Search results for: public score
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7703

Search results for: public score

5993 Assessment on the Improvement of the Quality of Life after One Year of Regular Physical Activity and Treatment in Patients with Postmenopausal Osteoporosis

Authors: Stoyanka Georgieva Vladeva, Elena Kirilova Kirilova, Nikola Kirilov Kirilov

Abstract:

Summary: WHO (World Health Organization) recommends the elder people a certain amount of regular physical activity in order to prevent some of the health issues. Postmenopausal osteoporosis is one of the chronic diseases which requires the maintaining of regular physical activity. The regular activity combined with an adequate medical treatment greatly improves the quality of life of the patient. Objectives: Assessment of the effect of the regular physical activity recommended by WHO on the quality of life in patients with postmenopausal osteoporosis. Material and methods: For the period of one year 68 female patients treated with Denosumab have been monitored. The bone density has been measured with the DEXA method in accordance to the T-score. No patients having any oncologic diseases and secondary osteoporosis have been included in the study. The subjects have been divided into groups by their age. The first group – women aged under 65 years (27 subjects) and the second group – women aged over 65 years (41 subjects). All patients have been advised to maintain regular physical activity included in the recommendations of the WHO in accordance with the age and the disease. The quality of life has been assessed in the beginning and at the end of the one-year period using the SF 36V2 questionnaire. Results: Only 31% of the subjects have engaged into regular increased physical activities for the whole period. Among them are mostly patients of the second group (aged over 65 years, 71%). The women from the both groups who were engaging into regular activities for this one-year period all experience an improvement of the quality of life. These results show that older patients understand the necessity of the physical activity for their health. The comparison of the output data to the scales of physical activity, durability, body pain, vitality, social activity and emotional stability has found an improvement at the end of the period in all patients. The osteodensitometry showed general improvement of the T-score. Patients with additional visits to their rheumatologist have better results. Conclusion: Combination of regular physical activity in accordance to the recommendations of WHO and medical treatment including anti-osteoporotic drugs improves the quality of life of women with postmenopausal osteoporosis.

Keywords: elderly patients, osteoporosis, physical activity, quality of life

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5992 A Shift in Approach from Cereal Based Diet to Dietary Diversity in India: A Case Study of Aligarh District

Authors: Abha Gupta, Deepak K. Mishra

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Food security issue in India has surrounded over availability and accessibility of cereal which is regarded as the only food group to check hunger and improve nutrition. Significance of fruits, vegetables, meat and other food products have totally been neglected given the fact that they provide essential nutrients to the body. There is a need to shift the emphasis from cereal-based approach to a more diverse diet so that aim of achieving food security may change from just reducing hunger to an overall health. This paper attempts to analyse how far dietary diversity level has been achieved across different socio-economic groups in India. For this purpose, present paper sets objectives to determine (a) percentage share of different food groups to total food expenditure and consumption by background characteristics (b) source of and preference for all food items and, (c) diversity of diet across socio-economic groups. A cross sectional survey covering 304 households selected through proportional stratified random sampling was conducted in six villages of Aligarh district of Uttar Pradesh, India. Information on amount of food consumed, source of consumption and expenditure on food (74 food items grouped into 10 major food groups) was collected with a recall period of seven days. Per capita per day food consumption/expenditure was calculated through dividing consumption/expenditure by household size and number seven. Food variety score was estimated by giving 0 values to those food groups/items which had not been eaten and 1 to those which had been taken by households in last seven days. Addition of all food group/item score gave result of food variety score. Diversity of diet was computed using Herfindahl-Hirschman index. Findings of the paper show that cereal, milk, roots and tuber food groups contribute a major share in total consumption/expenditure. Consumption of these food groups vary across socio-economic groups whereas fruit, vegetables, meat and other food consumption remain low and same. Estimation of dietary diversity show higher concentration of diet due to higher consumption of cereals, milk, root and tuber products and dietary diversity slightly varies across background groups. Muslims, Scheduled caste, small farmers, lower income class, food insecure, below poverty line and labour families show higher concentration of diet as compared to their counterpart groups. These groups also evince lower mean intake of number of food item in a week due to poor economic constraints and resultant lower accessibility to number of expensive food items. Results advocate to make a shift from cereal based diet to dietary diversity which not only includes cereal and milk products but also nutrition rich food items such as fruits, vegetables, meat and other products. Integrating a dietary diversity approach in food security programmes of the country would help to achieve nutrition security as hidden hunger is widespread among the Indian population.

Keywords: dietary diversity, food Security, India, socio-economic groups

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5991 Corporate Social Responsibility: A Comparative Study of Two Largest Banks in India

Authors: Navdeep Kaur

Abstract:

Corporate Social Responsibility is the process through which the organizations execute their philanthropic visions for social welfare. This paper considers the data of one Public Sector Bank–State Bank of India (SBI) and one Private Sector Bank-Industrial Credit and Investment Corporation of India (ICICI) from the year 2008 to 2016. The study is based on descriptive research design, and secondary data collected from the annual report of respective bank from website and different literature are reviewed. Least Square Method is used for estimating CSR spending for the financial year 2017-18. The analysis shows that these banks are making efforts for the implementation of CSR, but are not spending their 2% share of profits on CSR. There is a need for better CSR activities by the banks, which is possible by concentrating more on the prevailing social issues. The finding reveals that the percentage of profit after tax spends for CSR by SBI is more compare to ICICI. The estimated Spending for CSR for 2017-18 is also more in SBI as compared to ICICI.

Keywords: banking sector, corporate social responsibility in India, financial institution, public sector banks, SBI, ICICI

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5990 Towards an Equitable Proprietary Regime: Property Rights Over Human Genes as a Case Study

Authors: Aileen Editha

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The legal recognition of property rights over human genes is a divisive topic to which there is no resolution. As a frequently discussed topic, scholars and practitioners often highlight the inadequacies of a proprietary regime. However, little has been said in regard to the nature of human genetic materials (HGMs). This paper proposes approaching the issue of property over HGMs from an alternative perspective that looks at the personal and social value and valuation of HGMs. This paper will highlight how the unique and unresolved status of HGMs is incompatible with the main tenets of property and, consequently, contributes to legal ambiguity and uncertainty in the regulation of property rights over human genes. HGMs are perceived as part of nature and a free-for-all while also being within an individual’s private sphere. Additionally, it is also considered to occupy a unique “not-private-nor-public” status. This limbo-like position clashes with property’s fundamental characteristic that relies heavily on a clear public/private dichotomy. Moreover, as property is intrinsically linked to the legal recognition of one’s personhood, this irresolution benefits some while disadvantages others. In particular, it demands the publicization of once-private genes for the “common good” but subsequently encourages privatization (through labor) of these now-public genes. This results in the gain of some (already privileged) individuals while enabling the disenfranchisement of members of minority groups, such as Indigenous communities. This paper will discuss real and intellectual property rights over human genes, such as the right to income or patent rights, in Canada and the US. This paper advocates for a sui generis approach to governing rights and interests over human genes that would not rely on having a strict public/private dichotomy. Not only would this improve legal certainty and clarity, but it would also alleviate—or, at the very least, minimize—the role that the current law plays in further entrenching existing systemic inequalities. Despite the specificity of this topic, this paper argues that there are broader lessons to be learned. This issue is an insightful case study on the interconnection of various principles in law, society, and property, and what must be done when discordance between one or more of those principles has detrimental societal outcomes. Ultimately, it must be remembered that property is an adaptable and malleable instrument that can be developed to ensure it contributes to equity and flourishing.

Keywords: property rights, human genetic materials, critical legal scholarship, systemic inequalities

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5989 Housing Recovery in Heavily Damaged Communities in New Jersey after Hurricane Sandy

Authors: Chenyi Ma

Abstract:

Background: The second costliest hurricane in U.S. history, Sandy landed in southern New Jersey on October 29, 2012, and struck the entire state with high winds and torrential rains. The disaster killed more than 100 people, left more than 8.5 million households without power, and damaged or destroyed more than 200,000 homes across the state. Immediately after the disaster, public policy support was provided in nine coastal counties that constituted 98% of the major and severely damaged housing units in NJ overall. The programs include Individuals and Households Assistance Program, Small Business Loan Program, National Flood Insurance Program, and the Federal Emergency Management Administration (FEMA) Public Assistance Grant Program. In the most severely affected counties, additional funding was provided through Community Development Block Grant: Reconstruction, Rehabilitation, Elevation, and Mitigation Program, and Homeowner Resettlement Program. How these policies individually and as a whole impacted housing recovery across communities with different socioeconomic and demographic profiles has not yet been studied, particularly in relation to damage levels. The concept of community social vulnerability has been widely used to explain many aspects of natural disasters. Nevertheless, how communities are vulnerable has been less fully examined. Community resilience has been conceptualized as a protective factor against negative impacts from disasters, however, how community resilience buffers the effects of vulnerability is not yet known. Because housing recovery is a dynamic social and economic process that varies according to context, this study examined the path from community vulnerability and resilience to housing recovery looking at both community characteristics and policy interventions. Sample/Methods: This retrospective longitudinal case study compared a literature-identified set of pre-disaster community characteristics, the effects of multiple public policy programs, and a set of time-variant community resilience indicators to changes in housing stock (operationally defined by percent of building permits to total occupied housing units/households) between 2010 and 2014, two years before and after Hurricane Sandy. The sample consisted of 51 municipalities in the nine counties in which between 4% and 58% of housing units suffered either major or severe damage. Structural equation modeling (SEM) was used to determine the path from vulnerability to the housing recovery, via multiple public programs, separately and as a whole, and via the community resilience indicators. The spatial analytical tool ArcGIS 10.2 was used to show the spatial relations between housing recovery patterns and community vulnerability and resilience. Findings: Holding damage levels constant, communities with higher proportions of Hispanic households had significantly lower levels of housing recovery while communities with households with an adult >age 65 had significantly higher levels of the housing recovery. The contrast was partly due to the different levels of total public support the two types of the community received. Further, while the public policy programs individually mediated the negative associations between African American and female-headed households and housing recovery, communities with larger proportions of African American, female-headed and Hispanic households were “vulnerable” to lower levels of housing recovery because they lacked sufficient public program support. Even so, higher employment rates and incomes buffered vulnerability to lower housing recovery. Because housing is the "wobbly pillar" of the welfare state, the housing needs of these particular groups should be more fully addressed by disaster policy.

Keywords: community social vulnerability, community resilience, hurricane, public policy

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5988 Flexible Furniture in Urban Open Spaces: A Tool to Achieve Social Sustainability

Authors: Mahsa Ghafouri, Guita Farivarsadri

Abstract:

In urban open spaces, furniture plays a crucial role in meeting various needs of the users over time. Furniture consists of elements that not only can facilitate physical needs individually but also fulfill social, psychological, and cultural demands on an urban scale. Creating adjustable urban spaces and using flexible furniture can provide the possibility of using urban spaces for a wide range of uses and activities and allow the engagement of users with distinct abilities and limitations in these activities. Flexibility in urban furniture can be seen as designing a number of modular components that are movable, expandable, adjustable, and changeable to accommodate various functions. Although there is a great amount of research related to flexibility and its distinct insights into achieving spaces that can cope with changing demands, this fundamental issue is often neglected in the design of urban furniture. However, in the long term, to address changing public needs over time, it can be logical to bring this quality into the design process to make spaces that can be sustained for a long time. This study aims to first introduce diverse kinds of flexible furniture that can be designed for urban public spaces and then to realize how this flexible furniture can improve the quality of public open spaces and social interaction and make them more adaptable over time and, as a result, achieve social sustainability. This research is descriptive and is mainly based on an extensive literature review and the analysis and classification of existing examples around the world. This research tends to illustrate various kinds of approaches that can help designers create flexible furniture to enhance the sustainability and quality of urban open spaces and, in this way, act as a guide for urban designers in this respect.

Keywords: flexible furniture, flexible design, urban open spaces, adaptability, moveability, social sustainability

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5987 A Comparative Case Study of Institutional Work in Public Sector Organizations: Creating Knowledge Management Practice

Authors: Dyah Adi Sriwahyuni

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Institutional work has become a prominent and contemporary institutional theory perspective in organization studies. A wealth of studies in organizations have explored actor activities in creating, maintaining, and disrupting institutions at the field level. However, the exploration of the work of actors in creating new management practices at the organizational level has been somewhat limited. The current institutional work literature mostly describes the work of actors at the field level and ignores organizational actors who work to realize management practices. Organizational actors here are defined as actors in organizations who work to institutionalize a particular management practice within the organizations. The extant literature has also generalized the types of management practices, which meant overlooking the unique characteristics of each management fashion as well as a management practice. To fill these gaps, this study aims to provide empirical evidence so as to contribute theoretically to institutional work through a comparative case study on organizational actors’ creation of knowledge management (KM) practice in two public sector organizations in Indonesia. KM is a contemporary management practice employed to manage individual and organizational knowledge in order to improve organizational performance. This practice presents a suitable practical setting with which to provide a rich understanding of the organizational actors’ institutional work and their connection with technology. Drawing on and extending the work of Perkmann and Spicer (2008), this study explores the forms of institutional work performed by organizational actors, including their motivation, skills, challenges, and opportunities. The primary data collection is semi-structured interviews with knowledgeable actors and document analysis for validity and triangulation. Following Eisenhardt's cross-case patterns, the researcher analyzed the collected data focusing on within-group similarities and intergroup differences. The researcher coded interview data using NVivo and used documents to corroborate the findings. The study’s findings add to the wealth of institutional theory literature in organization studies, particularly institutional work related to management practices. This study builds a theory about the work of organizational actors in creating knowledge management practices. Using the perspective of institutional work, research can show the roles of the various actors involved, their practices, and their relationship to technology (materiality), not only focusing on actors with a power which has been the theorizing of institutional entrepreneurship. The development of knowledge management practices in the Indonesian public sector is also a significant additional contribution, given that the current KM literature is dominated by conceptualizing the KM framework and the impact of KM on organizations. The public sector, which is the research setting, also provides important lessons on how actors in a highly institutionalized context are creating an institution, in this case, a knowledge management practice.

Keywords: institutional work, knowledge management, case study, public sector organizations

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5986 A Comparative Understanding of Critical Problems Faced by Pakistani and Indian Transportation Industry

Authors: Fawad Hussain, Saleh Abdullah Saleh, Mohammad Basir B Saud, Mohd Azwardi Md. Isa

Abstract:

It is very important for a developing nation to develop their infrastursture on the prime priority because their infrastursture particularly their roads and transporation functions as a blood in the system. Almost 1.1 billion populations share the travel and transportation industry in India. On the other hand, the Pakistan transportation industry is also extensive and elevating about 170 million users of transportation. Indian and Pakistani specifically within bus industry have good interconnectivity within and between the urban and rural areas as well as connectivity between the two countries, which is dramatically helping the economic alleviation of both countries. Due to high economic instability, unemployment and poverty rate are among the reasons why both the governments are very committed and seriously taken further action to help boost their economy. They believe that any form of transportation development would play a vital role in the development of land, infrastructure which could indirectly support many other industries’ development, such as tourism, freighting and shipping businesses, just to mention a few. However, it seems that their previous transportation planning in the due course has failed to meet the fast growing demand. As with the spin of time, both the countries are looking forward for a reasonable, safe and economical long term solutions, which is from time to time keep appreciating and reacting according to other key economic drivers. Content analysis method and case study approach is used in this paper and secondary data from the bureau of statistic is used for case analysis. The paper centered on the mobility concerns of the lower and middle income people in India and Pakistan. The paper is aimed to highlight the weaknesses, opportunities and limitations resulting from low priority industry for government, which is making the either country's public suffer. The paper has concluded that the main issue is identified as the slow, inappropriate and unfavorable decisions which are not in favor of long term country’s economic development and public welfare as well as interest. The paper also recommends to future market sense public and private transportation, which has failed to meet the public expectations.

Keywords: bus transportation industries, transportation demand, government parallel initiatives, road and traffic congestions

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5985 Bridging the Gap between M and E, and KM: Towards the Integration of Evidence-Based Information and Policy Decision-Making

Authors: Xueqing Ivy Chen, Christo De Coning

Abstract:

It is clear from practice that a gap exists between Result-Based Monitoring and Evaluation (RBME) as a discipline, and Knowledge Management (KM) on the other hand. Whereas various government departments have institutionalised these functions, KM and M&E has functioned in isolation from each other in a practical sense in the public sector. It’s therefore necessary to explore the relationship between KM and M&E and the necessity for integration, so that a convergence of these disciplines can be established. An integration of KM and M&E will lead to integration and improvement of evidence-based information and policy decision-making. M&E and KM process models are available but the complementarity between specific process steps of these process models are not exploited. A need exists to clarify the relationships between these functions in order to ensure evidence based information and policy decision-making. This paper will depart from the well-known policy process models, such as the generic model and consider recent on the interface between policy, M&E and KM.

Keywords: result-based monitoring and evaluation, RBME, knowledge management, KM, evident based decision making, public policy, information systems, institutional arrangement

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5984 On the Road towards Effective Administrative Justice in Macedonia, Albania and Kosovo: Common Challenges and Problems

Authors: Arlinda Memetaj

Abstract:

A sound system of administrative justice represents a vital element of democratic governance. The proper control of public administration consists not only of a sound civil service framework and legislative oversight, but empowerment of the public and courts to hold public officials accountable for their decision-making through the application of fair administrative procedural rules and the use of appropriate administrative appeals processes and judicial review. The establishment of both effective public administration and administrative justice system has been for a long period of time among the most ‘important and urgent’ final strategic objectives of almost any country in the Balkans region, including Macedonia, Albania and Kosovo. Closely related to this is their common strategic goal to enter the membership in the European Union, which requires fulfilling of many criteria and standards as incorporated in EU acquis communautaire. The latter is presently done with the framework of the Stabilization and Association Agreement which each of these countries has concluded with the EU accordingly. To above aims, each of the three countries has so far adopted a huge series of legislative and strategic documents related to any aspects of their individual administrative justice system. ‘Changes and reforms’ in this field have been thus the most frequent terms being used in any of these countries. The three countries have already established their own national administrative judiciary, while permanently amending their laws on the general administrative procedure introducing thereby considerable innovations concerned. National administrative courts are expected to have crucial important role within the broader judiciary systems-related reforms of these countries; they are designed to check the legality of decisions of the state administration with the aim to guarantee an effective protection of human rights and legitimate interests of private persons through a regular, conform, fast and reasonable judicial administrative process. Further improvements in this field are presently an integral crucial part of all the relevant national strategic documents including the ones on judiciary reform and public administration reform, as adopted by each of the three countries; those strategic documents are designed among others to provide effective protection of their citizens` rights` of administrative justice. On the basis of the later, the paper finally is aimed at highlighting selective common challenges and problems of the three countries on their European road, while claiming (among others) that the current status quo situation in each of them may be overcome only if there is a proper implementation of the administrative courts decisions and a far stricter international monitoring process thereof. A new approach and strong political commitment from the highest political leadership is thus absolutely needed to ensure the principles of transparency, accountability and merit in public administration. The main methods used in this paper include the analytical and comparative ones due to the very character of the paper itself.

Keywords: administrative courts , administrative justice, administrative procedure, benefit, effective administrative justice, human rights, implementation, monitoring, reform

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5983 Understanding Tactical Urbanisms in Derelict Areas

Authors: Berna Yaylalı, Isin Can Traunmüller

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This paper explores the emergent bottom-up practices in the fields of architecture and urban design within comparative perspectives of two cities. As a temporary, easily affordable intervention that gives the possibility of transforming neglected spaces into vibrant public spaces, tactical urbanism, together with creative place-making strategies, presents alternative ways of creating sustainable developments in derelict and underused areas. This study examines the potential of social and physical developments through a reading of case studies of two creative spatial practices: a pop-up garden transformed from an unused derelict space in Favoriten, Vienna, and an urban community garden in Kuzguncuk, Istanbul. Two cities are chosen according to their multicultural population and diversity. Istanbul was selected as a design city by UNESCO Creative Cities Network in 2017, and Vienna was declared an open and livable city by its local government. This research will use media archives and reports, interviews with locals and local governments, site observations, and visual recordings as methods to provide a critical reading on creative public spaces from the view of local users in these neighborhoods. Reflecting on these emergent ways, this study aims at discussing the production process of tactile urbanism with the practices of locals and the decision-making process with cases from İstanbul and Vienna. The comparison between their place-making strategies in tactical urbanism will give important insights for future developments.

Keywords: creative city, tactical urbanism, neglected area, public space

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5982 Promoting Public Participation in the Digital Memory Project: Experience from My Peking Memory Project(MPMP)

Authors: Xiaoshuang Jia, Huiling Feng, Li Niu, Wei Hai

Abstract:

Led by Humanistic Beijing Studies Center in Renmin University of China, My Peking Memory Project(MPMP) is a long-time digital memory project under guarantee of public participation to enable the cultural and intellectual memory of Beijing to be collected, organized, preserved and promoted for discovery and research. Taking digital memory as a new way, MPMP is an important part of Peking Memory Project(PMP) which is aimed at using digital technologies to protect and (re)present the cultural heritage in Beijing. The key outcome of MPMP is the co-building of a total digital collection of knowledge assets about Beijing. Institutional memories are central to Beijing’s collection and consist of the official published documentary content of Beijing. These have already fall under the archival collection purview. The advances in information and communication technology and the knowledge form social memory theory have allowed us to collect more comprehensively beyond institutional collections. It is now possible to engage citizens on a large scale to collect private memories through crowdsourcing in digital formats. Private memories go beyond official published content to include personal narratives, some of which are just in people’s minds until they are captured by MPMP. One aim of MPMP is to engage individuals, communities, groups or institutions who have formed memories and content about Beijing, and would like to contribute them. The project hopes to build a culture of remembering and it believes ‘Every Memory Matters’. Digital memory contribution was achieved through the development of the MPMP. In reducing barriers to digital contribution and promoting high public Participation, MPMP has taken explored the harvesting of transcribe service for digital ingestion, mobile platform and some off-line activities like holding social forum. MPMP has also cooperated with the ‘Implementation Plan of Support Plan for Growth of Talents in Renmin University of China’ to get manpower and intellectual support. After six months of operation, now MPMP have more than 2000 memories added and 7 Special Memory Collections now online. The work of MPMP has ultimately helped to highlight the important role in safeguarding the documentary heritage and intellectual memory of Beijing.

Keywords: digital memory, public participation, MPMP, cultural heritage, collection

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5981 Fear-Mongering and Its Antidotes: The Case of the Hungarian Anti-Migrant Campaign

Authors: Zsofia Nagy

Abstract:

A sharp increase in the number of refugees crossing Hungary during 2015, coupled with the Hungarian government’s agenda-setting strategy led to a powerful anti-migrant campaign in public, framing asylum-seekers as external threats to the country. While this campaign was, by and large, unchallenged by the Hungarian parliamentary opposition, Two-Tailed Dog Party, a Hungarian mock-party launched a counter-billboard campaign attacking the governmental discourse. Taking the latter as a case of digitally supported civic action, the paper first discusses two theoretical problems related to contemporary social movements: the problem of voice and the problem of participation. Afterward the paper presents the case of the Hungarian anti-migrant billboard campaign led by the government and the counter-billboard campaign and examines their action repertoires. It argues that a number of strategic differences are noteworthy: contrasts between traditional and digital methods, the reliance on the ’spirals of silence’ on the one hand and the breaking of this very silence on the other, where people are holding a minority opinion were given a platform and visibility in public. On a deeper level, the counter-campaign challenged the hegemonic views about public discourse. It effectively contrasted the government’s one-to-many, top-bottom approach to political communication with a campaign that relied on many-to-many communication and a bottom-up approach. While it is true that through memetic engineering, the original governmental messages were altered and the outcomes were brought back to the streets of Hungary; the effects of the two campaigns nevertheless reinforced the original anti-migrant focus of the political agenda.

Keywords: counterpublics, migration, refugees, social movements

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5980 Integrating Evidence Into Health Policy: Navigating Cross-Sector and Interdisciplinary Collaboration

Authors: Tessa Heeren

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The following proposal pertains to the complex process of successfully implementing health policies that are based on public health research. A systematic review was conducted by myself and faculty at the Cluj School of Public Health in Romania. The reviewed articles covered a wide range of topics, such as barriers and facilitators to multi-sector collaboration, differences in professional cultures, and systemic obstacles. The reviewed literature identified communication, collaboration, user-friendly dissemination, and documentation of processes in the execution of applied research as important themes for the promotion of evidence in the public health decision-making process. This proposal fits into the Academy Health National Health Policy conference because it identifies and examines differences between the worlds of research and politics. Implications and new insights for federal and/or state health policy: Recommendations made based on the findings of this research include using politically relevant levers to promote research (e.g. campaign donors, lobbies, established parties, etc.), modernizing dissemination practices, and reforms in which the involvement of external stakeholders is facilitated without relying on invitations from individual policy makers. Description of how evidence and/or data was or could be used: The reviewed articles illustrated shortcomings and areas for improvement in policy research processes and collaborative development. In general, the evidence base in the field of integrating research into policy lacks critical details of the actual process of developing evidence based policy. This shortcoming in logistical details creates a barrier for potential replication of collaborative efforts described in studies. Potential impact of the presentation for health policy: The reviewed articles focused on identifying barriers and facilitators that arise in cross sector collaboration, rather than the process and impact of integrating evidence into policy. In addition, the type of evidence used in policy was rarely specified, and widely varying interpretations of the definition of evidence complicated overall conclusions. Background: Using evidence to inform public health decision making processes has been proven effective; however, it is not clear how research is applied in practice. Aims: The objectives of the current study were to assess the extent to which evidence is used in public health decision-making process. Methods: To identify eligible studies, seven bibliographic databases, specifically, PubMed, Scopus, Cochrane Library, Science Direct, Web of Science, ClinicalKey, Health and Safety Science Abstract were screened (search dates: 1990 – September 2015); a general internet search was also conducted. Primary research and systematic reviews about the use of evidence in public health policy in Europe were included. The studies considered for inclusion were assessed by two reviewers, along with extracted data on objective, methods, population, and results. Data were synthetized as a narrative review. Results: Of 2564 articles initially identified, 2525 titles and abstracts were screened. Ultimately, 30 articles fit the research criteria by describing how or why evidence is used/not used in public health policy. The majority of included studies involved interviews and surveys (N=17). Study participants were policy makers, health care professionals, researchers, community members, service users, experts in public health.

Keywords: cross-sector, dissemination, health policy, policy implementation

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5979 A Folk Theorem with Public Randomization Device in Repeated Prisoner’s Dilemma under Costly Observation

Authors: Yoshifumi Hino

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An infinitely repeated prisoner’s dilemma is a typical model that represents teamwork situation. If both players choose costly actions and contribute to the team, then both players are better off. However, each player has an incentive to choose a selfish action. We analyze the game under costly observation. Each player can observe the action of the opponent only when he pays an observation cost in that period. In reality, teamwork situations are often costly observation. Members of some teams sometimes work in distinct rooms, areas, or countries. In those cases, they have to spend their time and money to see other team members if they want to observe it. The costly observation assumption makes the cooperation difficult substantially because the equilibrium must satisfy the incentives not only on the action but also on the observational decision. Especially, it is the most difficult to cooperate each other when the stage-game is prisoner's dilemma because players have to communicate through only two actions. We examine whether or not players can cooperate each other in prisoner’s dilemma under costly observation. Specifically, we check whether symmetric Pareto efficient payoff vectors in repeated prisoner’s dilemma can be approximated by sequential equilibria or not (efficiency result). We show the efficiency result without any randomization device under certain circumstances. It means that players can cooperate with each other without any randomization device even if the observation is costly. Next, we assume that public randomization device is available, and then we show that any feasible and individual rational payoffs in prisoner’s dilemma can be approximated by sequential equilibria under a specific situation (folk theorem). It implies that players can achieve asymmetric teamwork like leadership situation when public randomization device is available.

Keywords: cost observation, efficiency, folk theorem, prisoner's dilemma, private monitoring, repeated games.

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5978 Functioning of Public Distribution System and Calories Intake in the State of Maharashtra

Authors: Balasaheb Bansode, L. Ladusingh

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The public distribution system is an important component of food security. It is a massive welfare program undertaken by Government of India and implemented by state government since India being a federal state; for achieving multiple objectives like eliminating hunger, reduction in malnutrition and making food consumption affordable. This program reaches at the community level through the various agencies of the government. The paper focuses on the accessibility of PDS at household level and how the present policy framework results in exclusion and inclusion errors. It tries to explore the sanctioned food grain quantity received by differentiated ration cards according to income criterion at household level, and also it has highlighted on the type of corruption in food distribution that is generated by the PDS system. The data used is of secondary nature from NSSO 68 round conducted in 2012. Bivariate and multivariate techniques have been used to understand the working and consumption of food for this paper.

Keywords: calories intake, entitle food quantity, poverty aliviation through PDS, target error

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5977 Investigating Visual Statistical Learning during Aging Using the Eye-Tracking Method

Authors: Zahra Kazemi Saleh, Bénédicte Poulin-Charronnat, Annie Vinter

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This study examines the effects of aging on visual statistical learning, using eye-tracking techniques to investigate this cognitive phenomenon. Visual statistical learning is a fundamental brain function that enables the automatic and implicit recognition, processing, and internalization of environmental patterns over time. Some previous research has suggested the robustness of this learning mechanism throughout the aging process, underscoring its importance in the context of education and rehabilitation for the elderly. The study included three distinct groups of participants, including 21 young adults (Mage: 19.73), 20 young-old adults (Mage: 67.22), and 17 old-old adults (Mage: 79.34). Participants were exposed to a series of 12 arbitrary black shapes organized into 6 pairs, each with different spatial configurations and orientations (horizontal, vertical, and oblique). These pairs were not explicitly revealed to the participants, who were instructed to passively observe 144 grids presented sequentially on the screen for a total duration of 7 min. In the subsequent test phase, participants performed a two-alternative forced-choice task in which they had to identify the most familiar pair from 48 trials, each consisting of a base pair and a non-base pair. Behavioral analysis using t-tests revealed notable findings. The mean score for the first group was significantly above chance, indicating the presence of visual statistical learning. Similarly, the second group also performed significantly above chance, confirming the persistence of visual statistical learning in young-old adults. Conversely, the third group, consisting of old-old adults, showed a mean score that was not significantly above chance. This lack of statistical learning in the old-old adult group suggests a decline in this cognitive ability with age. Preliminary eye-tracking results showed a decrease in the number and duration of fixations during the exposure phase for all groups. The main difference was that older participants focused more often on empty cases than younger participants, likely due to a decline in the ability to ignore irrelevant information, resulting in a decrease in statistical learning performance.

Keywords: aging, eye tracking, implicit learning, visual statistical learning

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5976 Corpus-Based Neural Machine Translation: Empirical Study Multilingual Corpus for Machine Translation of Opaque Idioms - Cloud AutoML Platform

Authors: Khadija Refouh

Abstract:

Culture bound-expressions have been a bottleneck for Natural Language Processing (NLP) and comprehension, especially in the case of machine translation (MT). In the last decade, the field of machine translation has greatly advanced. Neural machine translation NMT has recently achieved considerable development in the quality of translation that outperformed previous traditional translation systems in many language pairs. Neural machine translation NMT is an Artificial Intelligence AI and deep neural networks applied to language processing. Despite this development, there remain some serious challenges that face neural machine translation NMT when translating culture bounded-expressions, especially for low resources language pairs such as Arabic-English and Arabic-French, which is not the case with well-established language pairs such as English-French. Machine translation of opaque idioms from English into French are likely to be more accurate than translating them from English into Arabic. For example, Google Translate Application translated the sentence “What a bad weather! It runs cats and dogs.” to “يا له من طقس سيء! تمطر القطط والكلاب” into the target language Arabic which is an inaccurate literal translation. The translation of the same sentence into the target language French was “Quel mauvais temps! Il pleut des cordes.” where Google Translate Application used the accurate French corresponding idioms. This paper aims to perform NMT experiments towards better translation of opaque idioms using high quality clean multilingual corpus. This Corpus will be collected analytically from human generated idiom translation. AutoML translation, a Google Neural Machine Translation Platform, is used as a custom translation model to improve the translation of opaque idioms. The automatic evaluation of the custom model will be compared to the Google NMT using Bilingual Evaluation Understudy Score BLEU. BLEU is an algorithm for evaluating the quality of text which has been machine-translated from one natural language to another. Human evaluation is integrated to test the reliability of the Blue Score. The researcher will examine syntactical, lexical, and semantic features using Halliday's functional theory.

Keywords: multilingual corpora, natural language processing (NLP), neural machine translation (NMT), opaque idioms

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5975 Mercury Contamination of Wetland Caused by Wastewater from Chlor-Alkali Industry

Authors: Mitsuo Yoshida

Abstract:

A significant mercury contamination of soil/sediment was unveiled by an environmental monitoring program in a wetland along La Plata River, west to Montevideo City, Uruguay. The mercury contamination was caused by industrial wastewater discharged from a chlor-alkali plant using a mercury-cell process. The contamination level is above 60 mg/kg in soil/sediment. Most of mercury (Hg) in the environment is inorganic, but some fractions are converted by bacteria to methylmercury (MeHg), a toxic organic compound. MeHg biologically accumulates through a food-chain and become serious public health risk. In order to clarify the contaminated part for countermeasure operation, an intervention value of mercury contamination of sediment/soil was defined as 15 mg/kg (total Hg) by the authority. According to the intervention value, mercury contaminated area in the La Plata site is approximately 48,280 m² and estimated total volume of contaminated sediments/soils was around 18,750 m³. The countermeasures to contaminated zone were proposed in two stages; (i) mitigation of risks for public health and (ii) site remediation. The first stage is an installation of fens and net around the contamination zone, for mitigating risks of exposure, inhalation, and intake. The food chain among wetland-river ecosystem was also interrupted by the installation of net and fens. The state of mercury contamination in La Plata site and plan of countermeasure was disclosed to local people and the public, and consensus on setting off-limit area was successfully achieved. Mass media also contribute to share the information on the contamination site. The cost for countermeasures was borne by the industry under the polluter-pay-principle.

Keywords: chlor-alkali plant, mercury contamination, polluter pay principle, Uruguay, wetland

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5974 Industry 4.0 Adoption, Control Mechanism and Sustainable Performance of Healthcare Supply Chains under Disruptive Impact

Authors: Edward Nartey

Abstract:

Although the boundaries of sustainable performance and growth in the field of service supply chains (SCs) have been broadened by scholars in recent years, research on the impact and promises of Industry 4.0 Destructive Technologies (IDTs) on sustainability performance under disruptive events is still scarce. To mitigate disruptions in the SC and improve efficiency by identifying areas for cost savings, organizations have resorted to investments in digitalization, automation, and control mechanisms in recent years. However, little is known about the sustainability implications for IDT adoption and controls in service SCs, especially during disruptive events. To investigate this paradox, survey data were sought from 223 public health managers across Ghana and analyzed via covariance-based structural equations modelling. The results showed that both formal and informal control have a positive and significant relationship with IDT adoption. In addition, formal control has a significant and positive relationship with environmental and economic sustainability but an insignificant relationship with social sustainability. Furthermore, informal control positively impacts economic performance but has an insignificant relationship with social and environmental sustainability. While the findings highlight the prevalence of the IDTs being initiated by Ghanaian public health institutions (PHIs), this study concludes that the installed control systems in these organizations are inadequate for promoting sustainable SC behaviors under destructive events. Thus, in crisis situations, PHIs need to redesign their control systems to facilitate IDT integration towards sustainability issues in SCs.

Keywords: industry 4.0 destructive technologies, formal control, informal control, sustainable supply chain performance, public health organizations

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5973 The Issue of Pedagogical Approaches in Higher Education: Public Universities as an Example

Authors: Majda El Moufarej

Abstract:

Higher education plays a central role in socio-economic development. However, with the wave of change mainly due to the extensive use of technology in the workplace, the rate of unemployment among graduates rises because they lack the appropriate competencies and skills currently required in professional life. This situation has led higher education institutions worldwide to reconsider their missions, strategic planning, and curricula, among other elements to redress the image of the university as expected. When it comes to practice, there are many obstacles that hinder the achievement of the expected objectives, especially in public universities with free access, as in the case of Morocco. Nevertheless, huge efforts have been made by educational managers to improve the quality of education by focusing on the issue of pedagogical approaches, where university teachers assume more responsibility to save the situation. In this paper, the focus will be placed on the issue of pedagogical approaches to be adopted, depending on the nature of the subject, the size of the class, the available equipment, the students’ level and degree of motivation. Before elaborating on this idea, it may be more insightful to begin by addressing another variable, which concerns the new role of university teachers and their qualification in pedagogical competence. Then, the discussion will revolve around five pedagogical approaches currently adopted in western universities and the focus will be exclusively placed on the one which is called “the Systematic Approach to course Design”, due to its crucial relevance in the teaching of subjects in the schools of humanities, as it can guide the teacher in the development of an explicit program for purposeful teaching and learning. The study is based on a qualitative method, and the findings will be analyzed and followed by some recommendations about how to overcome difficulties in teaching large groups, while transmitting the relevant knowledge and skills on demand in the workplace.

Keywords: higher education, public universities, pedagogical approaches, pedagogical competence

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5972 Crowdfunding for Saudi Arabia Green Projects

Authors: Saleh Komies, Mona Alharbi, Razan Alhayyani, Mozah Almulhim, Roseanne Khawaja, Ahmed Alradhi

Abstract:

One of the proposed solutions that faces some challenges is encouraging sustainable energy consumption across Saudi Arabia through crowdfunding platforms. To address these challenges, we need to determine the level of awareness of crowdfunding and green projects, as well as the preferences and willingness of Saudis to utilize crowdfunding as an alternative funding source for green projects in Saudi Arabia. In this study, we aim to determine the influence of environmental awareness and concern on the propensity to crowdfund green projects. The survey is being conducted as part of environmental initiatives to assess public perceptions and opinions on crowdfunding green projects in Saudi Arabia. A total of 450 responses to an online questionnaire distributed via convenience and snowball sampling were utilized for data analysis. The survey reveals that Saudis have a low understanding of crowdfunding concepts and a relatively high understanding of implementing green projects. The public is interested in crowdfunding green projects if there is a return on investment.

Keywords: crowdfunding, green projects, awareness, Saudi Arabia, energy, solar, wind

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5971 Students’ Perceptions Regarding Homosexuality at Sefako Makgatho Health Sciences University

Authors: Deborah O. Okusanya, Chris Vanrooyen, Stefan de Jager

Abstract:

Introduction: Homosexuality has been and continues to be a controversial subject across many disciplines; it has generated many debates around religious, academic institutions, political, socio-cultural as well as medical domains. The current study investigated students from a previously disadvantaged African university’s perception regarding homosexuality. Method: This qualitative study utilized two focus groups to collect data, which then was analyzed using thematic content analysis. Result: The study revealed that students’ level of awareness with regard to homosexuality is very high and their perceptions largely negative. Students predominantly found the practice unethical, and un-African. Discussion: Students tend to show a lot of stereotypical prejudicial responses and there seems to be a general lack of willingness to discuss this in a public discourse. In conclusion, there seems to be a tension between cultural values and the open environment such as academic institutions. Students’ perceptions go a long way in shaping public discourse and the larger population’s general attitude toward homosexuality.

Keywords: discourse, homosexuality, stereotypical, un-African

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5970 Chance One’s Arm: Critical Evaluation on Laws of Sports Gambling in India

Authors: Archen Sara Vincent

Abstract:

Gambling is the practice or act of betting or wagering on uncertain events with the hope of winning money or any other valuable assets. Nowadays, the practice of gambling can be seen in almost all grounds of events, especially in sports. In sports, this is commonly known among people as sports betting. The history of gambling can be traced about 2,000 years back. It originated from Greeks, from Greeks to the Romans, then to England, where betting on horse races was much popular among the elites. The evolution of gambling in sports has made a greater impact in the modern era. In India, the legality of gambling in sports is regulated by The Public Gambling Act 1867, which prohibits gambling activities in public places. The major draw of this statute is that it does not have specific laws regarding online sports gambling. Section 30 of The Indian Contract Act 1872 considers wagering agreements void. However, there are certain exceptions for this section, that is, (1) state-owned lotteries and (2) wagering on horse races with a sum of Rupees 500 or upward. As per the Indian Constitution, the rules regarding sports gambling are within the powers of the state legislatures. Some of the states have enacted their own laws which explicitly permit or prohibit gambling within their jurisdiction. Recently in Tamilnadu, The Tamilnadu Gaming Act was amended in 2021 to completely ban online gambling and betting. Moreover, the Central Government has introduced the Online Gaming and Prevention of Fraud Bill, 2018, to legalize and regulate sports betting in India. However, this bill has not yet been passed as law. Now as the Indian legal system does not have a specific rule regarding online sports gambling, sports betting companies use this major drawback and attract people to use the gambling and betting apps by advertising with well-known sports players and other celebrities. This paper aims to critically evaluate gambling in sports and the laws relating to it in India.

Keywords: history of gambling, The Public Gambling Act 1862, state legislations, gambling in India

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5969 Reproductive Governmentality in Mexico: Production, Control and Regulation of Contraceptive Practices in a Public Hospital

Authors: Ivan Orozco

Abstract:

Introduction: Forced contraception constitutes part of an effort to control the life and reproductive capacity of women through public health institutions. This phenomenon has affected many Mexican women historically and still persists nowadays. The notion of reproductive governmentality refers to the mechanisms through which different historical configurations of social actors (state institutions, churches, donor agents, NGOs, etc.) use legislative controls, economic incentives, moral mandates, direct coercion, and ethical incitements, to produce, monitor and control reproductive behaviors and practices. This research focuses on the use of these mechanisms by the Mexican State to control women's contraceptive practices in a public hospital. Method: An Institutional Ethnography was carried out, with the objective of knowing women's experiences from their own perspective, as they occur in their daily lives, but at the same time, discovering the structural elements that shape the discourses that promote women's contraception, even against their will. The fieldwork consisted in an observation of the dynamics between different participants within a public hospital and the conduction of interviews with the medical and nursing staff in charge of family planning services, as well as women attending the family planning office. Results: Public health institutions in Mexico are state tools to control and regulate reproduction. There are several strategies that are used for this purpose, for example, health personnel provide insufficient or misleading information to ensure that women agree to use contraceptives; health institutions provide economic incentives to the members of the health staff who reach certain goals in terms of contraceptive placement; young women are forced to go to the family planning service, regardless of the reason they went to the clinic; health campaigns are carried out, consisting of the application of contraceptives outside the health facilities, directly in the communities of people who visit the hospital less frequently. All these mechanisms seek for women to use contraceptives, from the women’s perspective; however, the reception of these discourses is ambiguous. While, for some women, the strategies become coercive mechanisms to use contraceptives against their will, for others, they represent an opportunity to take control over their reproductive lives. Conclusion: Since 1974, the Mexican government has implemented campaigns for the promotion of family planning methods as a means to control population growth. Although it is established in several legislations that the counselling must be carried out with a gender and human rights perspective, always respecting the autonomy of people, these research testify that health personnel uses different strategies to force some women to use contraceptive methods, thereby violating their reproductive rights.

Keywords: feminist research, forced contraception, institutional ethnography, reproductive. governmentality

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5968 Hepatitis B Vaccination Status and Its Determinants among Primary Health Care Workers in Northwest Pakistan

Authors: Mohammad Tahir Yousafzai, Rubina Qasim

Abstract:

We assessed Hepatitis B vaccination and its determinants among health care workers (HCW) in Northwest Pakistan. HCWs from both public and private clinics were interviewed about hepatitis B vaccination, socio-demographic, hepatitis B virus transmission modes, disease threat and benefits of vaccination. Logistic regression was performed. Hepatitis B vaccination was 40% (Qualified Physicians: 86% and non-qualified Dispensers:16%). Being Qualified Physician (Adj. OR 26.6; 95%CI 9.3-73.2), Non-qualified Physician (Adj.OR 1.9; 95%CI 0.8-4.6), qualified Dispensers (Adj. OR 3.6; 95%CI 1.3-9.5) compared to non-qualified Dispensers, working in public clinics (Adj. OR 2.5; 95%CI 1.1-5.7) compared to private, perceived disease threat after exposure to blood and body fluids (Adj. OR 1.1; 95%CI 1.1-1.2) and perceived benefits of vaccination (Adj. OR 1.1; 95%CI 1.1-1.2) were significant predictors of hepatitis B vaccination. Improved perception of disease threat and benefits of vaccination and qualification of HCWs are associated with hepatitis B vaccination.

Keywords: Hepatitis B vaccine, immunization, healthcare workers, primary health

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5967 Determining the Collaboration and Challenges of Public Employment Service with Stakeholders, Employers and Job Seekers: In Case of Amhara National Regional State, Ethiopia

Authors: Redie Bezabih Hailu

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Unemployment is a problem of nations that needs a continuous research. This study aimed to determine the collaborations and challenges of public employment service (PES) with special emphasis of stakeholders, employers and job seekers. The researcher used pragmatic philosophy, exploratory design and inductive approach to collect data from the respondents using interview and focused group discussion techniques. PES provides job market information, vocational counseling, and training. As PES is not fully furnished with man power, budget, modern technologies, it is providing less adequate services to the employers and job seekers. Matching job seekers with job vacancies is the major challenge for the center and using paper-based data management system too. There is also a number of job seekers in spite of very limited number of vacancies that the service provision is poor due to the fact that there is low level of vacancies and high level of job seekers. The center has collaboration with AFE, AYA, BoTVED, BoWCY, and CETU. The major challenges with this collaborations was the absence of operational guidelines to evaluate effectiveness and performance, lottery method of selecting candidates for vacancies and nepotism or favoritism were challenges for job seekers. On the other hand, (COVID-19) pandemic, inability to get skilled labor, absence of standardized payment, expectation of job seekers and less educational quality and mass graduation were another challenges for employment services. The study recommended quality education and training, operational guideline for collaboration, technology based labor market information system and suggested further studies on quality of PES.

Keywords: public employment service, collaborations, stakeholders, employers, job seekers

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5966 The Impact of Step-By-Step Program in the Public Preschool Institutions in Kosova

Authors: Rozafa Shala

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Development of preschool education in Kosovo has passed through several periods. The period after the 1999 war was very intensive period when preschool education started to change. Step-by-step program was one of the programs which were very well extended during the period after the 1999 war until now. The aim of this study is to present the impact of the step-by-step program in the preschool education. This research is based on the hypothesis that: Step-by-step program continues to be present with its elements, in all other programs that the teachers can use. For data collection a questionnaire is constructed which was distributed to 25 teachers of preschool education who work in public preschool institutions. All the teachers have finished the training for step by step program. To support the data from the questionnaire a focus group is also organized with whom the critical issues of the program were discussed. From the results obtained we can conclude that the step-by-step program has a very strong impact in the preschool level. Many specific elements such as: circle time, weather calendar, environment inside the class, portfolios and many other elements are present in most of the preschool classes. The teacher's approach also has many elements of the step-by-step program.

Keywords: preschool education, step-by-step program, impact, teachers

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5965 Determination of the Walkability Comfort for Urban Green Space Using Geographical Information System

Authors: Muge Unal, Cengiz Uslu, Mehmet Faruk Altunkasa

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Walkability relates to the ability of the places to connect people with varied destinations within a reasonable amount of time and effort, and to offer visual interest in journeys throughout the network. So, the good quality of the physical environment and arrangement of walkway and sidewalk appear to be more crucial in influencing the pedestrian route choice. Also, proximity, connectivity, and accessibility are significant factor for walkability in terms of an equal opportunity for using public spaces. As a result, there are two important points for walkability. Firstly, the place should have a well-planned street network for accessible and secondly facilitate the pedestrian need for comfort. In this respect, this study aims to examine the both physical and bioclimatic comfort levels of the current condition of pedestrian route with reference to design criteria of a street to access the urban green spaces. These aspects have been identified as the main indicators for walkable streets such as continuity, materials, slope, bioclimatic condition, walkway width, greenery, and surface. Additionally, the aim was to identify the factors that need to be considered in future guidelines and policies for planning and design in urban spaces especially streets. Adana city was chosen as a study area. Adana is a province of Turkey located in south-central Anatolia. This study workflow can be summarized in four stages: (1) environmental and physical data were collected by referred to literature and used in a weighted criteria method to determine the importance level of these data , (2) environmental characteristics of pedestrian routes gained from survey studies are evaluated to hierarchies these criteria of the collected information, (3) and then each pedestrian routes will have a score that provides comfortable access to the park, (4) finally, the comfortable routes to park will be mapped using GIS. It is hoped that this study will provide an insight into future development planning and design to create a friendly and more comfort street environment for the users.

Keywords: comfort level, geographical information system (GIS), walkability, weighted criteria method

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5964 Incidence and Risk Factors of Central Venous Associated Infections in a Tunisian Medical Intensive Care Unit

Authors: Ammar Asma, Bouafia Nabiha, Ghammam Rim, Ezzi Olfa, Ben Cheikh Asma, Mahjoub Mohamed, Helali Radhia, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

Abstract:

Background: Central venous catheter associated infections (CVC-AI) are among the serious hospital-acquired infections. The aims of this study are to determine the incidence of CVC-AI, and their risk factors among patients followed in a Tunisian medical intensive care unit (ICU). Materials / Methods: A prospective cohort study conducted between September 15th, 2015 and November 15th, 2016 in an 8-bed medical ICU including all patients admitted for more than 48h. CVC-AI were defined according to CDC of ATLANTA criteria. The enrollment was based on clinical and laboratory diagnosis of CVC-AI. For all subjects, age, sex, underlying diseases, SAPS II score, ICU length of stay, exposure to CVC (number of CVC placed, site of insertion and duration catheterization) were recorded. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: Among 192 eligible patients, 144 patients (75%) had a central venous catheter. Twenty-eight patients (19.4%) had developed CVC-AI with density rate incidence 20.02/1000 CVC-days. Among these infections, 60.7% (n=17) were systemic CVC-AI (with negative blood culture), and 35.7% (n=10) were bloodstream CVC-AI. The mean SAPS II of patients with CVC-AI was 32.76 14.48; their mean Charlson index was 1.77 1.55, their mean duration of catheterization was 15.46 10.81 days and the mean duration of one central line was 5.8+/-3.72 days. Gram-negative bacteria was determined in 53.5 % of CVC-AI (n= 15) dominated by multi-drug resistant Acinetobacter baumani (n=7). Staphylococci were isolated in 3 CVC-AI. Fourteen (50%) patients with CVC-AI died. Univariate analysis identified men (p=0.034), the referral from another hospital department (p=0.03), tobacco (p=0.006), duration of sedation (p=0.003) and the duration of catheterization (p=0), as possible risk factors of CVC-AI. Multivariate analysis showed that independent factors of CVC-AI were, male sex; OR= 5.73, IC 95% [2; 16.46], p=0.001, Ramsay score; OR= 1.57, IC 95% [1.036; 2.38], p=0.033, and duration of catheterization; OR=1.093, IC 95% [1.035; 1.15], p=0.001. Conclusion: In a monocenter cohort, CVC-AI had a high density and is associated with poor outcome. Identifying the risk factors is necessary to find solutions for this major health problem.

Keywords: central venous catheter associated infection, intensive care unit, prospective cohort studies, risk factors

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