Search results for: catastrophic health expenditure
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9380

Search results for: catastrophic health expenditure

9260 Effects of Endurance Training and Thyme Consumption on Neuropeptide Y in Untrained Men

Authors: M. Ghasemi, S.Fazelifar

Abstract:

Abstract Aim: Over-weight is not desirable and has implications for health and in the case of athletes affects performance. Exercise is a strategy used to counteract overweight owing to create a negative energy balance by increasing energy expenditure and influencing appetite regulating hormones. Interestingly, recent studies have revealed inhibitory effects of exercise on the hunger associated with these hormones in healthy subjects Neuropeptide Y(NPY) is a 36 amino acid protein that is a powerful stimulant appetite. NPY is an important central orexigenic hormone predominantly produced by the hypothalamus, and recently found to be secreted in adipose tissue. This neurotransmitter is secreted in the brain and autonomic nervous system. On the other hand, research has shown that thyme in addition to various properties, also affects the appetite. The purpose of this study was to determine Effects of eight weeks endurance training and thyme consumption on neuropeptide Y in untrained men. Methodology: 36 Healthy untrained men (mean body weight 78.25±3.2 kg, height 176±6.8 cm, age 34.32±4.54 years and BMI 29.1±4.3 kg/m2) voluntarily participated in this study . Subjects were randomly divided into four groups: 1. control, 2. Endurance training, 3. Thyme 4. Endurance training + Thyme. Amount of 10cc Blood sampling were obtained pre-test and post-test (after 8 weeks). The taken blood samples were centrifuged at 1500 × g for 15 min then plasma was stored at -20 °C until analysis. Endurance training consisted three session per week with 60% -75% of reserve heart rate for eight weeks. Exclusion criteria were history of gastrointestinal, endocrine, cardiovascular or psychological disease, and consuming any supplementation, alcohol and tobacco products. Descriptive statistics including means, standard deviations, and ranges were calculated for all measures. K-S test to determine the normality of the data and analysis of variance for repeated measures was used to analyze the data. A significant difference in the p<0/05 accepted. Results: Results showed that aerobic training significantly reduced body weight, body mass index, percent body fat, but significant increase observed in maximal oxygen consumption level (p ≤ 0/05). The neuropeptide Y levels were significantly increased after exercise. Analysis of data determined that there was no significant difference between the four groups. Conclusion: Appetite control plays a critical role in the competition between energy consumption and energy expenditure. The results of this study showed that endurance training and thyme consumption can be cause improvement in physiological parameters such as increasing aerobic capacity, reduction of fat mass and improve body composition in untrained men.

Keywords: Endurance training, neuropeptide Y, thyme, untrained men

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9259 Impact of Treatment of Fragility Fractures Due to Osteoporosis as an Economic Burden Worldwide: A Systematic Review

Authors: Fabiha Tanzeem

Abstract:

BACKGROUND: Osteoporosis is a skeletal disease that is associated with a reduction in bone mass and microstructures of the bone and deterioration of bone tissue. Fragility fracture due to osteoporosis is the most significant complication of osteoporosis. The increasing prevalence of fragility fractures presents a growing burden on the global economy. There is a rapidly evolving need to improve awareness of the costs associated with these types of fractures and to review current policies and practices for the prevention and management of the disease. This systematic review will identify and describe the direct and indirect costs associated with osteoporotic fragility fractures from a global perspective from the included studies. The review will also find out whether the costs required for the treatment of fragility fractures due to osteoporosis impose an economic burden on the global healthcare system. METHODS: Four major databases were systematically searched for direct and indirect costs of osteoporotic fragility fracture studies in the English Language. PubMed, Cochrane Library, Embase and Google Scholar were searched for suitable articles published between 1990 and July 2020. RESULTS: The original search yielded 1166 papers; from these, 27 articles were selected for this review according to the inclusion and exclusion criteria. In the 27 studies, the highest direct costs were associated with the treatment of pelvic fractures, with the majority of the expenditure due to hospitalization and surgical treatments. It is also observed that most of the articles are from developed countries. CONCLUSION: This review indicates the significance of the economic burden of osteoporosis globally, although more research needs to be done in developing countries. In the treatment of fragility fractures, direct costs were the main reported expenditure in this review. The healthcare costs incurred globally can be significantly reduced by implementing measures to effectively prevent the disease. Raising awareness in children and adults by improving the quality of the information available and standardising policies and planning of services requires further research.

Keywords: systematic review, osteoporosis, cost of illness

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9258 Estimation and Forecasting Debris Flow Phenomena on the Highway of the 'TRACECA' Corridor

Authors: Levan Tsulukidze

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The paper considers debris flow phenomena and forecasting of them in the corridor of ‘TRACECA’ on the example of river Naokhrevistkali, as well as the debris flow -type channel passing between the villages of Vale-2 and Naokhrevi. As a result of expeditionary and reconnaissance investigations, as well as using empiric dependencies, the debris flow expenditure has been estimated in case of different debris flow provisions.

Keywords: debris flow, Traceca corridor, forecasting, river Naokhrevistkali

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9257 The Cost of Healthcare among Malaysian Community-Dwelling Elderly with Dementia

Authors: Roshanim Koris, Norashidah Mohamed Nor, Sharifah Azizah Haron, Normaz Wana Ismail, Syed Mohamed Aljunid Syed Junid, Amrizal Muhammad Nur, Asrul Akmal Shafie, Suraya Yusuff, Namaitijiang Maimaiti

Abstract:

An ageing population has huge implications for virtually every aspect of Malaysian societies. The elderly consume a greater volume of healthcare facilities not because they are older, but because of they are sick. The chronic comorbidities and deterioration of cognitive ability would lead the elderly’s health to become worst. This study aims to provide a comprehensive estimate of the direct and indirect costs of health care used in a nationally representative sample of community-dwelling elderly with dementia and as well as the determinants of healthcare cost. A survey using multi-stage random sampling techniques recruited a final sample of 2274 elderly people (60 years and above) in the state of Johor, Perak, Selangor and Kelantan. Mini Mental State Examination (MMSE) score was used to measure the cognitive capability among the elderly. Only the elderly with a score less than 19 marks were selected for further analysis and were classified as dementia. By using a two-part model findings also indicate household income and education level are variables that strongly significantly influence the healthcare cost among elderly with dementia. A number of visits and admission are also significantly affect healthcare expenditure. The comorbidity that highly influences healthcare cost is cancer and seeking the treatment in private facilities is also significantly affected the healthcare cost among the demented elderly. The level of dementia severity is not significant in determining the cost. This study is expected to attract the government's attention and act as a wake-up call for them to be more concerned about the elderly who are at high risk of having chronic comorbidities and cognitive problems by providing more appropriate health and social care facilities. The comorbidities are one of the factor that could cause dementia among elderly. It is hoped that this study will promote the issues of dementia as a priority in public health and social care in Malaysia.

Keywords: ageing population, dementia, elderly, healthcare cost, healthcare utiliztion

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9256 The Survey of Sexual Health and Pornography among Divorce-Asking Women in West Azerbaijan-Iran: A Cross-Sectional Study

Authors: Soheila Rabiepoor, Elham Sadeghi

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Introduction: Divorce is both a personal and a social issue. Nowadays, due to various factors such as rapid social, economical, and cultural changes, the family structure has undergone many rough changes, out of 3 marriages 2 of them lead to divorce. One of the factors affecting the incidence of divorce and relationship problems between couples is the sexual and marital behaviors. There are several different reasons to suspect that pornography might affect divorce in either a positive or a negative way. Therefore this study evaluated the sexual health of divorce-asking in Urmia, Iran. Methods: This was a cross-sectional descriptive study and was conducted on 71 married women of Urmia, Iran in 2016. Participants were applicants of divorce (referred to divorce center) who were selected by using convenient sampling method. Data gathering tool included the scales for measuring demographic, sexual health (sexual satisfaction and function), and researcher made pornography questions. Data were analyzed based on the SPSS 16 software. P-values less than 0.05 were considered significant. Results: Investigation of demographic features showed that age average of studied samples was 28.98 ± 7.44, with a marriage duration average 8.12 ± 6.53 years (min 1 year/ max 28 years). Most of their education was at diploma (45.1%). 69 % of the women declared their income and expenditure as equal. Nearly 42% of women and 59% of their partner had watched sexual pornography clips. 45.5% of participants reported that they compared own sexual relationship with sexual pornography clips. In the other hand, sexual satisfaction total score was 51.50 ± 17.92. The mean total sexual function score was 16.62 ± 10.58. According to these findings, most of women were experienced sexual dissatisfaction and dysfunction. Conclusions: The results of the study indicated that who had low sexual satisfaction score, had higher rate of watching pornography clips. Based on current study, paying attention to family education and counseling programs especially in the sexual field will be more fruitful.

Keywords: divorce-asking, pornography, sexual satisfaction, sexual function, women

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9255 Optimized Passive Heating for Multifamily Dwellings

Authors: Joseph Bostick

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A method of decreasing the heating load of HVAC systems in a single-dwelling model of a multifamily building, by controlling movable insulation through the optimization of flux, time, surface incident solar radiation, and temperature thresholds. Simulations are completed using a co-simulation between EnergyPlus and MATLAB as an optimization tool to find optimal control thresholds. Optimization of the control thresholds leads to a significant decrease in total heating energy expenditure.

Keywords: energy plus, MATLAB, simulation, energy efficiency

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9254 Corporate Social Responsibility (CSR) and Energy Efficiency: Empirical Evidence from the Manufacturing Sector of India

Authors: Baikunthanath Sahoo, Santosh Kumar Sahu, Krishna Malakar

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With the essence of global environmental sustainability and green business management, the wind of business research moved towards Corporate Social Responsibility. In addition to international and national treaties, businesses have also started realising environmental protection and energy efficiency through CSR as part of business strategy in response to climate change. Considering the ambitious emission reduction target and rapid economic development of India, this study is an attempt to explore the effect of CSR on the energy efficiency management of manufacturing firms in India. By using firm-level data, the panel fixed effect model shows that the CSR dummy variable is negatively influencing the energy intensity or technically, they are energy efficient. The result demonstrates that in the presence of CSR, all the production economic variables are significant. The result also shows that doing environmental expenditure does not improve energy efficiency might be because very few firms are motivated to do such expenditure and also not common to all sectors. The interactive effect model result conforms that without considering CSR dummy as an intervening variable only Manufacturers of Chemical and Chemical products, Manufacturers of Pharmaceutical, medical chemical, and botanical products firms energy intensity low but after considering CSR in their business practices all six sub-sector firms become energy efficient. The empirical result also validate that firms are continuously engaged in CSR activities they are highly energy efficient. It is an important motivational factor for firms to become economically and environmentally sustainable in the corporate world. This analysis would help business practitioners to know how to manage today’s profitability and tomorrow’s sustainability to achieve a comparative advantage in the emerging market economy. The paper concludes that reducing energy consumption as part of their social responsibility to care for the environment, will need collaborative efforts of business society and policy bodies.

Keywords: CSR, Energy Efficiency, Indian manufacturing Sector, Business strategy

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9253 Government of Ghana’s Budget: An Assessment of Its Compliance with Fundamental Budgeting Principles

Authors: Mohammed Sani Abdulai

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Public sector budgeting, all over the world, is underpinned by some universally accepted principles of sound budget management such as budget unity, universality, annuality, and a balanced budget. These traditional principles, though fundamental, had, in recent years, been augmented by the more modern principles of budgeting within fiscal objective, alignment with medium-term strategic plans as well as the observance of such related concepts as transparency, openness and accessibility. In this paper, we have endeavored to shed light, from literature and practice, on the meaning and purposes of such fundamental budgeting principles. We have also assessed the extent to which the Government of Ghana’s budget complies with the four traditional principles of budget unity, universality, annuality, and a balanced budget and the three out of the ten modern principles of budgetary governance of Organisation for Economic Co-operation and Development (OECD). We did so by using a qualitative method of review and analysis of existing documents and the performance assessment reports on Ghana’s Public Financial Management (PFM) measured using such frameworks as the Public Expenditure and Financial Accountability (PEFA), the Open Budget Survey (OBS) and its Index (OBI), the reports and action plans of Open Government Partnership (OGP) and the Global Initiative for Fiscal Transparency (GIFT). Other performance assessment reports that were relied on included, but not limited to, the Joint Evaluation Report of PFM in Ghana, 2001-2010, and the Joint Evaluation of Budget Support to Ghana, 2005-2015. We have, through this paper, brought to the fore the lessons that could be learned on how those budgetary principles undergird the Government of Ghana’s budget formulation, execution, accounting, control, and oversight. These lessons include, but are not limited to, the need for both scholars and practitioners in the PFM space to be aware of the impact of those principles on public sector budgeting.

Keywords: annulaity, balanced budget, budget unity, budgetary principles, OECD’s principles on budgetary governance, open budget index, public expenditure and financial accountability, universality

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9252 Storage Tank Overfill Protection in Compliance with Functional Safety Standard: IEC 61511

Authors: Hassan Alsada

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Tank overfill accidents are major concerns for industries handling large volumes of hydrocarbons. Buncefield, Jaipur, Puerto Rico, and West Virginia are just a few accidents with catastrophic consequences. Thus, it is very important for any industry to take the right safety measures for overfill prevention. Moreover, one of the main causative factors in the overfill accidents was inadequate risk analysis and, subsequently, inadequate design. This study aims to provide a full assessment in accordance with the Functional safety standard: “IEC 615 11 – Safety instrumented systems for the process industry” to the tank overfill scenario according to the standard’s Safety Life Cycle (SLC), which includes: the analysis phase, the implementation phase, and the operation phase. The paper discusses in depth the tank overfills Independent Protection Layers (IPLs) with systematic analysis to avoid the safety risks of under-design and the financial risk of facility overdesign. The result shows a clear and systematic assessment in compliance with the standards that can help to assist existing tank overfilling setup or a guide to support designing new storage facilities overfill protection.

Keywords: IEC 61511, PHA, LOPA, process safety, safety, health, environment, safety instrumented systems, safety instrumented function, functional safety, safety life cycle

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9251 Well-Being of Elderly with Nanonutrients

Authors: Naqvi Shraddha Rathi

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During the aging process, physical frailty may develop. A more sedentary lifestyle, a reduction in metabolic cell mass and, consequently, lower energy expenditure and dietary intake are important contributors to the progression of frailty. A decline in intake is in turn associated with the risk of developing a suboptimal nutritional state or multiple micro nutrient deficiencies.The tantalizing potential of nanotechnology is to fabricate and combine nano scale approaches and building blocks to make useful tools and, ultimately, interventions for medical science, including nutritional science, at the scale of ∼1–100 nm.

Keywords: aging, cells frailty, micronutrients, biochemical reactivity

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9250 Failure Analysis of a 304 Stainless Steel Flange Crack at Pipeline Transportation of Ethylene

Authors: Parisa Hasanpour, Bahram Borooghani, Vahid Asadi

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In the current research, a catastrophic failure of a 304 stainless steel flange at pipeline transportation of ethylene in a petrochemical refinery was studied. Cracking was found in the flange after about 78840h service. Through the chemical analysis, tensile tests in addition to microstructural analysis such as optical microscopy and Scanning Electron Microscopy (SEM) on the failed part, it found that the fatigue was responsible for the fracture of the flange, which originated from bumps and depressions on the outer surface and propagated by vibration caused by the working condition.

Keywords: failure analysis, 304 stainless steel, fatigue, flange, petrochemical refinery

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9249 Preventing Discharge to No Fixed Address-Youth (NFA-Y)

Authors: Cheryl Forchuk, Sandra Fisman, Steve Cordes, Dan Catunto, Katherine Krakowski, Melissa Jeffrey, John D’Oria

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The discharge of youth aged 16-25 from hospital into homelessness is a prevalent issue despite research indicating social, safety, health and economic detriments on both the individual and community. Lack of stable housing for youth discharged into homelessness results in long-term consequences, including exacerbation of health problems and costly health care service use and hospital readmission. People experiencing homelessness are four times more likely to be readmitted within one month of discharge and hospitals must spend $2,559 more per client. Finding safe housing for these individuals is imperative to their recovery and transition back to the community. People discharged from hospital to homelessness experience challenges, including poor health outcomes and increased hospital readmissions. Youth are the fastest-growing subgroup of people experiencing homelessness in Canada. The needs of youth are unique and include supports related to education, employment opportunities, and age-related service barriers. This study aims to identify the needs of youth at risk of homelessness by evaluating the efficacy of the “Preventing Discharge to No Fixed Address – Youth” (NFA-Y) program, which aims to prevent youth from being discharged from hospital into homelessness. The program connects youth aged 16-25 who are inpatients at London Health Sciences Centre and St. Joseph’s Health Care London to housing and financial support. Supports are offered through collaboration with community partners: Youth Opportunities Unlimited, Canadian Mental Health Association Elgin Middlesex, City of London Coordinated Access, Ontario Works, and Salvation Army’s Housing Stability Bank. This study was reviewed and approved by Western University’s Research Ethics Board. A series of interviews are being conducted with approximately ninety-three youth participants at three time points: baseline (pre-discharge), six, and twelve months post-discharge. Focus groups with participants, health care providers, and community partners are being conducted at three-time points. In addition, administrative data from service providers will be collected and analyzed. Since homelessness has a detrimental effect on recovery, client and community safety, and healthcare expenditure, locating safe housing for psychiatric patients has had a positive impact on treatment, rehabilitation, and the system as a whole. If successful, the findings of this project will offer safe policy alternatives for the prevention of homelessness for at-risk youth, help set them up for success in their future years, and mitigate the rise of the homeless youth population in Canada.

Keywords: youth homelessness, no-fixed address, mental health, homelessness prevention, hospital discharge

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9248 Metabolic Variables and Associated Factors in Acute Pancreatitis Patients Correlates with Health-Related Quality of Life

Authors: Ravinder Singh, Pratima Syal

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Background: The rising prevalence and incidence of Acute Pancreatitis (AP) and its associated metabolic variables known as metabolic syndrome (MetS) are common medical conditions with catastrophic consequences and substantial treatment costs. The correlation between MetS and AP, as well as their impact on Health Related Quality of Life (HRQoL) is uncertain, and because there are so few published studies, further research is needed. As a result, we planned this study to determine the relationship between MetS components impact on HRQoL in AP patients. Patients and Methods: A prospective, observational study involving the recruitment of patients with AP with and without MetS was carried out in tertiary care hospital of North India. Patients were classified with AP if they were diagnosed with two or more components of the following criteria, abdominal pain, serum amylase and lipase levels two or more times normal, imaging trans-abdominal ultrasound, computed tomography, or magnetic resonance. The National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATP III) criterion was used to diagnose the MetS. The various socio-demographic variables were also taken into consideration for the calculation of statistical significance (P≤.05) in AP patients. Finally, the correlation between AP and MetS, along with their impact on HRQoL was assessed using Student's t test, Pearson Correlation Coefficient, and Short Form-36 (SF-36). Results: AP with MetS (n = 100) and AP without MetS (n = 100) patients were divided into two groups. Gender, Age, Educational Status, Tobacco use, Body Mass Index (B.M.I), and Waist Hip Ratio (W.H.R) were the socio-demographic parameters found to be statistically significant (P≤.05) in AP patients with MetS. Also, all the metabolic variables were also found to statistically significant (P≤.05) and found to be increased in patients with AP with MetS as compared to AP without MetS except HDL levels. Using the SF-36 form, a greater significant decline was observed in physical component summary (PCS) and mental component summary (MCS) in patients with AP with MetS as compared to patients without MetS (P≤.05). Furthermore, a negative association between all metabolic variables with the exception of HDL, and AP was found to be producing deterioration in PCS and MCS. Conclusion: The study demonstrated that patients with AP with MetS had a worse overall HRQOL than patients with AP without MetS due to number of socio-demographic and metabolic variables having direct correlation impacting physical and mental health of patients.

Keywords: metabolic disorers, QOL, cost effectiveness, pancreatitis

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9247 The Impact of Public Finance Management on Economic Growth and Development in South Africa

Authors: Zintle Sikhunyana

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Management of public finance in many countries such as South Africa is affected by political decisions and by policies around fiscal decentralization amongst the government spheres. Economic success is said to be determined by efficient management of public finance and by the policies or strategies that are implemented to support efficient public finance management. Policymakers focus on pay attention to how economic policies have been implemented and how they are directed into ensuring stable development. This will allow policymakers to address economic challenges through the usage of fiscal policy parameters that are linked to the achieved rate of economic growth and development. Efficient public finance management reduces the likelihood of corruption and corruption is said to have negative effects on economic growth and development. Corruption in public finance refers to an act of using funds for personal benefits. To achieve macroeconomic objectives, governments make use of government expenditure and government expenditure is financed through tax revenue. The main aim of this paper is to investigate the potential impact of public finance management on economic growth and development in South Africa. The secondary data obtained from the South African Reserve Bank (SARB) and World Bank for 1980- 2020 has been utilized to achieve the research objectives. To test the impact of public finance management on economic growth and development, the study will use Seeming Unrelated Regression Equation (SURE) Modelling that allows researchers to model multiple equations with interdependent variables. The advantages of using SUR are that it efficiently allows estimation of relationships between variables by combining information on different equations and SUR test restrictions that involve parameters in different equations. The findings have shown that there is a positive relationship between efficient public finance management and economic growth/development. The findings also show that efficient public finance management has an indirect positive impact on economic growth and development. Corruption has a negative impact on economic growth and development. It results in an efficient allocation of government resources and thereby improves economic growth and development. The study recommends that governments who aim to stimulate economic growth and development should target and strengthen public finance management policies or strategies.

Keywords: corruption, economic growth, economic development, public finance management, fiscal decentralization

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9246 The Role of Sponsorship in Marketing Communication Tools

Authors: Mansur Ahmed Kazaure

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The emergence of sponsorship as a new marketing communication tool and a source of competitive advantage in the marketplace has changed the entire marketing communication process. Sponsorship has overtaken other marketing communication tools in terms of growth and expenditure. This paper seeks to evaluate the role of sponsorship in marketing communication tools. The study recommends that proper measures be taken before the company embarks into sponsorship programs. This is necessary because investment in sponsorship does not always guarantee sustainable competitive advantage in the marketplace.

Keywords: sponsorship, marketing communication theories, marketing communication tools

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9245 Fossil Health: Causes and Consequences of Hegemonic Health Paradigms

Authors: Laila Vivas

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Fossil Health is proposed as a value-concept to describe the hegemonic health paradigms that underpin health enactment. Such representation is justified by Foucaldian and related ideas on biopower and biosocialities, calling for the politicization of health and signalling the importance of narratives. This approach, hence, enables contemplating health paradigms as reflexive or co-constitutive of health itself or, in other words, conceiving health as a verb. Fossil health is a symbolic representation, influenced by Andreas Malm’s concept of fossil capitalism, that integrates environment and health as non-dichotomic areas. Fossil Health sustains that current notions of human and non-human health revolve around fossil fuel dependencies. Moreover, addressing disequilibria from established health ideals involves fossil-fixes. Fossil Health, therefore, represents causes and consequences of a health conception that has the agency to contribute to the functioning of a particular structural eco-social model. Moreover, within current capitalist relations, Fossil Health expands its meaning to cover not only fossil implications but also other dominant paradigms of the capitalist system that are (re)produced through health paradigms, such as the burgeoning of technoscience and biomedicalization, privatization of health, expertization of health, or the imposing of standards of uniformity. Overall, Fossil Health is a comprehensive approach to environment and health, where understanding hegemonic health paradigms means understanding our (human-non-human) nature paradigms and the structuring effect these narratives convey.

Keywords: fossil health, environment, paradigm, capitalism

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9244 Computational Prediction of the Effect of S477N Mutation on the RBD Binding Affinity and Structural Characteristic, A Molecular Dynamics Study

Authors: Mohammad Hossein Modarressi, Mozhgan Mondeali, Khabat Barkhordari, Ali Etemadi

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The COVID-19 pandemic, caused by SARS-CoV-2, has led to significant concerns worldwide due to its catastrophic effects on public health. The SARS-CoV-2 infection is initiated with the binding of the receptor-binding domain (RBD) in its spike protein to the ACE2 receptor in the host cell membrane. Due to the error-prone entity of the viral RNA-dependent polymerase complex, the virus genome, including the coding region for the RBD, acquires new mutations, leading to the appearance of multiple variants. These variants can potentially impact transmission, virulence, antigenicity and evasive immune properties. S477N mutation located in the RBD has been observed in the SARS-CoV-2 omicron (B.1.1. 529) variant. In this study, we investigated the consequences of S477N mutation at the molecular level using computational approaches such as molecular dynamics simulation, protein-protein interaction analysis, immunoinformatics and free energy computation. We showed that displacement of Ser with Asn increases the stability of the spike protein and its affinity to ACE2 and thus increases the transmission potential of the virus. This mutation changes the folding and secondary structure of the spike protein. Also, it reduces antibody neutralization, raising concern about re-infection, vaccine breakthrough and therapeutic values.

Keywords: S477N, COVID-19, molecular dynamic, SARS-COV2 mutations

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9243 The Relationship of Weight Regain with Biochemical and Psychological Factors in Non Postmenopausal Women

Authors: Farzad Shidfar, Najmeh Rostami, Ziaodin Mazhari, Fatemeh Hosseini Baharanchi

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Background and Aim: The rate of failure to maintain a reduced weight has been increased. By definition, people who regain about one-third to two-thirds of their lost weight after one year from the end of the dietary treatment and return all the lost weight after 5 years it is called weight regain. This study was performed to find the causes of weight regain and its relationship with biochemical and psychological factors. Materials and Methods: This cross-sectional study was performed by reviewing the files of people who followed the dietary treatment in 1397-1398.seventy-three persons was in the weight regain group, and seventy-three people were in the weight maintenance group. Psychological factors such as depression, anxiety, quality of life, physical activity, and dietary frequency were assessed through a questionnaire, and biochemical factors such as serum insulin and fasting blood sugar were measured. The mean basal energy in the weight regain group was significantly higher than the weight maintenance group (p = 0.004). There was no significant difference between the two groups in terms of food intake and inflammatory index of food. There was no significant difference between the two groups in terms of food intake and inflammatory index of food. Mean serum insulin concentration (p = 0.023), mean fasting blood sugar (p = 0.04) and insulin resistance (p = 0.013) in the weight regain group were higher than the weight maintenance group. The weight maintenance group showed higher insulin sensitivity than the weight regain group (p = 0.005). There was no significant difference between the two groups in terms of psychological indicators. Conclusion: The only body mass index after one year from the end of the treatment period, insulin sensitivity, serum insulin concentration, fasting blood sugar, insulin resistance, selenium intake, and basal energy expenditure Specific and significant with weight regain. However, the significance of insulin resistance, basal energy expenditure, and body mass index after one year from the end of the treatment period was higher than other variables in the weight regain group.

Keywords: body weight maintenance, weight regain, insulin resistance, insulin sensitivity

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9242 Defining the Push and Pull Factors to Adopt Health Information Technologies by Health Entrepreneurs

Authors: Elaheh Ezami, Behzad Mohammadian, Elham Aznab

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Health service design will need to change due to bringing in new digital health tools. This highlights the importance of innovation in adopting Health Information Technology (HIT). It can be argued that innovation in the health sector correlates with entrepreneurship. Various reasons exist for health entrepreneurs to advocate increased investment in HIT to compensate for shortcomings in the health sector and improve the quality of healthcare. Furthermore, every innovative program presents challenges and motivations for entrepreneurs that may distract or encourage the adoption of technology. Our study used a systematic literature review to identify relevant articles that defined the frustrations and promotions of using health information technology in organizations or enterprises. A meta-analysis of the articles was conducted to identify the factors driving or pulling entrepreneurs to use HIT.

Keywords: health information technology, health entrepreneurship, health enterprise, health entrepreneurs' innovation

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9241 Residual Life Prediction for a System Subject to Condition Monitoring and Two Failure Modes

Authors: Akram Khaleghei, Ghosheh Balagh, Viliam Makis

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In this paper, we investigate the residual life prediction problem for a partially observable system subject to two failure modes, namely a catastrophic failure and a failure due to the system degradation. The system is subject to condition monitoring and the degradation process is described by a hidden Markov model with unknown parameters. The parameter estimation procedure based on an EM algorithm is developed and the formulas for the conditional reliability function and the mean residual life are derived, illustrated by a numerical example.

Keywords: partially observable system, hidden Markov model, competing risks, residual life prediction

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9240 Exercise Training for Management Hypertensive Patients: A Systematic Review and Meta-Analysis

Authors: Noor F. Ilias, Mazlifah Omar, Hashbullah Ismail

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Exercise training has been shown to improve functional capacity and is recommended as a therapy for management of blood pressure. Our purpose was to establish whether different exercise capacity produces different effect size for Cardiorespiratory Fitness (CRF), systolic (SBP) and diastolic (DBP) blood pressure in patients with hypertension. Exercise characteristic is required in order to have optimal benefit from the training, but optimal exercise capacity is still unwarranted. A MEDLINE search (1985 to 2015) was conducted for exercise based rehabilitation trials in hypertensive patients. Thirty-seven studies met the selection criteria. Of these, 31 (83.7%) were aerobic exercise and 6 (16.3%) aerobic with additional resistance exercise, providing a total of 1318 exercise subjects and 819 control, the total of subjects was 2137. We calculated exercise volume and energy expenditure through the description of exercise characteristics. 4 studies (18.2%) were 451kcal - 900 kcal, 12 (54.5%) were 900 kcal – 1350 kcal and 6 (27.3%) >1351kcal per week. Peak oxygen consumption (peak VO2) increased by mean difference of 1.44 ml/kg/min (95% confidence interval [CI]: 1.08 to 1.79 ml/kg/min; p = 0.00001) with weighted mean 21.2% for aerobic exercise compare to aerobic with additional resistance exercise 4.50 ml/kg/min (95% confidence interval [CI]: 3.57 to 5.42 ml/kg/min; p = 0.00001) with weighted mean 14.5%. SBP was clinically reduce for both aerobic and aerobic with resistance training by mean difference of -4.66 mmHg (95% confidence interval [CI]: -5.68 to -3.63 mmHg; p = 0.00001) weighted mean 6% reduction and -5.06 mmHg (95% confidence interval [CI]: -7.32 to -2.8 mmHg; p = 0.0001) weighted mean 5% reduction respectively. Result for DBP was clinically reduce for aerobic by mean difference of -1.62 mmHg (95% confidence interval [CI]: -2.09 to -1.15 mmHg; p = 0.00001) weighted mean 4% reduction and aerobic with resistance training reduce by mean difference of -3.26 mmHg (95% confidence interval [CI]: -4.87 to -1.65 mmHg; p = 0.0001) weighted mean 6% reduction. Optimum exercise capacity for 451 kcal – 900 kcal showed greater improvement in peak VO2 and SBP by 2.76 ml/kg/min (95% confidence interval [CI]: 1.47 to 4.05 ml/kg/min; p = 0.0001) with weighted mean 40.6% and -16.66 mmHg (95% confidence interval [CI]: -21.72 to -11.60 mmHg; p = 0.00001) weighted mean 9.8% respectively. Our data demonstrated that aerobic exercise with total volume of 451 kcal – 900 kcal/ week energy expenditure may elicit greater changes in cardiorespiratory fitness and blood pressure in hypertensive patients. Higher exercise capacity weekly does not seem better result in management hypertensive patients.

Keywords: blood Pressure, exercise, hypertension, peak VO2

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9239 Entrepreneurship the Bed Rock and Mainstram of World Economy

Authors: Njeze Anthony

Abstract:

In the world economy, entrepreneurship is an outstanding venture. Failures in the businesses of over 70% of Entrepreneurs can be attributed to lack of proper planning. For an entrepreneur to succeed, there are some vital planning strategies that will come into play such as organizational, operational, financial and marketing plans. When an entrepreneur lacks the above mentioned, such an entrepreneur is bound to encounter a catastrophic failure. An entrepreneur with an adequate plan will examine his/her own goals, know why he is in business, look at the venture resource base, have a sound knowledge of his proposed venture and identify obstacles that will be surmounted to achieve the desired goals. This work is aimed at identifying the organizational, operational, financial and marketing impact of entrepreneurship in the world economy and as well the important issues in global entrepreneurship, possible obstacles, and solutions.

Keywords: economy, entrepreneurship, business, operation

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9238 Stress Corrosion Cracking, Parameters Affecting It, Problems Caused by It and Suggested Methods for Treatment: State of the Art

Authors: Adnan Zaid

Abstract:

Stress corrosion cracking (SCC) may be defined as a degradation of the mechanical properties of a material under the combined action of a tensile stress and corrosive environment of the susceptible material. It is a harmful phenomenon which might cause catastrophic fracture without a sign of prior warning. In this paper, the stress corrosion cracking, SCC, process, the parameters affecting it, and the different damages caused by it are given and discussed. Utilization of shot peening as a mean of enhancing the resistance of materials to SCC is given and discussed. Finally, a method for improving materials resistance to SCC by grain refining its structure by some refining elements prior to usage is suggested.

Keywords: stress corrosion cracking, parameters, damages, treatment methods

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9237 Resilience of Infrastructure Networks: Maintenance of Bridges in Mountainous Environments

Authors: Lorenza Abbracciavento, Valerio De Biagi

Abstract:

Infrastructures are key elements to ensure the operational functionality of the transport system. The collapse of a single bridge or, equivalently, a tunnel can leads an entire motorway to be considered completely inaccessible. As a consequence, the paralysis of the communications network determines several important drawbacks for the community. Recent chronicle events have demonstrated that ensuring the functional continuity of the strategic infrastructures during and after a catastrophic event makes a significant difference in terms of life and economical losses. Moreover, it has been observed that RC structures located in mountain environments show a worst state of conservation compared to the same typology and aging structures located in temperate climates. Because of its morphology, in fact, the mountain environment is particularly exposed to severe collapse and deterioration phenomena, generally: natural hazards, e.g. rock falls, and meteorological hazards, e.g. freeze-thaw cycles or heavy snows. For these reasons, deep investigation on the characteristics of these processes becomes of fundamental importance to provide smart and sustainable solutions and make the infrastructure system more resilient. In this paper, the design of a monitoring system in mountainous environments is presented and analyzed in its parts. The method not only takes into account the peculiar climatic conditions, but it is integrated and interacts with the environment surrounding.

Keywords: structural health monitoring, resilience of bridges, mountain infrastructures, infrastructural network, maintenance

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9236 Impact of Microbial Pathogen on Aquatic Environment

Authors: Muhammad Younis Laghari

Abstract:

Global climate change has had many effects on the aquatic environment, and the major issue is pollution. Along with the other pollutants, there are a significant number of human microbial pathogens that pollute the water bodies. Another concern about the water quality is that the major aquatic resources bring water-borne pathogens and other related diseases. These resources include industrial effluent, untreated domestic sewage, acid mine drainage, etc. However, these water discharges through various routes may have treatment to eliminate the pathogenic microbes. Therefore, it is essential to control the leakage from sewer systems, residential discharge, and agricultural run-off. These pathogenic microbes have been implicated in the lives of water health (fishes), which is harmful and causes diseases. Mostly, the mortality of aquatic species results because of catastrophic floods due to poor water waste treatment and sanitation that introduce pathogenic bacteria into rivers. Pathogens survive in rivers and remain poorly known but essential to control water-borne diseases. The presence of bacteria in watercourses is diverse and constitutes a complicated subject. Many species are autochthonous and play an important role in aquatic ecosystems, while many others arise from untreated or poorly treated waste from industrial and domestic sources. Further, more investigation is required to know the induction of water-borne pathogens in various water resources and the potential impacts of water resource development on pathogen contamination.

Keywords: microbial pathogens, contamination, water resources, river water body

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9235 Australian Football Supporters Engagement Patterns; Manchester United vs a-League

Authors: Trevor R. Higgins, Ben Lopez

Abstract:

Australian football fans have a tendency to indulge in foreign football clubs, often assigning a greater value to foreign clubs, in preference to the Australian National football competition; the A-League. There currently exists a gap in the knowledge available in relation to football fans in Australia, their engagement with foreign football teams and the impact that this may have with their engagement with A-League. The purpose of this study was to compare the engagement of the members of the Manchester United Supporters Club - Australia (MUSC-Aus) with Manchester United and the A-League. An online survey was implemented to gather the relevant data from members of the MUSC-Aus. Results from completed surveys were collected, and analyzed in relation to engagement levels with Manchester United and the A-League. Members of MUSC-Aus who responded to the survey were predominantly male (94%) and born in Australia (46%), England (25%), Ireland (7%), were greatly influenced in their choice of Manchester United by family (43%) and team history (16%), whereas location was the overwhelming influence in supporting the A-League (88%). Importantly, there was a reduced level of engagement in the A-League on two accounts. Firstly, only 64% of MUSC-Aus engaged with the A-League, reporting perceptions of low standard as the major reason (50%). Secondly, MUSC-Aus members who engaged in the A-League reported reduced engagement in the A-League, identified through spending patterns. MUSC-Aus members’ expenditure on Manchester United engagement was 400% greater than expenditure on A-League engagement. Furthermore, additional survey responses indicated that the level of commitment towards the A-League overall was less than Manchester United. The greatest impact on fan engagement in the A-League by MUSC-Aus can be attributed to several primary factors; family support, team history and perceptions to on-field performance and quality of players. Currently, there is little that can be done in regards to enhancing family and history as the A-League is still in its infancy. Therefore, perceptions of on-field performances and player quality should be addressed. Introducing short-term international marquee contracts to A-League rosters, across the entire competition, may provide the platform to raise the perception of the A-League player quality with minimal impact on local player development. In addition, a national marketing campaign promoting the success of A-League clubs in the ACL, as well as promoting the skill on display in the A-League may address the negative association with the standard of the A-League competition.

Keywords: engagement, football, perceptions of performance, team

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9234 Economic Cost of Malaria: A Threat to Household Income in Nigeria

Authors: Nsikan Affiah, Kayode Osungbade, Williams Uzoma

Abstract:

Malaria remains one of the major killers of humans worldwide, threatening the lives of more than one-third of the world’s population. Some people refers it to; a disease of poverty because it contributes towards national poverty through its impact on foreign direct investment, tourism, labour productivity, and trade. At the micro level, it may cause poverty through spending on health care, income losses, and premature deaths. Unfortunately, malaria is a disease that affects both low-income household and its high-income counterpart, but low-income households are still at greater risk because significant part of the available monthly income is dedicated to various preventive and treatment measures. The objective of this study is to estimate direct and indirect cost of malaria treatment in households in a section of South-South Region (Akwa Ibom State) of Nigeria. A cross-sectional study of Six Hundred and Forty (640) heads of households or any adult representative of households in three local government areas of Akwa Ibom State, Nigeria from May 1-31, 2015 were ascertained through interviewer-administered questionnaire adapted from Nigerian Malaria Indicator Survey Report. The clustering technique was used to select 640 households with the help of Primary Health Care (PHC) house numbering system. Using exchange rate of 197 Naira/USD, result shows that direct cost of malaria treatment was 8,894.44 USD while the indirect cost of malaria treatment was 11,012.81 USD. Total cost of treatment made up of 44.7% direct cost and 55.3% indirect cost, with average direct cost of malaria treatment per household estimated at 20.6 USD and the average indirect cost of treatment per household estimated at 25.1 USD. Average total cost for each episode (888) of malaria was estimated at 22.4 USD. While at household level, the average total cost was estimated at 45.5 USD. From the average total cost, low-income households would spend 36% of monthly household income on treating malaria and the impact could be said to be catastrophic, compared to high-income households where only 1.2% of monthly household income is spent on malaria treatment. It could be concluded that the cost of malaria treatment is well beyond the means of households and given the reality of repeated bouts of malaria and its contribution to the impoverishment of households, there is a need for urgent action.

Keywords: direct cost, indirect cost, low income households, malaria

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9233 The Effect of Affirmative Action in Private Schools on Education Expenditure in India: A Quasi-Experimental Approach

Authors: Athira Vinod

Abstract:

Under the Right to Education Act (2009), the Indian government introduced an affirmative action policy aimed at the reservation of seats in private schools at the entry-level and free primary education for children from lower socio-economic backgrounds. Using exogenous variation in the status of being in a lower social category (disadvantaged groups) and the year of starting school, this study investigates the effect of exposure to the policy on the expenditure on private education. It employs a difference-in-difference strategy with the help of repeated cross-sectional household data from the National Sample Survey (NSS) of India. It also exploits regional variation in exposure by combining the household data with administrative data on schools from the District Information System for Education (DISE). The study compares the outcome across two age cohorts of disadvantaged groups, starting school at different times, that is, before and after the policy. Regional variation in exposure is proxied with a measure of enrolment rate under the policy, calculated at the district level. The study finds that exposure to the policy led to an average reduction in annual private school fees of ₹223. Similarly, a 5% increase in the rate of enrolment under the policy in a district was associated with a reduction in annual private school fees of ₹240. Furthermore, there was a larger effect of the policy among households with a higher demand for private education. However, the effect is not due to fees waived through direct enrolment under the policy but rather an increase in the supply of low-fee private schools in India. The study finds that after the policy, 79,870 more private schools entered the market due to an increased demand for private education. The new schools, on average, charged a lower fee than existing schools and had a higher enrolment of children exposed to the policy. Additionally, the district-level variation in the enrolment under the policy was very strongly correlated with the entry of new schools, which not only charged a low fee but also had a higher enrolment under the policy. Results suggest that few disadvantaged children were admitted directly under the policy, but many were attending private schools, which were largely low-fee. This implies that disadvantaged households were willing to pay a lower fee to secure a place in a private school even if they did not receive a free place under the policy.

Keywords: affirmative action, disadvantaged groups, private schools, right to education act, school fees

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9232 An Attempt of Cost Analysis of Heart Failure Patients at Cardiology Department at Kasr Al Aini Hospitals: A Micro-Costing Study from Social Perspective

Authors: Eman Elsebaie, A. Sedrak, R. Ziada

Abstract:

Introduction: In the recent decades, heart failure (HF) has become one of the most prevalent cardio-vascular disease (CVDs), especially in the elderly and the main cause of hospitalization in Egypt cardiology departments. By 2030, the prevalence of HF is expected to increase by 25%. Total direct costs will increase to $818 billion, and the total indirect cost in terms of lost productivity is close to $275 billion. The current study was conducted to estimate the economic costs of services delivered for heart failure patients at the cardiology department in Cairo University Hospitals (CUHs). Aim: To gain an understanding of the cost of heart failure disease and its main drivers aiming to minimize associated health care costs. Subjects and Methods: Economic cost analysis study was conducted for a prospective group of all cases of HF admitted to the cardiology department in CUHs from end of March till end of April 2016 and another retrospective randomized sample from patients with HF, during the first 3 months of 2016 to measure estimated average cost per patient per day. Results: The mean age of the prospective group was 48.6 ± 17.16 years versus 52.3 ± 11.5 years for the retrospective group. The median (IQR) of Length of stay was 15 (15) days in the prospective group versus 9 (16) days in the retrospective group. The average HF inpatient cost/day in the cardiology department during April 2016 was 362.32 (255.5) L.E. versus 391.2(255.9) L.E. during January and February 2016. Conclusion: Up to 70% of expenditure in the management of HF is related to hospital admission. The average cost of such an admission was 5540.03 (IQR=7507.8) L.E. and 4687.4 (IQR=7818.8) L.E. with the average cost per day estimated at 362.32 (IQR=255.5) L.E. and 386.2(IQR=255.9) L.E. in prospective and retrospective groups respectively.

Keywords: health care cost, heart failure, hospitalization, inpatient

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9231 Examining the Behavioral, Hygienic and Expectational Changes in Adolescents and Young Women during COVID-19 Quarantine in Colombia

Authors: Rocio Murad, Marcela Sanchez, Mariana Calderon Jaramillo, Danny Rivera, Angela Cifuentes, Daniela Roldán, Juan Carlos Rivillas

Abstract:

Women and girls have specific health needs, but during health pandemics such as COVID19 they are less likely to have access to quality essential health information, commodities and services, or insurance coverage for routine and catastrophic health expenses, especially in rural and marginalized communities. This is compounded by multiple or intersecting inequalities, such as ethnicity, socioeconomic status, disability, age, geographic location, and sexual orientation, among others. Despite concerted collective action, there is a lack of information on the situation of women, adolescents and youth, including gender inequalities exacerbated by the pandemic. Much more needs to be done to amplify the lived realities of women and adolescents in global and national advocacy and policy responses. The COVID 19 pandemic reflects the need for systematic advocacy policies based on the lived experiences of women and adolescents, underpinned by human rights. This research is part of the initiative of Profamilia Association (Solidarity Study), and its objective is twofold: i) to analyze the behavioral changes and immediate expectations of Colombians during the stage of relaxation of the confinement measures decreed by the national government; and ii) to identify the needs, experiences and resilient practices of adolescents and young women during the COVID-19 crisis in Colombia. Descriptive analysis of data collected by Profamilia through the Solidaridad study, an exploratory cross-sectional descriptive study that used subnational level data from a nonprobabilistic sample survey conducted to 1735 adults, between September 01 and 11, 2020. Interviews were conducted with key stakeholders about their experiences during COVID19, under three key axes: i) main challenges for adolescents and young women; ii) examples of what has worked well in responding to the challenge; and iii) how/what services are/should be provided during COVID-19 (and beyond) to address the challenge. Interviewees were selected based on prior mapping of social groups of interest. In total, 23 adolescents and young women participated in the interviews. The results show that people adopted behavioral changes such as wearing masks, avoiding people with symptoms, and reducing mobility, but there was also a doubling of concerns for many reasons, from effects on mental health, sexual health, and unattended reproductive health to the burden of care and working at home. The favorable perception that people had at the beginning of the quarantine about the response and actions of the national and local government to control Covid-19 decreased over the course of the quarantine. The challenges and needs of adolescents and young women were highlighted during the most restrictive measures to contain the COVID-19 pandemic, which resulted in disruptions to daily activities, education and work, as well as restrictions to mobility and social interaction. Concerns raised by participants included: impact on mental health and wellbeing due to disruption of daily life; limitations in access to formal and informal education; food insecurity; migration; loss of livelihoods; lack of access to health information and services; limitations to sexual and reproductive health and rights; insecurity problems; and problems in communication and treatment among household members.

Keywords: COVID-19, changes in behavior, adolescents, women

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