Search results for: weighted risk scores

Authors: Jin Sheng

Abstract:

This paper addresses a promising area of insurance sector to develop in Asia. Captive insurance, which provides risk-mitigation services for its parent company, has great potentials to develop in energy, infrastructure, agriculture, logistics, catastrophe, and alternative risk transfer (ART), and will greatly affect the framework of insurance industry. However, the Asian captive insurance market only takes a small proportion in the global market. The recent supply chain interruption case of Hanjin Shipping indicates the significance of risk management for an Asian company’s sustainability and resilience. China has substantial needs and great potentials to develop captive insurance, on account of the currency volatility, enterprises’ credit risks, and legal and operational risks of the Belt and Road initiative. Up to date, Mainland Chinese enterprises only have four offshore captives incorporated by CNOOC, Sinopec, Lenovo and CGN Power), three onshore captive insurance companies incorporated by CNPC, China Railway, and COSCO, as well as one industrial captive insurance organization - China Ship-owners Mutual Assurance Association. Its captive market grows slowly with one or two captive insurers licensed yearly after September 2011. As an international financial center, Hong Kong has comparative advantages in taxation, professionals, market access and well-established financial infrastructure to develop a functional captive insurance market. For example, Hong Kong’s income tax for an insurance company is 16.5%; while China's income tax for an insurance company is 25% plus business tax of 5%. Furthermore, restrictions on market entry and operations of China’s onshore captives make establishing offshore captives in international or regional captive insurance centers such as Singapore, Hong Kong, and other overseas jurisdictions to become attractive options. Thus, there are abundant business opportunities in this area. Using methodology of comparative studies and case analysis, this paper discusses the incorporation, regulatory issues, taxation and prospect of captive insurance market in Hong Kong, China and Singapore. Hong Kong and Singapore are both international financial centers with prominent advantages in tax concessions, technology, implementation, professional services, and well-functioning legal system. Singapore, as the domicile of 71 active captives, has been the largest captive insurance hub in Asia, as well as an established reinsurance hub. Hong Kong is an emerging captive insurance hub with 5 to 10 newly licensed captives each year, according to the Hong Kong Financial Services Development Council. It is predicted that Hong Kong will become a domicile for 50 captive insurers by 2025. This paper also compares the formation of a captive in Singapore with other jurisdictions such as Bermuda and Vermont.

Keywords: Alternative Risk Transfer (ART), captive insurance company, offshore captives, risk management, reinsurance, self-insurance fund

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Authors: Samira-Sadat JamaliDinan, Haidar Almohri, Mohammad-Reza Nazem-Zadeh

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Lateralization of temporal lobe epilepsy (TLE) is very important for positive surgical outcomes. We propose a machine learning framework to ultimately identify the epileptogenic hemisphere for temporal lobe epilepsy (TLE) cases using magnetoencephalography (MEG) coherence source imaging (CSI) and diffusion tensor imaging (DTI). Unlike most studies that use classification algorithms, we propose an effective clustering approach to distinguish between normal and TLE cases. We apply the famous Minkowski weighted K-Means (MWK-Means) technique as the clustering framework. To overcome the problem of poor initialization of K-Means, we use particle swarm optimization (PSO) to effectively select the initial centroids of clusters prior to applying MWK-Means. We demonstrate that compared to K-means and MWK-means independently, this approach is able to improve the result of a benchmark data set.

Keywords: temporal lobe epilepsy, machine learning, clustering, magnetoencephalography

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Authors: Amin Padash, Javad Kazem Zadeh Khoiy, Hossein Vahidi

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Purpose: The mechanization system for the urban services was implemented in Tehran City in the year 2004 to promote the collection of domestic wastes; in 2010, in order to achieve the objectives of the project of urban services mechanization and qualitative promotion and improve the urban living environment, sustainable development and optimization of the recyclable solid wastes collection systems as well as other dry and non-organic wastes and conformity of the same to the modern urban management methods regarding integration of the mechanized urban services contractors and recycling contractors and in order to better and more correct fulfillment of the waste separation and considering the success of the mechanization plan of the dry wastes in most of the modern countries. The aim of this research is analyzing of Environmental Risk Assessment of the mechanization waste collection scheme in Tehran. Case Study: Tehran, the capital of Iran, with the population of 8.2 million people, occupies 730 km land expanse, which is 4% of total area of country. Tehran generated 2,788,912 ton (7,641 ton/day) of waste in year 2008. Hospital waste generation rate in Tehran reaches 83 ton/day. Almost 87% of total waste was disposed of by placing in a landfill located in Kahrizak region. This large amount of waste causes a significant challenge for the city. Methodology: To conduct the study, the methodology proposed in the standard Mil-St-88213 is used. This method is an efficient method to examine the position in opposition to the various processes and the action is effective. The method is based on the method of Military Standard and Specialized in the military to investigate and evaluate options to locate and identify the strengths and weaknesses of powers to decide on the best determining strategy has been used. Finding and Conclusion: In this study, the current status of mechanization systems to collect waste and identify its possible effects on the environment through a survey and assessment methodology Mil-St-88213, and then the best plan for action and mitigation of environmental risk has been proposed as Environmental Management Plan (EMP).

Keywords: environmental risk assessment, mechanization waste collection scheme, Mil-St-88213

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Authors: Birhanu Betela Warssamo

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Background: There is limited evidence on the prevalence and risk factors for hepatitis C virus (HCV) infection among waste handlers in the Sidama region, Ethiopia; however, this knowledge is necessary for the effective prevention of HCV infection in the region. Methods: A cross-sectional study was conducted among randomly selected waste collectors from October 2021 to 30 July 2022 in different public hospitals in the Sidama region of Ethiopia. Serum samples were collected from participants and screened for anti-HCV using a rapid immunochromatography assay. Socio-demographic and risk factor information of waste handlers was gathered by pretested and well-structured questionnaires. The generalized linear model (GLM) was conducted using R software, and P-value < 0.05 was declared statistically significant. Results: From a total of 282 participating waste handlers, 16 (5.7%) (95% CI, 4.2 – 8.7) were infected with the hepatitis C virus. The educational status of waste handlers was the significant demographic variable that was associated with the hepatitis C virus (AOR = 0.055; 95% CI = 0.012 – 0.248; P = 0.000). More married waste handlers, 12 (75%), were HCV positive than unmarried, 4 (25%) and married waste handlers were 2.051 times (OR = 2.051, 95%CI = 0.644 –6.527, P = 0.295) more prone to HCV infection, compared to unmarried, which was statistically insignificant. The GLM showed that exposure to blood (OR = 8.26; 95% CI = 1.878–10.925; P = 0.037), multiple sexual partners (AOR = 3.63; 95% CI = 2.751–5.808; P = 0.001), sharp injury (AOR = 2.77; 95% CI = 2.327–3.173; P = 0.036), not using PPE (AOR = 0.77; 95% CI = 0.032–0.937; P = 0.001), contact with jaundiced patient (AOR = 3.65; 95% CI = 1.093–4.368; P = 0 .0048) and unprotected sex (AOR = 11.91; 95% CI = 5.847–16.854; P = 0.001) remained statistically significantly associated with HCV positivity. Conclusions: The study revealed that there was a high prevalence of hepatitis C virus infection among waste handlers in the Sidama region, Ethiopia. This demonstrated that there is an urgent need to increase preventative efforts and strategic policy orientations to control the spread of the hepatitis C virus.

Keywords: Hepatitis C virus, risk factors, waste handlers, prevalence, Sidama Ethiopia

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Authors: R. Komsa-Penkova, G. Golemanov, G. Georgieva, K. Popovski, N. Slavov, P. Ivanov, K. Kovacheva, S. Rathee, E. Konova, A. Blajev

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Leptin and PAI-1 are important cytokines and may play a role in the regulation of PCOS development. PCOS is frequently associated with obesity, high BMI index and consequently with increased risk of metabolic disorders. The aim of the present study was to evaluate PAI-1 levels, genetic influence of the carriage of 675 4G/5G polymorphism in PAI-1 gene and leptin as a marker of obesity in the development of PCOS. Methods: Genotyping in 84 patients with PCOS and PCO and 100 healthy control subjects to detect single nucleotide deletion 675 G in the promoter of PAI-1 gene. The present study provides evidence that SNP 4G in the PAI-1 gene is associated with early pregnancy losses in patients with polycystosis. Further to this, there is a correlation between leptin levels, PAI-1 levels and BMI in the patients with PCOS, which confirms the role of obesity as a risk factor for PCOS.

Keywords: carriage of 675 4G/5G polymorphism, PCOS, early pregnancy losses, PAI-1 gene

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Authors: Nicholas Agyepong, Paul Gyan

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Inappropriate prescribing of antibiotic is a common healthcare concern globally resulted in an increased risk of adverse reactions and the emergence of antimicrobial resistance. The wrong antibiotic prescribing habits may lead to ineffective and unsafe treatment, worsening of disease condition, and thus increase in health care costs. The study was to examine the antibiotic prescribing pattern and associated risk factors at Regional Hospital in the Bono region of Ghana. A retrospective cross-sectional study was conducted to describe the current prescribing practices at the Hospital from January 2014 to December, 2021. A systematic random sampling method was used to select the participants for the study. STATA version 16 software was used for data management and analysis. Descriptive statistics and logistic regression analysis were used to analyze the data. Statistical significance set at p<0.05. Antibiotic consumption was equivalent to 11 per 1000 inhabitants consuming 1 DDD per day. Most common prescribed antibiotic was amoxicillin/clavulanic acid (14.39%) followed by erythromycin (11.44%), and ciprofloxacin (11.36%). Antibiotics prescription have been steadily increased over the past eight years (2014: n=59,280 to 2021: n=190,320). Prescribers above the age of 35 were more likely to prescribe antibiotics than those between the ages of 20 and 25 (COR=21.00; 95% CI: 1.78 – 48.10; p=0.016). Prescribers with at least 6 years of experience were also significantly more likely to prescribe antibiotics than those with at most 5 years of experience (COR=14.17; 95% CI: 2.39 – 84.07; p=0.004). Thus, the establishment of an antibiotic stewardship program in the hospitals is imperative, and further studies need to be conducted in other facilities to establish the national antibiotic prescription guideline.

Keywords: antibiotic, antimicrobial resistance, prescription, prescribers

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Authors: Neil Singla, Derek Muse, Karen DiDonato, Pamela Palmer

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Introduction: Pain is the most common reason people visit emergency rooms. Studies indicate however, that Emergency Department (ED) physicians often do not provide adequate analgesia to their patients as a result of gender and age bias, opiophobia and insufficient knowledge of and formal training in acute pain management. Novel classes of analgesics have recently been introduced, but many patients suffer from acute pain in settings where the availability of intravenous (IV) access may be limited, so there remains a clinical need for rapid-acting, potent analgesics that do not require an invasive route of delivery. A sublingual sufentanil tablet (SST), dispensed using a single-dose applicator, is in development for treatment of moderate-to-severe acute pain in a medically-supervised setting. Objective: The primary objective of this study was to demonstrate the repeat-dose efficacy, safety and tolerability of sufentanil 20 mcg and 30 mcg sublingual tablets compared to placebo for the management of acute pain as determined by the time-weighted sum of pain intensity differences (SPID) to baseline over the 12-hour study period (SPID12). Key secondary efficacy variables included SPID over the first hour (SPID1), Total pain relief over the 12-hour study period (TOTPAR12), time to perceived pain relief (PR) and time to meaningful PR. Safety variables consisted of adverse events (AE), vital signs, oxygen saturation and early termination. Methods: In this Phase 2, double-blind, dose-finding study, an equal number of male and female patients were randomly assigned in a 2:2:1 ratio to SST 20 mcg, SS 30 mcg or placebo, respectively, following bunionectomy. Study drug was dosed as needed, but not more frequently than hourly. Rescue medication was available as needed. The primary endpoint was the Summed Pain Intensity Difference to baseline over 12h (SPIDI2). Safety was assessed by continuous oxygen saturation monitoring and adverse event reporting. Results: 101 patients (51 Male/50 Female) were randomized, 100 received study treatment (intent-to-treat [ITT] population), and 91 completed the study. Reasons for early discontinuation were lack of efficacy (6), adverse events (2) and drug-dosing error (1). Mean age was 42.5 years. For the ITT population, SST 30 mcg was superior to placebo (p=0.003) for the SPID12. SPID12 scores in the active groups were superior for both male (ANOVA overall p-value =0.038) and female (ANOVA overall p-value=0.005) patients. Statistically significant differences in favour of sublingual sufentanil were also observed between the SST 30mcg and placebo group for SPID1(p<0.001), TOTPAR12(p=0.002), time to perceived PR (p=0.023) and time to meaningful PR (p=0.010). Nausea, vomiting and somnolence were more frequent in the sufentanil groups but there were no significant differences between treatment arms for the proportion of patients who prematurely terminated due to AE or inadequate analgesia. Conclusions: Sufentanil tablets dispensed sublingually using a single-dose applicator is in development for treatment of patients with moderate-to-severe acute pain in a medically-supervised setting where immediate IV access is limited. When administered sublingually, sufentanil’s pharmacokinetic profile and non-invasive delivery makes it a useful alternative to IM or IV dosing.

Keywords: acute pain, pain management, sublingual, sufentanil

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Authors: Mona Almansoori, Ahmed Mustafa, Ahmad Elshamy

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Wireless sensor network was formed by a combination of nodes, systematically it transmitting the data to their base stations, this transmission data can be easily compromised if the limited processing power and the data consistency from these nodes are kept in mind; there is always a discussion to address the secure data transfer or transmission in actual time. This will present a mechanism to securely transmit the data over a chain of sensor nodes without compromising the throughput of the network by utilizing available battery resources available in the sensor node. Our methodology takes many different advantages of Z-MAC protocol for its efficiency, and it provides a unique key by sharing the mechanism using neighbor node MAC address. We present a light weighted data integrity layer which is embedded in the Z-MAC protocol to prove that our protocol performs well than Z-MAC when we introduce the different attack scenarios.

Keywords: hybrid MAC protocol, data integrity, lightweight encryption, neighbor based key sharing, sensor node dataprocessing, Z-MAC

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Authors: Rawan Hakawati, Beatrice Smyth, David Rooney, Geoffrey McCullough

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Targets have been set in the EU to increase the share of renewable energy consumption to 20% by 2020, but developments have not occurred evenly across the member states. Northern Ireland is almost 90% dependent on imported fossil fuels. With such high energy dependency, Northern Ireland is particularly susceptible to the security of supply issues. Linked to fossil fuels are greenhouse gas emissions, and the EU plans to reduce emissions by 20% by 2020. The use of indigenously produced biomass could reduce both greenhouse gas emissions and external energy dependence. With a wide range of both crop and waste feedstock potentially available in Northern Ireland, anaerobic digestion has been put forward as a possible solution for renewable energy production, waste management, and greenhouse gas reduction. Not all feedstock, however, is the same, and an understanding of feedstock suitability is important for both plant operators and policy makers. The aim of this paper is to investigate biomass suitability for anaerobic digestion in Northern Ireland. It is also important that decisions are based on solid scientific evidence. For this reason, the methodology used is multi-criteria decision matrix analysis which takes multiple criteria into account simultaneously and ranks alternatives accordingly. The model uses the weighted sum method (which follows the Entropy Method to measure uncertainty using probability theory) to decide on weights. The Topsis method is utilized to carry out the mathematical analysis to provide the final scores. Feedstock that is currently available in Northern Ireland was classified into two categories: wastes (manure, sewage sludge and food waste) and energy crops, specifically grass silage. To select the most suitable feedstock, methane yield, feedstock availability, feedstock production cost, biogas production, calorific value, produced kilowatt-hours, dry matter content, and carbon to nitrogen ratio were assessed. The highest weight (0.249) corresponded to production cost reflecting a variation of £41 gate fee to 22£/tonne cost. The weights calculated found that grass silage was the most suitable feedstock. A sensitivity analysis was then conducted to investigate the impact of weights. The analysis used the Pugh Matrix Method which relies upon The Analytical Hierarchy Process and pairwise comparisons to determine a weighting for each criterion. The results showed that the highest weight (0.193) corresponded to biogas production indicating that grass silage and manure are the most suitable feedstock. Introducing co-digestion of two or more substrates can boost the biogas yield due to a synergistic effect induced by the feedstock to favor positive biological interactions. A further benefit of co-digesting manure is that the anaerobic digestion process also acts as a waste management strategy. From the research, it was concluded that energy from agricultural biomass is highly advantageous in Northern Ireland because it would increase the country's production of renewable energy, manage waste production, and would limit the production of greenhouse gases (current contribution from agriculture sector is 26%). Decision-making methods based on scientific evidence aid policy makers in classifying multiple criteria in a logical mathematical manner in order to reach a resolution.

Keywords: anaerobic digestion, biomass as feedstock, decision matrix, renewable energy

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Authors: Roongtiwa Chobchuen, Siriporn Mongkholthawornchai, Boonsong Hatawaikarn, Uriwan Chaichangreet, Kobkaew Thongtid, Pusda Pukdeekumjorn, Panita Limpawattana

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Background: Age-friendly nursing service system in Srinagarind Hospital has been developed continuously based on the value and cultural background of Thailand which corporates with the modified WHO’s Age friendly Primary Care Service System. It consists of 3 issues; 1) development of staff training, 2) age-friendly service and 3) appropriate physical environment. Objective: To evaluate the efficacy of Age-friendly Nursing Service System: KKU (AFNS:KKU) model and to evaluate factors associated with nursing perception with AFN:KKU. Study design: Descriptive study Setting: 31 wards that served older patients in Srinagarind Hospital Populations: Nursing staff from 11 departments (31 wards) Instrument: Age-friendly nursing care scale as perceived by hospitalized older person Procedure and statistical analysis: All participants were asked questions using age-friendly nursing care scale as perceived by hospitalized older person questionnaires. Descriptive statistics and multiple logistic regression analyses were used to analyse the outcomes. Results: There were 337 participants recruited in this study. The majority of them were women (92%) with the mean ages of 29 years and 77.45% were nurse practitioners. They had average nursing experiences of 5 years. The average scores of age-friendly nursing care scale were high and highest in the area of attitude and communication. Age, sex, educational level, duration of work among, and having experience in aging training were not associated with nursing perception where type of department was an independent factor. Nurses from department of Surgery and Orthopedic, Eye and ENT, special ward and Obstetrics and Gynecological had significant greater perception than nurses from Internal Medicine Department (p < 0.05). Conclusion: Nurses had high scores in all dimensions of age-friendly concept. The result indicates that nurses have good attitude to aging care which can lead to improve quality of care. Organization should support other domains of ageing care to achieve greater effectiveness in geriatric care.

Keywords: age-friendly, nursing service system, excellence model, geriatric care

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Authors: Sibusiso Mkwananzi

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The health of mother and child remain at risk among pregnant adolescents. Nevertheless, these are placed in even greater jeopardy when an expectant adolescent experiences violence. This paper sought to explore the levels and determinants of expecting adolescents in five Southern African countries. The study used the most recent (2010/2015) nationally representative demographic health survey (DHS) data from Malawi, Mozambique, Namibia, Zambia, and Zimbabwe. The highest levels of violence during pregnancy occurred amongst adolescent females living in Zimbabwe at 11.4%, followed by Zambia (8.3%) and Namibia (7.7%). Lowest levels were seen in Mozambique at 3.6%. Additionally, the determinants of experiencing violence during pregnancy included educational attainment, marital status, wealth and place of residence. Expectant adolescents that had a higher likelihood of experiencing violence were married and lived predominantly in rural settings. Higher risk was also associated with lower acquisition of education and poverty. These results show a very similar pattern to the risk factors associated with early pregnancy in the region. The predictors point to issues of possible lowered empowerment amongst younger women in their relationships and the structural challenges faced by this fledgling group. Nevertheless, addressing these dynamics could go a long way in not only decreasing the likelihood of unwanted motherhood at this early stage of the life course, but indeed even ensuring the prevention of violence during wanted early pregnancy. This would lead to improved levels of maternal and child health despite younger maternal age and aid in achieving a number of sustainable development goals.

Keywords: adolescents, determinants, Southern Africa, violence during pregnancy

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Authors: A. Bhatt, C. Bassi, H. Farragher, J. Musk

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Background: All medicines placed on the EU market are legally required to be accompanied by labeling and package leaflet, which provide comprehensive information, enabling its safe and appropriate use. Mock-ups with results of assessments using a target patient group must be submitted for a marketing authorisation application. Consumers need confidence in non-prescription, OTC medicines in order to manage their minor ailments and umbrella brands assist purchasing decisions by assisting easy identification within a particular therapeutic area. A number of regulatory agencies have risk management tools and guidelines to assist in developing umbrella brands for OTC medicines, however assessment and decision making is subjective and inconsistent. This study presents an evaluation in the UK following the US FDA warning concerning methaemoglobinaemia following 21 reported cases (11 children under 2 years) caused by OTC oral analgesics containing benzocaine. METHODS: A standard face to face, 25 structured task based user interview testing methodology using a standard questionnaire and rating scale in consumers aged 15-91 years, was conducted independently between June and October 2015 in their homes. Whether individuals could discriminate between the labelling, safety information and warnings on cartons and PILs between 3 different OTC medicines packs with the same umbrella name was evaluated. Each pack was presented with differing information hierarchy using, different coloured cartons, containing the 3 different active ingredients, benzocaine (oromucosal spray) and two lozenges containing 2, 4, dichlorobenzyl alcohol, amylmetacresol and hexylresorcinol respectively (for the symptomatic relief of sore throat pain). The test was designed to determine whether warnings on the carton and leaflet were prominent, accessible to alert users that one product contained benzocaine, risk of methaemoglobinaemia, and refer to the leaflet for the signs of the condition and what to do should this occur. Results: Two consumers did not locate the warnings on the side of the pack, eventually found them on the back and two suggestions to further improve accessibility of the methaemoglobinaemia warning. Using a gold pack design for the oromucosal spray, all consumers could differentiate between the 3 drugs, minimum age particulars, pharmaceutical form and the risk factor methaemoglobinaemia. The warnings for benzocaine were deemed to be clear or very clear; appearance of the 3 packs were either very well differentiated or quite well differentiated. The PIL test passed on all criteria. All consumers could use the product correctly, identify risk factors ensuring the critical information necessary for the safe use was legible and easily accessible so that confusion and errors were minimised. Conclusion: Patients with known methaemoglobinaemia are likely to be vigilant in checking for benzocaine containing products, despite similar umbrella brand names across a range of active ingredients. Despite these findings, the package design and spray format were not deemed to be sufficient to mitigate potential safety risks associated with differences in target populations and contraindications when submitted to the Regulatory Agency. Although risk management tools are increasingly being used by agencies to assist in providing objective assurance of package safety, further transparency, reduction in subjectivity and proportionate risk should be demonstrated.

Keywords: labelling, OTC, risk, user testing

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Authors: Ashit Syngle, Nidhi Garg, Pawan Krishan

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Objective: Bone marrow derived stem cells, endothelial progenitor cells (EPCs), protect against atherosclerotic vascular damage. However, EPCs are depleted in AS and contribute to the enhanced cardiovascular risk. Statins have a protective effect in CAD and diabetes by enhancing the proliferation, migration and survival of EPCs. Therapeutic potential of augmenting EPCs to treat the heightened cardiovascular risk of AS has not yet been exploited. We aimed to investigate the effect of rosuvastatin on EPCs population and inflammation in AS. Methods: 30 AS patients were randomized to receive 6 months of treatment with rosuvastatin (10 mg/day, n=15) and placebo (n=15) as an adjunct to existing stable anti-rheumatic drugs. EPCs (CD34+/CD133+) were quantified by Flow Cytometry. Inflammatory measures (BASDAI, BASFI, CRP and ESR), pro-inflammatory cytokines (TNF-α, IL-6 and IL-1) and lipids were measured at baseline and after treatment. Results: At baseline, inflammatory measures and pro-inflammatory cytokines were elevated and EPCs depleted among both groups. EPCs increased significantly (p < 0.01) after treatment with rosuvastatin. At 6 months, BASDAI, BASFI, ESR, CRP, TNF-α, and IL-6 improved significantly in rosuvastatin group. Significant negative correlation was observed between EPCs and BASDAI, CRP and IL-6 after rosuvastatin treatment. Conclusion: First study to show that rosuvastatin augments EPCs population in AS. This defines a novel mechanism of rosuvastatin treatment in AS: the augmentation of EPCs with improvement in proinflammatory cytokines and inflammatory disease activity. The augmentation of EPCs by rosuvastatin may provide a novel strategy to prevent cardiovascular events in AS.

Keywords: ankylosing spondylitis, Endothelial Progenitor Cells, inflammation, pro-inflammatory cytokines, rosuvastatin

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Authors: Molshree A. Sharma

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As a result of globalization, it is increasingly common for people to live in different parts of the world. However there is a corresponding rise of international family law issues and competing jurisdictions. The Hague Convention on the Civil Aspects of Child Abduction is a multilateral treaty that provides an expeditious method to return a child to their country of habitual residence when ‘internationally abducted’ by a parent from one member country to another. Specifically, the Convention provides a protocol for expeditious return of the child to their habitual residence unless there is a valid exception, the most common being that return would result in an intolerable situation or cause grave risk of harm to the child. This paper analyzes case law from various signatory countries including the United States, highlighting the differences in interpretation of key terms under the Convention, as well as case law in non-Hague signatory countries, with a focus on India and the Middle East.

Keywords: best interest of the child, grave risk of harm, habitual residence, well-settled

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Authors: Tsu-Yin Wu, Jenni Hoffman, Lydia McMurrows, Sarah Lally

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Recent events of the Flint Water Crisis and elevated lead levels in Detroit public school water have highlighted a specific public health disparity and shown the need for better education of healthcare providers on lead education. Identifying children and pregnant women with a high risk for lead poisoning and ensuring lead testing is completed is critical. The purpose of this study is to explore the impact of an educational intervention on knowledge and confidence levels among nursing students enrolled in the prelicensure Bachelor of Science in Nursing (BSN) and Registered Nurse to BSN program (R2B). The study used both quantitative and qualitative research methods to assess the impact of multi-modal pedagogy on knowledge and confidence of lead screening and prevention among prelicensure and R2B nursing students. The students received lead poisoning and prevention content in addition to completing an e-learning module developed by the Pediatric Environmental Health Specialty Units. A total of 115 students completed the pre-and post-test instrument that consisted of demographic, lead knowledge, and confidence items. Despite the increase of total knowledge, three dimensions of lead poisoning, and confidence from pre- to post-test scores for both groups, there was no statistical significance on the increase between prelicensure and R2B students. Thematic analysis of qualitative data showed five themes from participants' learning experiences: lead exposure, signs and symptoms of lead poisoning, screening and diagnosis, prevention, and policy and statewide issues. The study is limited by a small sample and participants recalling some correct answers from the pretest, thus, scoring higher on the post-test. The results contribute to the minimally existent literature examining a critical public health concern regarding lead health exposure and prevention education of nursing students. Incorporating such content area into the nursing curriculum is essential in ensuring that such public health disparities are mitigated.

Keywords: lead poisoning, emerging public health issue, community health, nursing edducation

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Authors: Erna Judith Roach, Nalini Bhaskaranand

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Background & Significance: Asthma is the most common chronic disease among children. Education is the cornerstone of management of asthma to help the affected children. In India there are about 1.5- 3.0 million asthmatic children in the age group of 5-11 years. Many parents face management dilemmas in administration of medications to their children. Mothers being primary caregivers of children are often responsible for administering medications to them. The purpose of the study was to develop an educational package on techniques of drug administration for mothers of asthmatic children and determine its effectiveness in terms of improvement in skill in drug administration. Methodology: A quasi- experimental time series pre-test post -test control group design was used. Mothers of asthmatic children attending paediatric outpatient departments of selected hospitals along with their children between 5 and 12 years were included. Sample size consisted of 40 mothers in the experimental and 40 mothers in the control groups. Block randomization was used to assign samples to both the groups. The data collection instruments used were Baseline Proforma, Clinical Proforma, Daily asthma drug intake and symptoms diary and Observation Rating Scales on technique of using a metered dose inhaler with spacer; metered dose inhaler with facemask; metered dose inhaler alone and dry powder inhaler. The educational package consisted of a video and booklet on techniques of drug administration. Data were collected at baseline, 1, 3 and 6 months. Findings: The mean post-test scores in techniques of drug administration were higher than the mean pre-test scores in the experimental group in all techniques. The Friedman test (p < 0.01), Wilcoxon Signed Rank test (p < 0.008) and Mann Whitney U (p < 0.01) showed statistically significant difference in the experimental group than the control group. There was significant decrease in the average number of symptom days (11 Vs. 4 days/ month) and hospital visits (5 to 1 per month) in the experimental group when compared to the control group. Conclusion: The educational package was found to be effective in improving the skill of mothers in drug administration in all the techniques, especially with using the metered dose inhaler with spacer.

Keywords: childhood asthma, drug administration, mothers of children, inhaler

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Authors: Evridiki Zachopoulou, Vasilis Grammatikopoulos, Michail Vitoulis, Athanasios Gregoriadis

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In the last ten years, the recent economic crisis in Greece has decreased the financial ability and strength of several families when it comes to supporting their children’s studies. As a result, the number of students who are significantly delaying or even dropping out of their university studies is constantly increasing. The students who are at greater risk for academic failure are those who are facing various problems and social disadvantages, like health problems, special needs, family poverty or unemployment, single-parent students, immigrant students, etc. The ‘Umbrella’ project is a volunteer-based initiative to tackle this problem at International Hellenic University. The main purpose of the project is to provide support to disadvantaged students at a socio-emotional, academic, and practical level in order to help them complete their undergraduate studies. More specifically, the ‘Umbrella’ project has the following goals: (a) to develop a consulting-supporting network based on volunteering senior students, called ‘i-mentors’. (b) to train the volunteering i-mentors and create a systematic and consistent support procedure for students at-risk, (c), to develop a service that, parallel to the i-mentor network will be ensuring opportunities for at-risk students to find a job, (d) to support students who are coping with accessibility difficulties, (e) to secure the sustainability of the ‘Umbrella’ project after the completion of the funding of the project. The innovation of the Umbrella project is in its holistic-person-centered approach that will be providing individualized support -via the i-mentors network- to any disadvantaged student that will come ‘under the Umbrella.’

Keywords: peer mentoring, student support, socially disadvantaged students, volunteerism in higher education

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Authors: Jonathan Iworiso

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Forecasting the equity premium out-of-sample is a major concern to researchers in finance and emerging markets. The quest for a superior model that can forecast the equity premium with significant economic gains has resulted in several controversies on the choice of variables and suitable techniques among scholars. This research focuses mainly on the application of Regression Training (RT) techniques to forecast monthly equity premium out-of-sample recursively with an expanding window method. A broad category of sophisticated regression models involving model complexity was employed. The RT models include Ridge, Forward-Backward (FOBA) Ridge, Least Absolute Shrinkage and Selection Operator (LASSO), Relaxed LASSO, Elastic Net, and Least Angle Regression were trained and used to forecast the equity premium out-of-sample. In this study, the empirical investigation of the RT models demonstrates significant evidence of equity premium predictability both statistically and economically relative to the benchmark historical average, delivering significant utility gains. They seek to provide meaningful economic information on mean-variance portfolio investment for investors who are timing the market to earn future gains at minimal risk. Thus, the forecasting models appeared to guarantee an investor in a market setting who optimally reallocates a monthly portfolio between equities and risk-free treasury bills using equity premium forecasts at minimal risk.

Keywords: regression training, out-of-sample forecasts, expanding window, statistical predictability, economic significance, utility gains

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Authors: Li Jiuen Ong, Magdalin Cheong, Sri Rahayu, Lek Alexander, Pei Ting Tan

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Background: Previous programme evaluations from the diabetes training programme conducted in Changi General Hospital revealed that healthcare professionals (HCPs) are keen to receive advance diabetes training and education, specifically in medical, nutritional therapy. HCPs also expressed a preference for interactive activities over didactic teaching methods to enhance their learning. Since the War on Diabetes was initiated by MOH in 2016, HCPs are challenged to be actively involved in continuous education to be better equipped to reduce the growing burden of diabetes. Hence, streamlining training to incorporate an element of fun is of utmost importance. Aim: The nutrition programme incorporates game play using an interactive board game that aims to provide a more conducive and less stressful environment for learning. The board game could be adapted for training of community HCPs, health ambassadors or caregivers to cope with the increasing demand of diabetes care in the hospital and community setting. Methodology: Stages for game’s conception (Jaffe, 2001) were adopted in the development of the interactive board game ‘Sweet Score™ ’ Nutrition concepts and topics in diabetes self-management are embedded into the game elements of varying levels of difficulty (‘Easy,’ ‘Medium,’ ‘Hard’) including activities such as a) Drawing/ sculpting (Pictionary-like) b)Facts/ Knowledge (MCQs/ True or False) Word definition) c) Performing/ Charades To study the effects of game play on knowledge acquisition and perceived experiences, participants were randomised into two groups, i.e., lecture group (control) and game group (intervention), to test the difference. Results: Participants in both groups (control group, n= 14; intervention group, n= 13) attempted a pre and post workshop quiz to assess the effectiveness of knowledge acquisition. The scores were analysed using paired T-test. There was an improvement of quiz scores after attending the game play (mean difference: 4.3, SD: 2.0, P<0.001) and the lecture (mean difference: 3.4, SD: 2.1, P<0.001). However, there was no significance difference in the improvement of quiz scores between gameplay and lecture (mean difference: 0.9, 95%CI: -0.8 to 2.5, P=0.280). This suggests that gameplay may be as effective as a lecture in terms of knowledge transfer. All the13 HCPs who participated in the game rated 4 out of 5 on the likert scale for the favourable learning experience and relevance of learning to their job, whereas only 8 out of 14 HCPs in the lecture reported a high rating in both aspects. 16. Conclusion: There is no known board game currently designed for diabetes training for HCPs.Evaluative data from future training can provide insights and direction to improve the game format and cover other aspects of diabetes management such as self-care, exercise, medications and insulin management. Further testing of the board game to ensure learning objectives are met is important and can assist in the development of awell-designed digital game as an alternative training approach during the COVID-19 pandemic. Learning through gameplay increases opportunities for HCPs to bond, interact and learn through games in a relaxed social setting and potentially brings more joy to the workplace.

Keywords: active learning, game, diabetes, nutrition

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Authors: Elijah Cavan

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In Major League Sports (MLB, NBA, NHL, NFL), it is the Front Office Staff (FOS) who make decisions about who plays for their respective team. The FOS bear the brunt of the responsibility for acquiring players through drafting, trading and signing players in free agency while typically contesting with maximum roster salary constraints. The players themselves are volatile assets of these teams- their value fluctuates with age and performance. A simple comparison can be made when viewing players as assets. The problem here is similar to that of optimizing your investment portfolio. The The goal is ultimately to maximize your periodic returns while tolerating a fixed risk (degree of uncertainty/ potential loss). Each franchise may value assets differently, and some may only tolerate lower risk levels- these are examples of factors that introduce additional constraints into the model. In this talk, we will detail the mathematical formulation of this problem as a constrained optimization problem- which can be solved with classical machine learning methods but is also well posed as a problem to be solved on quantum computers

Keywords: optimization, financial mathematics, sports analytics, simulated annealing

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Authors: Z. A. Ahmad, R. C. Omar, I. Z. Baharuddin, R. Roslan

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Assessments of social vulnerability, carried out holistically, can provide an important guide to the planning process and to decisions on resource allocation at various levels, and can help to raise public awareness of geo-hazard risks. The assessments can help to provide answers for basic questions such as the human vulnerability at the geo-hazard prone or disaster areas causing health damage, economic loss, loss of natural heritage and vulnerability impact of extreme natural hazard event. To overcome these issues, integrated framework for assessing the increasing human vulnerability to environmental changes caused by geo-hazards will be introduced using an indicator from landslide risk map that is related to agent based modeling platform. The indicators represent the underlying factors, which influence a community’s ability to deal with and recover from the damage associated with geo-hazards. Scope of this paper is particularly limited to landslides.

Keywords: social, vulnerability, geo-hazard, methodology, indicators

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Authors: Mohan Bilikallahalli Sannathimmappa, Vinod Nambiar, Rajeev Aravindakshan

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Background: Image-based teaching-learning module is innovative student-centered andragogy. The objective of our study was to explore medical students’ perception of effectiveness of image-based learning strategy in promoting their lifelong learning skills and evaluate its impact on improving students’ exam grades. Methods: A prospective single-cohort study was conducted on undergraduate medical students of the academic year 2021-22. The image-based teaching-learning module was assessed through pretest, posttest, and exam grades. Students’ feedback was collected through a predesigned questionnaire on a 3-point Likert Scale. The reliability of the questionnaire was assessed using Cronbach’s alpha coefficient test. In-Course Exam-4 results were compared with In-Course Exams 1, 2, and 3. Correlation coefficients were worked out wherever relevant to find the impact of the exercise on grades. Data were collected, entered into Microsoft Excel, and statistically analyzed using SPSS version 22. Results: In total, 127 students were included in the study. The posttest scores of the students were significantly high (24.75±) as compared to pretest scores (8.25±). Students’ opinion towards the effectiveness of image-based learning in promoting their lifelong learning skills was overwhelmingly positive (Cronbach’s alpha for all items was 0.756). More than 80% of the students indicated image-based learning was interesting, encouraged peer discussion, and helped them to identify, explore, and revise key information and knowledge improvement. Nearly 70% expressed image-based learning enhanced their critical thinking and problem-solving skills. Nine out of ten students recommended image-based learning module for future topics. Conclusion: Overall, Image-based learning was found to be effective in achieving undergraduate medical students learning outcomes. The results of the study are in favor of the implementation of Image-based learning in Microbiology courses. However, multicentric studies are required to authenticate our study findings.

Keywords: active learning, knowledge, medical education, microbes, problem solving

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Authors: Alina Svechkina, Boris A. Portnov

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In line with a rapid increase in pollution sources and enforcement of stricter air pollution regulation, which lowers pollution levels, it becomes more difficult to identify actual risk sources behind the observed morbidity patterns, and new approaches are required to identify potential risks and take preventive actions. In the present study, we discuss a probabilistic approach to the spatial identification of a priori unidentified environmental health hazards. The underlying assumption behind the tested approach is that the observed adverse health patterns (morbidity, mortality) can become a source of information on the geographic location of environmental risk factors that stand behind them. Using this approach, we analyzed sources of environmental exposure using data on mortality rates available for the year 2015 for NUTS 3 (Nomenclature of Territorial Units for Statistics) subdivisions of the European Union. We identified several areas in the southwestern part of Europe as primary risk sources for the observed mortality patterns. Multivariate regressions, controlled by geographical location, climate conditions, GDP (gross domestic product) per capita, dependency ratios, population density, and the level of road freight revealed that mortality rates decline as a function of distance from the identified hazard location. We recommend the proposed approach an exploratory analysis tool for initial investigation of regional patterns of population morbidity patterns and factors behind it.

Keywords: mortality, environmental hazards, air pollution, distance decay gradient, multi regression analysis, Europe, NUTS3

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Authors: Salwa S. Dawaki, Init Ithoi, Sa’adatu I. Yelwa

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Introduction: Parasitic infections are major public health problems worldwide, particularly in developing countries. Two third of the world population is infected while about 3 billion are at risk of parasitic infections. It is demonstrated that most parasitic infections occur as multiple infections especially among poor and rural communities of most countries in the tropical regions. Parasitic infections are endemic in Nigeria, yet multiple infections are rarely reported. The study aimed to estimate the prevalence and identify factors associating with multiple parasitic infections among rural population in Kano State Nigeria. Methodology: A cross-sectional survey was conducted from June to August 2013 in rural Kano State, Nigeria. Three samples stool, urine, and blood were collected from each of the 551 volunteers aged between one and ninety years old recruited for the survey. A pre-tested questionnaire was used to obtain epidemiological data. Data were analysed using appropriate descriptive, univariate and multivariate logistic regression methods. Major findings: The participants were 61.7% male, 38.3% female, and 69.0% were adults of 15 years and above. Overall, 463 (84%) were infected with parasitic infections among which 60.9% had multiple infections. A total of 15 parasitic species were recovered, and up to 8 different parasitic species were found concurrently in a single host. Plasmodium was the most common parasite followed by Blastocystis, Entamoeba species, and hookworms. It was found that presence of an infected family member (P = 0.017; OR = 1.52; 95% CI = 1.08, 2.13) and not wearing shoes outside home (P = 0.043; OR = 1.50; 95% CI = 1.01, 2.18) significantly associated with higher risk of having multiple parasitic infections among the studied population. Conclusion: Parasitic infections pose a public health challenge in the rural community of Kano. Multiple parasitic infections are highly prevalent and presence of an infected family member as well as not wearing proper foot wear outside home increases the risk of infection. Poor hygiene, unfavourable socioeconomic conditions, and culture promote survival and transmission of parasites. There is a need for implementation of integrated approach aimed at controlling or eliminating the infections with emphasis on public awareness.

Keywords: multiple infections, parasitic infections, poor hygiene, risk of infection

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Authors: John Faucett, Hao Wu, Bruce Moore, Sean Nadji

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The demands of the ministry often conflict with responsibilities at home, and clergy often experience domain ambiguity between the domains of work and family. However, the unique level of family involvement in the pastor’s profession might enrich the pastor’s ministry as well as the functioning of the family unit. Life in the church family might offer clergy family members a sense of meaning and purpose, social support, and a feeling of belonging. Church activities can offer enhanced opportunities for family interaction. The purpose of this study was to investigate the relationships of work/family enrichment to clergy job satisfaction, burnout, engagement, and withdrawal. Method: Participants were clergy serving within a state conference of the United Methodist Church. A survey was administered electronically, with e-mails and the United Methodist Church (UMC) Facebook page used as access points to the survey. Usable responses for this portion of the survey were obtained from 132 clergy. Participants completed The Work-Family Enrichment Scales, The Utrecht Work Engagement Scale, The Scale of Emotional Exhaustion in Ministry, The Satisfaction in Ministry Scale, and a scale of withdrawal developed for the present study. They also answered questions relating to how involved their spouses are in their ministry and the degree to which spouse involvement in church ministry strengthens church ministry. Findings: Higher scores for work to family enrichment correlated positively with job satisfaction (r = - .69, p < .01) and engagement (r = .50, p < .01), and negatively with burnout (r = -.48, p < .01) and withdrawal (r = -.46, p < .01). Higher scores for family to work enrichment correlated positively with job satisfaction (r = .29, p = .01) and engagement (.24, p < .05), and negatively with burnout (r = -.48, p < .01), and withdrawal (r = -.46, p < .01). Hierarchical regression analysis suggested that clergy perceptions concerning the degree to which spouse involvement in church ministry strengthens church ministry moderates the relationship between degree of spouse involvement in church activities and clergy withdrawal. To the degree that spouse involvement is believed to strengthen ministry, high spouse involvement is related to less clergy withdrawal (Multiple R-Squared = .068, Adj. R-Squared = .043, F = 2.69 on 3 & 110 DF, p = .05). Concluding Statement: Clergy job attitudes are related to work/family enrichment. Spouse involvement in parish ministry is associated with less clergy withdrawal, as long as clergy believe spouse involvement strengthens their ministry.

Keywords: clergy, emotional exhaustion, job engagement, job satisfaction, work/family enrichment

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Authors: Di Luo, Maria Buchberger, Anja Pickhard

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Objectives: The purpose of this study was to assess and compare the diagnostic accuracy of four common morphological approaches, including sonography, computed tomography (CT), positron emission tomography/computed tomography (PET/CT), and magnetic resonance imaging (MRI) for the evaluation of cervical lymph node metastases in head and neck squamous cell carcinoma (HNSCC) patients. Material and Methods: Included in this retrospective study were 26 patients diagnosed with HNSCC between 2010 and 2011 who all underwent sonography, CT, PET/CT, and MRI imaging before neck dissection. Morphological data were compared to the corresponding histopathological results. Statistical analysis was performed with SPSS statistic software (version 26.0), calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for detection of cervical lymph node metastases. Results: The 5-year survival rate of the patient collective was 55.5%.Risk factors for survival included initial primary tumor stage, initial lymph node stage, initial metastasis status, and therapeutic approaches. Cox regression showed initial metastasis status(HR 8.671, 95%CI 1.316-57.123, p=0.025) and therapeutic approaches(HR 6.699, 95%CI 1.746-25.700, p=0.006)to be independent predictive risk factors for survival. Sensitivity was highest for MRI (96% compared to 85% for sonography and 89% for CT and PET/CT). Specificity was comparable with 95 % for CT and 98 % for sonography and PET/CT, but only 68% for MRI. While the MRI showed the least PPV (34%) compared to all other methods (85% for sonography,75% for CT, and 86% for PET/CT), the NPV was comparable in all methods(98-99%). The overall accuracy of cervical lymph node metastases detection was comparable for sonography, CT, and PET/CT with 96%,97%,94%, respectively, while MRI had only 72% accuracy. Conclusion: Since the initial status of metastasis is an independent predictive risk factor for patients’ survival, efficient detection is crucial to plan adequate therapeutic approaches. Sonography, CT, and PET/CT have better diagnostic accuracy than MRI for the evaluation of cervical lymph node metastases in HNSCC patients.

Keywords: cervical lymph node metastases, diagnostic accuracy, head and neck squamous carcinoma, risk factors, survival

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Authors: Moushira Zaki, Wafaa Ezzat, Yasser Elhosary, Omnia Saleh

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Nonalcoholic fatty liver disease (NAFLD) has increased in conjunction with obesity. The accuracy of risk factors for detecting NAFLD in obese adolescents has not undergone a formal evaluation. The aim of this study was to evaluate predictors of NAFLD among Egyptian female obese adolescents. The study included 162 obese female adolescents. All were subjected to anthropometry, biochemical analysis and abdominal ultrasongraphic assessment. Metabolic syndrome (MS) was diagnosed according to the IDF criteria. Significant association between presence of MS and NAFLD was observed. Obese adolescents with NAFLD had significantly higher levels of ALT, triglycerides, fasting glucose, insulin, blood pressure and HOMA-IR, whereas decreased HDL-C levels as compared with obese cases without NAFLD. Receiver–operating characteristic (ROC) curve analysis shows that ALT is a sensitive predictor for NAFLD, confirming that ALT can be used as a marker of NAFLD.

Keywords: obesity, NAFLD, predictors, adolescents, Egyptians, risk factors, prevalence

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Authors: Ali Mohaghar, Iman Ghasemian Sahebi, Alireza Arab

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In the last decades, increasing in human and natural disaster occurrence had very irreparable effects on human life. Hence, one of the important issues in humanitarian supply chain management is identifying and prioritizing the different risks and finding suitable solutions for encountering them at the time of disaster occurrence. This study is an attempt to provide a comprehensive review of humanitarian supply chain risks in a case study of Tehran Red Crescent Societies. For this purpose, Best-Worst method (BWM) has been used for analyzing the risks of the humanitarian supply chain. 22 risks of the humanitarian supply chain were identified based on the literature and interviews with four experts. According to BWM method, the importance of each risk was calculated. The findings showed that culture contexts, little awareness of people, and poor education system are the most important humanitarian supply chain risks. This research provides a useful guideline for managers so that they can benefit from the results to prioritize their solutions.

Keywords: Best-Worst Method, humanitarian logistics, humanitarian supply chain, risk management

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Authors: Thyagi Ponnamperuma

Abstract:

Background: Comorbidity between posttraumatic stress disorder (PTSD) and other psychological problems is common. Recent studies focused to investigate the underlying relationship between PTSD and comorbid psychopathologies. Among adolescents, higher rates of emotional and behavioral problems (EBP) have been reported following trauma, often coexisted with PTSD. The current study, thus, examined the relationship of posttraumatic stress symptoms to EBP in adolescents exposed to a variety of traumatic events. Further, the study investigated the relationship of trauma and comorbid PTSS to the self-perceived negative impact of EBP on daily functioning. Methods: Participants were 729 Sri Lankan adolescents (age 12 to 16 years; 54.9% female) living in areas impacted in varying degrees by the 2004 tsunami. In 2008, school-based screening was conducted and completed measures of, trauma exposure, PTSS, EBP, and related functional impairment. Results: Participants reported a high prevalence of trauma exposure (n = 438), including interpersonal violence (n = 155). DSM-IV criteria for full or partial PTSD were met by 23.7% of the trauma-exposed sample. Across all participants, 13.4% and 16.7% displayed clinically relevant levels of EBP and functional impairment, respectively. Among the trauma-exposed, 7% met criteria for both EBP and PTSD. EBP total scores and caseness were significantly higher in trauma-exposed adolescents with PTSD than in either those without PTSD or the non-traumatized control group. In subscale analysis, higher prevalence of serious emotional, conduct, and hyperactivity problems were reported in the PTSD positive group; the PTSD negative group did not differ significantly from the control group on any of the problem scales. In regression analyses, PTSS (β = .28, p < .001) and interpersonal violence (β = .13, p = .033) were significant predictors of EBP, cumulative trauma (β = .11, p = .076) showed no significant effect. Further, PTSS exacerbated the impact of EBP on daily functioning (β = 0.29, p = .023). Conclusion: PTSS were closely linked to EBP in adolescents, even years after the traumatic experience. PTSD and emotional and behavioral problems together pose a heightened risk for impaired daily functioning. Longitudinal studies are needed to clarify the causal pathway.

Keywords: adolescents, comorbidity, emotional and behavioral problems, functional impairment, posttraumatic stress, traumatic events

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Authors: Onesimus Bulus Shiaki

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The study investigated the effect of cooperative learning strategy on mathematics achievement and retention among senior secondary school students of different abilities in Taraba State Nigeria. Cooperative learning strategy could hopefully contribute to students’ achievement which will spur the teachers to develop strategies for better learning. The quasi-experimental of pretest, posttest and control group design was adopted in this study. A sample of one hundred and sixty-four (164) Senior Secondary Two (SS2) students were selected from a population of twelve thousand, eight hundred and seventy-three (12,873) SS2 Students in Taraba State. Two schools with equivalent mean scores in the pre-test were randomly assigned to experimental and control groups. The experimental group students were stratified according to ability levels of low, medium and high. The experimental group was guided by the research assistants using the cooperative learning instructional package. After six weeks post-test was administered to the two groups while the retention test was administered two weeks after the post-test. The researcher developed a 50-item Mathematics Achievement Test (MAT) which was validated by experts obtaining the reliability coefficient of 0.87. Mean scores and standard deviations were used to answer the research questions while the Analysis of Co-variance (ANCOVA) was used to test the hypotheses. Major findings from the statistical analysis showed that cooperative learning strategy has a significant effect on the mean achievement of students as well as retention among students of high, medium and low ability in mathematics. However, cooperative learning strategy has no effect on the interaction of ability level and retention. Based on the results obtained, it was therefore recommended that the adoption of the use of cooperative learning strategy in the teaching and learning of mathematics in senior secondary schools be initiated, maintained and sustained for the benefit of senior secondary school students in Taraba State. Periodic Government sponsored in-service training in form of long vacation training programme, workshops, conferences and seminars on the nature, scope, and use of cooperative learning strategy should be organized for senior secondary school mathematics teachers in Taraba state.

Keywords: ability level, cooperative learning, mathematics achievement, retention

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