Deposit Ratio, Operating Expenses and Operating Revenue and Net Income Margin on the disclosure of financial risk in Sharia banks. To achieve these objectives conducted associative research method with data source in the form of secondary data that is annual report data with period 2013-2016. The population in this study is the sharia banking industry in Indonesia and who issued the annual financial statements. A method of sampling use probability sampling. Analysis in this research is with SEM-PLS. The result is Net Income Margin has a significant effect on financial risk disclosure while Non Performing Financing (NPF) Financing to Deposit Ratio (FDR), Operating Expenses and Operating Revenue (OEOR) have no effect on the disclosure of financial risk in sharia bank.

Keywords: Sharia banks, disclosure of risk financial, non performing financing, financing deposit ratio, operating expenses and operating revenue, net income margin

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Authors: Halima Akhtar, Abhijeet Chandra

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The paper attempts to analyze the factors that influence the Consumer Behavior to purchase apparel through the internet. The intentions to buy apparels online were based on in terms of user style, orientation, size and reputation of the merchant, social influence, perceived information utility, perceived ease of use, perceived pleasure and attractiveness and perceived trust and risk. The basic framework used was Technology acceptance model to explain apparels acceptance. A survey was conducted to gather the data from 200 people. The measures and hypotheses were analyzed using Correlation testing and would be further validated by the Structural Equation Modelling. The implications of the findings for theory and practice could be used by marketers of online apparel websites. Based on the values obtained, we can conclude that the factors such as social influence, Perceived information utility, attractiveness and trust influence the decision for a user to buy apparels online. The major factors which are found to influence an online apparel buying decision are ease of use, attractiveness that a website can offer and the trust factor which a user shares with the website.

Keywords: E-tailers, consumer behaviour, technology acceptance model, structural modelling

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Authors: Merih Welay Welesilassie

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Understanding educators' readiness to incorporate AI tools into their teaching methods requires comprehensively examining the influencing factors. This understanding is crucial, given the potential of these technologies to personalise learning experiences, improve instructional effectiveness, and foster innovative pedagogical approaches. This study evaluated factors affecting teachers' adoption of AI tools in their English language instruction by extending the Technology Acceptance Model (TAM) to encompass digital readiness support, perceived risk, and trust. A cross-sectional quantitative survey was conducted with 128 English language teachers, supplemented by qualitative data collection from 15 English teachers. The structural mode analysis indicated that implementing AI tools in Ethiopian higher education was notably influenced by digital readiness support, perceived ease of use, perceived usefulness, perceived risk, and trust. Digital readiness support positively impacted perceived ease of use, usefulness, and trust while reducing safety and privacy risks. Perceived ease of use positively correlated with perceived usefulness but negatively influenced trust. Furthermore, perceived usefulness strengthened trust in AI tools, while perceived safety and privacy risks significantly undermined trust. Trust was crucial in increasing educators' willingness to adopt AI technologies. The qualitative analysis revealed that the teachers exhibited strong content and pedagogical knowledge but needed more technology-related knowledge. Moreover, It was found that the teachers did not utilise digital tools to teach English. The study identified several obstacles to incorporating digital tools into English lessons, such as insufficient digital infrastructure, a shortage of educational resources, inadequate professional development opportunities, and challenging policies and governance. The findings provide valuable guidance for educators, inform policymakers about creating supportive digital environments, and offer a foundation for further investigation into technology adoption in educational settings in Ethiopia and similar contexts.

Keywords: digital readiness support, AI acceptance, perceived risc, AI trust

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Authors: Mikhail V. Khachaturyan

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The article analyzes problems of improving the management systems of the ownership risks in the conditions of the transformation of the Russian economy. Among the main sources of threats business owners should highlight is the inefficiency of the implementation of business models and interaction with hired managers. In this context, it is particularly important to analyze the relationship of business models and ownership risks. The analysis of this problem appears to be relevant for a number of reasons: Firstly, the increased risk appetite of the owner directly affects the business model and the composition of his holdings; secondly, owners with significant stakes in the company are factors in the formation of particular types of risks for owners, for which relations have a significant influence on a firm's competitiveness and ultimately determines its survival; and thirdly, inefficient system of management ownership of risk is one of the main causes of mass bankruptcies, which significantly affects the stable operation of the economy as a whole. The separation of the processes of possession, disposal and use in modern organizations is the cause of not only problems in the process of interaction between the owner and managers in managing the organization as a whole, but also the asymmetric information about the kinds and forms of the main risks. Managers tend to avoid risky projects, inhibit the diversification of the organization's assets, while owners can insist on the development of such projects, with the aim not only of creating new values for themselves and consumers, but also increasing the value of the company as a result of increasing capital. In terms of separating ownership and management, evaluation of projects by the ratio of risk-yield requires preservation of the influence of the owner on the process of development and making management decisions. It is obvious that without a clearly structured system of participation of the owner in managing the risks of their business, further development is hopeless. In modern conditions of forming a risk management system, owners are compelled to compromise between the desire to increase the organization's ability to produce new value, and, consequently, increase its cost due to the implementation of risky projects and the need to tolerate the cost of lost opportunities of risk diversification. Improving the effectiveness of the management of ownership risks may also contribute to the revitalization of creditors on implementation claims to inefficient owners, which ultimately will contribute to the efficiency models of ownership control to exclude variants of insolvency. It is obvious that in modern conditions, the success of the model of the ownership of risk management and audit is largely determined by the ability and willingness of the owner to find a compromise between potential opportunities for expanding the firm's ability to create new value through risk and maintaining the current level of new value creation and an acceptable level of risk through the use of models of diversification.

Keywords: improving, ownership risks, problem, Russia

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

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

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

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Authors: Han Gul Lee

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When water treatments utilities are designed, an initial construction site risk assessment is conducted. This helps us to understand general safety risks that each utility needs to be complemented in the designing stage. Once it’s built, an additional risk reassessment process secures and supplements its disaster management and response plan. Because of its constantly changing surroundings with city renovation and developments, the degree of various risks that each facility has to face changes. Therefore, to improve the preparedness for spill incidents or disasters, emergency managers should run spill simulations with the available scientific technologies. This research used a two-dimensional flow routing model to simulate its spill disaster scenario based on its digital elevation model (DEM) collected with drone technologies. The results of the simulations can help emergency managers to supplement their response plan with concrete situational awareness in advance. Planning based on this simulation model minimizes its potential loss and damage when an incident like earthquakes man-made disaster happens, which could eventually be a threat in a public health context. This pilot research provides an additional paradigm to increase the preparedness to spill disasters. Acknowledgment: This work was supported by Korea Environmental Industry & Technology Institute (KEITI) through Environmental R&D Project on the Disaster Prevention of Environmental Facilities Program funded by Korea Ministry of Environment (MOE) (No.202002860001).

Keywords: risk assessment, disaster management, water treatment utilities, situational awareness, drone technologies

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Authors: Yao Song

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Objectives: We aimed to explore the clinicodemographic characteristics and prognosis of grey zone squamous cell cancer (GZSCC) located in the overlapping or ambiguous area of the oral cavity and oropharynx and to identify valuable factors that would improve its differential diagnosis and prognosis. Methods: Information of GZSCC patients in the Surveillance, Epidemiology, and End Results (SEER) database was compared to patients with an oral cavity (OCSCC) and oropharyngeal (OPSCC) squamous cell carcinomas with corresponding HPV status, respectively. Kaplan-Meier method with log-rank test and multivariate Cox regression analysis were applied to assess associations between clinical characteristics and overall survival (OS). A predictive model integrating age, gender, marital status, HPV status, and staging variables was conducted to classify GZSCC patients into three risk groups and verified internally by 10-fold cross validation. Results: A total of 3318 GZSCC, 10792 OPSCC, and 6656 OCSCC patients were identified. HPV-positive GZSCC patients had the best 5-year OS as HPV-positive OPSCC (81% vs. 82%). However, the 5-year OS of HPV-negative/unknown GZSCC (43%/42%) was the worst among all groups, indicating that HPV status and the overlapping nature of tumors were valuable prognostic predictors in GZSCC patients. Compared with the strategy of dividing GZSCC into two groups by HPV status, the predictive model integrating more variables could additionally identify a unique high-risk GZSCC group with the lowest OS rate. Conclusions: GZSCC patients had distinct clinical characteristics and prognoses compared with OPSCC and OCSCC; integrating HPV status and other clinical factors could help distinguish GZSCC and predict their prognosis.

Keywords: GZSCC, OCSCC, OPSCC, HPV

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Authors: Bright Annang Baah

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Evaluating public perceptions of climate change risk and the elements that impact them has been shown to be critical in developing support for climate change action. Previous research has found a variety of elements, including the experience of extreme weather events, that impact public perceptions and worries about climate change. However, little is known about the public's perception of climate change risks and the variables that influence them in developing countries. Using a household survey, this study attempted to evaluate respondents' risk perceptions of climate change, as well as the impact of flooding experience on such beliefs. The findings demonstrate that flood victims have a greater risk perception and are more concerned about climate change than non-victims. Concerns regarding the effects of climate change, on the other hand, were found to be the lowest when compared to other pressing challenges confronting the country. This study's findings contribute to the understanding of climate change risk perception and the impact of extreme weather events from the perspective of a developing nation.

Keywords: climate change risk perception, harsh weather, perceived concern, Accra, Ghana

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Authors: Sopit Tubtimhin, Chaliya Wamaloon, Anchalee Supattagorn

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Background and Significance: Breast cancer is the most frequently diagnosed and leading cause of cancer death among women. This study aims to determine factors potentially predicting recurrence and long-term survival after the first recurrence in surgically treated patients between postmenopausal and younger women. Methods and Analysis: A retrospective cohort study was performed on 498 Thai women with invasive breast cancer, who had undergone mastectomy and been followed-up at Ubon Ratchathani Cancer Hospital, Thailand. We collected based on a systematic chart audit from medical records and pathology reports between January 1, 2002, and December 31, 2011. The last follow-up time point for surviving patients was December 31, 2016. A Cox regression model was used to calculate hazard ratios of recurrence and death. Findings: The median age was 49 (SD ± 9.66) at the time of diagnosis, 47% was post-menopausal women ( ≥ 51years and not experienced any menstrual flow for a minimum of 12 months), and 53 % was younger women ( ˂ 51 years and have menstrual period). Median time from the diagnosis to the last follow-up or death was 10.81 [95% CI = 9.53-12.07] years in younger cases and 8.20 [95% CI = 6.57-9.82] years in postmenopausal cases. The recurrence-free survival (RFS) for younger estimates at 1, 5 and 10 years of 95.0 %, 64.0% and 58.93% respectively, appeared slightly better than the 92.7%, 58.1% and 53.1% for postmenopausal women [HRadj = 1.25, 95% CI = 0.95-1.64]. Regarding overall survival (OS) for younger at 1, 5 and 10 years were 97.7%, 72.7 % and 52.7% respectively, for postmenopausal patients, OS at 1, 5 and 10 years were 95.7%, 70.0% and 44.5 respectively, there were no significant differences in survival [HRadj = 1.23, 95% CI = 0.94 -1.64]. Multivariate analysis identified five risk factors for negatively impacting on survival were triple negative [HR= 2.76, 95% CI = 1.47-5.19], Her2-enriched [HR = 2.59, 95% CI = 1.37-4.91], luminal B [HR = 2.29, 95 % CI=1.35-3.89], not free margin [HR = 1.98, 95%CI=1.00-3.96] and patients who received only adjuvant chemotherapy [HR= 3.75, 95% CI = 2.00-7.04]. Statistically significant risks of overall cancer recurrence were Her2-enriched [HR = 5.20, 95% CI = 2.75-9.80], triple negative [HR = 3.87, 95% CI = 1.98-7.59], luminal B [HR= 2.59, 95% CI = 1.48-4.54,] and patients who received only adjuvant chemotherapy [HR= 2.59, 95% CI = 1.48-5.66]. Discussion and Implications: Outcomes from this studies have shown that postmenopausal women have been associated with increased risk of recurrence and mortality. As the results, it provides useful information for planning the screening and treatment of early-stage breast cancer in the future.

Keywords: breast cancer, menopause status, recurrence-free survival, overall survival

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