Search results for: risk perception
Commenced in January 2007
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Edition: International
Paper Count: 7897

Search results for: risk perception

6217 The Impact of CSR Satisfaction on Employee Commitment

Authors: Silke Bustamante, Andrea Pelzeter, Andreas Deckmann, Rudi Ehlscheidt, Franziska Freudenberger

Abstract:

Many companies increasingly seek to enhance their attractiveness as an employer to bind their employees. At the same time, corporate responsibility for social and ecological issues seems to become a more important part of an attractive employer brand. It enables the company to match the values and expectations of its members, to signal fairness towards them and to increase its brand potential for positive psychological identification on the employees’ side. In the last decade, several empirical studies have focused this relationship, confirming a positive effect of employees’ CSR perception and their affective organizational commitment. The current paper aims to take a slightly different view by analyzing the impact of another factor on commitment: the weighted employee’s satisfaction with the employer CSR. For that purpose, it is assumed that commitment levels are rather a result of the fulfillment or disappointment of expectations. Hence, instead of merely asking how CSR perception affects commitment, a more complex independent variable is taken into account: a weighted satisfaction construct that summarizes two different factors. Therefore, the individual level of commitment contingent on CSR is conceptualized as a function of two psychological processes: (1) the individual significance that an employee ascribes to specific employer attributes and (2) the individual satisfaction based on the fulfillment of expectation that rely on preceding perceptions of employer attributes. The results presented are based on a quantitative survey that was undertaken among employees of the German service sector. Conceptually a five-dimensional CSR construct (ecology, employees, marketplace, society and corporate governance) and a two-dimensional non-CSR construct (company and workplace) were applied to differentiate employer characteristics. (1) Respondents were asked to indicate the importance of different facets of CSR-related and non-CSR-related employer attributes. By means of a conjoint analysis, the relative importance of each employer attribute was calculated from the data. (2) In addition to this, participants stated their level of satisfaction with specific employer attributes. Both indications were merged to individually weighted satisfaction indexes on the seven-dimensional levels of employer characteristics. The affective organizational commitment of employees (dependent variable) was gathered by applying the established 15-items Organizational Commitment Questionnaire (OCQ). The findings related to the relationship between satisfaction and commitment will be presented. Furthermore, the question will be addressed, how important satisfaction with CSR is in relation to the satisfaction with other attributes of the company in the creation of commitment. Practical as well as scientific implications will be discussed especially with reference to previous results that focused on CSR perception as a commitment driver.

Keywords: corporate social responsibility, organizational commitment, employee attitudes/satisfaction, employee expectations, employer brand

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6216 Implications of Measuring the Progress towards Financial Risk Protection Using Varied Survey Instruments: A Case Study of Ghana

Authors: Jemima C. A. Sumboh

Abstract:

Given the urgency and consensus for countries to move towards Universal Health Coverage (UHC), health financing systems need to be accurately and consistently monitored to provide valuable data to inform policy and practice. Most of the indicators for monitoring UHC, particularly catastrophe and impoverishment, are established based on the impact of out-of-pocket health payments (OOPHP) on households’ living standards, collected through varied household surveys. These surveys, however, vary substantially in survey methods such as the length of the recall period or the number of items included in the survey questionnaire or the farming of questions, potentially influencing the level of OOPHP. Using different survey instruments can provide inaccurate, inconsistent, erroneous and misleading estimates of UHC, subsequently influencing wrong policy decisions. Using data from a household budget survey conducted by the Navrongo Health Research Center in Ghana from May 2017 to December 2018, this study intends to explore the potential implications of using surveys with varied levels of disaggregation of OOPHP data on estimates of financial risk protection. The household budget survey, structured around food and non-food expenditure, compared three OOPHP measuring instruments: Version I (existing questions used to measure OOPHP in household budget surveys), Version II (new questions developed through benchmarking the existing Classification of the Individual Consumption by Purpose (COICOP) OOPHP questions in household surveys) and Version III (existing questions used to measure OOPHP in health surveys integrated into household budget surveys- for this, the demographic and health surveillance (DHS) health survey was used). Version I, II and III contained 11, 44, and 56 health items, respectively. However, the choice of recall periods was held constant across versions. The sample size for Version I, II and III were 930, 1032 and 1068 households, respectively. Financial risk protection will be measured based on the catastrophic and impoverishment methodologies using STATA 15 and Adept Software for each version. It is expected that findings from this study will present valuable contributions to the repository of knowledge on standardizing survey instruments to obtain estimates of financial risk protection that are valid and consistent.

Keywords: Ghana, household budget surveys, measuring financial risk protection, out-of-pocket health payments, survey instruments, universal health coverage

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6215 The Amorphousness of the Exposure Sphere

Authors: Nipun Ansal

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People guard their beliefs and opinions with their lives. Beliefs that they’ve formed over a period of time, and can go to any lengths to defy, desist from, resist and negate any outward stimulus that has the potential to shake them. Cognitive dissonance is term used to describe it in theory. And every human being, in order to defend himself from cognitive dissonance applies 4 rings of defense viz. Selective Exposure, Selective Perception, Selective Attention, and Selective Retention. This paper is a discursive analysis on how the onslaught of social media, complete with its intrusive weaponry, has amorphized the external ring of defense: the selective exposure. The stimulus-response model of communication is one of the most inherent model that encompasses communication behaviours of children and elderly, individual and masses, humans and animals alike. The paper deliberates on how information bombardment through the uncontrollable channels of the social media, Facebook and Twitter in particular, have dismantled our outer sphere of exposure, leading users online to a state of constant dissonance, and thus feeding impulsive action-taking. It applies case study method citing an example to corroborate how knowledge generation has given in to the information overload and the effect it has on decision making. With stimulus increasing in number of encounters, opinion formation precedes knowledge because of the increased demand of participation and decrease in time for the information to permeate from the outer sphere of exposure to the sphere of retention, which of course, is through perception and attention. This paper discusses the challenge posed by this fleeting, stimulus rich, peer-dominated media on the traditional models of communication and meaning-generation.

Keywords: communication, discretion, exposure, social media, stimulus

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6214 Prevalence and Risk Factors of Musculoskeletal Disorders among School Teachers in Mangalore: A Cross Sectional Study

Authors: Junaid Hamid Bhat

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Background: Musculoskeletal disorders are one of the main causes of occupational illness. Mechanisms and the factors like repetitive work, physical effort and posture, endangering the risk of musculoskeletal disorders would now appear to have been properly identified. Teacher’s exposure to work-related musculoskeletal disorders appears to be insufficiently described in the literature. Little research has investigated the prevalence and risk factors of musculoskeletal disorders in teaching profession. Very few studies are available in this regard and there are no studies evident in India. Purpose: To determine the prevalence of musculoskeletal disorders and to identify and measure the association of such risk factors responsible for developing musculoskeletal disorders among school teachers. Methodology: An observational cross sectional study was carried out. 500 school teachers from primary, middle, high and secondary schools were selected, based on eligibility criteria. A signed consent was obtained and a self-administered, validated questionnaire was used. Descriptive statistics was used to compute the statistical mean and standard deviation, frequency and percentage to estimate the prevalence of musculoskeletal disorders among school teachers. The data analysis was done by using SPSS version 16.0. Results: Results indicated higher pain prevalence (99.6%) among school teachers during the past 12 months. Neck pain (66.1%), low back pain (61.8%) and knee pain (32.0%) were the most prevalent musculoskeletal complaints of the subjects. Prevalence of shoulder pain was also found to be high among school teachers (25.9%). 52.0% subjects reported pain as disabling in nature, causing sleep disturbance (44.8%) and pain was found to be associated with work (87.5%). A significant association was found between musculoskeletal disorders and sick leaves/absenteeism. Conclusion: Work-related musculoskeletal disorders particularly neck pain, low back pain, and knee pain, is highly prevalent and risk factors are responsible for the development of same in school teachers. There is little awareness of musculoskeletal disorders among school teachers, due to work load and prolonged/static postures. Further research should concentrate on specific risk factors like repetitive movements, psychological stress, and ergonomic factors and should be carried out all over the country and the school teachers should be studied carefully over a period of time. Also, an ergonomic investigation is needed to decrease the work-related musculoskeletal disorder problems. Implication: Recall bias and self-reporting can be considered as limitations. Also, cause and effect inferences cannot be ascertained. Based on these results, it is important to disseminate general recommendations for prevention of work-related musculoskeletal disorders with regards to the suitability of furniture, equipment and work tools, environmental conditions, work organization and rest time to school teachers. School teachers in the early stage of their careers should try to adapt the ergonomically favorable position whilst performing their work for a safe and healthy life later. Employers should be educated on practical aspects of prevention to reduce musculoskeletal disorders, since changes in workplace and work organization and physical/recreational activities are required.

Keywords: work related musculoskeletal disorders, school teachers, risk factors funding, medical and health sciences

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6213 Prospective Randomized Trial of Na/K Citrate for the Prevention of Contrast-Induced Nephropathy in High-Risk Patients

Authors: Leili Iranirad, Mohammad Saleh Sadeghi, Seyed Fakhreddin Hejazi, Negar Vakili Razlighi

Abstract:

Objective: Contrast-induced nephropathy (CIN) or contrast-induced acute kidney injury (CI-AKI) is an unknown acute kidney injury (AKI) occurring after exposure to contrast media (CM). Contrast agents are most often used for diagnostic procedures or therapeutic angiographic interventions. Recently, Na/K citrate as a urine alkalinization has been evaluated for the prevention of CIN. We conducted this experiment to evaluate the efficiency of Na/K citrate on CIN in high-risk patients treated with cardiac catheterization. Methods: A prospective randomized clinical trial was conducted on 400 patients having moderate to high-risk factors for CIN treated with elective percutaneous coronary intervention (PCI) and were assigned randomly to the control group or the Na/K citrate group. The Na/K citrate group (n=200) received 5 g Na/K citrate solution, which was diluted in 200 mL water two h before and four hours after the first administration and intravenous hydration for two h prior to and six h after the procedure, while the control group (n=200) only received intravenous hydration. Serum creatinine (SCr) was calculated prior to the contrast exposure and after 48 h. CIN was described as a 25% increase in creatinine of serum (SCr) or >0.5 mg/dl 48 h after contrast administration. Results: CIN was observed in 33 patients (16.5%) in the control group and in 6 patients (3%) in the Na/K citrate group. A significant variation was recorded in the CIN incidence between the two groups 48 h after the radiocontrast agent administration (p < 0.001). Conclusion: Our results show that Na/K citrate is useful and substantially reduces the incidence of CIN.

Keywords: contrast media, citrate, PCI

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6212 Differences in Guilt, Shame, Self-Anger, and Suicide Cognitions Based on Recent Suicide Ideation and Lifetime Suicide Attempt History

Authors: E. H. Szeto, E. Ammendola, J. V. Tabares, A. Starkey, J. Hay, J. G. McClung, C. J. Bryan

Abstract:

Introduction: Suicide is a leading cause of death globally, which accounts for more deaths annually than war, acquired immunodeficiency syndrome, homicides, and car accidents, while an estimated 140 million individuals have significant suicide ideation (SI) each year in the United States. Typical risk factors such as hopelessness, depression, and psychiatric disorders can predict suicide ideation but cannot distinguish between those who ideate from those who attempt suicide (SA). The Fluid Vulnerability Theory of suicide posits that a person’s activation of the suicidal mode is predicated on one’s predisposition, triggers, baseline/acute risk, and protective factors. The current study compares self-conscious cognitive-affective states (including guilt, shame, anger towards the self, and suicidal beliefs) among patients based on the endorsement of recent SI (i.e., past two weeks; acute risk) and lifetime SA (i.e., baseline risk). Method: A total of 2,722 individuals in an outpatient primary care setting were included in this cross-sectional, observational study; data for 2,584 were valid and retained for analysis. The Differential Emotions Scale measuring guilt, shame, and self-anger and the Suicide Cognitions Scale measuring suicide cognitions were administered. Results: A total of 2,222 individuals reported no recent SI or lifetime SA (Group 1), 161 reported recent SI only (Group 2), 145 reported lifetime SA only (Group 3), 56 reported both recent SI and lifetime SA (Group 4). The Kruskal-Wallis test showed that guilt, shame, self-anger, and suicide cognitions were the highest for Group 4 (both recent SI and lifetime SA), followed by Group 2 (recent SI-only), then Group 3 (lifetime SA-only), and lastly, Group 1 (no recent SI or lifetime SA). Conclusion: The results on recent SI-only versus lifetime SA-only contribute to the literature on the Fluid Vulnerability Theory of suicide by capturing SI and SA in two different time periods, which signify the acute risks and chronic baseline risks of the suicidal mode, respectively. It is also shown that: (a) people with a lifetime SA reported more severe symptoms than those without, (b) people with recent SI reported more severe symptoms than those without, and (c) people with both recent SI and lifetime SA were the most severely distressed. Future studies may replicate the findings here with other pertinent risk factors such as thwarted belongingness, perceived burdensomeness, and acquired capability, the last of which is consistently linked to attempting among ideators.

Keywords: suicide, guilt, shame, self-anger, suicide cognitions, suicide ideation, suicide attempt

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6211 Cardiotrophin-1 and Leptin in Male Patients with Obstructive Sleep Apnea Syndrome

Authors: Isil Cakir, Mustafa Uluhan

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Elevated serum Cardiotrophin-1 (CT-1) and leptin levels are important risk factors for cardiovascular diseases (CVDs). Obstructive sleep apnea syndrome (OSAS) has been reported to increase the risk of CVDs, too. The aim of this study was to evaluate the concentrations of serum CT-1 and leptin in these patients and whether their possible association with the disease severity. Fifty newly diagnosed patients with OSAS and thirty nonapneic snoring subjects were participated in this study. The mean ages of patients and control groups were 47.40±13.30 and 43.23±10.50 years, respectively (P=0.128). Fasting serum triglyseride, total cholesterol, LDL and HDL cholesterol, also CT-1 and leptin levels were evaluated. A significant difference was found in the serum CT-1 and leptin levels between the patients and the controls:serum median CT-1 levels in patients and control groups, respectively, were 19.47 and 8.23 pg/mL (P < 0.001) and leptin levels were 2.07 and 1.29 ng/mL (P < 0.001). In severe patients group (n=39), serum median CT-1 level was found statistically significantly higher than the median level in mild/moderate patients (n=11) group. Patients CT-1 concentrations were not associated with lipoprotein levels and there was no correlation between patients’ leptin and lipid profile parameters. Two risk factors for CVDs, CT-1 and leptin, have significantly elevated and they were associated with OSAS. Furthermore, CT-1 was associated with the severity of disease. We recommend the use of increased serum CT-1 and leptin concentrations as markers of the presence and severity of OSAS.They can be used as early markers in male OSAS patients without known CVDs.

Keywords: obstructive sleep apnea syndrome, cardiotrophin-1, leptin, cardiovascular disease

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6210 Evidence of Total Mercury Biomagnification in Tropical Estuary Lagoon in East Coast of Peninsula, Malaysia

Authors: Quang Dung Le, Kentaro Tanaka, Viet Dung Luu, Kotaro Shirai

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Mercury pollutant is great concerns in globe due to its toxicity and biomagnification through the food web. Recently increasing approaches of stable isotope analyses which have applied in food-web structure are enabled to elucidate more insight trophic transfer of pollutants in ecosystems. In this study, the integration of total mercury (Hg) and stable isotopic analyses (δ13C and δ15N) were measured from basal food sources to invertebrates and fishes in order to determine Hg transfer in Setiu lagoon food webs. The average Hg concentrations showed the increasing trend from low to high trophic levels. The result also indicated that potential Hg exposure from inside mangrove could be higher than that from the tidal flat of mangrove creek. Fish Hg concentrations are highly variable, and many factors driving this variability need further examinations. A positive correlation found between Hg concentrations and δ15N values (the trophic magnification factor was 3.02), suggesting Hg biomagnification through the lagoon food web. Almost all Hg concentrations in fishes and mud crabs did not present a risk for human consumption, however, the Hg concentrations of Caranx ignobilis exceed the permitted level could raise a concern of the potential risk for the marine system. Further investigations should be done to elucidate whether trophic relay relates to high Hg concentrations of some fish species in coastal systems.

Keywords: mercury, transfer, stable isotopes, health risk, mangrove, food web

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6209 A Case Study of Brownfield Revitalization in Taiwan

Authors: Jen Wang, Wei-Chia Hsu, Zih-Sin Wang, Ching-Ping Chu, Bo-Shiou Guo

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In the late 19th century, the Jinguashi ore deposit in northern Taiwan was discovered, and accompanied with flourishing mining activities. However, tons of contaminants including heavy metals, sulfur dioxide, and total petroleum hydrocarbons (TPH) were released to surroundings and caused environmental problems. Site T was one of copper smelter located on the coastal hill near Jinguashi ore deposit. In over ten years of operation, variety contaminants were emitted that it polluted the surrounding soil and groundwater quality. In order to exhaust fumes produced from smelting process, three stacks were built along the hill behind the factory. The sediment inside the stacks contains high concentration of heavy metals such as arsenic, lead, copper, etc. Moreover, soil around the discarded stacks suffered a serious contamination when deposition leached from the ruptures of stacks. Consequently, Site T (including the factory and its surroundings) was declared as a pollution remediation site that visiting the site and land-use activities on it are forbidden. However, the natural landscape and cultural attractions of Site T are spectacular that it attracts a lot of visitors annually. Moreover, land resources are extremely precious in Taiwan. In addition, Taiwan Environmental Protection Administration (EPA) is actively promoting the contaminated land revitalization policy. Therefore, this study took Site T as case study for brownfield revitalization planning to the limits of activate and remediate the natural resources. Land-use suitability analysis and risk mapping were applied in this study to make appropriate risk management measures and redevelopment plan for the site. In land-use suitability analysis, surrounding factors into consideration such as environmentally sensitive areas, biological resources, land use, contamination, culture, and landscapes were collected to assess the development of each area; health risk mapping was introduced to show the image of risk assessments results based on the site contamination investigation. According to land-use suitability analysis, the site was divided into four zones: priority area (for high-efficiency development), secondary area (for co-development with priority area), conditional area (for reusing existing building) and limited area (for Eco-tourism and education). According to the investigation, polychlorinated biphenyls (PCB), heavy metals and TPH were considered as target contaminants while oral, inhalation and dermal would be the major exposure pathways in health risk assessment. In accordance with health risk map, the highest risk was found in the southwest and eastern side. Based on the results, the development plan focused on zoning and land use. Site T was recommended be divides to public facility zone, public architectonic art zone, viewing zone, existing building preservation zone, historic building zone, and cultural landscape zone for various purpose. In addition, risk management measures including sustained remediation, extinguish exposure and administration management are applied to ensure particular places are suitable for visiting and protect the visitors’ health. The consolidated results are corroborated available by analyzing aspects of law, land acquired method, maintenance and management and public participation. Therefore, this study has a certain reference value to promote the contaminated land revitalization policy in Taiwan.

Keywords: brownfield revitalization, land-use suitability analysis, health risk map, risk management

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6208 For a Poetic Clinic: Experimentations at Risk on the Images in Performances

Authors: Juliana Bom-Tempo

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The proposed composition occurs between images, performances, clinics and philosophies. For this enterprise we depart for what is not known beforehand, so with a question as a compass: "would it be in the creation, production and implementation of images in a performance a 'when' for the event of a poetic clinic?” In light of this, there are, in order to think a 'when' of the event of a poetic clinic, images in performances created, produced and executed in partnerships with the author of this text. Faced with this composition, we built four indicators to find spatiotemporal coordinates that would spot that "when", namely: risk zones; the mobilizations of the signs; the figuring of the flesh and an education of the affections. We dealt with the images in performances; Crútero; Flesh; Karyogamy and the risk of abortion; Egg white; Egg-mouth; Islands, threads, words ... germs; Egg-Mouth-Debris, taken as case studies, by engendering risks areas to promote individuations, which never actualize thoroughly, thus always something of pre-individual and also individuating a environment; by mobilizing the signs territorialized by the ordinary, causing them to vary the language and the words of order dictated by the everyday in other compositions of sense, other machinations; by generating a figure of flesh, disarranging the bodies, isolating them in the production of a ground force that causes the body to leak out and undo the functionalities of the organs; and, finally, by producing an education of affections, by placing the perceptions in becoming and disconnecting the visible in the production of small deserts that call for the creation of a people yet to come. The performance is processed as a problematizing of the images fixed by the ordinary, producing gestures that precipitate the individuation of images in performance, strange to the configurations that gather bodies and spaces in what we call common. Lawrence proposes to think of "people" who continually use umbrellas to protect themselves from chaos. These have the function of wrapping up the chaos in visions that create houses, forms and stabilities; they paint a sky at the bottom of the umbrella, where people march and die. A chaos, where people live and wither. Pierce the umbrella for a desire of chaos; a poet puts himself as an enemy of the convention, to be able to have an image of chaos and a little sun that burns his skin. The images in performances presented, thereby, were moving in search for the power of producing a spatio-temporal "when" putting the territories in risk areas, mobilizing the signs that format the day-to-day, opening the bodies to a disorganization and the production of an education of affections for the event of a poetic clinic.

Keywords: Experimentations , Images in Performances, Poetic Clinic, Risk

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6207 A Possible Connection Between Taste Change and Zinc Deficiency after Bariatric Surgery: A Literature Review

Authors: Boshra Mozaffar, Iskandar Idris

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Taste change is a common complication after Bariatric surgery (BS). However, the cause of this is still not clear. Since zinc is important fortaste perception, zinc deficiency, which is common after BS, may play an important role for taste change after BS. In this review, we aimto collate evidence relating to taste change and zinc deficiencyin relation to BS; effects of zinc replacement on taste perception in general and thereafter discuss the possible role of zinc deficiency to induce taste change after BS. A literature search was conducted, using four electronic bibliographical databases—EMBASE, PubMed, AMED and MEDLINE. We identified all available and relevant articles published before 30th February 2021.In total, 33 studies were included. The total number of participants analysed was N= 3264. We showed that taste change is a frequent complication after BS, especially after Roux-en-Y gastric bypass RYGBP comparing to other types of procedures. Patients' taste sensitivity differs among studies, but the most important decline in taste preference was observed for sweet food. Twelve studies investigating zinc deficiency following BS showed a significant decrease in zinc levels at six months after surgery. Supplementation with 45–50 mg of zinc sulphate was effective in improving taste, except in cancer patients, who showed no improvement in taste following zinc supplementation. Zinc deficiency appears to be associated with taste change after BS. Supplementation with much higher levels of zinc, at 45–50 mg, was effective in taste change treatment for many cases of taste disorder. The currently recommended levels of zinc replacements currently prescribed to patients following BS were not effective for avoiding zinc deficiency after BS—and thus not effective for averting taste change. It is therefore suggested that taste change following BS is closely related to zinc deficiency induced by the surgery.

Keywords: taste change, taste disorder, bariatric surgery, zinc, zinc sulphate or Zn, deficiency, supplementation, and micro-nutrient deficiencies

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6206 Community Pharmacist's Perceptions, Attitude and Role in Oral Health Promotion and Diseases Prevention

Authors: Bushra Alghamdi, Alla Alsharif, Hamzah Aljohani, Saba Kassim

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Introduction: Collaborative work has always been acknowledged as a fundamental concept in delivering oral health care. Aim: This study aimed to assess the perception and attitude of pharmacists in oral health promotion and to determine the confident levels of pharmacists in delivering advice on oral health problems. Methods: An observational cross-sectional survey, using self-administered anonymous questionnaires, was conducted between March and April 2017. The study recruited a convenience sample of registered community pharmacists who were working in local private pharmaceutical stores in the urban area of Madinah, Kingdom of Saudi Arabia (KSA). A preliminary descriptive analysis was performed. Results: Thirty-five pharmacists have completed the surveys. All participants were males, with a mean age of 35.5 ( ± 6.92) years. Eighty-six percent of the participants reported that pharmacists should have a role in oral health promotion. Eighty percent have reported adequate level of confident when giving advice on most of the common oral health problems that include; oral health related risk behaviors such as tobacco cessation (46%), bleeding gums (63%) and sensitive teeth (60%). However, higher percentages of pharmacists have reported low confident levels when giving advice in relation to specific domain of dentistry, such as lost dental fillings (57%), loose crowns (60%), trauma to teeth (40%), denture-related problems (51%) and oral cancer (6.9%). Conclusion: Community pharmacists recognized their potential role in promoting oral health in KSA. Community pharmacists had varying levels of ability and confidence to offer support for oral health. The study highlighted that inner professional collaboration between pharmacists and dental care healthcare should be enhanced.

Keywords: community, oral health, promotion, pharmacist

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6205 Patterns of Change in Perception of Imagined and Physically Induced Pain over the Course of Repeated Thermal Stimulations

Authors: Boroka Gács, Tibor Szolcsányi, Árpad Csathó

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Background: Individuals frequently show habituation to repeated noxious heat. However, given the defensive function of human pain processing, it is reasonable to assume that individuals imagine that they would become increasingly sensitive to repeated thermal pain stimuli. To the best of the authors' knowledge, no previous studies have, however, been addressed to this assumption. Therefore, in the current study, we investigated how healthy human individuals imagine the intensity of repeated thermal pain stimulations, and compared this with the intensity ratings given after physically induced thermal pain trials. Methods: Healthy participants (N = 20) gave pain intensity ratings in two conditions: imagined and real thermal pain. In the real pain condition thermal pain stimuli of two intensities (minimal and moderate pain) were delivered in four consecutive trials. The duration of the peak temperature was 20s, and stimulation was always delivered to the same location. In each trial, participants rated the pain intensity twice, 5s and 15s after the onset of the peak temperature. In the imagined pain condition, participants were subjected to a reference pain stimulus and then asked to imagine and rate the same sequence of stimulations as in the induced pain condition. Results: Ratings of imagined pain and physically induced pain followed opposite courses over repeated stimulation: Ratings of imagined pain indicated sensitization whereas ratings for physically induced pain indicated habituation. The findings were similar for minimal and moderate pain intensities. Conclusions: The findings suggest that, rather than habituating to pain, healthy individuals imagine that they would become increasingly sensitive to repeated thermal pain stimuli.

Keywords: habituation, imagined pain, pain perception, thermal stimulation

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6204 Risk Assessment of Roof Structures in Concepcion, Tarlac in the Event of an Ash Fall

Authors: Jerome Michael J. Sadullo, Jamaica Lois A. Torres, Trisha Muriel T. Valino

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In the Philippines, Central Luzon is one of the regions at high risk in terms of volcanic eruption. In fact, last June 15, 1991, which were the Mount Pinatubo has erupted, the most affected provinces were Zambales, Olangapo, Pampanga, Tarlac, Bataan, Bulacan and Nueva Ecija. During the Mount Pinatubo eruption, Castillejos, Zambales, has recorded the most significant damage to both commercial and residential structures. In this study, the researchers aim to determine and analyze the various impacts of ashfall on roof structures in Concepcion, Tarlac, during the event of a volcanic eruption. In able for the researcher to determine the sample size of the study, they have utilized Cochran's sample size formula. With the computed sample size, the researchers have gathered data through the distribution of survey forms, utilizing public records, and picture documentation of different roof structures in Concepcion, Tarlac. With the data collected, Chi-squared goodness of fit was done by the researcher in order to compare the data collected from the observed N (Concepcion, Tarlac) and expected N (Castillejos, Zambales). The results showed that when it comes to the roof constructions material used in Concepcion, Tarlac and Castillejos, Zambales. Structures in Concepcion, Tarlac were most likely to suffer worse when another eruption happens compared to the structures in Castillejos, Zambales. Yet, considering the current structural statuses of structure in Concepcion Tarlac and its location from Mount Pinatubo, they are less likely to experience ashfall.

Keywords: risk assessment, Concepcion, Tarlac, Volcano Pinatubo, roof structures, ashfall

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6203 Morphology and Risk Factors for Blunt Aortic Trauma in Car Accidents: An Autopsy Study

Authors: Ticijana Prijon, Branko Ermenc

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Background: Blunt aortic trauma (BAT) includes various morphological changes that occur during deceleration, acceleration and/or body compression in traffic accidents. The various forms of BAT, from limited laceration of the intima to complete transection of the aorta, depends on the force acting on the vessel wall and the tolerance of the aorta to injury. The force depends on the change in velocity, the dynamics of the accident and of the seating position in the car. Tolerance to aortic injury depends on the anatomy, histological structure and pathomorphological alterations due to aging or disease of the aortic wall.An overview of the literature and medical documentation reveals that different terms are used to describe certain forms of BAT, which can lead to misinterpretation of findings or diagnoses. We therefore, propose a classification that would enable uniform systematic screening of all forms of BAT. We have classified BAT into three morphologycal types: TYPE I (intramural), TYPE II (transmural) and TYPE III (multiple) aortic ruptures with appropriate subtypes. Methods: All car accident casualties examined at the Institute of Forensic Medicine from 2001 to 2009 were included in this retrospective study. Autopsy reports were used to determine the occurrence of each morphological type of BAT in deceased drivers, front seat passengers and other passengers in cars and to define the morphology of BAT in relation to the accident dynamics and the age of the fatalities. Results: A total of 391 fatalities in car accidents were included in the study. TYPE I, TYPE II and TYPE III BAT were observed in 10,9%, 55,6% and 33,5%, respectively. The incidence of BAT in drivers, front seat and other passengers was 36,7%, 43,1% and 28,6%, respectively. In frontal collisions, the incidence of BAT was 32,7%, in lateral collisions 54,2%, and in other traffic accidents 29,3%. The average age of fatalities with BAT was 42,8 years and of those without BAT 39,1 years. Conclusion: Identification and early recognition of the risk factors of BAT following a traffic accident is crucial for successful treatment of patients with BAT. Front seat passengers over 50 years of age who have been injured in a lateral collision are the most at risk of BAT.

Keywords: aorta, blunt trauma, car accidents, morphology, risk factors

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6202 Analysis of Access Pattern to School and Travel Risks among School Children in Benin City, Edo State, Nigeria

Authors: Barry Aifesehi Aiworo, Henry Oriakhi

Abstract:

This paper, examines the analysis of access pattern to school and travel risks among school children in Benin City, Edo State, Nigeria. The risk includes accident, molestation (sexually) and kidnapping. The objective of this paper are to examine the various means (modes) of transport to school; determine the type and incidences of risk experienced by school children in the study area; examine the risk incidences and ages of school children in the study area. Hypothesis which states that the types of risks encountered by school children are independent of means of transport was tested using the chi-square test (X2). A sampling ratio of twelve percent (12%) was taken from 396 schools in Benin City. By implication, 49 schools were randomly selected in Benin City for this research. A total of 42,053 students in the 49 schools constitute the sample frame for the research. Two percent (2%), 841 students were taken as the sample size. The use of stratified sampling method was applied by stratifying the study area (Benin City) into local governments- Egor, Ikpoba-Okha and Oredo. Thereafter, the lists of schools in the various local governments were obtained from the Ministry of Education before the schools for research were randomly chosen from each local government area. The analysis revealed that 6.7% of the total students interviewed have been involved in road accidents. 1.04% of the total respondents said at one time or the other that they have been kidnapped. Finally, the research found that travel is comparatively safe and believes this may be partly attributable to safer route to schools and school children being more familiar with the school journey. The research indicates that children aged between eleven and fifteen are most at risk of hit or knocked down on Benin City’s roads. These findings may help in planning and targeting road safety initiative (education, campaigns) in Benin City.

Keywords: accident, molestation (sexually), kidnapping, pedophile, pedestrian

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6201 Schistosoma mansoni Infection and Risk Factors among Fishermen at Lake Hawassa, Southern Ethiopia

Authors: Tadesse Menjetta, Daniel Dana, Serkadis Debalke

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Schistosomiasis/Bilharziasis is one of the neglected tropical parasitic diseases caused by different species of genus Schistosoma. Among the species, S. mansoni (causative agents of intestinal schistosomiasis) is one of the causes of severe intestinal parasitic infections with high public and medical importance in Ethiopia. There is a scarcity of information about the status of S. mansoni infection among the fisherman in our study area and in the country at large. Therefore, this study was designed to determine the prevalence and risk factors of S.mansoni infection among fishermen at Lake Hawassa, southern Ethiopia. A cross-sectional study was conducted among the fishermen from April to June 2013 in Hawassa, Southern Ethiopia. A total of 243 fishermen were included by systematic sampling from the lists of the fishermen members in the registration book of fishermen associations in the Hawassa Town. Data on socio-demographic features and risk factors were collected by using semi-structured questionnaires. Stool samples were collected and processed using Kato-Katz thick smear techniques and examined between 30- 40 minute for hookworm and after 24 hours for S. mansoni and other soil-transmitted helminths (STHs). The overall prevalence of S.mansoni among the fishermen was 29.21% (71/243), and the mean intensity of infection was 158.88 egg per gram (EPG). The prevalence of intestinal helminths including S. mansoni was 69.54% (169/243). Moreover, the prevalence of soil-transmitted helminths (STHs) was 40.74% (99/243), 35.80% (87/243) and 5.76% (14/243) for A. lumbricoides, T. trichiura and hookworm species, respectively. Almost similar prevalence of S.mansoni, 31.82%, 31.75%, 31.94% were recorded in age groups of 15-19, 20-24 and 25-29 years, respectively. Fishermen who are swimming always were 2.92 times [95% CI: 1.554, 5.502] more likely to acquire S. mansoni infection than other water contacting habit of the study participants. The results of the current investigation indicated the moderate endemicity of S. mansoni among the fishermen at Lake Hawassa, southern Ethiopia. Fishermen could be the potential risk group for S. mansoni infection and might be responsible for the transmission of S. mansoni to other segments of the communities. Since the high prevalence of STH was recorded among the fishermen, integrated prevention and control strategies from different sectors might be important to tackle the problem.

Keywords: S. mansoni, soil transmitted helminths, fishermen, Lake Hawassa, Ethiopia

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6200 Willingness of Spanish Wineries to Implement Renewable Energies in Their Vineyards and Wineries, as Well as the Limitations They Perceive for Their Implementation

Authors: Javier Carroquino, Nieves García-Casarejos, Pilar Gargallo

Abstract:

Climate change, depletion of non-renewable resources in the current energies, pollution from them, the greater ecological awareness of the population, are factors that suggest the change of energy sources in business. The agri-food industry is a growth sector, concerned about product innovation, process and with a clear awareness of what climate change may mean for it. This sector is supposed to have a high receptivity to the implementation of clean energy, as this favors not only the environment but also the essence of its business. This work, through surveys, aims to know the willingness of Spanish wineries to implement renewable energies in their vineyards, as well as the limitations they perceive for their implementation. This questionnaire allows the characterization of the sector in terms of its geographical typologies, their activity levels, their perception of environmental issues, the degree of implementation of measures to mitigate climate change and improve energy efficiency, and its uses and energy consumption. The analysis of data proves that the penetration of renewable energies is still at low levels, being the most used energies, solar thermal, photovoltaic and biomass. The initial investment seems to be at the origin of the lack of implantation of this type of energy in the wineries, and not so much the costs of operations and maintenance. The environmental management of the wineries is still at an embryonic stage within the company's organization chart, because these services are either outsourced or, if technicians are available, they are not exclusively dedicated to these tasks. However, there is a strong environmental awareness, as evidenced by the number of climate change mitigation and energy efficiency measures already adopted. The gap between high awareness and low achievement is probably due to the lack of knowledge about how to do it or the perception of a high cost.

Keywords: survey, renewable energy, winery, Spanish case

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6199 A Comparison between Five Indices of Overweight and Their Association with Myocardial Infarction and Death, 28-Year Follow-Up of 1000 Middle-Aged Swedish Employed Men

Authors: Lennart Dimberg, Lala Joulha Ian

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Introduction: Overweight (BMI 25-30) and obesity (BMI 30+) have consistently been associated with cardiovascular (CV) risk and death since the Framingham heart study in 1948, and BMI was included in the original Framingham risk score (FRS). Background: Myocardial infarction (MI) poses a serious threat to the patient's life. In addition to BMI, several other indices of overweight have been presented and argued to replace FRS as more relevant measures of CV risk. These indices include waist circumference (WC), waist/hip ratio (WHR), sagittal abdominal diameter (SAD), and sagittal abdominal diameter to height (SADHtR). Specific research question: The research question of this study is to evaluate the interrelationship between the various body measurements, BMI, WC, WHR, SAD, and SADHtR, and which measurement is strongly associated with MI and death. Methods: In 1993, 1,000 middle-aged Caucasian, randomly selected working men of the Swedish Volvo-Renault cohort were surveyed at a nurse-led health examination with a questionnaire, EKG, laboratory tests, blood pressure, height, weight, waist, and sagittal abdominal diameter measurements. Outcome data of myocardial infarction over 28 years come from Swedeheart (the Swedish national myocardial infarction registry) and the Swedish death registry. The Aalen-Johansen and Kaplan–Meier methods were used to estimate the cumulative incidences of MI and death. Multiple logistic regression analyses were conducted to compare BMI with the other four body measurements. The risk for the various measures of obesity was calculated with outcomes of accumulated first-time myocardial infarction and death as odds ratios (OR) in quartiles. The ORs between the 4th and the 1st quartile of each measure were calculated to estimate the association between the body measurement variables and the probability of cumulative incidences of myocardial infarction (MI) over time. Double-sided P values below 0.05 will be considered statistically significant. Unadjusted odds ratios were calculated for obesity indicators, MI, and death. Adjustments for age, diabetes, SBP, and the ratio of total cholesterol/HDL-C and blue/white collar status were performed. Results: Out of 1000 people, 959 subjects had full information about the five different body measurements. Of those, 90 participants had a first MI, and 194 persons died. The study showed that there was a high and significant correlation between the five different body measurements, and they were all associated with CVD risk factors. All body measurements were significantly associated with MI, with the highest (OR=3.6) seen for SADHtR and WC. After adjustment, all but SADHtR remained significant with weaker ORs. As for all-cause mortality, WHR (OR=1.7), SAD (OR=1.9), and SADHtR (OR=1.6) were significantly associated, but not WC and BMI. However, after adjustment, only WHR and SAD were significantly associated with death, but with attenuated ORs.

Keywords: BMI, death, epidemiology, myocardial infarction, risk factor, sagittal abdominal diameter, sagittal abdominal diameter to height, waist circumference, waist-hip ratio

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6198 Self-Efficacy Perceptions of Pre-Service Art and Music Teachers towards the Use of Information and Communication Technologies

Authors: Agah Tugrul Korucu

Abstract:

Information and communication technologies have become an important part of our daily lives with significant investments in technology in the 21st century. Individuals are more willing to design and implement computer-related activities, and they are the main component of computer self-efficacy and self-efficacy related to the fact that the increase in information technology, with operations in parallel with these activities more successful. The Self-efficacy level is a significant factor which determines how individuals act in events, situations and difficult processes. It is observed that individuals with higher self-efficacy perception of computers who encounter problems related to computer use overcome them more easily. Therefore, this study aimed to examine self-efficacy perceptions of pre-service art and music teachers towards the use of information and communication technologies in terms of different variables. Research group consists of 60 pre-service teachers who are studying at Necmettin Erbakan University Ahmet Keleşoğlu Faculty of Education Art and Music department. As data collection tool of the study; “personal information form” developed by the researcher and used to collect demographic data and "the perception scale related to self-efficacy of informational technology" are used. The scale is 5-point Likert-type scale. It consists of 27 items. The Kaiser-Meyer-Olkin (KMO) sample compliance value is found 0.959. The Cronbach alpha reliability coefficient of the scale is found to be 0.97. computer-based statistical software package (SPSS 21.0) is used in order to analyze the data collected by data collection tools; descriptive statistics, t-test, analysis of variance are used as statistical techniques.

Keywords: self-efficacy perceptions, teacher candidate, information and communication technologies, art teacher

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6197 Demand for Index Based Micro-Insurance (IBMI) in Ethiopia

Authors: Ashenafi Sileshi Etefa, Bezawit Worku Yenealem

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Micro-insurance is a relatively new concept that is just being introduced in Ethiopia. For an agrarian economy dominated by small holder farming and vulnerable to natural disasters, mainly drought, the need for an Index-Based Micro Insurance (IBMI) is crucial. Since IBMI solves moral hazard, adverse selection, and access issues to poor clients, it is preferable over traditional insurance products. IBMI is being piloted in drought prone areas of Ethiopia with the aim of learning and expanding the service across the country. This article analyses the demand of IBMI and the barriers to demand and finds that the demand for IBMI has so far been constrained by lack of awareness, trust issues, costliness, and the level of basis risk; and recommends reducing the basis risk and increasing the role of government and farmer cooperatives.

Keywords: agriculture, index based micro-insurance (IBMI), drought, micro-finance institution (MFI)

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6196 Investigating the Association between Escherichia Coli Infection and Breast Cancer Incidence: A Retrospective Analysis and Literature Review

Authors: Nadia Obaed, Lexi Frankel, Amalia Ardeljan, Denis Nigel, Anniki Witter, Omar Rashid

Abstract:

Breast cancer is the most common cancer among women, with a lifetime risk of one in eight of all women in the United States. Although breast cancer is prevalent throughout the world, the uneven distribution in incidence and mortality rates is shaped by the variation in population structure, environment, genetics and known lifestyle risk factors. Furthermore, the bacterial profile in healthy and cancerous breast tissue differs with a higher relative abundance of bacteria capable of causing DNA damage in breast cancer patients. Previous bacterial infections may change the composition of the microbiome and partially account for the environmental factors promoting breast cancer. One study found that higher amounts of Staphylococcus, Bacillus, and Enterobacteriaceae, of which Escherichia coli (E. coli) is a part, were present in breast tumor tissue. Based on E. coli’s ability to damage DNA, it is hypothesized that there is an increased risk of breast cancer associated with previous E. coli infection. Therefore, the purpose of this study was to evaluate the correlation between E. coli infection and the incidence of breast cancer. Holy Cross Health, Fort Lauderdale, provided access to the Health Insurance Portability and Accountability (HIPAA) compliant national database for the purpose of academic research. International Classification of Disease 9th and 10th Codes (ICD-9, ICD-10) was then used to conduct a retrospective analysis using data from January 2010 to December 2019. All breast cancer diagnoses and all patients infected versus not infected with E. coli that underwent typical E. coli treatment were investigated. The obtained data were matched for age, Charlson Comorbidity Score (CCI score), and antibiotic treatment. Standard statistical methods were applied to determine statistical significance and an odds ratio was used to estimate the relative risk. A total of 81286 patients were identified and analyzed from the initial query and then reduced to 31894 antibiotic-specific treated patients in both the infected and control group, respectively. The incidence of breast cancer was 2.51% and present in 2043 patients in the E. coli group compared to 5.996% and present in 4874 patients in the control group. The incidence of breast cancer was 3.84% and present in 1223 patients in the treated E. coli group compared to 6.38% and present in 2034 patients in the treated control group. The decreased incidence of breast cancer in the E. coli and treated E. coli groups was statistically significant with a p-value of 2.2x10-16 and 2.264x10-16, respectively. The odds ratio in the E. coli and treated E. coli groups was 0.784 and 0.787 with a 95% confidence interval, respectively (0.756-0.813; 0.743-0.833). The current study shows a statistically significant decrease in breast cancer incidence in association with previous Escherichia coli infection. Researching the relationship between single bacterial species is important as only up to 10% of breast cancer risk is attributable to genetics, while the contribution of environmental factors including previous infections potentially accounts for a majority of the preventable risk. Further evaluation is recommended to assess the potential and mechanism of E. coli in decreasing the risk of breast cancer.

Keywords: breast cancer, escherichia coli, incidence, infection, microbiome, risk

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6195 Aesthetics and Semiotics in Theatre Performance

Authors: Păcurar Diana Istina

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Structured in three chapters, the article attempts an X-ray of the theatrical aesthetics, correctly understood through the emotions generated in the intimate structure of the spectator that precedes the triggering of the viewer’s perception and not through the superposition, unfortunately common, of the notion of aesthetics with the style in which a theater show is built. The first chapter contains a brief history of the appearance of the word aesthetic, the formulation of definitions for this new term, as well as its connections with the notions of semiotics, in particular with the perception of the message transmitted. Starting with Aristotle and Plato, and reaching Magritte, their interventions should not be interpreted in the sense that the two scientific concepts can merge into one discipline. The perception that is the object of everyone’s analysis, the understanding of meaning, the decoding of the messages sent, and the triggering of feelings that culminate in pleasure, shaping the aesthetic vision, are some elements that keep semiotics and aesthetics distinct, even though they share many methods of analysis. The compositional processes of aesthetic representation and symbolic formation are analyzed in the second part of the paper from perspectives that include or do not include historical, cultural, social, and political processes. Aesthetics and the organization of its symbolic process are treated, taking into account expressive activity. The last part of the article explores the notion of aesthetics in applied theater, more specifically in the theater show. Taking the postmodern approach that aesthetics applies to the creation of an artifact and the reception of that artifact, the intervention of these elements in the theatrical system must be emphasized –that is, the analysis of the problems arising in the stages of the creation, presentation, and reception, by the public, of the theater performance. The aesthetic process is triggered involuntarily, simultaneously, or before the moment when people perceive the meaning of the messages transmitted by the work of art. The finding of this fact makes the mental process of aesthetics similar or related to that of semiotics. No matter how perceived individually, beauty, the mechanism of production can be reduced to two. The first step presents similarities to Peirce’s model, but the process between signified and signified additionally stimulates the related memory of the evaluation of beauty, adding to the meanings related to the signification itself. Then, the second step, a process of comparison, is followed, in which one examines whether the object being looked at matches the accumulated memory of beauty. Therefore, even though aesthetics is derived from the conceptual part, the judgment of beauty and, more than that, moral judgment come to be so important to the social activities of human beings that it evolves as a visible process independent of other conceptual contents.

Keywords: aesthetics, semiotics, symbolic composition, subjective joints, signifying, signified

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6194 The Epidemiological Study on Prevalence of Giardia lamblia among Children in Esfahan City of Iran

Authors: Shahla Rostamirad

Abstract:

Purpose: Giardiasis is a widespread infection in humans caused by Giardia lamblia. The prevalence of this parasite among children in Isfahan of Iran is unknown. This study intended to estimate Giardia lamblia infection prevalence and identify possible associated risk factors in a healthy pediatric population living in the Isfahan, a metropolitan city of Iran. Methods: Between September 2010 and March 2012, 1448 stool sample from children with clinical manifestation that refer to clinical lab in Isfahan city for stool examination were collected and analyzed. About 1218 samples were positive for parasitic disease. All of samples were examined and diagnosed by direct examination and formalin-ether concentration of stools. Results: A total of 1218 positive cases were analyzed in this study. The findings showed that 92.5% of patients were infected by protozoa and 7.5 percent with helminth infection. The highest and lowest rate of infection belongs to Giardia lamblia and Entamoeba histolytica with 75% and 1.1%, respectively. Other infection cases were included of Blastocystys hominis 9.9%, E. coli 6.5%, H. nana 1.3%, Enterobious vermicolaris 4% and Ascaris lumbricoides 2.2% percent. The population studied revealed a gender distribution of 53.2% male and 46.8% female. Age distribution was 57.3% between 0-5 years and 42.7% between 6-15 years.The prevalence was higher among children aged 0-5 years (57.8%), than among older children (42.2%). Conclusion: The prevalence of protozoan parasite, especially Giardiasis, in children residing in the region of Isfahan is high. Several risk factors were associated with this prevalence and highlight the importance of parents' education and sanitation conditions in the children's well being. The association between Giardia lamblia and H. pylori seems an important issue deserving further investigation in order to promote prevention or treatment strategies. Other risk factor include presence of Helicobacter pylori infection, living in houses with own drainage system and reported household, pet contact, especially with cat and dog.

Keywords: Giardia duodenalis, prevalence, risk factors, children, Isfahan, Iran

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6193 Correlation between Overweightness and the Extent of Coronary Atherosclerosis among the South Caspian Population

Authors: Maryam Nabati, Mahmood Moosazadeh, Ehsan Soroosh, Hanieh Shiraj, Mahnaneh Gholami, Ali Ghaemian

Abstract:

Background: Reported effects of obesity on the extent of angiographic coronary artery disease(CAD) have beeninconsistent. The present study aimed to investigate the relationships between the indices of obesity and otheranthropometric markers with the extent of CAD. Methods: This study was conducted on 1008 consecutive patients who underwent coronary angiography. Bodymass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) wereseparately calculated for each patient. Extent, severity, and complexity of CAD were determined by the Gensini andSYNTAX scores. Results: According to the results, there was a significant inverse correlation between the SYNTAX score with BMI(r = − 0.110; P < 0.001), WC (r = − 0.074; P = 0.018), and WHtR (r = − 0.089; P = 0.005). Furthermore, a significant inversecorrelation was observed between the Gensini score with BMI (r = − 0.090; P = 0.004) and WHtR (r = − 0.065; P =0.041). However, the results of multivariate linear regression analysis did not show any association between theSYNTAX and Gensini scores with the indices of obesity and overweight. On the other hand, the patients with anunhealthy WC had a higher prevalence of diabetes mellitus (DM) (P = 0.004) and hypertension (HTN) (P < 0.001) compared to the patients with healthy values. Coexistence of HTN and DM was more prevalent in subjects with anunhealthy WC and WHR compared to that in those with healthy values (P = 0.002 and P = 0.032, respectively). Conclusion: It seems that the anthropometric indices of obesity are not the predictors of the angiographic severityof CAD. However, they are associated with an increased risk of cardiovascular risk factors and higher risk profile.

Keywords: body mass index, BMI, coronary artery disease, waist circumference

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6192 Workload and Task Distribution in Public Healthcare: A Qualitative Explorative Study From Nurse Leaders’ Perceptions

Authors: Jessica Hemberg, Mikaela Miller

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Unreasonable workload and work-related stress can reduce nurse leaders’ job satisfaction and productivity and can increase absence and burnout. Nurse leaders’ workload in public healthcare settings is relatively unresearched. The aim of this study was to investigate nurse leaders’ perceptions of workload and task distribution with relation to leading work tasks in public healthcare. A qualitative explorative design was used. The data material consisted of texts from interviews with nurse leaders in public healthcare (N=8). The method was inspired by content analysis. The COREQ checklist was used. Informed consent was sought from the participants regarding study participation and the storage and handling of data for research purposes. Six main themes were found: Increased and unreasonable workload, Length of work experience as nurse leader affects perception of workload, Number of staff and staff characteristics affect perception of workload, Versatile and flexible task distribution, Working overtime as a way of managing high workload, and Insufficient time for leadership mission. The workload for nurse leaders in a public healthcare setting was perceived to be unreasonable. Common measures for managing high workload included working overtime, delegating work tasks and organizing more staff resources in the form of additional staff. How nurse leaders perceive their workload was linked to both the number of staff and staff characteristics. These should both be considered equally important when determining staff levels and measuring nurse leaders’ workload. Future research should focus on investigating workload and task distribution from nurses’ perspectives.

Keywords: nurse leaders, workload, task distribution, public healthcare, qualitative

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6191 Sustainability Fitting into Supply Chain

Authors: Menoka Bal, David Bryde

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Sustainability in supply chain has become a topic of great interest and is linked to the assumption that a more sustainable the supply chain is the more the supply chain can perform better. The aim of this paper is to identify the different key aspects of the sustainable supply chain management. This paper will also identify the practices that are required to fulfill the demands of sustainability and, therefore, contributing to improve the sustainability performance. As part of this, the authors will identify how these different practices of implementing to achieve Sustainability in Supply Chain. This paper is conceptual in nature. This paper identifies some of the key categories which are of high importance for the sustainable management of supply chains. These key categories are: Managing the Supply Chain Risk, Improving the Supply Chain Performance, Managing the Supply Chain Value, Making the Supply Chain Leaner, Managing the Supply Chain Relationship. Through in-depth analysis, this paper aims to develop a theory of integrated management process that is most appropriate for sustainability assessment in supply chain.

Keywords: sustainability, risk management, value management, project performance, supply chain management

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6190 Comparison of Formation Sensitivity Gap between Islamic Maybank Indonesia and Islamic Maybank Malaysia

Authors: Puji Sucia Sukmaningrum, Achsania Hendratmi, Noven Suprayogi, Muhammad Madyan

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Theoretically, Islamic banks in Indonesia and Malaysia not necessarily aware to the interest rate fluctuation, since they don’t use interest-based instruments. Both countries use dual banking system in which Islamic and conventional banking system are exist. This situation makes the profit-sharing level of the Islamic banks will be indirectly affected by the interest rate fluctuation from the conventional banks system. One of the risk management tools for anticipating the risk of interest rate fluctuation is gap management, which has purpose to narrow the difference between Rate Sensitive Asset (RSA) and Rate Sensitive Liability (RSL). This formed gap will give the information about the risk potential in Islamic banks which respect to the fluctuation on the interest rate. This study aims to determine the position of the gap formed at Islamic Maybank Indonesia and Islamic Maybank Malaysia, and analyze the difference in the formation of gap based on the period of sensitivity. This study is a quantitative research with comparative study using sensitivity gap analysis, independent sample t-test, and Mann-Whitney method. The data being used was secondary data from Maturity Profile contained in the Annual Financial Report of Islamic Maybank Indonesia and Islamic Maybank Malaysia from 2011 to 2015 period. The result shows that, cumulatively the formation of the gap was negative gap. From the results of independent sample t-test and Mann-Whitney, the formation of the gap in Islamic Maybank Indonesia and Islamic Maybank Malaysia for a period of sensitivity of ≤ 1 month and >1-3 months show a significant difference, while the period of sensitivity >3-12 months does not. The result shows, even though Indonesia and Malaysia using same dual banking systems, the gap values are different. The difference in debt policy between Indonesia and Malaysia also affecting the gap sensitivity in debt. In can be concluded that each country needs an appropriate gap management to support its Islamic banking performance specifically.

Keywords: assets and liability management, gap management, interest rate risk, Islamic bank

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6189 Interdisciplinary Teaching for Nursing Students: A Key to Understanding Teamwork

Authors: Ilana Margalith, Yaron Niv

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One of the most important factors of professional health treatment is teamwork, in which each discipline contributes its expert knowledge, thus ensuring quality and a high standard of care as well as efficient communication (one of the International Patient Safety Goals). However, in most countries, students are educated separately by each health discipline. They are exposed to teamwork only during their clinical experience, which in some cases is short and skill-oriented. In addition, health organizations in most countries are hierarchical and although changes have occurred in the hierarchy of the medical system, there are still disciplines that underrate the unique contributions of other health professionals, thus, young graduates of health professions develop and base their perception of their peers from other disciplines on insufficient knowledge. In order to establish a wide-ranging perception among nursing students as to the contribution of different health professionals to the health of their patients, students at the Clalit Nursing Academy, Rabin Campus (Dina), Israel, participated in an interdisciplinary clinical discussion with students from several different professions, other than nursing, who were completing their clinical experience at Rabin Medical Center in medicine, health psychology, social work, audiology, physiotherapy and occupational therapy. The discussion was led by a medical-surgical nursing instructor. Their tutors received in advance, a case report enabling them to prepare the students as to how to present their professional theories and interventions regarding the case. Mutual stimulation and acknowledgment of the unique contribution of each part of the team enriched the nursing students' understanding as to how their own nursing interventions could be integrated into the entire process towards a safe and speedy recovery of the patient.

Keywords: health professions' students, interdisciplinary clinical discussion, nursing education, patient safety

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6188 A 10 Year Review of the Complications of Ingested and Aspirated Dentures

Authors: Rory Brown, Jessica Daniels, Babatunde Oremule, William Tsang, Sadie Khwaja

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Introduction: Dentures are common and are an intervention for both physical and psychological symptoms associated with tooth loss. However, the humble denture can cause morbidity and mortality if swallowed or aspirated. Numerous case reports document complications including hollow viscus perforation, fistula formation and airway compromise. The purpose of this review was to examine the literature documenting cases of swallowed or aspirated dentures over the past ten years to investigate factors that contribute to developing complications. Methods: A Medline literature search was performed to identify cases of denture ingestion or aspiration for over ten years. Data was collected to include patient, appliance and temporal factors that may contribute to developing complications including hollow viscus perforation, fistula formation, abscess, bowel obstruction, necrosis, hemorrhage and airway obstruction. The data was analyzed using observational and inferential statistics in the form of Chi-Squared and Pearson correlation tests. Results: Eighty-five cases of ingested or aspirated dentures were identified from 77 articles published between 1/10/2009 and 31/10/2019. Fourteen articles were excluded because they did not provide sufficient information on individual cases. Complications were documented in 37.6% of patients, and 2 cases resulted in death. There was no significant difference in complication risk based on patient age, hooked appliance, level of impaction, or radiolucency. However, symptoms of greater than 1-day duration are associated with an increased risk of complication (p=0.005). Increased time from ingestion or aspiration to removal is associated with an increased risk of complications, and the p-value remains significant up to and including day 4 (p=0.017). Conclusions: With denture use predicted to rise complications from the denture, ingestion and aspiration may become more frequent. We have demonstrated that increased symptom duration significantly increases the risk of developing complications. Additionally, we established the risk of developing complications is significantly reduced if the denture is removed with four days of aspiration or ingestion. By actively intervening early when presented with a case of swallowed or aspirated dentures, we may be able to reduce the morbidity associated with this unassuming device.

Keywords: aspiration, denture, ingestion, endoscopic foreign, body removal, foreign body impaction

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