Search results for: relative risk

Authors: Ebrahim Alamatian, Seyed Mehdi Afzalnia

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One of the most vital hydraulic structures is the dam. Regarding the unrecoverable damages which may occur after a dam break phenomenon, analyzing dams’ break is absolutely essential. GOLESTAN dam is located in the western South of Mashhad city in Iran. GOLESTAN dam break might lead to severe problems due to adjacent tourist and entertainment areas. In this paper, a numerical code based on the finite volume method was applied for assessing the risk of GOLESTAN dam break. As to this issue, first, a canal with a triangular barrier was modeled so as to verify the capability of the concerned code. Comparing analytical, experimental and numerical results showed that water level in the model results is in a good agreement with the similar water level in the analytical solutions and experimental data. The results of dam break modeling are revealed that two of the bridges, that are PARTOIE and NAMAYESHGAH, located downstream in the flow direction, are at risk following the potential GOLESTAN dam break. Therefore, the required times to conduct the precautionary measures at bridges were calculated at about 12 and 21 minutes, respectively. Thus, it is crucial to announce people about the possible risks of the dam break in order to decrease likely losses.

Keywords: numerical model, shallow water equations, GOLESTAN dam break, dry and wet beds modeling

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Authors: Delva Richard, Zahibo Narcisse, Yalciner Ahmet

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The Republic of Haiti is one of the poor countries of the world, therefore the authorities must make choices to provide timely solutions to the many difficulties that this Caribbean country is experiencing. There is a very acute lack of scientific research to study natural phenomena in depth. A working group meeting was established under the aegis of the World Bank, UNESCO and the authorities, to study the level of exposure of the Hispaniola. The devastating earthquake of August 2021 killed about 2100 and caused massive material damage; and the 14 12 January 2010 killed more than 250,000 people and caused massive material damage, the evidence of which is still 11 years later. In this paper we want to contribute to the assessment of the risk of tsunami on the southern peninsula of the Republic of Haiti. For the realization of this work we have the bathymetric and topographic data of very good qualities from the private measurement campaigns that we have combined with GEBCO for the inundation grids. We use two numerical models MOST and NAMI DANCE for the calculation of the parameters required in any tsunami risk assessment.

Keywords: modélisation numérique, ondes longues océaniques, bathymetrie, evaluation risque, tsunamis

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Authors: Shanza Akram, Sameen Toor, Heba Harb Abu Alkass, Zainab Abdulsalam Altaha, Sara Taha Abdulla, Saleem Imran

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Acute pulmonary embolism (PE) is a common disease and can be fatal. The clinical presentation is variable and nonspecific, making accurate diagnosis difficult. Testing patients with suspected acute PE has increased dramatically. However, the overuse of some tests, particularly CT and D-dimer measurement, may not improve care while potentially leading to patient harm and unnecessary expense. CTPA is the investigation of choice for PE. Its easy availability, accuracy and ability to provide alternative diagnosis has lowered the threshold for performing it, resulting in its overuse. Guidelines have recommended the use of clinical pretest probability tools such as ‘Wells score’ to assess risk of suspected PE. Unfortunately, implementation of guidelines in clinical practice is inconsistent. This has led to low risk patients being subjected to unnecessary imaging, exposure to radiation and possible contrast related complications. Aim: To study the diagnostic yield of CT PA, clinical pretest probability of patients according to wells score and to determine whether or not there was an overuse of CTPA in our service. Methods: CT scans done on patients with suspected P.E in our hospital from 1st January 2014 to 31st December 2014 were retrospectively reviewed. Medical records were reviewed to study demographics, clinical presentation, final diagnosis, and to establish if Wells score and D-Dimer were used correctly in predicting the probability of PE and the need for subsequent CTPA. Results: 100 patients (51male) underwent CT PA in the time period. Mean age was 57 years (24-91 years). Majority of patients presented with shortness of breath (52%). Other presenting symptoms included chest pain 34%, palpitations 6%, collapse 5% and haemoptysis 5%. D Dimer test was done in 69%. Overall Wells score was low (<2) in 28 %, moderate (>2 - < 6) in 47% and high (> 6) in 15% of patients. Wells score was documented in medical notes of only 20% patients. PE was confirmed in 12% (8 male) patients. 4 had bilateral PE’s. In high-risk group (Wells > 6) (n=15), there were 5 diagnosed PEs. In moderate risk group (Wells >2 - < 6) (n=47), there were 6 and in low risk group (Wells <2) (n=28), one case of PE was confirmed. CT scans negative for PE showed pleural effusion in 30, Consolidation in 20, atelactasis in 15 and pulmonary nodule in 4 patients. 31 scans were completely normal. Conclusion: Yield of CT for pulmonary embolism was low in our cohort at 12%. A significant number of our patients who underwent CT PA had low Wells score. This suggests that CT PA is over utilized in our institution. Wells score was poorly documented in medical notes. CT-PA was able to detect alternative pulmonary abnormalities explaining the patient's clinical presentation. CT-PA requires concomitant pretest clinical probability assessment to be an effective diagnostic tool for confirming or excluding PE. . Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being considered. Combining Wells scores with clinical and laboratory assessment may reduce the need for CTPA.

Keywords: CT PA, D dimer, pulmonary embolism, wells score

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Authors: Rajkumar Ghosh

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Earthquakes are natural disasters that pose a significant risk to human life and infrastructure. Effective earthquake mitigation measures require a thorough understanding of the dynamics of seismic occurrences, including thrust movement. Traditionally, estimating thrust movement has relied on typical techniques that may not capture the full complexity of these events. Therefore, investigating alternative approaches, such as incorporating out-of-sequence thrust movement data, could enhance earthquake mitigation strategies. This review aims to provide an overview of the applications of out-of-sequence thrust movement in earthquake mitigation. By examining existing research and studies, the objective is to understand how precise estimation of thrust movement can contribute to improving structural design, analyzing infrastructure risk, and developing early warning systems. The study demonstrates how to estimate out-of-sequence thrust movement using multiple data sources, including GPS measurements, satellite imagery, and seismic recordings. By analyzing and synthesizing these diverse datasets, researchers can gain a more comprehensive understanding of thrust movement dynamics during seismic occurrences. The review identifies potential advantages of incorporating out-of-sequence data in earthquake mitigation techniques. These include improving the efficiency of structural design, enhancing infrastructure risk analysis, and developing more accurate early warning systems. By considering out-of-sequence thrust movement estimates, researchers and policymakers can make informed decisions to mitigate the impact of earthquakes. This study contributes to the field of seismic monitoring and earthquake risk assessment by highlighting the benefits of incorporating out-of-sequence thrust movement data. By broadening the scope of analysis beyond traditional techniques, researchers can enhance their knowledge of earthquake dynamics and improve the effectiveness of mitigation measures. The study collects data from various sources, including GPS measurements, satellite imagery, and seismic recordings. These datasets are then analyzed using appropriate statistical and computational techniques to estimate out-of-sequence thrust movement. The review integrates findings from multiple studies to provide a comprehensive assessment of the topic. The study concludes that incorporating out-of-sequence thrust movement data can significantly enhance earthquake mitigation measures. By utilizing diverse data sources, researchers and policymakers can gain a more comprehensive understanding of seismic dynamics and make informed decisions. However, challenges exist, such as data quality difficulties, modelling uncertainties, and computational complications. To address these obstacles and improve the accuracy of estimates, further research and advancements in methodology are recommended. Overall, this review serves as a valuable resource for researchers, engineers, and policymakers involved in earthquake mitigation, as it encourages the development of innovative strategies based on a better understanding of thrust movement dynamics.

Keywords: earthquake, out-of-sequence thrust, disaster, human life

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Authors: Chui-Hsin Chen, Yu-Ting Chen

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Special concentrically braced frames is one of the seismic load resisting systems, which dissipates seismic energy when bracing members within the frames undergo yielding and buckling while sustaining their axial tension and compression load capacities. Most of the inelastic deformation of a buckling bracing member concentrates in the mid-length region. While experiencing cyclic loading, the region dissipates most of the seismic energy being input into the frame. Such a concentration makes the braces vulnerable to failure modes associated with low-cycle fatigue. In this research, a strategy to improve the cyclic behavior of the conventional steel bracing member is proposed by filling the Hollow Structural Shape (HSS) member with reinforcement. It prevents the local section from concentrating large plastic deformation caused by cyclic loading. The infill helps spread over the plastic hinge region into a wider area hence postpone the initiation of local buckling or even the rupture of the braces. The finite element method is introduced to simulate the complicated bracing member behavior and member-versus-infill interaction under cyclic loading. Fifteen 3-D-element-based models are built by ABAQUS software. The verification of the FEM model is done with unreinforced (UR) HSS bracing members’ cyclic test data and aluminum honeycomb plates’ bending test data. Numerical models include UR and filled HSS bracing members with various compactness ratios based on the specification of AISC-2016 and AISC-1989. The primary variables to be investigated include the relative bending stiffness and the material of the filling reinforcement. The distributions of von Mises stress and equivalent plastic strain (PEEQ) are used as indices to tell the strengths and shortcomings of each model. The result indicates that the change of relative bending stiffness of the infill is much more influential than the change of material in use to increase the energy dissipation capacity. Strengthen the relative bending stiffness of the reinforcement results in additional energy dissipation capacity to the extent of 24% and 46% in model based on AISC-2016 (16-series) and AISC-1989 (89-series), respectively. HSS members with infill show growth in 𝜂Local Buckling, normalized energy cumulated until the happening of local buckling, comparing to UR bracing members. The 89-series infill-reinforced members have more energy dissipation capacity than unreinforced 16-series members by 117% to 166%. The flexural rigidity of infills should be less than 29% and 13% of the member section itself for 16-series and 89-series bracing members accordingly, thereby guaranteeing the spread over of the plastic hinge and the happening of it within the reinforced section. If the parameters are properly configured, the ductility, energy dissipation capacity, and fatigue-life of HSS SCBF bracing members can be improved prominently by the infill-reinforced method.

Keywords: special concentrically braced frames, HSS, cyclic loading, infill reinforcement, finite element analysis, PEEQ

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Authors: Sai Hung Cheung, Zhe Shao

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It is of our great interest to quantify the risk to structural dynamic systems due to earthquake-induced tsunamis in view of recent earthquake-induced tsunamis in Padang, 2004 and Tohoku, 2011 which brought huge losses of lives and properties. Despite continuous advancement in computational simulation of the tsunami and wave-structure interaction modeling, it still remains computationally challenging to evaluate the reliability of a structural dynamic system when uncertainties related to the system and its modeling are taken into account. The failure of the structure in a tsunami-wave-structural system is defined as any response quantities of the system exceeding specified thresholds during the time when the structure is subjected to dynamic wave impact due to earthquake-induced tsunamis. In this paper, an approach based on a novel integration of a recently proposed moving least squares response surface approach for stochastic sampling and the Subset Simulation algorithm is proposed. The effectiveness of the proposed approach is discussed by comparing its results with those obtained from the Subset Simulation algorithm without using the response surface approach.

Keywords: response surface, stochastic simulation, structural reliability tsunami, risk

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Authors: Pedro Barros, Ana Breda, Eugenio Rocha, M. Isabel Santos

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As visual and spatial awareness develops, children apprehension of the concept of direction, (relative) distance and (relative) location materializes. Here we present the educational inclusive digital game ORIESPA, under development by the Thematic Line Geometrix, for children aged between 6 and 10 years old, aiming the improvement of their visual and spatial awareness. Visual-spatial abilities are of crucial importance to succeed in many everyday life tasks. Unavoidable in the technological age we are living in, they are essential in many fields of study as, for instance, mathematics.The game, set on a 2D/3D environment, focusses in tasks/challenges on the following categories (1) static orientation of the subject and object, requiring an understanding of the notions of up–down, left–right, front–back, higher-lower or nearer-farther; (2) interpretation of perspectives of three-dimensional objects, requiring the understanding of 2D and 3D representations of three-dimensional objects; and (3) orientation of the subject in real space, requiring the reading and interpreting of itineraries. In ORIESPA, simpler tasks are based on a quadrangular grid, where the front-back and left-right directions and the rotations of 90º, 180º and 270º play the main requirements. The more complex ones are produced on a cubic grid adding the up and down movements. In the first levels, the game's mechanics regarding the reading and interpreting maps (from point A to point B) is based on map routes, following a given set of instructions. In higher levels, the player must produce a list of instructions taking the game character to the desired destination, avoiding obstacles. Being an inclusive game the user has the possibility to interact through the mouse (point and click with a single button), the keyboard (small set of well recognized keys) or a Kinect device (using simple gesture moves). The character control requires the action on buttons corresponding to movements in 2D and 3D environments. Buttons and instructions are also complemented with text, sound and sign language.

Keywords: digital game, inclusion, itinerary, spatial ability

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Authors: Yousef Barahmeh

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This paper is a linguistic and pragmatic analysis of the use of the diminutive in Colloquial Jordanian Arabic (CJA). It demonstrates a peculiar form of the diminutive in CJA inflected by means of feminine plural ends with -aat suffix. The analysis shows that the pragmatic function(s) of the diminutive in CJA refers primarily to ‘littleness’ while the morphological inflection conveys the message of ‘the plethora’. Examples of this linguistic phenomenon are intelligible and often include a large number of words that are culture-specific to the rural dialect in the north of Jordan. In both cases, the diminutive in CJA is an adaptive strategy relative to its pragmatic and social contexts.

Keywords: Colloquial Jordanian Arabic, diminutive, morphology, pragmatics

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Authors: Cristina Cirone, Katrina Cirone, Monali S. Malvankar-Mehta

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Purpose: An increased risk of visual impairment has been observed in individuals lacking a balanced diet. The purpose of this paper is to characterize the relationship between plant-based diets and specific ocular outcomes among adults. Design: Systematic review and meta-analysis. Methods: This systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. The databases MEDLINE, EMBASE, Cochrane, and PubMed, were systematically searched up until May 27, 2021. Of the 503 articles independently screened by two reviewers, 21 were included in this review. Quality assessment and data extraction were performed by both reviewers. Meta-analysis was conducted using STATA 15.0. Fixed-effect and random-effect models were computed based on heterogeneity. Results: A total of 503 studies were identified which then underwent duplicate removal and a title and abstract screen. The remaining 61 studies underwent a full-text screen, 21 progressed to data extraction and fifteen were included in the quantitative analysis. Meta-analysis indicated that regular consumption of fish (OR = 0.70; CI: [0.62-0.79]) and skim milk, poultry, and non-meat animal products (OR = 0.70; CI: [0.61-0.79]) is positively correlated with a reduced risk of visual impairment (age-related macular degeneration, age-related maculopathy, cataract development, and central geographic atrophy) among adults. Consumption of red meat [OR = 1.41; CI: [1.07-1.86]) is associated with an increased risk of visual impairment. Conclusion: Overall, a pescatarian diet is associated with the most favorable visual outcomes among adults, while the consumption of red meat appears to negatively impact vision. Results suggest a need for more local and government-led interventions promoting a healthy and balanced diet.

Keywords: plant-based diet, pescatarian diet, visual impairment, systematic review, meta-analysis

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Authors: Jing Zhang

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Sustainable development in the new energy vehicles field is the requirement of the net zero aim. Green bonds are accepted as a practical financial tool to boost the transformation of relevant enterprises. The paper analyzes the interactions among governments, enterprises of new energy vehicles, and financial institutions by an evolutionary game theory model and offers advice to stakeholders in China. The decision-making subjects of green behavior are affected by experiences, interests, perception ability, and risk preference, so it is difficult for them to be completely rational. Based on the bounded rationality hypothesis, this paper applies prospect theory in the evolutionary game analysis framework and analyses the costs of government regulation of enterprises adopting green bonds. The influence of the perceived value of revenue prospect and the probability and risk transfer coefficient of the government's active regulation on the decision-making agent's strategy is verified by numerical simulation. Finally, according to the research conclusions, policy suggestions are given to promote green bonds.

Keywords: green bonds, new energy vehicles, sustainable development, evolutionary Game Theory model

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Authors: Sastry Y. Kandukuri, Isak Andersen

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Despite recent advances in the manufacturing sector, quality issues remain a frequent occurrence, and can result in fatal accidents, equipment downtime, and loss of life. Adequate quality is of high importance in high-risk industries such as sea-going vessels and offshore installations in which third party quality assurance and product control play an important essential role in ensuring manufacturing quality of critical components. Classification societies play a vital role in mitigating risk in these industries by making sure that all the stakeholders i.e. manufacturers, builders, and end users are provided with adequate rules and standards that effectively ensures components produced at a high level of quality based on the area of application and risk of its failure. Quality issues have also been linked to the lack of competence or negligence of stakeholders in supply value chain. However, continued actions and regulatory reforms through modernization of rules and requirements has provided additional tools for purchasers and manufacturers to confront these issues. Included among these tools are updated ‘approval of manufacturer class programs’ aimed at developing and implementing a set of standardized manufacturing quality metrics for use by the manufacturer and verified by the classification society. The establishment and collection of manufacturing and testing requirements described in these programs could provide various stakeholders – from industry to vessel owners – with greater insight into the state of quality at a given manufacturing facility, and allow stakeholders to anticipate better and address quality issues while simultaneously reducing unnecessary failures that are costly to the industry. The publication introduces, explains and discusses critical manufacturing and testing requirements set in a leading class society’s approval of manufacturer regime and its rationale and some case studies.

Keywords: classification society, manufacturing, materials processing, materials testing, quality control

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Authors: Serpil Kilic, Ihsan Burak Cam, Murat Kilic, Timur Tongur

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Interest in the lead (Pb) has considerably increased due to knowledge about the potential toxic effects of this element, recently. Exposure to heavy metals above the acceptable limit affects human health. Indeed, Pb is accumulated through food chains up to toxic concentrations; therefore, it can pose an adverse potential threat to human health. A sensitive and reliable method for determination of Pb element in red pepper were improved in the present study. Samples (33 red pepper products having different brands) were purchased from different markets in Turkey. The selected method validation criteria (linearity, Limit of Detection, Limit of Quantification, recovery, and trueness) demonstrated. Recovery values close to 100% showed adequate precision and accuracy for analysis. According to the results of red pepper analysis, all of the tested lead element in the samples was determined at various concentrations. A Perkin- Elmer ELAN DRC-e model ICP-MS system was used for detection of Pb. Organic red pepper was used to obtain a matrix for all method validation studies. The certified reference material, Fapas chili powder, was digested and analyzed, together with the different sample batches. Three replicates from each sample were digested and analyzed. The results of the exposure levels of the elements were discussed considering the scientific opinions of the European Food Safety Authority (EFSA), which is the European Union’s (EU) risk assessment source associated with food safety. The Target Hazard Quotient (THQ) was described by the United States Environmental Protection Agency (USEPA) for the calculation of potential health risks associated with long-term exposure to chemical pollutants. THQ value contains intake of elements, exposure frequency and duration, body weight and the oral reference dose (RfD). If the THQ value is lower than one, it means that the exposed population is assumed to be safe and 1 < THQ < 5 means that the exposed population is in a level of concern interval. In this study, the THQ of Pb was obtained as < 1. The results of THQ calculations showed that the values were below one for all the tested, meaning the samples did not pose a health risk to the local population. This work was supported by The Scientific Research Projects Coordination Unit of Akdeniz University. Project Number: FBA-2017-2494.

Keywords: lead analyses, red pepper, risk assessment, daily exposure

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Authors: Nabil Abu-Heakal, Ismail Abo-Ghanema, Basma Hamed Merghani

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The aim of this investigation is to study the effect of seasonal variations in Egypt on hematological parameters, reproductive and metabolic hormones of Egyptian buffalo-cows. This study lasted one year extending from December 2009 to November 2010 and was conducted on sixty buffalo-cows. Group of 5 buffalo-cows at estrus phase were selected monthly. Then, after blood sampling through tail vein puncture in the 2nd day after natural service, they were divided in two samples: one with anticoagulant for hematological analysis and the other without anticoagulant for serum separation. Results of this investigation revealed that the highest atmospheric temperature was in hot summer 32.61±1.12°C versus 26.18±1.67°C in spring and 19.92±0.70°C in winter season, while the highest relative humidity % was in winter season 43.50±1.60% versus 32.50±2.29% in summer season. The rise in temperature-humidity index from 63.73±1.29 in winter to 78.53±1.58 in summer indicates severe heat stress which is associated with significant reduction in total red blood cell count (3.20±0.15×106), hemoglobin concentration (8.83±0.43 g/dl), packed cell volume (30.73±0.12%), lymphocytes % (40.66±2.33 %), serum progesterone hormone concentration (0.56±0.03 ng/mll), estradiol17-B concentration (16.8±0.64 ng/ml), triiodothyronin (T3) concentration (2.33±0.33 ng/ml) and thyroxin hormone (T4) concentration (21.66±1.66 ng/ml), while hot summer resulted in significant increase in mean cell volume (96.55±2.25 fl), mean cell hemoglobin (30.81±1.33 pg), total white blood cell count (10.63±0.97×103), neutrophils % (49.66±2.33%), serum prolactin hormone (PRL) concentration (23.45±1.72 ng/ml) and cortisol hormone concentration (4.47±0.33 ng/ml) compared to winter season. There was no significant seasonal variation in mean cell hemoglobin concentration (MCHC). It was concluded that in Egypt there was a seasonal variation in atmospheric temperature, relative humidity, temperature humidity index (THI) and the rise in THI above the upper critical level (72 units), which, for lactating buffalo-cows in Egypt is the major constraint on buffalo-cows' hematological parameters and hormonal secretion that affects animal reproduction. Hence, we should improve climatic conditions inside the dairy farm to eliminate or reduce summer infertility.

Keywords: buffalo, climate change, Egypt, physiological parameters

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Authors: Zehra Buyuktuncer, Aylin H. Büyükkaragöz, Tuğçe N. Balcı, Nevin Ergun

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Background: Undergoing rigid dietary habits for enhancing athletic performance could lead to eating disorders. High prevalence of eating disorders among female athletes has been already reported. However, the risk of disordered eating among disabled athletes is not known. A better knowledge of the different eating behaviors and their prevalence in disabled athletes would be helpful to understand interactions between eating and health. This study aimed to examine the cognitive restraint, uncontrolled eating and emotional eating behaviors in a disabled athlete population. Method: A total of 70 disabled Turkish national athletes (33 female, 37 male) from 5 sport branches (soccer, weight lifting, shooting, table tennis and basketball) were involved in the study. The cognitive restraint, uncontrolled eating and emotional eating behaviors were assessed using the revised version of Three Factor Eating Questionnaire-R18 (TFEQ-R18). The questionnaires were conducted by dietitian during the preparation camps of athletes. Body weight, height and waist circumference (WC) were measured; and body composition was analyzed by bioelectrical impedance analysis method. Results: The TFEQ scales showed a cognitive dietary restraint score of 13.9±4.2, uncontrolled eating score of 17.7±5.8 and emotional eating score of 4.9±2.5. The mean score of total TFEQ-R18 was 36.5±8.62. Neither total TFEQ-R18 score nor subscale scores differed significantly by gender or sport branches (p>0.05, for each). The scores were also similar in BMI groups (n=63; p>0.05). Total TFEQ, uncontrolled eating and emotional eating scores were significantly higher among the athletes with congenital disabilities compared to the scores of the athletes with acquired disabilities (p<0.05, for each). Moreover, the cognitive dietary restraint score was significantly high in athletes who would like to lose weight (p=0.009). Conclusion: Disabled athletes might have a risk of disordered eating. The different eating behaviors among disabled athletes should be assessed using validated tools to develop personalized nutritional strategies for those athletes.

Keywords: disabled athletes, eating behaviour, three-factor eating questionnaire-r18, body composition

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Authors: Rusnardi Rahmat Putra, Junji Kiyono, Aiko Furukawa

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Several powerful earthquakes have struck Padang during recent years, one of the largest of which was an M 7.6 event that occurred on September 30, 2009 and caused more than 1000 casualties. Following the event, we conducted a 12-site microtremor array investigation to gain a representative determination of the soil condition of subsurface structures in Padang. From the dispersion curve of array observations, the central business district of Padang corresponds to relatively soft soil condition with Vs30 less than 400 m/s. because only one accelerometer existed, we simulated the 2009 Padang earthquake to obtain peak ground acceleration for all sites in Padang city. By considering the damage data of the 2009 Padang earthquake, we produced seismic risk vulnerability estimation of non-engineered houses for rock, medium and soft soil condition. We estimated the loss ratio based on the ground response, seismic hazard of Padang and the existing damaged to non-engineered structure houses due to Padang earthquake in 2009 data for several return periods of earthquake events.

Keywords: profile, Padang earthquake, microtremor array, seismic vulnerability

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Authors: Aaron Herve Mbwe Mbissik, Lotfi Khiari, Otmane Raji, Abdellatif Elghali, Abdelkarim Lajili, Muhammad Ouabid, Martin Jemo, Jean-Louis Bodinier

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Potassium (K) is an essential macronutrient for plant growth, helping to regulate several physiological and metabolic processes. Evaporite-related potash salts, mainly sylvite minerals (K chloride or KCl), are the principal source of K for the fertilizer industry. However, due to the high potash-supply risk associated with its considerable price fluctuations and uneven geographic distribution for most agriculture-based developing countries, the development of alternative sources of fertilizer K is imperative to maintain adequate crop yield, reduce yield gaps, and food security. Alkaline Igneous rocks containing significant K-rich silicate minerals such as K feldspar are increasingly seen as the best alternative available. However, these rocks may require to be hydrothermally treatment to enhance the release of potassium. In this study, we evaluate the fertilizing capacity of raw and hydrothermally treated K-bearing silicate rocks from different areas in Morocco. The effectiveness of rock powders was tested in a greenhouse experiment using ryegrass (Lolium multiflorum) by comparing them to a control (no K added) and to a conventional fertilizer (muriate of potash: MOP or KCl). The trial was conducted in a randomized complete block design with three replications, and plants were grown on K-depleted soils for three growing cycles. To achieve our objective, in addition to the analysis of the muriate response curve and the different biomasses, we also examined three necessary coefficients, namely: the K uptake, then apparent K recovery (AKR), and the relative K efficiency (RKE). The results showed that based on the optimum economic rate of MOP (230 kg.K.ha⁻¹) and the optimum yield (44 000 kg.K.ha⁻¹), the efficiency of K silicate rocks was as high as that of MOP. Although the plants took up only half of the K supplied by the powdered rock, the hydrothermal material was found to be satisfactory, with a biomass value reaching the optimum economic limit until the second crop cycle. In comparison, the AKR of the MOP (98.6%) and its RKE in the 1st cycle were higher than our materials: 39% and 38%, respectively. Therefore, the raw and hydrothermal materials mixture could be an appropriate solution for long-term agronomic use based on the obtained results.

Keywords: K-uptake, AKR, RKE, K-bearing silicate rock, MOP

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Authors: M. A. Tayfun, M. A. Alkhalidi

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The exact theoretical expression describing the probability distribution of nonlinear sea-surface elevations derived from the second-order narrowband model has a cumbersome form that requires numerical computations, not well-disposed to theoretical or practical applications. Here, the same narrowband model is re-examined to develop a simpler closed-form approximation suitable for theoretical and practical applications. The salient features of the approximate form are explored, and its relative validity is verified with comparisons to other readily available approximations, and oceanic data.

Keywords: ocean waves, probability distributions, second-order nonlinearities, skewness coefficient, wave steepness

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Authors: Kelly S. Parkinson, Katherine Y. Teh-White

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Futureye has a bespoke social licence to operate methodology which has successfully secured community approval and commercial return for fisheries which have faced regulatory and financial risk. This unique approach to fisheries management focuses on delivering improved social and environmental outcomes to support the fishing industry make steps towards achieving the United Nations SDGs. An SLO is the community’s implicit consent for a business or project to exist. An SLO must be earned and maintained alongside regulatory licences. In current and new operations, it helps you to anticipate and measure community concerns around your operations – leading to more predictable and sensible policy outcomes that will not jeopardise your commercial returns. Rising societal expectations and increasing activist sophistication mean the international fishing industry needs to resolve community concerns at each stage their supply chain. Futureye applied our tested social licence to operate (SLO) methodology to help Austral Fisheries who was being attacked by activists concerned about the sustainability of Patagonian Toothfish. Austral was Marine Stewardship Council certified, but pirates were making the overall catch unsustainable. Austral wanted to be carbon neutral. SLO provides a lens on the risk that helps industries and companies act before regulatory and political risk escalates. To do this assessment, we have a methodology that assesses the risk that we can then translate into a process to create a strategy. 1) Audience: we understand the drivers of change and the transmission of those drivers across all audience segments. 2) Expectation: we understand the level of social norming of changing expectations. 3) Outrage: we understand the technical and perceptual aspects of risk and the opportunities to mitigate these. 4) Inter-relationships: we understand the political, regulatory, and reputation system so that we can understand the levers of change. 5) Strategy: we understand whether the strategy will achieve a social licence through bringing the internal and external stakeholders on the journey. Futureye’s SLO methodologies helped Austral to understand risks and opportunities to enhance its resilience. Futureye reviewed the issues, assessed outrage and materiality and mapped SLO threats to the company. Austral was introduced to a new way that it could manage activism, climate action, and responsible consumption. As a result of Futureye’s work, Austral worked closely with Sea Shepherd who was campaigning against pirates illegally fishing Patagonian Toothfish as well as international governments. In 2016 Austral launched the world’s first carbon neutral fish which won Austral a thirteen percent premium for tender on the open market. In 2017, Austral received the prestigious Banksia Foundation Sustainability Leadership Award for seafood that is sustainable, healthy and carbon neutral. Austral’s position as a leader in sustainable development has opened doors for retailers all over the world. Futureye’s SLO methodology can identify the societal, political and regulatory risks facing fisheries and position them to proactively address the issues and become an industry leader in sustainability.

Keywords: carbon neutral, fisheries management, risk communication, social licence to operate, sustainable development

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Authors: Tauseef-ur-Rehman, Rao Zahid Abbas, Wasim Babar, Arbab Sikandar

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Babesiosis is an infection due to the multiplication of tick borne parasite, Babesia sp., in erythrocytes of host (variety of vertebrates) including small ruminants and is responsible for decreased livestock output and hence economic losses. A cross-sectional study was designed in order to evaluate the prevalence of Babesia and its relation with various associated factors in district Toba Tek Singh, Central Punjab, Pakistan in 2009-2010. A total 10.84% (50/461) out of 461 examined cases for Babesia were found positive for Babesia infection. Month-wise peak prevalence was observed in July (17.95%), while no positive case was recorded in Dec-2009 and Jan-2010. The prevalence of infection in different goat breeds was found as non-significant (P < 0.05) for Babesia infection. The prevalence of Babesia was found significantly (P < 0.05) dependent to the goat age and sex. The feeding system, housing system, floor type and herd size revealed strong correlation with Babesia prevalence, while watering system and body conditions were found to be non-significant (P < 0.05), and hence it is suggested that with the improvement of management precautions Babesiosis can be avoided.

Keywords: Babesia, goat, prevalence, Pakistan, risk factors

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Authors: Mehdi Nakisa, Adi Maimun, Yasser M. Ahmed, Fatemeh Behrouzi

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Squat is the reduction in under-keel clearance between a vessel at-rest and underway due to the increased flow of water past the moving body. The forward motion of the ship induces a relative velocity between the ship and the surrounding water that causes a water level depression in which the ship sinks. The problem of ship squat is one among the crucial factors affecting the navigation of ships in restricted waters. This article investigates the LNG ship squat, its effects on flow streamlines around the ship hull and ship behavior and motion using computational fluid dynamics which is applied by Ansys-Fluent.

Keywords: ship squat, CFD, confined, mechanic

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Authors: Ndiaye Mouhamadou, Seck Abdoulaye, Ndiaye Babacar, Diallo Thierno Abdoulaye, Diop Abdou, Seck Mame Cheikh, Diongue Khadim, Badiane Aida Sadikh, Diallo Mamadou Alpha, Kouedvidjin Ekoué, Ndiaye Daouda

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Background: Toxoplasmosis is a parasite disease that presents high rates of gestational and congenital infection worldwide and is therefore considered a public health problem and a neglected disease. The aim of this study was to determine the seroprevalence of toxoplasmosis in pregnant women referred to the medical biology laboratory of the Pasteur Institute of Dakar (Senegal) between January 2014 and December 2019. Methodology: This was a cross-sectional, descriptive, retrospective study of 10892 blood samples from pregnant women aged 16 to 46 years. The Architect toxo IgG/IgM from Abbot Laboratories, which is a chemiluminescent microparticle immunoassay (CMIA), was used for the quantitative determination of antibodies against Toxoplasma gondii in human serum. Results: In total, over a period from January 2014 to December 2019, 10892 requests for toxoplasmosis serology in pregnant women were included. The age of the patients included in our series ranged from 16 to 46 years. The mean age was 31.2 ± 5.72 years. The overall seroprevalence of T. gondii in pregnant women was estimated to be 28.9% [28.0-29.7]. In a multivariate logistic regression analysis, after adjustment for a covariate such as a study period, pregnant women aged 36-46 years were more likely to carry IgG antibodies to T. gondii than pregnant women younger than 36 years. Conclusion: T. gondii seroprevalence was significantly higher in pregnant women older than 36 years, leaving younger women more susceptible to primary T. gondii infection and their babies to congenital toxoplasmosis. There will be a need to increase awareness of the risk factors for toxoplasmosis and its different modes of transmission in these high-risk groups, but this should be supported by epidemiologic studies of the distribution of risk factors for toxoplasmosis in pregnant women and women of childbearing age.

Keywords: toxoplasmosis, pregnancy, seroprevalence, Senegal

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Authors: Inten Meutia, Emylia Yuniarti

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The objective of this study is to analyze the effects of interest rate, the rate of return of Islamic banks on the amount of mudarabah deposits in Islamic banks. In analyzing the effect of rate of return in the Islamic banks and interest rate risk in the conventional banks, the 1-month Islamic deposit rate of return and 1 month fixed deposit interest rate of a total Islamic deposit are considered. Using data covering the period from January 2010 to Sepember 2013, the study applies the regression analysis to analyze the effect between variable and independence t-test to analyze the mean difference between rate of return and rate of interest. Regression analysis shows that rate of return have significantly negative influence on mudarabah deposits, while interest rate have negative influence but not significant. The result of independent t test shows that the interest rate is not different from the rate of return in Islamic Bank. It supports the hyphotesis that rate of return in Islamic banking mimic rate of interest in conventional bank. The results of the study have important implications on the risk management practices of the Islamic banks in Indonesia.

Keywords: conventional bank, interest rate, Islamic bank, rate of return

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Authors: Yori Gidron, Maartje Mol, Norbert Foudraine, Frits Van Osch, Joop Van Den Bergh, Moshe Farchi, Maud Straus

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Background: The worldwide pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-COV2), which began in 2019, also known as Covid-19, has infected over 136 million people and tragically took the lives of over 2.9 million people worldwide. Many of the complications and deaths are predicted by the inflammatory “cytokine storm.” One way to progress in the prevention of death is by finding a predictive and protective factor that inhibits inflammation, on the one hand, and which also increases anti-viral immunity on the other hand. The vagal nerve does precisely both actions. This study examined whether vagal nerve activity, indexed by heart-rate variability (HRV), predicts survival in patients with Covid-19. Method: We performed a pseudo-prospective study, where we retroactively obtained ECGs of 271 Covid-19 patients arriving at a large regional hospital in The Netherlands. HRV was indexed by the standard deviation of the intervals between normal heartbeats (SDNN). We examined patients’ survival at 3 weeks and took into account multiple confounders and known prognostic factors (e.g., age, heart disease, diabetes, hypertension). Results: Patients’ mean age was 68 (range: 25-95) and nearly 22% of the patients had died by 3 weeks. Their mean SDNN (17.47msec) was far below the norm (50msec). Importantly, relatively higher HRV significantly predicted a higher chance of survival, after statistically controlling for patients’ age, cardiac diseases, hypertension and diabetes (relative risk, H.R, and 95% confidence interval (95%CI): H.R = 0.49, 95%CI: 0.26 – 0.95, p < 0.05). However, since HRV declines rapidly with age and since age is a profound predictor in Covid-19, we split the sample by median age (40). Subsequently, we found that higher HRV significantly predicted greater survival in patients older than 70 (H.R = 0.35, 95%CI: 0.16 – 0.78, p = 0.01), but HRV did not predict survival in patients below age 70 years (H.R = 1.11, 95%CI: 0.37 – 3.28, p > 0.05). Conclusions: To the best of our knowledge, this is the first study showing that higher vagal nerve activity, as indexed by HRV, is an independent predictor of higher chances for survival in Covid-19. The results are in line with the protective role of the vagal nerve in diseases and extend this to a severe infectious illness. Studies should replicate these findings and then test in controlled trials whether activating the vagus nerve may prevent mortality in Covid-19.

Keywords: Covid-19, heart-rate Variability, prognosis, survival, vagal nerve

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Authors: Edwin Mwasakidzeni Mutyenyoka

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Without ignoring migration-related challenges in transit zones and places of origin, this inquiry focuses on arrived international immigrants’ exacerbated vulnerability during crises. The aim is to underline longstanding inequalities and demonstrate that crises merely amplify and exacerbate challenges that low-income migrants already face during ‘non-crises’ periods. Social protection, as an agenda for reducing vulnerability, poverty, and risk for low-income households, with regard to basic consumption and services, has been foregrounded in the post-apartheid development discourse in South Africa. Evidently, however, the state, through the South African Social Security Agency (SASSA), systemically excludes the majority of non-citizens from state-sponsored social assistance programs - often leaving them heavily dependent on sporadic non-state options and erosive coping mechanisms. In this paper, migration itself should not only be understood as a social protection strategy against poverty and risk but also as a source of vulnerability that often requires social protection. For quasi-ethnographic, it use one migrant destination, Alex Park Township, as a “contact zone” and space of negotiation during the pandemic.

Keywords: south-south migration, crises, social protection, Covid-19 pandemic

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Authors: Zal U’yun Wan Mahmood, Norfaizal Mohamed, Nita Salina Abu Bakar, Yii Mei Wo, Abdul Kadir Ishak, Mohamad Noh Sawon, Mohd Tarmizi Ishak, Khairul Nizam Razali

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The study of thorium radiotracer bioaccumulation in the whole body tropical freshwater fish (Anabas testudeneus; climb pearch) was performed. The objective of this study was to evaluate the effect of different Th-232 activity concentration andradiological dose in Anabas testudeneus under the laboratory bioaccumulation condition. Anabas testudeneus adults were exposed to different waterborne Th-232 levels: 0 BqL-1 (control), 50 BqL-1, 100 BqL-1,150 BqL-1and 200 BqL-1for 30 days. Radionuclide concentration ratios between the whole body levels and water levels were calculated and; total dose rates and risk quotients using ERICA Assessment Tool were also estimated. The results showed the increase of waterborne Th-232 concentration corresponded to a progressive decrease of Th concentration ratio. Meanwhile, the total dose rate (internal and external) in the whole body of Anabas testudeneus less than the ERICA dose rate screening value of 10 µGyh-1 and the risk quotient less than one. Thus, the findings can be concluded that the radiological dose of Th-232 to Anabas testudeneus is a very low probability and the situation may be considered to be of negligible radiological concern.

Keywords: Anabas testudeneus, bioaccumulation, radiological dose, Th-232

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Authors: Rasha Shoumar

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Background: Since the onset of the Syria crisis in 2011, Jordan has hosted many Syrian refugees, many of which are residing in urban and rural areas. Vulnerability of refugees has increased due to the COVID-19 pandemic, adding to their already existing challenge in access to medical services, rendering them vulnerable to the complications of untreated medical conditions and amplifying their risk for severe COVID-19 disease. To improve health outcomes and access to health care services in a COVID-19 context, IOM (The International Organization for Migration) provided health services including awareness raising, direct primary health care through mobile teams and referrals to secondary services were extended to the vulnerable populations of refugees. Method: 6 community health volunteers were trained and deployed to different governorates to provide COVID-19 and non-communicable disease awareness and collect data rated to non-communicable disease and access to medical health services. Primary health care services were extended to 7 governorates through a mobile medical team, providing medical management. The collected Data was reviewed and analyzed. Results: 2150 refugees in rural areas were reached out by community health volunteers, out of which 78 received their medications through the Ministry of Health, 121 received their medications through different non-governmental organizations, 665 patients couldn’t afford buying any medications, 1286 patients were occasionally buying their medications when they were able to afford it. 853 patients received medications and follow up through IOM mobile clinics, the most common conditions were hypertension, diabetes, hyperlipidemia, anemia, heart disease, thyroid disease, asthma, seizures, and psychiatric conditions. 709 of these patients had more than 3 of the comorbidities. Multiple cases were referred for secondary and tertiary lifesaving interventions. Conclusion: Non communicable diseases are highly prevalent among refugee population in Jordan, access to medical services have proven to be a challenge in rural areas especially during the COVID-19 era, many of the patients have multiple uncontrolled medical conditions placing them at risk for complications and risk for severe COVID-19 disease. Deployment of mobile clinics to rural areas plays an essential role in managing such medical conditions, thus improving the continuum of health care approach, physical and mental wellbeing of refugees and reducing the risk for severe COVID-19 disease among this group, taking us one step forward toward universal health access.

Keywords: COVID-19, refugees, mobile clinics, primary health care

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Authors: Palak V. Patel, Jessica Pixley, Steven R. Feldman

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Introduction: Basal cell carcinoma (BCC) is the most common skin cancer worldwide and requires substantial resources to treat. When choosing between indicated therapies, providers consider their associated adverse effects, efficacy, cosmesis, and function preservation. The patient’s tumor burden, infiltrative risk, and risk of tumor recurrence are also considered. Treatment cost is often left out of these discussions. This can lead to financial toxicity, which describes the harm and quality of life reductions inflicted by high care costs. Methods: We studied the guidelines set forth by the American Academy of Dermatology for the treatment of BCC. A PubMed literature search was conducted to identify the costs of each recommended therapy. We discuss costs alongside treatment efficacy and side-effect profile. Results: Surgical treatment for BCC can be cost-effective if the appropriate treatment is selected for the presenting tumor. Curettage and electrodesiccation can be used in low-grade, low-recurrence tumors in aesthetically unimportant areas. The benefits of cost-conscious care are not likely to be outweighed by the risks of poor cosmesis or tumor return ($471 BCC of the cheek). When tumor burden is limited, MMS offers better cure rates and lower recurrence rates than surgical excision, and with comparable costs (MMS $1263; SE $949). Surgical excision with permanent sections may be indicated when tumor burden is more extensive or if molecular testing is necessary. The utility of surgical excision with frozen sections, which costs substantially more than MMS without comparable outcomes, is less clear (SE with frozen sections $2334-$3085). Less data exists on non-surgical treatments for BCC. These techniques cost less, but recurrence-risk is high. Side-effects of nonsurgical treatment are limited to local skin reactions, and cosmesis is good. Cryotherapy, 5-FU, and MAL-PDT are all more affordable than surgery, but high recurrence rates increase risk of secondary financial and psychosocial burden (recurrence rates 21-39%; cost $100-270). Radiation therapy offers better clearance rates than other nonsurgical treatments but is associated with similar recurrence rates and a significantly larger financial burden ($2591-$3460 BCC of the cheek). Treatments for advanced or metastatic BCC are extremely costly, but few patients require their use, and the societal cost burden remains low. Vismodegib and sonidegib have good response rates but substantial side effects, and therapy should be combined with multidisciplinary care and palliative measures. Expert-review has found sonidegib to be the less expensive and more efficacious option (vismodegib $128,358; sonidegib $122,579). Platinum therapy, while not FDA-approved, is also effective but expensive (~91,435). Immunotherapy offers a new line of treatment in patients intolerant of hedgehog inhibitors ($683,061). Conclusion: Dermatologists working within resource-compressed practices and with resource-limited patients must prudently manage the healthcare dollar. Surgical therapies for BCC offer the lowest risk of recurrence at the most reasonable cost. Non-surgical therapies are more affordable, but high recurrence rates increase the risk of secondary financial and psychosocial burdens. Treatments for advanced BCC are incredibly costly, but the low incidence means the overall cost to the system is low.

Keywords: nonmelanoma skin cancer, basal cell skin cancer, squamous cell skin cancer, cost of care

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Authors: Sabina Huč, Staffan Svensson, Tomaž Hozjan

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Timber structures may be exposed to various environmental conditions during their service life. Often, the structures have to resist extreme changes in the relative humidity of surrounding air, with simultaneously carrying the loads. Wood material response for this load case is seen as increasing deformation of the timber structure. Relative humidity variations cause moisture changes in timber and consequently shrinkage and swelling of the material. Moisture changes and loads acting together result in mechano-sorptive creep, while sustained load gives viscoelastic creep. In some cases, magnitude of the mechano-sorptive strain can be about five times the elastic strain already at low stress levels. Therefore, analyzing mechano-sorptive creep and its influence on timber structures’ long-term behavior is of high importance. Relatively many one-dimensional rheological models for rheological behavior of wood can be found in literature, while a number of models coupling creep response in each material direction is limited. In this study, mathematical formulation of a coupled two-dimensional mechano-sorptive model and its application to the experimental results are presented. The mechano-sorptive model constitutes of a moisture transport model and a mechanical model. Variation of the moisture content in wood is modelled by multi-Fickian moisture transport model. The model accounts for processes of the bound-water and water-vapor diffusion in wood, that are coupled through sorption hysteresis. Sorption defines a nonlinear relation between moisture content and relative humidity. Multi-Fickian moisture transport model is able to accurately predict unique, non-uniform moisture content field within the timber member over time. Calculated moisture content in timber members is used as an input to the mechanical analysis. In the mechanical analysis, the total strain is assumed to be a sum of the elastic strain, viscoelastic strain, mechano-sorptive strain, and strain due to shrinkage and swelling. Mechano-sorptive response is modelled by so-called spring-dashpot type of a model, that proved to be suitable for describing creep of wood. Mechano-sorptive strain is dependent on change of moisture content. The model includes mechano-sorptive material parameters that have to be calibrated to the experimental results. The calibration is made to the experiments carried out on wooden blocks subjected to uniaxial compressive loaded in tangential direction and varying humidity conditions. The moisture and the mechanical model are implemented in a finite element software. The calibration procedure gives the required, distinctive set of mechano-sorptive material parameters. The analysis shows that mechano-sorptive strain in transverse direction is present, though its magnitude and variation are substantially lower than the mechano-sorptive strain in the direction of loading. The presented mechano-sorptive model enables observing real temporal and spatial distribution of the moisture-induced strains and stresses in timber members. Since the model’s suitability for predicting mechano-sorptive strains is shown and the required material parameters are obtained, a comprehensive advanced analysis of the stress-strain state in timber structures, including connections subjected to constant load and varying humidity is possible.

Keywords: mechanical analysis, mechano-sorptive creep, moisture transport model, timber

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Authors: Linda Smail, Zineb Azouz

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Given a Bayesian network relative to a set I of discrete random variables, we are interested in computing the probability distribution P(S) where S is a subset of I. The general idea is to write the expression of P(S) in the form of a product of factors where each factor is easy to compute. More importantly, it will be very useful to give an interpretation of each of the factors in terms of conditional probabilities. This paper considers a semantic interpretation of the factors involved in computing marginal probabilities in Bayesian networks. Establishing such a semantic interpretations is indeed interesting and relevant in the case of large Bayesian networks.

Keywords: Bayesian networks, D-Separation, level two Bayesian networks, factorization of computation

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Authors: Jenny Fairthorne, Yuka Mori, Helen Leonard

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Background: Primary care-givers of children with autism spectrum disorder (ASD) or intellectual disability (ID) have poorer health and quality of life (QoL) than primary care-givers (hereafter referred to as just care-givers) of typically developing children. We aimed to review original research which described factors impacting the health of care-givers of children with ASD or ID and to discuss how these factors might influence care-giver health. Methods: We searched Web of Knowledge, Medline, Scopus and Google Scholar using selections of words from each of three groups. The first comprised terms associated with ASD and ID and included autism, pervasive development disorder, intellectual disability, mental retardation, disability, disabled, Down and Asperger. The second included terms related to health such as depression, physical, mental, psychiatric, psychological and well-being. The third was terms related to care-givers such as mother, parent and care-giver. We included an original paper in our review if it was published between 1st January 1990 and 31st December, 2016, described original research in a peer-reviewed journal and was written in English. Additional criteria were that the research used a study population of 15 persons or more; described a risk or protective factor for the health of care-givers of a child with ASD, ID or a sub-type (such as ASD with ID or Down syndrome). Using previous research, we developed a simple and objective five-level tool to assess the strength of evidence provided by the reviewed papers. Results: We retained 33 papers. Factors impacting primary care-giver health included child behaviour, level of support, socio-economic status (SES) and diagnostic issues. Challenging child behaviour, the most commonly identified risk factor for poorer care-giver health and QoL was reported in ten of the studies. A higher level of support was associated with improved care-giver health and QoL. For example, substantial evidence indicated that family support reduced care-giver burden in families with a child with ASD and that family and neighbourhood support was associated with improved care-giver mental health. Higher socio-economic status (SES) was a protective factor for care-giver health and particularly maternal health. Diagnostic uncertainty and an unclear prognosis are factors which can cause the greatest concern to care-givers of children with ASD and those for whom a cause of their child’s ID has not been identified. We explain how each of these factors might impact caregiver health and how they might act differentially in care-givers of children with different types of ASD or ID (such as Down syndrome and ASD without ID). Conclusion: Care-givers of children with ASD may be more likely to experience many risk factors and less likely to experience the protective factors we identified for poorer mental health. Interventions to reduce risk factors and increase protective factors could pave the way for improved care-giver health. For example, workshops to train care-givers to better manage challenging child behaviours and earlier diagnosis of ASD (and particularly ASD without ID) would seem likely to improve care-giver well-being. Similarly, helping to expand support networks might reduce care-giver burden and stress leading to improved health.

Keywords: autism, caregivers, health, intellectual disability, mothers, review

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