Search results for: occupational risk factors
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15350

Search results for: occupational risk factors

13820 Frailty Patterns in the US and Implications for Long-Term Care

Authors: Joelle Fong

Abstract:

Older persons are at greatest risk of becoming frail. As survival to the age of 80 and beyond continues to increase, the health and frailty of older Americans has garnered much recent attention among policy makers and healthcare administrators. This paper examines patterns in old-age frailty within a multistate actuarial model that characterizes the stochastic process of biological ageing. Using aggregate population-level U.S. mortality data, we implement a stochastic aging model to examine cohort trends and gender differences in frailty distributions for older Americans born 1865 – 1894. The stochastic ageing model, which draws from the fields of actuarial science and gerontology, is well-established in the literature. The implications for public health insurance programs are also discussed. Our results suggest that, on average, women tend to be frailer than men at older ages and reveal useful insights about the magnitude of the male-female differential at critical age points. Specifically, we note that the frailty statuses of males and females are actually quite comparable from ages 65 to 80. Beyond age 80, however, the frailty levels start to diverge considerably implying that women are moving quicker into worse states of health than men. Tracking average frailty by gender over 30 successive birth cohorts, we also find that frailty levels for both genders follow a distinct peak-and-trough pattern. For instance, frailty among 85-year old American survivors increased in years 1954-1963, decreased in years 1964-1971, and again started to increase in years 1972-1979. A number of factors may have accounted for these cohort differences including differences in cohort life histories, differences in disease prevalence, differences in lifestyle and behavior, differential access to medical advances, as well as changes in environmental risk factors over time. We conclude with a discussion on the implications of our findings on spending for long-term care programs within the broader health insurance system.

Keywords: actuarial modeling, cohort analysis, frail elderly, health

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13819 Performance of Shariah-Based Investment: Evidence from Pakistani Listed Firms

Authors: Mohsin Sadaqat, Hilal Anwar Butt

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Following the stock selection guidelines provided by the Sharia Board (SB), we segregate the firms listed at Pakistan Stock Exchange (PSX) into Sharia Compliant (SC) and Non-Sharia Compliant (NSC) stocks. Subsequently, we form portfolios within each group based on market capitalization and volatility. The purpose is to analyze and compare the performance of these two groups as the SC stocks have lesser diversification opportunities due to SB restrictions. Using data ranging from January 2004 until June 2016, our results indicate that in most of the cases the risk-adjusted returns (alphas) for the returns differential between SC and NCS firms are positive. In addition, the SC firms in comparison to their counterparts in PSX provides excess returns that are hedged against the market, size, and value-based systematic risks factors. Overall, these results reconcile with one prevailing notion that the SC stocks that have lower financial leverage and higher investment in real assets are lesser exposed to market-based risks. Further, the SC firms that are more capitalized and less volatile, perform better than lower capitalized and higher volatile SC and NSC firms. To sum up our results, we do not find any substantial evidence for opportunity loss due to limited diversification opportunities in case of SC firms. To optimally utilize scarce resources, investors should consider SC firms as a candidate in portfolio construction.

Keywords: diversification, performance, sharia compliant stocks, risk adjusted returns

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13818 Integrated Clean Development Mechanism and Risk Management Approach for Infrastructure Transportation Project

Authors: Debasis Sarkar

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Clean development mechanism (CDM) can act as an effective instrument for mitigating climate change. This mechanism can effectively reduce the emission of CO2 and other green house gases (GHG). Construction of a mega infrastructure project like underground corridor construction for metro rail operation involves in consumption of substantial quantity of concrete which consumes huge quantity of energy consuming materials like cement and steel. This paper is an attempt to develop an integrated clean development mechanism and risk management approach for sustainable development for an underground corridor metro rail project in India during its construction phase. It was observed that about 35% reduction in CO2 emission can be obtained by adding fly ash as a part replacement of cement. The reduced emission quantity of CO2 which is of the quantum of about 21,646.36 MT would result in cost savings of approximately INR 8.5 million (USD 1,29,878).But construction and operation of such infrastructure projects of the present era are subject to huge risks and uncertainties throughout all the phases of the project, thus reducing the probability of successful completion of the project within stipulated time and cost frame. Thus, an integrated approach of combining CDM with risk management would enable the metro rail authorities to develop a sustainable risk mitigation measure framework to ensure more cost and energy savings and lesser time and cost over-run.

Keywords: clean development mechanism (CDM), infrastructure transportation, project risk management, underground metro rail

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13817 Climate Change Adaptation in the U.S. Coastal Zone: Data, Policy, and Moving Away from Moral Hazard

Authors: Thomas Ruppert, Shana Jones, J. Scott Pippin

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State and federal government agencies within the United States have recently invested substantial resources into studies of future flood risk conditions associated with climate change and sea-level rise. A review of numerous case studies has uncovered several key themes that speak to an overall incoherence within current flood risk assessment procedures in the U.S. context. First, there are substantial local differences in the quality of available information about basic infrastructure, particularly with regard to local stormwater features and essential facilities that are fundamental components of effective flood hazard planning and mitigation. Second, there can be substantial mismatch between regulatory Flood Insurance Rate Maps (FIRMs) as produced by the National Flood Insurance Program (NFIP) and other 'current condition' flood assessment approaches. This is of particular concern in areas where FIRMs already seem to underestimate extant flood risk, which can only be expected to become a greater concern if future FIRMs do not appropriately account for changing climate conditions. Moreover, while there are incentives within the NFIP’s Community Rating System (CRS) to develop enhanced assessments that include future flood risk projections from climate change, the incentive structures seem to have counterintuitive implications that would tend to promote moral hazard. In particular, a technical finding of higher future risk seems to make it easier for a community to qualify for flood insurance savings, with much of these prospective savings applied to individual properties that have the most physical risk of flooding. However, there is at least some case study evidence to indicate that recognition of these issues is prompting broader discussion about the need to move beyond FIRMs as a standalone local flood planning standard. The paper concludes with approaches for developing climate adaptation and flood resilience strategies in the U.S. that move away from the social welfare model being applied through NFIP and toward more of an informed risk approach that transfers much of the investment responsibility over to individual private property owners.

Keywords: climate change adaptation, flood risk, moral hazard, sea-level rise

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13816 The Effects of the Parent Training Program for Obesity Reduction on Child Waist Circumference and Health Behaviors of Pre-School Children at the Samut-Songkhram Kindergarten School, Samut-Songkhram Province, Thailand

Authors: Muntanavadee Maytapattana

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This research aims to study the effects of the Parent Training Program for Obesity Reduction (PTPOR) on child waist circumference and health behaviors of pre-school children at the Samut-Songkhram kindergarten school, Samut-Songkhram province, Thailand. The objective of this research is to evaluate the effectiveness of the PTPOR on child waist circumference and health behaviors of the pre-school children. The conceptual framework of this study is developed on the basis of the Ecological Systems Theory (EST), not only do the individual factors such as child characteristics and child risk factors contribute to the child’s weight status, but also other factors such as parenting style and family characteristics, as well as community and demographic factors. This research is a quasi-experimental study. Participants were pre-school overweight and obese children and their parents. Forty-one parent-child dyads were recruited into the program. Parents participated in two sessions including an educational session and a group discussion session. Research methodology uses Paired-Samples t-test to determine the difference between groups in the mean scores of the outcome variables of the children and parents. The research results show that there was significant difference between child waist circumferences mean score at the baseline and finishing the program at the 0.01 level (p = 0.001), mean score of the child waist circumference was decrease after finishing the program. And there was no significant difference between child exercise health behaviors mean score at the baseline and finishing the program at the 0.05 level; however, mean score of the child exercise behavior was increase after finishing the program. Meanwhile, there was significant difference between child dietary health behavior mean score at the baseline and finishing the program at the 0.01 level (p = 0.001), mean score of the child dietary was increase after finishing the program.

Keywords: PTPOR, child waist circumference, child health behaviors, pre-school children

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13815 Investigating the Impact of Individual Risk-Willingness and Group-Interaction Effects on Business Model Innovation Decisions

Authors: Sarah Müller-Sägebrecht

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Today’s volatile environment challenges executives to make the right strategic decisions to gain sustainable success. Entrepreneurship scholars postulate mainly positive effects of environmental changes on entrepreneurship behavior, such as developing new business opportunities, promoting ingenuity, and the satisfaction of resource voids. A strategic solution approach to overcome threatening environmental changes and catch new business opportunities is business model innovation (BMI). Although this research stream has gained further importance in the last decade, BMI research is still insufficient. Especially BMI barriers, such as inefficient strategic decision-making processes, need to be identified. Strategic decisions strongly impact organizational future and are, therefore, usually made in groups. Although groups draw on a more extensive information base than single individuals, group-interaction effects can influence the decision-making process - in a favorable but also unfavorable way. Decisions are characterized by uncertainty and risk, whereby their intensity is perceived individually differently. Individual risk-willingness influences which option humans choose. The special nature of strategic decisions, such as in BMI processes, is that these decisions are not made individually but in groups due to their high organizational scope. These groups consist of different personalities whose individual risk-willingness can vary considerably. It is known from group decision theory that these individuals influence each other, observable in different group-interaction effects. The following research questions arise: i) Which impact has the individual risk-willingness on BMI decisions? And ii) how do group interaction effects impact BMI decisions? After conducting 26 in-depth interviews with executives from the manufacturing industry, the applied Gioia methodology reveals the following results: i) Risk-averse decision-makers have an increased need to be guided by facts. The more information available to them, the lower they perceive uncertainty and the more willing they are to pursue a specific decision option. However, the results also show that social interaction does not change the individual risk-willingness in the decision-making process. ii) Generally, it could be observed that during BMI decisions, group interaction is primarily beneficial to increase the group’s information base for making good decisions, less than for social interaction. Further, decision-makers mainly focus on information available to all decision-makers in the team but less on personal knowledge. This work contributes to strategic decision-making literature twofold. First, it gives insights into how group-interaction effects influence an organization’s strategic BMI decision-making. Second, it enriches risk-management research by highlighting how individual risk-willingness impacts organizational strategic decision-making. To date, it was known in BMI research that risk aversion would be an internal BMI barrier. However, with this study, it becomes clear that it is not risk aversion that inhibits BMI. Instead, the lack of information prevents risk-averse decision-makers from choosing a riskier option. Simultaneously, results show that risk-averse decision-makers are not easily carried away by the higher risk-willingness of their team members. Instead, they use social interaction to gather missing information. Therefore, executives need to provide sufficient information to all decision-makers to catch promising business opportunities.

Keywords: business model innovation, decision-making, group biases, group decisions, group-interaction effects, risk-willingness

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13814 Risk Management in Industrial Supervision Projects

Authors: Érick Aragão Ribeiro, George André Pereira Thé, José Marques Soares

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Several problems in industrial supervision software development projects may lead to the delay or cancellation of projects. These problems can be avoided or contained by using identification methods, analysis and control of risks. These procedures can give an overview of the possible problems that can happen in the projects and what are the immediate solutions. Therefore, we propose a risk management method applied to the teaching and development of industrial supervision software. The method is developed through a literature review and previous projects can be divided into phases of management and have basic features that are validated with experimental research carried out by mechatronics engineering students and professionals. The management is conducted through the stages of identification, analysis, planning, monitoring, control and communication of risks. Programmers use a method of prioritizing risks considering the gravity and the possibility of occurrence of the risk. The outputs of the method indicate which risks occurred or are about to happen. The first results indicate which risks occur at different stages of the project and what risks have a high probability of occurring. The results show the efficiency of the proposed method compared to other methods, showing the improvement of software quality and leading developers in their decisions. This new way of developing supervision software helps students identify design problems, evaluate software developed and propose effective solutions. We conclude that the risk management optimizes the development of the industrial process control software and provides higher quality to the product.

Keywords: supervision software, risk management, industrial supervision, project management

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13813 Effective Design Factors for Bicycle-Friendly Streets

Authors: Zohreh Asadi-Shekari, Mehdi Moeinaddini, Muhammad Zaly Shah, Amran Hamzah

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Bicycle level of service (BLOS) is a measure for evaluating street conditions for cyclists. Currently, various methods are proposed for BLOS. These analytical methods however have some drawbacks: they usually assume cyclists as users that can share street facilities with motorized vehicles, it is not easy to link them to design process and they are not easy to follow. In addition, they only support a narrow range of cycling facilities and may not be applicable for all situations. Along this, the current paper introduces various effective design factors for bicycle-friendly streets. This study considers cyclists as users of streets who have special needs and facilities. Therefore, the key factors that influence BLOS based on different cycling facilities that are proposed by developed guidelines and literature are identified. The combination of these factors presents a complete set of effective design factors for bicycle-friendly streets. In addition, the weight of each factor in existing BLOS models is estimated and these effective factors are ranked based on these weights. These factors and their weights can be used in further studies to propose special bicycle-friendly street design model.

Keywords: bicycle level of service, bicycle-friendly streets, cycling facilities, rating system, urban streets

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13812 Neural Network based Risk Detection for Dyslexia and Dysgraphia in Sinhala Language Speaking Children

Authors: Budhvin T. Withana, Sulochana Rupasinghe

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The educational system faces a significant concern with regards to Dyslexia and Dysgraphia, which are learning disabilities impacting reading and writing abilities. This is particularly challenging for children who speak the Sinhala language due to its complexity and uniqueness. Commonly used methods to detect the risk of Dyslexia and Dysgraphia rely on subjective assessments, leading to limited coverage and time-consuming processes. Consequently, delays in diagnoses and missed opportunities for early intervention can occur. To address this issue, the project developed a hybrid model that incorporates various deep learning techniques to detect the risk of Dyslexia and Dysgraphia. Specifically, Resnet50, VGG16, and YOLOv8 models were integrated to identify handwriting issues. The outputs of these models were then combined with other input data and fed into an MLP model. Hyperparameters of the MLP model were fine-tuned using Grid Search CV, enabling the identification of optimal values for the model. This approach proved to be highly effective in accurately predicting the risk of Dyslexia and Dysgraphia, providing a valuable tool for early detection and intervention. The Resnet50 model exhibited a training accuracy of 0.9804 and a validation accuracy of 0.9653. The VGG16 model achieved a training accuracy of 0.9991 and a validation accuracy of 0.9891. The MLP model demonstrated impressive results with a training accuracy of 0.99918, a testing accuracy of 0.99223, and a loss of 0.01371. These outcomes showcase the high accuracy achieved by the proposed hybrid model in predicting the risk of Dyslexia and Dysgraphia.

Keywords: neural networks, risk detection system, dyslexia, dysgraphia, deep learning, learning disabilities, data science

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13811 Screening for Women with Chorioamnionitis: An Integrative Literature Review

Authors: Allison Herlene Du Plessis, Dalena (R.M.) Van Rooyen, Wilma Ten Ham-Baloyi, Sihaam Jardien-Baboo

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Introduction: Women die in pregnancy and childbirth for five main reasons—severe bleeding, infections, unsafe abortions, hypertensive disorders (pre-eclampsia and eclampsia), and medical complications including cardiac disease, diabetes, or HIV/AIDS complicated by pregnancy. In 2015, WHO classified sepsis as the third highest cause for maternal mortalities in the world. Chorioamnionitis is a clinical syndrome of intrauterine infection during any stage of the pregnancy and it refers to ascending bacteria from the vaginal canal up into the uterus, causing infection. While the incidence rates for chorioamnionitis are not well documented, complications related to chorioamnionitis are well documented and midwives still struggle to identify this condition in time due to its complex nature. Few diagnostic methods are available in public health services, due to escalated laboratory costs. Often the affordable biomarkers, such as C-reactive protein CRP, full blood count (FBC) and WBC, have low significance in diagnosing chorioamnionitis. A lack of screening impacts on effective and timeous management of chorioamnionitis, and early identification and management of risks could help to prevent neonatal complications and reduce the subsequent series of morbidities and healthcare costs of infants who are health foci of perinatal infections. Objective: This integrative literature review provides an overview of current best research evidence on the screening of women at risk for chorioamnionitis. Design: An integrative literature review was conducted using a systematic electronic literature search through EBSCOhost, Cochrane Online, Wiley Online, PubMed, Scopus and Google. Guidelines, research studies, and reports in English related to chorioamnionitis from 2008 up until 2020 were included in the study. Findings: After critical appraisal, 31 articles were included. More than one third (67%) of the literature included ranked on the three highest levels of evidence (Level I, II and III). Data extracted regarding screening for chorioamnionitis was synthesized into four themes, namely: screening by clinical signs and symptoms, screening by causative factors of chorioamnionitis, screening of obstetric history, and essential biomarkers to diagnose chorioamnionitis. Key conclusions: There are factors that can be used by midwives to identify women at risk for chorioamnionitis. However, there are a paucity of established sociological, epidemiological and behavioral factors to screen this population. Several biomarkers are available to diagnose chorioamnionitis. Increased Interleukin-6 in amniotic fluid is the better indicator and strongest predictor of histological chorioamnionitis, whereas the available rapid matrix-metalloproteinase-8 test requires further testing. Maternal white blood cells count (WBC) has shown poor selectivity and sensitivity, and C-reactive protein (CRP) thresholds varied among studies and are not ideal for conclusive diagnosis of subclinical chorioamnionitis. Implications for practice: Screening of women at risk for chorioamnionitis by health care providers providing care for pregnant women, including midwives, is important for diagnosis and management before complications arise, particularly in resource-constraint settings.

Keywords: chorioamnionitis, guidelines, best evidence, screening, diagnosis, pregnant women

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13810 Consumer Behavior in Buying Organic Product: A Case Study of Consumer in the Bangkok Metropolits and Vicinity

Authors: Piluntana Panpluem, Monticha Putsakum

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The objectives of this study were to investigate 1) consumers’ behaviors in buying organic products; and 2) the relationships between personal factors, cultural factors, social factors, psychological factors and marketing mix factors, and the behavior in buying organic products of consumers in the greater Bangkok metropolitan area. The sample group was 400 consumers at the age of 15 and older, who bought organic agricultural products from green markets and green shops in Bangkok, including its suburbs. The data were collected by using a questionnaire, which were analyzed by descriptive statistics and chi-square test. The results showed that the consumers bought 3 – 4 types of fresh vegetables with a total expenditure of less than 499 Baht each time. They purchased organic products mainly at a supermarket, 2 – 4 times per month, most frequently on Sundays, which took less than 30 minutes of shopping each time. The purpose of the purchase was for self-consuming. Gaining or retaining good health was the reason for the consumption of the products. Additionally, the first considered factor in the organic product selection was the quality. The decisions in purchasing the products were made directly by consumers, who were influenced mainly by advertising media on television. For the relationships among personal, cultural, social, psychological and marketing mix factors, and consumers’ behavior in buying organic products, the results showed the following: 1) personal factors, which were gender, age and educational level, were related to the behavior in terms of “What”, “Why”, and “Where” the consumers bought organic products (p<0.05); 2) cultural factors were related to “Why” the consumers bought organic products (p<0.05); 3) social factors were related to “Where” and “How” the consumers bought organic products (p<0.05); 4) psychological factors were related to “When” the consumers bought organic products (p<0.05). 5) For the marketing mix factors, “Product” was related to “Who participated” in buying, “What” and “Where” the consumers bought organic products (p<0.05), while “Price” was related to “What” and “When” the consumers bought organic products (p<0.05). “Place” was related to “What” and “How” the consumers bought organic products (p<0.05). Furthermore, “Promotion” was related to “What” and “Where” the consumers bought organic products (p<0.05).

Keywords: consumer behavior, organic products, Bangkok Metropolis and Vicinity

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13809 Business Intelligence Dashboard Solutions for Improving Decision Making Process: A Focus on Prostate Cancer

Authors: Mona Isazad Mashinchi, Davood Roshan Sangachin, Francis J. Sullivan, Dietrich Rebholz-Schuhmann

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Background: Decision-making processes are nowadays driven by data, data analytics and Business Intelligence (BI). BI as a software platform can provide a wide variety of capabilities such as organization memory, information integration, insight creation and presentation capabilities. Visualizing data through dashboards is one of the BI solutions (for a variety of areas) which helps managers in the decision making processes to expose the most informative information at a glance. In the healthcare domain to date, dashboard presentations are more frequently used to track performance related metrics and less frequently used to monitor those quality parameters which relate directly to patient outcomes. Providing effective and timely care for patients and improving the health outcome are highly dependent on presenting and visualizing data and information. Objective: In this research, the focus is on the presentation capabilities of BI to design a dashboard for prostate cancer (PC) data that allows better decision making for the patients, the hospital and the healthcare system related to a cancer dataset. The aim of this research is to customize a retrospective PC dataset in a dashboard interface to give a better understanding of data in the categories (risk factors, treatment approaches, disease control and side effects) which matter most to patients as well as other stakeholders. By presenting the outcome in the dashboard we address one of the major targets of a value-based health care (VBHC) delivery model which is measuring the value and presenting the outcome to different actors in HC industry (such as patients and doctors) for a better decision making. Method: For visualizing the stored data to users, three interactive dashboards based on the PC dataset have been developed (using the Tableau Software) to provide better views to the risk factors, treatment approaches, and side effects. Results: Many benefits derived from interactive graphs and tables in dashboards which helped to easily visualize and see the patients at risk, better understanding the relationship between patient's status after treatment and their initial status before treatment, or to choose better decision about treatments with fewer side effects regarding patient status and etc. Conclusions: Building a well-designed and informative dashboard is related to three important factors including; the users, goals and the data types. Dashboard's hierarchies, drilling, and graphical features can guide doctors to better navigate through information. The features of the interactive PC dashboard not only let doctors ask specific questions and filter the results based on the key performance indicators (KPI) such as: Gleason Grade, Patient's Age and Status, but may also help patients to better understand different treatment outcomes, such as side effects during the time, and have an active role in their treatment decisions. Currently, we are extending the results to the real-time interactive dashboard that users (either patients and doctors) can easily explore the data by choosing preferred attribute and data to make better near real-time decisions.

Keywords: business intelligence, dashboard, decision making, healthcare, prostate cancer, value-based healthcare

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13808 The Effects of Alpha-Lipoic Acid Supplementation on Post-Stroke Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Authors: Hamid Abbasi, Neda Jourabchi, Ranasadat Abedi, Kiarash Tajernarenj, Mehdi Farhoudi, Sarvin Sanaie

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Background: Alpha lipoic acid (ALA), fat- and water-soluble, coenzyme with sulfuret content, has received considerable attention for its potential therapeutic role in diabetes, cardiovascular diseases, cancers, and central nervous disease. This investigation aims to evaluate the probable protective effects of ALA in stroke patients. Methods: Based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, This meta-analysis was performed. The PICO criteria for this meta-analysis were as follows: Population/Patients (P: stroke patients); Intervention (I: ALA); Comparison (C: control); Outcome (O: blood glucose, lipid profile, oxidative stress, inflammatory factors).In addition, Studies that were excluded from the analysis consisted of in vitro, in vivo, and ex vivo studies, case reports, quasi-experimental studies. Scopus, PubMed, Web of Science, EMBASE databases were searched until August 2023. Results: Of 496 records that were screened in the title/abstract stage, 9 studies were included in this meta-analysis. The sample sizes in the included studies vary between 28 and 90. The result of risk of bias was performed via risk of bias (RoB) in randomized-controlled trials (RCTs) based on the second version of the Cochrane RoB assessment tool. 8 studies had a definitely high risk of bias. Discussion: To the best of our knowledge, The present meta-analysis is the first study addressing the effectiveness of ALA supplementation in enhancing post-stroke metabolic markers, including lipid profile, oxidative stress, and inflammatory indices. It is imperative to acknowledge certain potential limitations inherent in this study. First of all, type of treatment (oral or intravenous infusion) could alter the bioavailability of ALA. Our study had restricted evidence regarding the impact of ALA supplementation on included outcomes. Therefore, further research is warranted to develop into the effects of ALA specifically on inflammation and oxidative stress. Funding: The research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number: 72825). Registration: This study was registered in the International prospective register of systematic reviews (PROSPERO ID: CR42023461612).

Keywords: alpha-lipoic acid, lipid profile, blood glucose, inflammatory factors, oxidative stress, meta-analysis, post-stroke

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13807 Statistical Approach to Identify Stress and Biases Impairing Decision-Making in High-Risk Industry

Authors: Ph. Fauquet-Alekhine

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Decision-making occurs several times an hour when working in high risk industry and an erroneous choice might have undesirable outcomes for people and the environment surrounding the industrial plant. Industrial decisions are very often made in a context of acute stress. Time pressure is a crucial stressor leading decision makers sometimes to boost up the decision-making process and if it is not possible then shift to the simplest strategy. We thus found it interesting to update the characterization of the stress factors impairing decision-making at Chinon Nuclear Power Plant (France) in order to optimize decision making contexts and/or associated processes. The investigation was based on the analysis of reports addressing safety events over the last 3 years. Among 93 reports, those explicitly addressing decision-making issues were identified. Characterization of each event was undertaken in terms of three criteria: stressors, biases impairing decision making and weaknesses of the decision-making process. The statistical analysis showed that biases were distributed over 10 possibilities among which the hypothesis confirmation bias was clearly salient. No significant correlation was found between criteria. The analysis indicated that the main stressor was time pressure and highlights an unexpected form of stressor: the trust asymmetry principle of the expert. The analysis led to the conclusion that this stressor impaired decision-making from a psychological angle rather than from a physiological angle: it induces defensive bias of self-esteem, self-protection associated with a bias of confirmation. This leads to the hypothesis that this stressor can intervene in some cases without being detected, and to the hypothesis that other stressors of the same kind might occur without being detected too. Further investigations addressing these hypotheses are considered. The analysis also led to the conclusion that dealing with these issues implied i) decision-making methods being well known to the workers and automated and ii) the decision-making tools being well known and strictly applied. Training was thus adjusted.

Keywords: bias, expert, high risk industry, stress.

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13806 An Empirical Assessment of Indoor Environmental Quality in Developing Sub-Saharan Countries: Evaluation of Existing Gaps and Potential Risk

Authors: Jean-Paul Kapuya Bulaba Nyembwe, John Omomoluwa Ogundiran, Manuel Carlos Gameiro da Silva

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Indoor environmental quality (IEQ) remains a global concern because it impacts people's comfort, health, performance, and general well-being. People spend a significant amount of time in buildings or while commuting, hence ensuring the minimal risk in indoor spaces by ensuring suitable IEQ. IEQ studies are limited regarding developing sub-Saharan countries, whereas there is also a huge risk and concern for the current population and geometric growth as many cities in the region will become mega-cities by 2040 (World Bank report). The absence of suitable IEQ regulations and energy poverty are reasons to assess the IEQ gaps for increased awareness of sustainable interventions to minimize the associated risk. This study evaluates the gaps and potential hazards that exist in the IEQ of sub-Saharan countries using empirical studies of hospital occupants and BRT bus passengers and drivers. The Surveys were conducted in 3 cities of the Democratic Republic of Congo and Lagos metropolis of Nigeria. The results suggest that gaps exist in IEQ for these regions. The gaps indicate existential risk to people’s health, comfort, and well-being. The inferential conclusions are that there is a need for further scientific studies, improvement in IEQ conditions, and ensuring suitable regulations for developing sub-Saharan countries.

Keywords: health hazards, hospitals indoor environmental quality, indoor spaces, occupants, sub-Saharan countries, vehicles

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13805 Determining Factors for Successful Blended Learning in Higher Education: A Qualitative Study

Authors: Pia Wetzl

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The learning process of students can be optimized by combining online teaching with face-to-face sessions. So-called blended learning offers extensive flexibility as well as contact opportunities with fellow students and teachers. Furthermore, learning can be individualized and self-regulated. The aim of this article is to investigate which factors are necessary for blended learning to be successful. Semi-structured interviews were conducted with students (N = 60) and lecturers (N = 21) from different disciplines at two German universities. The questions focused on the perception of online, face-to-face and blended learning courses. In addition, questions focused on possible optimization potential and obstacles to practical implementation. The results show that on-site presence is very important for blended learning to be successful. If students do not get to know each other on-site, there is a risk of loneliness during the self-learning phases. This has a negative impact on motivation. From the perspective of the lecturers, the willingness of the students to participate in the sessions on-site is low. Especially when there is no obligation to attend, group work is difficult to implement because the number of students attending is too low. Lecturers would like to see more opportunities from the university and its administration to enforce attendance. In their view, this is the only way to ensure the success of blended learning. In addition, they see the conception of blended learning courses as requiring a great deal of time, which they are not always willing to invest. More incentives are necessary to keep the lecturers motivated to develop engaging teaching material. The study identifies factors that can help teachers conceptualize blended learning. It also provides specific implementation advice and identifies potential impacts. This catalogue has great value for the future-oriented development of courses at universities. Future studies could test its practical use.

Keywords: blended learning, higher education, teachers, student learning, qualitative research

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13804 Factors for Success in Eco-Industrial Town Development in Thailand

Authors: Jirarat Teeravaraprug, Tarathorn Podcharathitikull

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Nowadays, Ministry of Industry has given an attention to develop Eco-industrial towns in Thailand. Eco-industrial towns are a way of demonstrating the application of industrial ecology and are subjects of increased interest as government, business and society. This concept of Eco-industrial town is quite new in Thailand. It is used as a way of achieving more sustainable industrial development. However, many firms or organizations have misunderstood the concept and treated with suspicion. The planning and development of Eco-industrial towns is a significant challenge for the developers and public agencies. This research then gives an attempt to determine current problems of being Eco-Industrial towns and determine success factors for developing Eco-Industrial towns in Thailand. The research starts with giving knowledge about Eco-industrial towns to stakeholders and conducting public hearing in order to acquire the problems of being Eco-industrial towns. Then, factors effecting the development of Eco-Industrial town are collected. The obtained factors are analyzed by using the concept of IOC. Then, the remained factors are categorized and structured based on the concept of AHP. A questionnaire is constructed and distributed to the experts who are involved in the Eco-industrial town project. The result shows that the most significant success criterion is management teams of industrial parks or groups and the second most significant goes to governmental policies.

Keywords: AHP, Eco-Industrial town, success factors, Thailand

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13803 Using Tilted Façade to Reduce Thermal Discomfort in a UK Passivhaus Dwelling for a Warming Climate

Authors: Yahya Lavafpour, Steve Sharples

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This study investigated the potential negative impacts of future UK climate change on dwellings. In particular, the risk of overheating was considered for a Passivhaus dwelling in London. The study used dynamic simulation modelling software to investigate the potential use of building geometry to control current and future overheating risks in the dwelling for London climate. Specifically, the focus was on the optimum inclination of a south façade to make use of the building’s shape to self-protect itself. A range of different inclined façades were examined to test their effectiveness in reducing the overheating risk. The research found that implementing a 115° tilted façade could completely eliminate the risk of overheating in current climate, but with some consequence for natural ventilation and daylighting. Future overheating was significantly reduced by the tilted façade. However, geometric considerations could not eradicate completely the risk of overheating particularly by the 2080s. The study also used CFD modelling and sensitivity analysis to investigate the effect of the façade geometry on the wind pressure distributions on and around the building surface. This was done to assess natural ventilation flows for alternative façade inclinations.

Keywords: climate change, tilt façade, thermal comfort, passivhaus, overheating

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13802 Study of Factors Linked to Alcohol Consumption among Young People from the Lycée De La Convivialité De Kanyosha in Burundi

Authors: Niyiragira Sixte, Jules Verne Nakimana

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Introduction: Alcoholism is gradually becoming a public health issue due to its frequency, which continues to increase, especially in schools and at young ages. The general objective of the study was to contribute to the determination of the factors associated with alcohol consumption among young people. Methodology: This descriptive and analytical cross-sectional study entitled “Study of factors associated with alcohol consumption among young people aged 15 to 24. The study was conducted using a non-probability method, and the sampling technique was for convenience. The data collection technique used was the survey by questionnaire and the exploitation of the documentary. Microsoft Word 2013, Microsoft Excel 2.13 and EPI INFO7 software were used for this purpose. Results: The results of in study showed that 43.36% of the students surveyed took alcohol, and the factors associated with alcohol consumption are: religion, smoking and influence from friends. Conclusion: The prevalence of alcohol consumption among young people is very high, and awareness is more than necessary to prevent alcohol-related harm among young people.

Keywords: consumption, alcohol, young people, factors

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13801 Challenges in Environmental Governance: A Case Study of Risk Perceptions of Environmental Agencies Involved in Flood Management in the Hawkesbury-Nepean Region, Australia

Authors: S. Masud, J. Merson, D. F. Robinson

Abstract:

The management of environmental resources requires engagement of a range of stakeholders including public/private agencies and different community groups to implement sustainable conservation practices. The challenge which is often ignored is the analysis of agencies involved and their power relations. One of the barriers identified is the difference in risk perceptions among the agencies involved that leads to disjointed efforts of assessing and managing risks. Wood et al 2012, explains that it is important to have an integrated approach to risk management where decision makers address stakeholder perspectives. This is critical for an effective risk management policy. This abstract is part of a PhD research that looks into barriers to flood management under a changing climate and intends to identify bottlenecks that create maladaptation. Experiences are drawn from international practices in the UK and examined in the context of Australia through exploring the flood governance in a highly flood-prone region in Australia: the Hawkesbury Ne-pean catchment as a case study. In this research study several aspects of governance and management are explored: (i) the complexities created by the way different agencies are involved in assessing flood risks (ii) different perceptions on acceptable flood risk level; (iii) perceptions on community engagement in defining acceptable flood risk level; (iv) Views on a holistic flood risk management approach; and, (v) challenges of centralised information system. The study concludes that the complexity of managing a large catchment is exacerbated by the difference in the way professionals perceive the problem. This has led to: (a) different standards for acceptable risks; (b) inconsistent attempt to set-up a regional scale flood management plan beyond the jurisdictional boundaries: (c) absence of a regional scale agency with license to share and update information (d) Lack of forums for dialogue with insurance companies to ensure an integrated approach to flood management. The research takes the Hawkesbury-Nepean catchment as case example and draws from literary evidence from around the world. In addition, conclusions were extrapolated from eighteen semi-structured interviews from agencies involved in flood risk management in the Hawkesbury-Nepean catchment of NSW, Australia. The outcome of this research is to provide a better understanding of complexity in assessing risks against a rapidly changing climate and contribute towards developing effective risk communication strategies thus enabling better management of floods and achieving increased level of support from insurance companies, real-estate agencies, state and regional risk managers and the affected communities.

Keywords: adaptive governance, flood management, flood risk communication, stakeholder risk perceptions

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13800 Quantifying Multivariate Spatiotemporal Dynamics of Malaria Risk Using Graph-Based Optimization in Southern Ethiopia

Authors: Yonas Shuke Kitawa

Abstract:

Background: Although malaria incidence has substantially fallen sharply over the past few years, the rate of decline varies by district, time, and malaria type. Despite this turn-down, malaria remains a major public health threat in various districts of Ethiopia. Consequently, the present study is aimed at developing a predictive model that helps to identify the spatio-temporal variation in malaria risk by multiple plasmodium species. Methods: We propose a multivariate spatio-temporal Bayesian model to obtain a more coherent picture of the temporally varying spatial variation in disease risk. The spatial autocorrelation in such a data set is typically modeled by a set of random effects that assign a conditional autoregressive prior distribution. However, the autocorrelation considered in such cases depends on a binary neighborhood matrix specified through the border-sharing rule. Over here, we propose a graph-based optimization algorithm for estimating the neighborhood matrix that merely represents the spatial correlation by exploring the areal units as the vertices of a graph and the neighbor relations as the series of edges. Furthermore, we used aggregated malaria count in southern Ethiopia from August 2013 to May 2019. Results: We recognized that precipitation, temperature, and humidity are positively associated with the malaria threat in the area. On the other hand, enhanced vegetation index, nighttime light (NTL), and distance from coastal areas are negatively associated. Moreover, nonlinear relationships were observed between malaria incidence and precipitation, temperature, and NTL. Additionally, lagged effects of temperature and humidity have a significant effect on malaria risk by either species. More elevated risk of P. falciparum was observed following the rainy season, and unstable transmission of P. vivax was observed in the area. Finally, P. vivax risks are less sensitive to environmental factors than those of P. falciparum. Conclusion: The improved inference was gained by employing the proposed approach in comparison to the commonly used border-sharing rule. Additionally, different covariates are identified, including delayed effects, and elevated risks of either of the cases were observed in districts found in the central and western regions. As malaria transmission operates in a spatially continuous manner, a spatially continuous model should be employed when it is computationally feasible.

Keywords: disease mapping, MSTCAR, graph-based optimization algorithm, P. falciparum, P. vivax, waiting matrix

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13799 Designing and Formulating Action Plan for Development of Corporate Citizenship in Producing Units in Iran

Authors: Freyedon Ahmadi

Abstract:

Corporate citizenship is considered as one of the most discussed topics in the developed countries, in which a citizen considers a Corporate just like a usual citizen with every civil right as respectful for corporate as for actual citizens, and in return citizens expect that corporate would pay a reciprocal respect to them. The current study’s purpose is to identify the impact of the current state of corporate citizenship along effective factors on its condition on industrial producing units, in order to find an accession plane for corporate citizenship development. In this study corporate citizenship is studied in four dimensions like legal corporate, economical corporate, ethical corporate and voluntary corporate. Moreover, effective factors’ impact on corporate citizenship is explored based on threefold dimensional model: behavioral, structural, and content factors, as well. In this study, 50 corporate of Food industry and of petrochemical industry, along with 200 selected individuals from directors’ board on Tehran province’s scale with stratified random sampling method, are chosen as actuarial sample. If based on functional goal and compilation methods, the present study is a description of correlation type; questionnaire is used for accumulation of initial Data. For Instrument Validity expert’s opinion is used and structural equations and its reliability is qualified by using Cronbach Alpha. The results of this study indicate that close to 70 percent of under survey corporate have not a good condition in corporate citizenship. And all of structural factors, behavioral factors, contextual factors, have a great deal of impression and impact on the advent corporate citizenship behavior in the producing Units. Among the behavioral factors, social responsibility; among structural factors, organic structure and human centered orientation, medium size, high organizational capacity; and among the contextual factors, the clientele’s positive viewpoints toward corporate had the utmost importance in impression on under survey Producing units.

Keywords: corporate citizenship, structural factors, behavioral factors, contextual factors, producing units

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13798 Risk Based Building Information Modeling (BIM) for Urban Infrastructure Transportation Project

Authors: Debasis Sarkar

Abstract:

Building Information Modeling (BIM) is a holistic documentation process for operational visualization, design coordination, estimation and project scheduling. BIM software defines objects parametrically and it is a tool for virtual reality. Primary advantage of implementing BIM is the visual coordination of the building structure and systems such as Mechanical, Electrical and Plumbing (MEP) and it also identifies the possible conflicts between the building systems. This paper is an attempt to develop a risk based BIM model which would highlight the primary advantages of application of BIM pertaining to urban infrastructure transportation project. It has been observed that about 40% of the Architecture, Engineering and Construction (AEC) companies use BIM but primarily for their outsourced projects. Also, 65% of the respondents agree that BIM would be used quiet strongly for future construction projects in India. The 3D models developed with Revit 2015 software would reduce co-ordination problems amongst the architects, structural engineers, contractors and building service providers (MEP). Integration of risk management along with BIM would provide enhanced co-ordination, collaboration and high probability of successful completion of the complex infrastructure transportation project within stipulated time and cost frame.

Keywords: building information modeling (BIM), infrastructure transportation, project risk management, underground metro rail

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13797 Identifying Principle Components Affecting Competitiveness of Thai Automotive Parts Industry

Authors: Thanatip Lerttanaporn, Tuanjai Somboonwiwat, Charoenchai Khompatraporn

Abstract:

The automotive parts industry is one of the vital sectors in Thai economy and now is facing a greater competition from ASEAN Economic Community (AEC). This article identifies important factors that impact the competitiveness of Thai automotive parts industry. There are eight groups of factors with a total of 58 factors. Due to a variety of factors, the Exploratory Factor Analysis and Principle Component Analysis have been applied to classify factors into groups or principle components. The results show that there are 15 groups and four of them are critical, covering 80% of important value. These four critical groups are then used to formulate strategies to improve the competitiveness of the Thai automotive parts industry.

Keywords: factor analysis, Thai automotive parts, principle components, exploratory factor, ASEAN economic community

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13796 First-Trimester Screening of Preeclampsia in a Routine Care

Authors: Tamar Grdzelishvili, Zaza Sinauridze

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Introduction: Preeclampsia is a complication of the second trimester of pregnancy, which is characterized by high morbidity and multiorgan damage. Many complex pathogenic mechanisms are now implicated to be responsible for this disease (1). Preeclampsia is one of the leading causes of maternal mortality worldwide. Statistics are enough to convince you of the seriousness of this pathology: about 100,000 women die of preeclampsia every year. It occurs in 3-14% (varies significantly depending on racial origin or ethnicity and geographical region) of pregnant women, in 75% of cases - in a mild form, and in 25% - in a severe form. During severe pre-eclampsia-eclampsia, perinatal mortality increases by 5 times and stillbirth by 9.6 times. Considering that the only way to treat the disease is to end the pregnancy, the main thing is timely diagnosis and prevention of the disease. Identification of high-risk pregnant women for PE and giving prophylaxis would reduce the incidence of preterm PE. First-trimester screening model developed by the Fetal Medicine Foundation (FMF), which uses the Bayes-theorem to combine maternal characteristics and medical history together with measurements of mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor, has been proven to be effective and have superior screening performance to that of traditional risk factor-based approach for the prediction of PE (2) Methods: Retrospective single center screening study. The study population consisted of women from the Tbilisi maternity hospital “Pineo medical ecosystem” who met the following criteria: they spoke Georgian, English, or Russian and agreed to participate in the study after discussing informed consent and answering questions. Prior to the study, the informed consent forms approved by the Institutional Review Board were obtained from the study subjects. Early assessment of preeclampsia was performed between 11-13 weeks of pregnancy. The following were evaluated: anamnesis, dopplerography of the uterine artery, mean arterial blood pressure, and biochemical parameter: Pregnancy-associated plasma protein A (PAPP-A). Individual risk assessment was performed with performed by Fast Screen 3.0 software ThermoFisher scientific. Results: A total of 513 women were recruited and through the study, 51 women were diagnosed with preeclampsia (34.5% in the pregnant women with high risk, 6.5% in the pregnant women with low risk; P<0.000 1). Conclusions: First-trimester screening combining maternal factors with uterine artery Doppler, blood pressure, and pregnancy-associated plasma protein-A is useful to predict PE in a routine care setting. More patient studies are needed for final conclusions. The research is still ongoing.

Keywords: first-trimester, preeclampsia, screening, pregnancy-associated plasma protein

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13795 Application of Container Technique to High-Risk Children: Its Effect on Their Levels of Stress, Anxiety and Depression

Authors: Nguyen Thi Loan, Phan Ngoc Thanh Tra

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Container is one of the techniques used in Eye Movement Desensitization and Reprocessing (EDMR) Therapy. This paper presents the positive results of applying Container technique to “high risk children”. The sample for this research is composed of 60 “high risk children” whose ages range from 11 to 18 years old, housed in Ho Chi Minh City Youth Center. They have been under the program of the Worldwide Orphans Foundation since August 2015 for various reasons such as, loss of parents, anti-social behaviors, homelessness, child labor among others. These “high risk children” are under high levels of stress, anxiety and depression. The subjects were divided into two groups: the control and the experimental with 30 members each. The experimental group was applied Container Technique and the instruments used to measure their levels of stress, anxiety, and depression are DASS-42 and ASEBA. Results show that after applying the Container Technique to the experimental group, there are significant differences between the two groups’ levels of stress, anxiety and depression. The experimental group’s levels of stress, anxiety and depression decreased significantly. The results serve as a basis for the researchers to make an appeal to psychologists to apply Container Technique in doing psychological treatment in a suitable context.

Keywords: anxiety, depression, container technique, EMDR

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13794 Exploring the Social Factors of a Country that Influence International Migration: A Sociological Perspective

Authors: Md. Shahriar Sabuz

Abstract:

Different social factors influence individuals to migrate from their native lands. This qualitative study was designed to analyze the main social factors that have a significant role in the movement of people across borders. In this study, two research questions, i.e., ‘Which social factors of a country significantly influence the persons' decision to migrate from their homeland?’ and ’2: do different social factors of a country influence the process of international migration?" were formulated and relevant data were analyzed to get the logical answer to these two questions. Data analysis revealed that people migrate in large numbers due to deplorable and unsafe social conditions in their home countries. Sometimes migration occurs due to a lack of basic facilities in native countries. It is quite significant to know that these social conditions create a sense of deprivation and insecurity in individuals, and they move to other lands to get a sense of achievement and greater security for themselves and their whole families. This study is significant and distinct from previous studies in that it provides comprehensive information about the major social factors responsible for international migrations and their role in influencing an individual's proclivity to migrate. Besides this, it greatly opens new horizons of research and analysis for other researchers working on the agenda of international migration.

Keywords: International migration, social factors, income inequality, social discrimination

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13793 Inappropriate Job Behaviour and Performance of Employees

Authors: Prakash Singh

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The focus of this paper is on the impact of internal organizational factors on the inappropriate job performance and behaviour of employees. The Buffalo City Metropolitan Municipality (BCMM) in South Africa has been experiencing inappropriate job behaviour and performance of some of its workers. They include misappropriation of resources, maladministration, mismanagement, lack of service delivery, fraud, and corruption. Since many workers in this organization have various levels of formal education, such practices are not expected, because the structural-functionalist assumption is that formal education is a solution to societal challenges. Since inappropriate job behaviour and performance continue to be reported in spite of the formal education of BCMM workers, this study seeks to investigate how the two phenomena co-exist. It thus seeks to put into perspective the paradoxical co-existence of formal education with inappropriate job behaviour and performance, by focusing on the BCMM as a case-study. For data collection, this study used the mixed method approach; that is, a combination of qualitative and quantitative methods. The findings revealed structural, systemic and human impediments to labour productivity in the organization. By and large, the unquestioning acceptance of the assumption that the skills shortage is responsible for inappropriate workers’ job performance and behaviour is discredited by the evidence of skilled personnel who exercise their responsibilities in a manner that undermines their occupational requirements. Therefore, this exploratory study affirms that the narrow conception of skills, that privileges job-specific capabilities, is not enough for cultivating a workforce with appropriate job behaviour and performance practices.

Keywords: inappropriate job behaviour, labour productivity, mismanagement, skills shortage

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13792 Levels of Selected Heavy Metals in Varieties of Vegetable oils Consumed in Kingdom of Saudi Arabia and Health Risk Assessment of Local Population

Authors: Muhammad Waqar Ashraf

Abstract:

Selected heavy metals, namely Cu, Zn, Fe, Mn, Cd, Pb, and As, in seven popular varieties of edible vegetable oils collected from Saudi Arabia, were determined by graphite furnace atomic absorption spectrometry (GF-AAS) using microwave digestion. The accuracy of procedure was confirmed by certified reference materials (NIST 1577b). The concentrations for copper, zinc, iron, manganese, lead and arsenic were observed in the range of 0.035 - 0.286, 0.955 - 3.10, 17.3 - 57.8, 0.178 - 0.586, 0.011 - 0.017 and 0.011 - 0.018 µg/g, respectively. Cadmium was found to be in the range of 2.36 - 6.34 ng/g. The results are compared internationally and with standards laid down by world health agencies. A risk assessment study has been carried out to assess exposure to these metals via consumption of vegetable oils. A comparison has been made with safety intake levels for these heavy metals recommended by Institute of Medicine of the National Academies (IOM), US Environmental Protection Agency (US EPA) and Joint FAO/WHO Expert Committee on Food Additives (JECFA). The results indicated that the dietary intakes of the selected heavy metals from daily consumption of 25 g of edible vegetable oils for a 70 kg individual should pose no significant health risk to local population.

Keywords: vegetable oils, heavy metals, contamination, health risk assessment

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13791 Tip-Apex Distance as a Long-Term Risk Factor for Hospital Readmission Following Intramedullary Fixation of Intertrochanteric Fractures

Authors: Brandon Knopp, Matthew Harris

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Purpose: Tip-apex distance (TAD) has long been discussed as a metric for determining risk of failure in the fixation of peritrochanteric fractures. TAD measurements over 25 millimeters (mm) have been associated with higher rates of screw cut out and other complications in the first several months after surgery. However, there is limited evidence for the efficacy of this measurement in predicting the long-term risk of negative outcomes following hip fixation surgery. The purpose of our study was to investigate risk factors including TAD for hospital readmission, loss of pre-injury ambulation and development of complications within 1 year after hip fixation surgery. Methods: A retrospective review of proximal hip fractures treated with single screw intramedullary devices between 2016 and 2020 was performed at a 327-bed regional medical center. Patients included had a postoperative follow-up of at least 12 months or surgery-related complications developing within that time. Results: 44 of the 67 patients in this study met the inclusion criteria with adequate follow-up post-surgery. There was a total of 10 males (22.7%) and 34 females (77.3%) meeting inclusion criteria with a mean age of 82.1 (± 12.3) at the time of surgery. The average TAD in our study population was 19.57mm and the average 1-year readmission rate was 15.9%. 3 out of 6 patients (50%) with a TAD > 25mm were readmitted within one year due to surgery-related complications. In contrast, 3 out of 38 patients (7.9%) with a TAD < 25mm were readmitted within one year due to surgery-related complications (p=0.0254). Individual TAD measurements, averaging 22.05mm in patients readmitted within 1 year of surgery and 19.18mm in patients not readmitted within 1 year of surgery, were not significantly different between the two groups (p=0.2113). Conclusions: Our data indicate a significant improvement in hospital readmission rates up to one year after hip fixation surgery in patients with a TAD < 25mm with a decrease in readmissions of over 40% (50% vs 7.9%). This result builds upon past investigations by extending the follow-up time to 1 year after surgery and utilizing hospital readmissions as a metric for surgical success. With the well-documented physical and financial costs of hospital readmission after hip surgery, our study highlights a reduction of TAD < 25mm as an effective method of improving patient outcomes and reducing financial costs to patients and medical institutions. No relationship was found between TAD measurements and secondary outcomes, including loss of pre-injury ambulation and development of complications.

Keywords: hip fractures, hip reductions, readmission rates, open reduction internal fixation

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