Search results for: cardio-metabolic risk factors

Authors: Yolanda Indah Permatasari, Sudarsono Hardjosoekarto

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Public private partnership (PPP) scheme was considered as an alternative source of funding for infrastructure provision. However, the performance of PPP scheme and interest of private sector to participate in the provision of infrastructure was still practically low. This phenomenon motivates the research to reconstruct the form of collaborative governance at the policy level from the perspective of transaction cost of the PPP scheme. Soft-system methodology (SSM)-based action research was used as this research methodology. The result of this study concludes that the emergence of transaction cost sources at the policy level is caused by the absence of a law that governs infrastructure investment, especially the implementation of PPP scheme. This absence is causing the imbalance in risk allocation and risk mitigation between the public and private sector. Thus, this research recommended the formulation of infrastructure investment law that aims to minimize asymmetry information, to anticipate the principal-principal problems, and to provide legal basis that ensures risk certainty and guarantee fair risk allocation between public and private sector.

Keywords: public governance, public private partnership, soft system methodology, transaction cost

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Authors: Godswill Nwabuisi Osuafor, Sonto Maria Maputle

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Background: Abounding studies found that religiosity and social factors modulate alcohol use among university students. However, there is a scarcity of empirical studies examining the protective effects of religiosity and other social factors on alcohol use and abuse in South African universities. The aim of this study was therefore to assess the protective effects of religiosity and roles of social factors on alcohol use among university students. Methodology: A survey on the use of alcohol among 416 university students was conducted using structured questionnaire in 2014. Data were sourced on religiosity and contextual variables. Students were classified as practicing intrinsic religiosity or extrinsic religiosity based on the response to the measures of religiosity. Descriptive, chi square and binary logistic analyses were used in processing the data. Result: Results revealed that alcohol use was associated with religiosity, religion, sex, family history of alcohol use and experimenting with alcohol. Reporting alcohol abuse was significantly predicted by sex, family history of alcohol use and experimenting with alcohol. Religiosity mediated lower alcohol use whereas family history of alcohol use and experimenting with alcohol promoted alcohol use and abuse. Conclusion: Families, religious groups and societal factors may be the specific niches for intervention on alcohol use among university students.

Keywords: religiosity, alcohol use, protective factors, university students

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Authors: N. M. Sani, I. Bitrus, A. M. Sarki, N. S. Mujahid

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Hepatitis is one of the neglected infectious diseases in sub Saharan Africa, and most of the available data is based on blood donors. Health care workers (HCWs) often get infected as a result of their close contact with patients. A cross-sectional study was conducted to determine the prevalence of hepatitis B and C among this group of professionals with a view to improving the quality of care to their patients. Hepatitis B and C infections pose a major public health problem worldwide. While infection is highest in the developing world particularly Asia and sub-Saharan Africa, healthcare workers are at higher risk of acquiring blood-borne viral infections, particularly Hepatitis B and C which are mostly asymptomatic. This study was aimed at determining the prevalence of Hepatitis B and C infections and associated risk factors among health care workers in Dutse Metropolis, Jigawa State - Nigeria. A standard rapid immuno-chromatographic technique i.e. rapid ELISA was used to screen all sera for Hepatitis B surface antigen (HBsAg) and Hepatitis C viral antibody (HCVAb) respectively. Strips containing coated antibodies and antigens to HBV and HCV respectively were removed from the foil. Strips were labeled according to samples. Using a separate disposable pipette, 2 drops of the sample (plasma) were added into each test strip and allowed to run across the absorbent pad. Results were read after 15 minutes. The prevalence of HBV and HCV infection in 100 healthcare workers was determined by testing the plasma collected from the clients during their normal checkup using HBsAg and HCVAb test strips. Results were subjected to statistical analysis using chi-square test. The prevalence of HBV among HCWs was 19 out of 100 (19.0%) and that of HCV was 5 out of 100 (5.0%) where in both cases, higher prevalence was observed among female nurses. It was also observed that all HCV positive cases were recorded among nurses only. The study revealed that nurses are at greater risk of contracting HBV and HCV due to their frequent contact with patients. It is therefore recommended that effective vaccination and other infection control measures be encouraged among healthcare workers.

Keywords: prevalence, hepatitis, viruses, healthcare workers, infection

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Authors: Chantelle Francis, Karen McKenzie, Charlotte Emmerson

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In the context of the rise in mental health difficulties amongst pupils, this review explores the factors that have been indicated as affecting psychological well-being in mainstream school contexts. Search terms relating to school-based psychological well-being were entered into five databases, and twenty-two studies were included in the review. The results suggested that pupil psychological well-being is affected by both direct and indirect factors. The former included a sense of belonging and inclusion, relationships with teachers, and academic attainment. The latter included family socioeconomic status, whole-school approaches, and individual differences factors, such as gender and Special Educational Needs. The implications for policymakers and practitioners are discussed.

Keywords: psychological wellbeing, mainstream schools, special educational needs, school-based wellbeing

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Authors: Edoghogho Ogbeifun, Charles Mbohwa, J. H. C. Pretorius

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Several research report on the factors responsible for the delays in the completion of construction projects has identified the issue of funding as a critical factor; insufficient funding, low cash-flow or lack of funds. Indeed, adequate funding plays pivotal role in the effective execution of construction projects. In the last twenty years (or so), there has been increase in the funds available for infrastructure development in tertiary institution in Nigeria, especially, through the Tertiary Education Trust Fund. This funding body ensures that there is enough fund for each approved project, which is released in three stages during the life of the construction project. However, a random tour of many of the institutions reveals striking evidence of projects not delivered on schedule, to quality and sometime out rightly abandoned. This suggests, therefore, that there are other latent factors, responsible for project delays, that should be investigated. Thus, this research, a pilot scheme, is aimed at unearthing the possible reasons for the delays being experienced in the execution of construction projects for infrastructure upgrade in public tertiary institutions in Nigeria, funded by Tertiary Education Trust Fund. The multiple site case study of qualitative research was adopted. The respondents were the Directors of Physical Planning and the Directors of Works of four Nigerian Public Universities. The findings reveal that delays can be situated within three entities, namely, the funding body, the institutions and others. Therefore, the emerging factors have been classified as external factors (haven to do with the funding body), internal factors (these concern the operations within the institutions) and general factors. The outcome of this pilot exercise provides useful information to guide the Directors as they interact with the funding body as well as challenges themselves to address the loopholes in their internal operations.

Keywords: delays, external factors, funding, general factors, Internal factors

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Authors: Pema Choejey, David Murray, Chun Che Fung

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Bhutan is becoming increasingly dependent on Information and Communications Technologies (ICTs), especially the Internet for performing the daily activities of governments, businesses, and individuals. Consequently, information systems and networks are becoming more exposed and vulnerable to cybersecurity threats. This paper highlights the findings of the survey study carried out to understand the perceptions of cybersecurity implementation among government organizations in Bhutan. About 280 ICT personnel were surveyed about the effectiveness of cybersecurity implementation in their organizations. A questionnaire based on a 5 point Likert scale was used to assess the perceptions of respondents. The questions were asked on cybersecurity practices such as cybersecurity policies, awareness and training, and risk management. The survey results show that less than 50% of respondents believe that the cybersecurity implementation is effective: cybersecurity policy (40%), risk management (23%), training and awareness (28%), system development life cycle (34%); incident management (26%), and communications and operational management (40%). The findings suggest that many of the cybersecurity practices are inadequately implemented and therefore, there exist a gap in achieving a required cybersecurity posture. This study recommends government organizations to establish a comprehensive cybersecurity program with emphasis on cybersecurity policy, risk management, and awareness and training. In addition, the research study has practical implications to both government and private organizations for implementing and managing cybersecurity.

Keywords: awareness and training, cybersecurity policy, risk management, security risks

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Authors: Godfrey Nsereko, Daniel Kadobera, Denis Okethwangu, Joyce Nguna, Alex Riolexus Ario

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Background: Malaria is a leading cause of morbidity and mortality in Uganda. In April 2018, malaria cases surged in Nwoya District, northern Uganda, exceeding the action thresholds. We investigated to assess the outbreak’s magnitude, identify transmission risk factors, and recommend evidence-based control measures. Methods: We defined a malaria case as onset of fever in a resident of Nwoya District with a positive Rapid Diagnostic Test or microscopy for malaria P. falciparum from 1 February to 22 May 2018. We reviewed medical records in all health facilities of affected sub-counties to find cases. In a case-control study, we compared exposure risk factors between 107 case-persons and 107 asymptomatic controls matched by age and village. We conducted entomological assessment on vector-density and behavior. Results: We identified 3,879 case-persons (attack rate [AR]=6.5%) and 2 deaths (case-fatality rate=5.2/10,000). Females (AR=8.1%) were more affected than males (AR=4.7%). Of all age groups, the 5-18 year age group (AR=8.4%) was most affected. Heavy rain started on 4 March; a propagated outbreak began during the week of 2 April. In the case-control study, 55% (59/107) of case-patients and 18% (19/107) of controls had stagnant water around households for several days following rainfall (ORM-H=5.6, 95%CI=3.0-11); 25% (27/107) of case-patients and 51% (55/107) of controls wore long-sleeve cloths during evening hours (ORM-H=0.30, 95%CI=0.20-0.60); 29% (31/107) of case-patients and 15% (16/107) of controls did not sleep under a long-lasting insecticide-treated net (LLIN) (ORM-H=2.3, 95%CI=1.1-4.9); 37% (40/107) of case-patients and 52% (56/107) of controls had ≥1 LLIN per 2 household members (ORM-H=0.54, 95%CI=0.30-0.97). Entomological assessment indicated active breeding sites; Anopheles gambiae sensu lato species were the predominant vector. Conclusion: Increased vector breeding sites after heavy rainfall, together with inadequate malaria preventive measures caused this outbreak. We recommended increasing coverage for LLINs and larviciding breeding sites.

Keywords: malaria outbreak, Plasmodium falciparum, global health security, Uganda

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Authors: Chantal Hendriks, Harry Gibson, Anna Trett, Penny Hancock, Catherine Moyes

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The use of modern inputs for crop protection, such as insecticides, is strongly underestimated in Sub-Saharan Africa. Several studies measured toxic concentrations of insecticides in fruits, vegetables and fish that were cultivated in Sub-Saharan Africa. The use of agricultural insecticides has impact on human and environmental health, but it also has the potential to impact on insecticide resistance in malaria transmitting mosquitos. To analyse associations between historic use of agricultural insecticides and the distribution of insecticide resistance through space and time, the use and environmental fate of agricultural insecticides needs to be mapped through the same time period. However, data on the use and environmental fate of agricultural insecticides in Africa are limited and therefore risk maps on the spatiotemporal occurrence of agricultural insecticides are created using environmental data. Environmental data on crop density and crop type were used to select the areas that most likely receive insecticides. These areas were verified by a literature review and expert knowledge. Pesticide fate models were compared to select most dominant processes that are involved in the environmental fate of insecticides and that can be mapped at a continental scale. The selected processes include: surface runoff, erosion, infiltration, volatilization and the storing and filtering capacity of soils. The processes indicate the risk for insecticide accumulation in soil, water, sediment and air. A compilation of all available data for traces of insecticides in the environment was used to validate the maps. The risk maps can result in space and time specific measures that reduce the risk of insecticide exposure to non-target organisms.

Keywords: crop protection, pesticide fate, tropics, insecticide resistance

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Authors: Muhammad Umar Hassan

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Renal cell carcinoma is a subset of kidney cancer that arises in the lining of DCT and is present in parenchymal tissue. Diagnosis is based on lab reports, including urinalysis, renal function tests (RFTs), and electrolyte balance, along with imaging techniques. Organ failure and other complications have been commonly observed in these cases. Over the years, the presentation of patients has varied, so carcinoma was classified on the basis of site, shape, and consistency for detailed analysis. Lifestyle patterns and occupational history were inquired about and recorded. Methods: Data from 100 patients presenting to the oncology and nephrology department of Mayo Hospital in the year 2015-2020 were included in this retrospective study on a random basis. The study was specifically focused on three risk factors. Smoking, occupational exposures, and Hakim medicine are taken by the patient for any cause. After procurement of data, follow-up contacts of these patients were established, resulting in a detailed analysis of lifestyle. Conclusion: The inference drawn is a direct causal link between smoking, industrial workplace exposure, and Hakim medicine with the development of Renal Cell Carcinoma. It was shown in the majority of the patients and hence confirmed our hypothesis.

Keywords: renal cell carcinoma, kidney cancer, clear cell carcinoma

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Authors: Khalid A. Alotaibi

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To assess the students, there are different strategies adopted by teachers and all are important while taking their scope into consideration. Teachers may face some obstacles that prevent them using the assessment for learning. These obstacles can be internal or external. The present study has been collected from two regions (Riyadh and Hotat Bani Tamim) of Saudi Arabia, with sample size of 174 teachers. The results of the study have shown that the significant factors that can prevent teachers using assessment for learning are; the way of introducing the new form of assessment, lack of teachers' training, clarity of the regulations and size of students in the class. Additionally, other elements have also shown in this paper.

Keywords: teachers, assessment, assessment for learning, internal factors and external factors

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Authors: Jing Yu Pan, Dahai Liu

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Airlines in the US have taken protective measures to battle the COVID-19 pandemic, with a mask mandate being the most important one, especially in the aircraft cabin. As the industry is recovering from the pandemic, mask-wearing will eventually become a personal choice during flight. Nevertheless, COVID-19 will continue to create uncertainty for a long time into the future, making it necessary to understand the attitude and voluntary use of masks by air travelers on airplanes even after masks are no longer mandatory. This study aimed to understand the relationship between demographic characteristics and mask-wearing intention in the US. For age, gender, income, educational, and ethnicity groups, this study examined three factors – subjective norms, risk avoidance, and information seeking and their influence on the mask-wearing intention onboard airplanes during COVID-19 and whether or not attitude toward masks was an important mediator. The results show that all demographic factors except gender could help to explain the group variations in factor impact and the mediating effect in mask-wearing intentions. In particular, Asian travelers had mask-wearing intentions that were not affected by attitude either directly or indirectly. These findings provide useful implications to enhance the health and safety of air travelers, especially in the US, where opposing views toward mask-wearing still widely exist.

Keywords: COVID-19, passenger demographics, aircraft cabin, mask-wearing intention, attitude as mediator

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Authors: Jian Zheng, Yoshiyasu Takahashi, Yuichi Kobayashi, Tatsuhiro Sato

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In the study, we present a conceptual framework for developing a scheduling system that can generate self-explanatory and easy-understanding schedules. To this end, a user interface is conceived to help planners record factors that are considered crucial in scheduling, as well as internal and external sources relating to such factors. A hybrid approach combining machine learning and constraint programming is developed to generate schedules and the corresponding factors, and accordingly display them on the user interface. Effects of the proposed system on scheduling are discussed, and it is expected that scheduling efficiency and system understandability will be improved, compared with previous scheduling systems.

Keywords: constraint programming, factors considered in scheduling, machine learning, scheduling system

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Authors: Abbas Keramati, Abtin Boostani, Mohammad Jamal Sadeghi

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This paper examines the influence of knowledge management factors on organizational commitment for employees in the oil and gas drilling industry of Iran. We determine what knowledge factors have the greatest impact on the personnel loyalty and commitment to the organization using collected data from a survey of over 300 full-time personnel working in three large companies active in oil and gas drilling industry of Iran. To specify the effect of knowledge factors in the organizational commitment of the personnel in the studied organizations, the Principal Component Analysis (PCA) is used. Findings of our study show that the factors such as knowledge and expertise, in-service training, the knowledge value and the application of individuals’ knowledge in the organization as the factor “learning and perception of personnel from the value of knowledge within the organization” has the greatest impact on the organizational commitment. After this factor, “existence of knowledge and knowledge sharing environment in the organization”; “existence of potential knowledge exchanging in the organization”; and “organizational knowledge level” factors have the most impact on the organizational commitment of personnel, respectively.

Keywords: drilling industry, knowledge management, organizational commitment, loyalty, principle component analysis

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Authors: Naser Kazemi Eilaki, Carolyn Ahmer, Ilona Heldal, Bjarne Christian Hagen

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Older people and people with disabilities are recognized as at-risk groups when it comes to egress and travel from hazard zone to safe places. One's disability can negatively influence her or his escape time, and this becomes even more important when people from this target group live alone. This research deals with the fire safety of mentioned people's buildings by means of probabilistic methods. For this purpose, fire safety is addressed by modeling the egress of our target group from a hazardous zone to a safe zone. A common type of detached house with a prevalent plan has been chosen for safety analysis, and a limit state function has been developed according to the time-line evacuation model, which is based on a two-zone and smoke development model. An analytical computer model (B-Risk) is used to consider smoke development. Since most of the involved parameters in the fire development model pose uncertainty, an appropriate probability distribution function has been considered for each one of the variables with indeterministic nature. To achieve safety and reliability for the at-risk groups, the fire safety index method has been chosen to define the probability of failure (causalities) and safety index (beta index). An improved harmony search meta-heuristic optimization algorithm has been used to define the beta index. Sensitivity analysis has been done to define the most important and effective parameters for the fire safety of the at-risk group. Results showed an area of openings and intervals to egress exits are more important in buildings, and the safety of people would improve with increasing dimensions of occupant space (building). Fire growth is more critical compared to other parameters in the home without a detector and fire distinguishing system, but in a home equipped with these facilities, it is less important. Type of disabilities has a great effect on the safety level of people who live in the same home layout, and people with visual impairment encounter more risk of capturing compared to visual and movement disabilities.

Keywords: fire safety, at-risk groups, zone model, egress time, uncertainty

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Authors: E. Cenderelli, E. Bruno, G. Iacoviello, A. Lazzini

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The financial sector is exposed to the risk of cyber-attacks like any other industrial sector. Furthermore, the topic of CybeRisk (cyber risk) has become particularly relevant given that Information Technology (IT) attacks have increased drastically in recent years, and cannot be stopped by single organizations requiring a response at international and national level. IT risk is never a matter purely for the IT manager, although he clearly plays a key role. A bank's risk management function requires a thorough understanding of the evolving risks as well as the tools and practical techniques available to address them. Upon the request of European and national legislation regarding CybeRisk in the financial system, banks are therefore called upon to strengthen the operational model for CybeRisk management. This will require an important change with a more intense collaboration with the structures that deal with information security for the development of an ad hoc system for the evaluation and control of this type of risk. The aim of the work is to propose a framework for the management and control of CybeRisk that will bridge the gap in the literature regarding the understanding and consideration of CybeRisk as an integral part of business management. The IT function has a strong relevance in the management of CybeRisk, which is perceived mainly as operational risk, but with a positive tendency on the part of risk management to the identification of CybeRisk assessment methods that are increasingly complete, quantitative and able to better describe the possible impacts on the business. The paper provides answers to the research questions: Is it possible to define a CybeRisk governance structure able to support the comparison between risk and security? How can the relationships between IT assets be integrated into a cyberisk assessment framework to guarantee a system of protection and risks control? From a methodological point of view, this research uses a case study approach. The choice of “Monte dei Paschi di Siena” was determined by the specific features of one of Italy’s biggest lenders. It is chosen to use an intensive research strategy: an in-depth study of reality. The case study methodology is an empirical approach to explore a complex and current phenomenon that develops over time. The use of cases has also the advantage of allowing the deepening of aspects concerning the "how" and "why" of contemporary events, on which the scholar has little control. The research bases on quantitative data and qualitative information obtained through semi-structured interviews of an open-ended nature and questionnaires to directors, members of the audit committee, risk, IT and compliance managers, and those responsible for internal audit function and anti-money laundering. The added value of the paper can be seen in the development of a framework based on a mapping of IT assets from which it is possible to identify their relationships for purposes of a more effective management and control of cyber risk.

Keywords: bank, CybeRisk, information technology, risk management

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Authors: Amel Oueslati, Olfa Benouda

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New Value at Risk (VaR) estimation is proposed and investigated. The well-known two stages Garch-EVT approach uses conditional volatility to generate one step ahead forecasts of VaR. With daily data for twelve stocks that decompose the Dow Jones Industrial Average (DJIA) index, this paper incorporates the volume in the first stage volatility estimation. Afterwards, the forecasting ability of this conditional volatility concerning the VaR estimation is compared to that of a basic volatility model without considering any trading component. The results are significant and bring out the importance of the trading volume in the VaR measure.

Keywords: Garch-EVT, value at risk, volume, volatility

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Authors: Nasreen Abdulmannan

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Fetal abnormalities are categorized as a structural abnormality, non-structural abnormality, or a combination of both. Fetal structural abnormalities (FSA) include, but are not limited, to Down syndrome, congenital diaphragmatic hernia, and cleft lip and palate. These abnormalities can be detected in the first weeks of pregnancy, which is almost around 9 - 20 weeks gestational. Etiological factors for FSA are unknown; however, transmitted genetic risk can be one of these factors. Consanguineous marriage often referred to as inbreeding, represents a significant risk factor for FSA due to the increased likelihood of deleterious genetic traits shared by both biological parents. In a country such as the Kingdom of Saudi Arabia (KSA), consanguineous marriage is high, which creates a significant risk of children being born with congenital abnormalities. Historically, the practice of consanguinity occurred commonly among European royalty. For example, Great Britain’s Queen Victoria married her German first cousin, Prince Albert of Coburg. Although a distant blood relationship, the United Kingdom’s Queen Elizabeth II married her cousin, Prince Philip of Greece and Denmark—both of them direct descendants of Queen Victoria. In Middle Eastern countries, a high incidence of consanguineous unions still exists, including in the KSA. Previous studies indicated that a significant gap exists in understanding the lived experiences of Saudi women dealing with an FSA-complicated pregnancy. Eleven participants were interviewed using a semi-structured interview format for this qualitative phenomenological study investigating the lived experiences of pregnant Saudi women carrying a child with FSA. This study explored the gaps in current literature regarding the lived experiences of pregnant Saudi women whose pregnancies were complicated by FSA. In addition, the researcher acquired knowledge about the available support and resources as well as the Saudi cultural perspective on FSA. This research explored the lived experiences of pregnant Saudi women utilizing Giorgi’s (2009) approach to data collection and data management. Findings for this study cover five major themes: (1) initial maternal reaction to the FSA diagnosis per ultrasound screening; (2) strengthening of the maternal relationship with God; (3) maternal concern for their child’s future; (4) feeling supported by their loved ones; and (5) lack of healthcare provider support and guidance. Future research in the KSA is needed to explore the network support for these mothers. This study recommended further clinical nursing research, nursing education, clinical practice, and healthcare policy/procedures to provide opportunities for improvement in nursing care and increase awareness in KSA society.

Keywords: fetal structural abnormalities, psychological distress, health provider, health care

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Authors: Mohammed Aljoma, Eblal Zakzok

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Safety is a science that seeks to protect and avoid humans from risks in any field and prevent losses in properties and lives as much as possible. On the other hand, occupational safety goals aim to protect workers from risks which can occur during work execution. The main purpose of occupational safety is to ultimately protect people, properties and the environment by reducing accidents and injuries that may cause losses and damages. To achieve this goal, we must remove the direct and indirect reasons which cause accidents and injuries; some of the reasons of accidents are the unsafe cases and inept behavior or both of them. This research focuses on the manner of providing instant protection from the very first beginning to people, properties and the environment by: -Inserting safety demands in the planning and designing works by identifying risk levels in every task of the project, -Using a new risk managing system or modifying or changing a previously-used one.

Keywords: planning, scheduling, risk management, project duration, site safety

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Authors: Alma Shehu, Majlinda Vasjari, Sonila Duka, Loreta Vallja, Nevila Broli

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Humans consume drinking water from several sources, including tap water, bottled water, natural springs, filtered tap water, etc. The quality of drinking water is crucial for human survival given the fact that the consumption of contaminated drinking water is related to many diseases and deaths all over the world. This study represents the investigation of the quality and health risks of different types of drinking waters being consumed by the population in Albania, arising from heavy metals content. Investigated water included industrialized water, tap water, and spring water. In total, 20 samples were analyzed for the content of Pb, Cd, Cr, Ni, Cu, Fe, Zn, Al, and Mn. Determination of each metal concentration in selected samples was conducted by atomic absorption spectroscopy method with electrothermal atomization, GFAAS. Water quality was evaluated by comparing the obtained metals concentrations with the recommended maximum limits, according to the European Directive (98/83/EC) and Guidelines for Drinking Water Quality (WHO, 2017). Metal Index (MI) was used to assess the overall water quality due to heavy metals content. Health risk assessment was conducted based on the recommendations of the USEPA (1996), human health risk assessment, via ingestion. Results of this investigation showed that Al, Ni, Fe, and Cu were the metals found in higher concentrations while Cd exhibited the lowest concentration. Among the analyzed metals, Al (one sample) and Ni (in five samples) exceeded the maximum allowed limit. Based on the pollution metal index, it was concluded that the overall quality of Glina bottled water can be considered as toxic to humans, while the quality of bottled water (Trebeshina) was classified as moderately toxic. Values of health risk quotient (HQ) varied between 1x10⁻⁶-1.3x10⁻¹, following the order Ni > Cd > Pb > Cu > Al > Fe > Zn > Mn. All the values were lower than 1, which suggests that the analyzed samples exhibit no health risk for humans.

Keywords: drinking water, health risk assessment, heavy metals, pollution index

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Authors: Meng-Huan Wu, Wei-Er Wang, Tsu-Nai Wang, Wei-Jian Hsu, Vincent Chin-Hung Chen

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Objective: Studies have reported a strong link between asthma and bipolar disorder. We conducted a 17-year community-based large cohort study to examine the relationship between asthma, early smoking initiation, and bipolar disorder during adolescence and early adulthood. Methods: A total of 162,766 participants aged 11–16 years were categorized into asthma and non-asthma groups at baseline and compared within the observation period. Covariates during late childhood or adolescence included parental education, cigarette smoking by family members of participants, and participant’s gender, age, alcohol consumption, smoking, and exercise habits. Data for urbanicity, prednisone use, allergic comorbidity, and Charlson comorbidity index were acquired from the National Health Insurance Research Database. The Cox proportional-hazards model was used to evaluate the association between asthma and bipolar disorder. Results: Our findings revealed that asthma increased the risk of bipolar disorder after adjustment for key confounders in the Cox proportional hazard regression model (adjusted HR: 1.31, 95% CI: 1.12-1.53). Hospitalizations or visits to the emergency department for asthma exhibited a dose–response effect on bipolar disorder (adjusted HR: 1.59, 95% CI: 1.22-2.06). Patients with asthma with onset before 20 years of age who smoked during late childhood or adolescence had the greatest risk for bipolar disorder (adjusted HR: 3.10, 95% CI: 1.29-7.44). Conclusions: Patients newly diagnosed with asthma had a 1.3 times higher risk of developing bipolar disorder. Smoking during late childhood or adolescence increases the risk of developing bipolar disorder in patients with asthma.

Keywords: adolescence, asthma, smoking, bipolar disorder, early adulthood

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Authors: M. J. Reis Lima, J. Oliveira, M. Brito, C. Lemos, A. Mascarenhas, E. Teixeira Lemos

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Hypertension is a common condition causing cardio and cerebrovascular complications. Portugal has one of the highest mortality rates from stroke and a high prevalence of hypertension. Systolic blood pressure (SBP) is an important risk factor for cardiovascular events (myocardial infarction and stroke) and premature mortality, particularly in the elderly population. The present study aims to estimate the prevalence of hypertension in a Portuguese population living in a coastal city and to identify some of its determinants (namely gender, age, the body mass index and physical activity frequency). A total of 91 adults who attended three pharmacies of a coastal city in the center of Portugal, between May and August of 2013 were evaluated. Attendants who reported to have diabetes or taking antihypertensive drugs in the 2 previous weeks were excluded from the study. Sociodemographic factors, BMI, habits of exercise and BP were assessed. Hypertension was defined as blood pressure ≥140/90 mmHg. The majority of the studied population was constituted by women (75.8%), with a mean age of 54.2±1.6 years old, married or living in civil union and that had completed secondary school or had higher education (40%). They presented a mean BMI of 26.2±4.76 Kg/m2. and were sedentary. The mean BP was 127.0±17.77mmHg- 74.69 ± 9.53. In this population, we found 4.3% of people with hypertension and 16.1% with normal high blood pressure. Men exhibit a tendency to present higher systolic blood pressure values than women. Of all the factors considered, SBP values also tended to be higher with age and higher BMI values. Despite the fact that the mean values of SBP did not present values higher than 140 mmHg we must be concerned because the studied population is undiagnosed for hypertension. Our study even with some limitations might be a prelude to the upcoming research about the underlying factors responsible for the occurrence of SBP.

Keywords: hypertension, age, exercise, obesity and gender

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Authors: Sasan Chalaki, Seyed Ali Mirgholange, Touba Nadri, Saman Chalaki

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In the current world, proper poultry nutrition has garnered special attention as one of the fundamental factors for enhancing their health and performance. Concerns related to the excessive use of antibiotics in the poultry industry and their role in antibiotic resistance have transformed this issue into a global challenge in public health and the environment. On the other hand, poultry farming plays a vital role as a primary source of meat and eggs in human nutrition, and improving their health and performance is crucial. One effective approach to enhance poultry nutrition is the utilization of the antibiotic properties of plant-based ingredients. The use of plant-based alternatives as natural antibiotics in poultry nutrition not only aids in improving poultry health and performance but also plays a significant role in reducing the consumption of synthetic antibiotics and preventing antibiotic resistance-related issues. Plants contain various antibacterial compounds, such as flavonoids, tannins, and essential oils. These compounds are recognized as active agents in combating bacteria. Plant-based antibiotics are compounds extracted from plants with antibacterial properties. They are acknowledged as effective substitutes for chemical antibiotics in poultry diets. The advantages of plant-based antibiotics include reducing the risk of resistance to chemical antibiotics, increasing poultry growth performance, and lowering the risk of disease transmission.

Keywords: poultry, antibiotics, essential oils, plant-based

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Authors: Mumtaz Mooncey, Alexander Jolly, Megan Fisher, Kerry Robinson, Robert Lloyd, Dave Fielding

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Introduction: The integration of the WingFactors in-situ simulation programme has transformed the education landscape at the Whittington Health NHS Trust. To date, there have been a total of 90 simulations - 19 aimed at Paediatric trainees, including 2 Child and Adolescent Mental Health (CAMHS) scenarios. The opportunity for joint debriefs provided by clinical faculty and airline pilots, has created a new exciting avenue to explore human factors within psychiatry. Through the use of real clinical environments and primed actors; the benefits of high fidelity simulation, interdisciplinary and interprofessional learning has been highlighted. The use of in-situ simulation within Psychiatry is a newly emerging concept and its success here has been recognised by unanimously positive feedback from participants and acknowledgement through nomination for the Health Service Journal (HSJ) Award (Best Education Programme 2021). Methodology: The first CAMHS simulation featured a collapsed patient in the toilet with a ligature tied around her neck, accompanied by a distressed parent. This required participants to consider:; emergency physical management of the case, alongside helping to contain the mother and maintaining situational awareness when transferring the patient to an appropriate clinical area. The second simulation was based on a 17- year- old girl attempting to leave the ward after presenting with an overdose, posing potential risk to herself. The safe learning environment enabled participants to explore techniques to engage the young person and understand their concerns, and consider the involvement of other members of the multidisciplinary team. The scenarios were followed by an immediate ‘hot’ debrief, combining technical feedback with Human Factors feedback from uniformed airline pilots and clinicians. The importance of psychological safety was paramount, encouraging open and honest contributions from all participants. Key learning points were summarized into written documents and circulated. Findings: The in-situ simulations demonstrated the need for practical changes both in the Emergency Department and on the Paediatric ward. The presence of airline pilots provided a novel way to debrief on Human Factors. The following key themes were identified: -Team-briefing (‘Golden 5 minutes’) - Taking a few moments to establish experience, initial roles and strategies amongst the team can reduce the need for conversations in front of a distressed patient or anxious relative. -Use of checklists / guidelines - Principles associated with checklist usage (control of pace, rigor, team situational awareness), instead of reliance on accurate memory recall when under pressure. -Read-back - Immediate repetition of safety critical instructions (e.g. drug / dosage) to mitigate the risks associated with miscommunication. -Distraction management - Balancing the risk of losing a team member to manage a distressed relative, versus it impacting on the care of the young person. -Task allocation - The value of the implementation of ‘The 5A’s’ (Availability, Address, Allocate, Ask, Advise), for effective task allocation. Conclusion: 100% of participants have requested more simulation training. Involvement of airline pilots has led to a shift in hospital culture, bringing to the forefront the value of Human Factors focused training and multidisciplinary simulation. This has been of significant value in not only physical health, but also mental health simulation.

Keywords: human factors, in-situ simulation, inter-professional, multidisciplinary

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Authors: Vladyslav Povoroznyuk, Tetiana Orlуk, Nataliia Dzerovych

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Introduction: Back pain is an extremely common health care problem worldwide. Many studies show a link between an obesity and risk of lower back pain. The aim is to study correlation and peculiarities of vertebral pain in women of different age depending on their anthropometric indicators. Materials: 1886 women aged 25-89 years were examined. The patients were divided into groups according to age (25-44, 45-59, 60-74, 75-89 years old) and body mass index (BMI: to 18.4 kg/m2 (underweight), 18.5-24.9 kg/m2 (normal), 25-30 kg/m2 (overweight) and more than 30.1 kg/m2 (obese). Methods: The presence and intensity of pain was evaluated in the thoracic and lumbar spine using a visual analogue scale (VAS). BMI is calculated by the standard formula based on body weight and height measurements. Statistical analysis was performed using parametric and nonparametric methods. Significant changes were considered as p <0.05. Results: The intensity of pain in the thoracic spine was significantly higher in the underweight women in the age groups of 25-44 years (p = 0.04) and 60-74 years (p=0.005). The intensity of pain in the lumbar spine was significantly higher in the women of 45-59 years (p = 0.001) and 60-74 years (p = 0.0003) with obesity. In the women of 45-74 years BMI was significantly positively correlated with the level of pain in the lumbar spine. Obesity significantly increases the relative risk of pain in the lumbar region (RR=0.07 (95% CI: 1.03-1.12; p=0.002)), while underweight significantly increases the risk of pain in the thoracic region (RR=1.21 (95% CI: 1.00-1.46; p=0.05)). Conclusion: In women, vertebral pain syndrome may be related to the anthropometric characteristics (e.g., BMI). Underweight may indirectly influence the development of pain in the thoracic spine and increase the risk of pain in this part by 1.21 times. Obesity influences the development of pain in the lumbar spine increasing the risk by 1.07 times.

Keywords: body mass index, age, pain in thoracic and lumbar spine, women

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Authors: Tadele Araya, Tsehaye Asmelash, Girmatsion Fiseha

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Background: Hepatitis B virus (HBV), Hepatitis C virus (HCV) and Human Immunodeficiency Virus (HIV) constitute serious healthcare problems worldwide. Blood-borne pathogens HBV, HCV and HIV are commonly associated with infections among substance or Injection Drug Users (IDUs). The objective of this study was to determine the prevalence of HBV, HCV, and HIV infections among substance users in Mekelle Substance users Treatment and Rehabilitation Centers. Methods: A cross-sectional study design was used from Dec 2020 to Sep / 2021 to conduct the study. A total of 600 substance users were included. Data regarding the socio-demographic, clinical and sexual behaviors of the substance users were collected using a structured questionnaire. For laboratory analysis, 5-10 ml of venous blood was taken from the substance users. The laboratory analysis was performed by Enzyme-Linked Immunosorbent Assay (ELISA) at Mekelle University, Department of Medical Microbiology and Immunology Research Laboratory. The Data was analyzed using SPSS and Epi-data. The association of variables with HBV, HCV and HIV infections was determined using multivariate analysis and a P value < 0.05 was considered statistically significant. Result: The overall prevalence rate of HBV, HCV and HIV infections were 10%, 6.6%, and 7.5%, respectively. The mean age of the study participants was 28.12 ± 6.9. A higher prevalence of HBV infection was seen in participants who were users of drug injections and in those who were infected with HIV. HCV was comparatively higher in those who had a previous history of unsafe surgical procedures than their counterparts. Homeless participants were highly exposed to HCV and HIV infections than their counterparts. The HBV/HIV Co-infection prevalence was 3.5%. Those doing unprotected sexual practices [P= 0.03], Injection Drug users [P= 0.03], those who had an HBV-infected person in their family [P=0.02], infected with HIV [P= 0.025] were statistically associated with HBV infection. HCV was significantly associated with Substance users and previous history of unsafe surgical procedures [p=0.03, p=0.04), respectively. HIV was significantly associated with unprotected sexual practices and being homeless [p=0.045, p=0.05) respectively. Conclusion-The highly prevalent viral infection was HBV compared to others. There was a High prevalence of HBV/HIV co-infection. The presence of HBV-infected persons in a family, unprotected sexual practices and sharing of needles for drug injection were the risk factors associated with HBV, HIV, and HCV. Continuous health education and screening of the viral infection coupled with medical and psychological treatment is mandatory for the prevention and control of the infections.

Keywords: hepatitis b virus, hepatitis c virus, HIV, substance users

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Authors: Yang Wenjuan, Xu Yilun

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Based on the comparative analysis of the relevant evaluation methods of walking environment, this paper selects the combined evaluation method of macro urban morphology analysis and micro urban design quality survey, then investigates and analyzes the walking environment of three rail transit station area in Nanjing to explore the influence factor and internal relation of walkability of rail transit station area. Analysis shows that micro urban design factors have greater impact on the walkability of rail transit station area compared with macro urban morphology factors, the convenience is the key factor in the four aspects of convenience, security, identity and comfortability of the urban design factors, the convenience is not only affected by the block network form, but also related to the quality of the street space. The overall evaluation of walkability comes from the overlapping and regrouping of the walking environment at different levels, but some environmental factors play a leading role. The social attributes of pedestrians also partly influence their walking perception and evaluation.

Keywords: rail transit station area, walkability, evaluation, influence factors

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Authors: Eftekhari M. H., Mozaffari-Khosravi H., Shidfar F.

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Background: Many Iranian adolescent girls are iron deficient, but it is unclear whether the iron deficiency is associated with other nutritional risk indicators. Objective: we aimed to investigate the association between iron deficiency and weight status (measured as BMI) among a reprehensive sample of teenage girls. Methods: A cross-sectional study was performed in a region of southern I.R.Iran. One hundred eighty-seven iron-deficient participants (aged between 11 to 14) were selected by systematic random sampling among all students in grades 1 to 3 from high schools for girls. We assayed hemoglobin, hematocrit, serum ferritin, iron and total iron binding capacity and measured weight and height. Body mass index was calculated according to age and gender-specific BMI growth charts for children 2 to 20 years of age. Results: 13% were at risk for being overweight and 8.3% were overweight. The severity of iron deficiency increased as BMI increased from normal to at risk for overweight and overweight. Iron deficiency anemia was most prevalent among overweight adolescents than at risk for overweight and normal weight adolescents (28%, 18%, and 13%, respectively). Conclusions: The results of this study showed an inverse association of BMI with serum ferritin. Overweight adolescents demonstrated an increased prevalence of anemia. Because of the potentially harmful effects of iron deficiency, obese adolescents should be routinely screened and treated as necessary.

Keywords: adolescent, over weight, iron deficiency, Iran

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Authors: Nuran Nur Aypar, Merlinda Alus Tokat

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The aim of the study is to determine the knowledge level of pregnant women with Gestational Diabetes Mellitus (GDM) about the disease and affecting factors. The data of this descriptive study were collected from 184 pregnant women who were followed up in Dokuz Eylul University Hospital (n=34), Izmir Ege Maternity Hospital, Gynecology Training and Research Hospital (n=133), and Egepol Private Hospital (n=17). Data collection forms were prepared by the researcher according to the literature. ANOVA test, Kruskal Wallis test, Mann-Whitney U test, Student’s t-test, and Pearson correlation test were used for statistical analyses. Average GDM knowledge score of pregnant women was 40.10±19.56. The GDM knowledge scores were affected by factors such as age, educational level, working status, income status, educational level of the spouse, and the GDM background. It has been shown in our study that the GDM knowledge scores were negatively affected by factors such as young age, low educational level, low-income level, unemployment, having a spouse with low educational level, the absence of the GDM story. It has been identified that 86.4% of the pregnant women were trained about GDM. The education provided in the antenatal period significantly increased GDM knowledge scores of pregnant women (p=0.000, U=515.0). It has been determined that GDM knowledge of the pregnant women with GDM is affected by various factors. These factors must be considered in order to determine new strategies.

Keywords: affecting factors, gestational diabetes mellitus (GDM), knowledge level, nursing, pregnancy

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Authors: Syed Atif Ali, Farzan Yahya

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This research paper covers the issue of risk management impact on the company performance. Degree of financial leverage (DFL), degree of operating leverage (DOL) and the working capital ratio (WCR) are taken as independent variables which are the representative of risk and the earning price per share (EPS), return on assets (ROA), return on equity (ROE), Sales and Net profits which are the representative of performance. Last 10 years (2004-2013) of Cement sector of Pakistan data is chosen as sample for analyze their relations by multiple regression technique. Through analyses, it is found that WCR impact adequately on the company performance because if company has enough liquidity than it perform its operations smoothly and enhance its performance very well. DFL should be control moderately because enough DFL leads performance of company downward. On the other hand, the DOL should be less because it causes the less profitability for a company from its operations.

Keywords: degree of financial leverage (DFL), degree of operating leverage (DOL), working capital ratio (WCR), earning per share (EPS), return on equity (ROE), return on assets (ROA)

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Authors: N. R. P Withana, E. Auch

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The purpose of this study was to investigate perceptions of climate change risk to forest ecosystems and forest-based communities as well as perceived effectiveness of adaptation strategies for climate change as well as challenges for adaptation. Data was gathered using a pre-tested semi-structured questionnaire. Simple random selection technique was applied. For the majority of issues, the responses were obtained on multi-point Likert scales, and the scores provided were, in turn, used to estimate the means and other useful estimates. A composite knowledge index developed using correct responses to a set of self-rated statements were used to evaluate the issues. The mean of the knowledge index was 0.64. Also all respondents recorded values of the knowledge index above 0.25. Increase forest fire was perceived by respondents as the greatest risk to forest eco-system. Decrease access to water supplies was perceived as the greatest risk to livelihoods of forest based communities. The most effective adaptation strategy relevant to climate change risks to forest eco-systems and forest based communities livelihoods in Kathmandu valley in Nepal as perceived by the respondents was reforestation and afforestation. As well, lack of public awareness was perceived as the major limitation for climate change adaptation. However, perceived risks as well as effective adaptation strategies showed an inconsistent association with knowledge indicators and social-cultural variables. The results provide useful information to any party who involve with climate change issues in Nepal, since such attempts would be more effective once the people’s perceptions on these aspects are taken into account.

Keywords: climate change, risk perceptions, forest ecosystems, forest-based communities

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