Search results for: equity risk premium
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6327

Search results for: equity risk premium

4227 The Right to Development as Constitutive and Prescriptive Right: The Lower Omo Valley Case of Ethiopia

Authors: Kebene K. Wodajo

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The right to development (RTD) has gone through different phases of metamorphoses, from the right to economic growth to full human development. Despite the fact that Africa has taken the lead in articulating and recognizing the RTD in a binding multilateral human rights treaty, realization of the right poses a challenge at the operational level. The challenge is worse in Sub-Saharan Africa, mainly because governments often tend to set economic growth as their ultimate goal, with very little consideration to the local peoples’ welfare in their territory. Ethiopia is not an exception to this. While recording a fast economic growth, yet this has been accompanied by increasing severity of multidimensional poverty. This paper explores the place of the ‘people’ in the development trajectory Ethiopia is pursuing and if and how a right-based approach to development could be brought to practice beyond the rhetoric. By inquiring into the place of the ‘people’, the paper attempts to show whether the people are at the center or at the periphery, beneficiary or victims of the ongoing development. In doing so, it divulges the gulf between the rhetoric and the reality of development practice. By asking/discussing if and how a right-based approach to development could bridge the gap, the paper shows how this approach could translate ‘people’s’ need into right, and recognize them as active subjects and stakeholders of the process of development. As an instance of showing the gap, the paper takes the Lower Omo valley sugar plantation project as a case in point. Through analysis the paper demonstrates that the development trajectory being followed by Ethiopia falls short of fitting into the human development discourse of UN Declaration on the Right to Development (DRD), the African Charter on People and Human Rights (the Charter) and the Ethiopian constitution. The paper argues that Ethiopia’s development efforts must take account of both the constitutive and prescriptive nature of the RTD if social equity is to be met.

Keywords: development, Ethiopia, lower Omo valley, right-based approach, right to development, people, people’s right

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4226 Association between Elder Mistreatment and Suicidal Ideation among Community-Dwelling Chinese Older Adults in the USA

Authors: Xin Qi Dong, Melissa Simon

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Aims: Elder mistreatment and suicidal ideation are important public health concerns among aging populations. This study will examine the association between elder mistreatment and suicidal ideation among Chinese older adults in the USA. Methods: Guided by a community-based participatory research approach, in this study we conducted in-person interviews with Chinese older adults aged 60 years and older in the Greater Chicago area from 2011 to 2013. Elder mistreatment was assessed by a 10-item instrument derived from the Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST) and the Vulnerability to Abuse Screening Scale (VASS). Suicidal ideation was assessed by the ninth item of the Patient Health Questionnaire-9 (PHQ-9) and the Geriatric Mental State Examination-Version A (GMS-A). Results: Overall, 3,159 Chinese older adults participated in this study, and their mean age was 72.8 years. After controlling for age, gender, education, income, medical comorbidities, depressive symptoms, and social support, elder mistreatment was significantly associated with 2-week suicidal ideation (OR 2.46, 95% CI 1.52--4.01) and 12-month suicidal ideation (OR 2.46, 95% CI 1.62--3.73). With respect to gender differences, the study found that the association remained significant for older women but not for older men after adjusting for all confounding factors. Conclusion: As the largest epidemiology study conducted among Chinese older adults in the USA, this study suggests that elder mistreatment is significantly associated with 2-week and 12-month suicidal ideation in older women but not in older men. Longitudinal studies should be conducted to explore the mechanisms through which elder mistreatment links with suicidal ideation.

Keywords: suicidal ideation, elder abuse, family violence, Asian health equity

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4225 Emerging Cyber Threats and Cognitive Vulnerabilities: Cyberterrorism

Authors: Oludare Isaac Abiodun, Esther Omolara Abiodun

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The purpose of this paper is to demonstrate that cyberterrorism is existing and poses a threat to computer security and national security. Nowadays, people have become excitedly dependent upon computers, phones, the Internet, and the Internet of things systems to share information, communicate, conduct a search, etc. However, these network systems are at risk from a different source that is known and unknown. These network systems risk being caused by some malicious individuals, groups, organizations, or governments, they take advantage of vulnerabilities in the computer system to hawk sensitive information from people, organizations, or governments. In doing so, they are engaging themselves in computer threats, crime, and terrorism, thereby making the use of computers insecure for others. The threat of cyberterrorism is of various forms and ranges from one country to another country. These threats include disrupting communications and information, stealing data, destroying data, leaking, and breaching data, interfering with messages and networks, and in some cases, demanding financial rewards for stolen data. Hence, this study identifies many ways that cyberterrorists utilize the Internet as a tool to advance their malicious mission, which negatively affects computer security and safety. One could identify causes for disparate anomaly behaviors and the theoretical, ideological, and current forms of the likelihood of cyberterrorism. Therefore, for a countermeasure, this paper proposes the use of previous and current computer security models as found in the literature to help in countering cyberterrorism

Keywords: cyberterrorism, computer security, information, internet, terrorism, threat, digital forensic solution

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4224 Management Tools for Assessment of Adverse Reactions Caused by Contrast Media at the Hospital

Authors: Pranee Suecharoen, Ratchadaporn Soontornpas, Jaturat Kanpittaya

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Background: Contrast media has an important role for disease diagnosis through detection of pathologies. Contrast media can, however, cause adverse reactions after administration of its agents. Although non-ionic contrast media are commonly used, the incidence of adverse events is relatively low. The most common reactions found (10.5%) were mild and manageable and/or preventable. Pharmacists can play an important role in evaluating adverse reactions, including awareness of the specific preparation and the type of adverse reaction. As most common types of adverse reactions are idiosyncratic or pseudo-allergic reactions, common standards need to be established to prevent and control adverse reactions promptly and effectively. Objective: To measure the effect of using tools for symptom evaluation in order to reduce the severity, or prevent the occurrence, of adverse reactions from contrast media. Methods: Retrospective review descriptive research with data collected on adverse reactions assessment and Naranjo’s algorithm between June 2015 and May 2016. Results: 158 patients (10.53%) had adverse reactions. Of the 1,500 participants with an adverse event evaluation, 137 (9.13%) had a mild adverse reaction, including hives, nausea, vomiting, dizziness, and headache. These types of symptoms can be treated (i.e., with antihistamines, anti-emetics) and the patient recovers completely within one day. The group with moderate adverse reactions, numbering 18 cases (1.2%), had hypertension or hypotension, and shortness of breath. Severe adverse reactions numbered 3 cases (0.2%) and included swelling of the larynx, cardiac arrest, and loss of consciousness, requiring immediate treatment. No other complications under close medical supervision were recorded (i.e., corticosteroids use, epinephrine, dopamine, atropine, or life-saving devices). Using the guideline, therapies are divided into general and specific and are performed according to the severity, risk factors and ingestion of contrast media agents. Patients who have high-risk factors were screened and treated (i.e., prophylactic premedication) for prevention of severe adverse reactions, especially those with renal failure. Thus, awareness for the need for prescreening of different risk factors is necessary for early recognition and prompt treatment. Conclusion: Studying adverse reactions can be used to develop a model for reducing the level of severity and setting a guideline for a standardized, multidisciplinary approach to adverse reactions.

Keywords: role of pharmacist, management of adverse reactions, guideline for contrast media, non-ionic contrast media

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4223 Hygrothermal Performance of Sheep Wool in Cold and Humid Climates

Authors: Yuchen Chen, Dehong Li, Bin Li, Denis Rodrigue, Xiaodong (Alice) Wang

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When selecting insulation materials, not only should their thermal efficiency be considered, but also their impact on the environment. Compared to conventional insulation materials, bio-based materials not only have comparable thermal performance, but they also have a lower embodied energy. Sheep wool has the advantages of low negative health impact, high fire resistance, eco-friendliness, and high moisture resistance. However, studies on applying sheep wool insulation in cold and humid climates are still insufficient. The purpose of this study is to simulate the hygrothermal performance of sheep wool insulation for the Quebec City climate, as well as analyze the mold growth risks. The results show that a sheep wool wall has better thermal performance than a reference wall and that both meet the minimum requirements of the Quebec Code for the thermal performance of above-ground walls. The total water content indicates that the sheep wool wall can reach dynamic equilibrium in the Quebec climate and can dry out. At the same time, a delay of almost four months in the maximum total water content indicates that the sheep wool wall has high moisture absorption compared to the reference wall. The hygrothermal profiles show that the sheathing-insulation interface of both walls is at the highest risk for condensation. When the interior surface gypsum was replaced by stucco, the mold index significantly dropped.

Keywords: sheep wool, water content, hygrothermal performance, mould growth risk

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4222 Regulatory and Economic Challenges of AI Integration in Cyber Insurance

Authors: Shreyas Kumar, Mili Shangari

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Integrating artificial intelligence (AI) in the cyber insurance sector represents a significant advancement, offering the potential to revolutionize risk assessment, fraud detection, and claims processing. However, this integration introduces a range of regulatory and economic challenges that must be addressed to ensure responsible and effective deployment of AI technologies. This paper examines the multifaceted regulatory landscape governing AI in cyber insurance and explores the economic implications of compliance, innovation, and market dynamics. AI's capabilities in processing vast amounts of data and identifying patterns make it an invaluable tool for insurers in managing cyber risks. Yet, the application of AI in this domain is subject to stringent regulatory scrutiny aimed at safeguarding data privacy, ensuring algorithmic transparency, and preventing biases. Regulatory bodies, such as the European Union with its General Data Protection Regulation (GDPR), mandate strict compliance requirements that can significantly impact the deployment of AI systems. These regulations necessitate robust data protection measures, ethical AI practices, and clear accountability frameworks, all of which entail substantial compliance costs for insurers. The economic implications of these regulatory requirements are profound. Insurers must invest heavily in upgrading their IT infrastructure, implementing robust data governance frameworks, and training personnel to handle AI systems ethically and effectively. These investments, while essential for regulatory compliance, can strain financial resources, particularly for smaller insurers, potentially leading to market consolidation. Furthermore, the cost of regulatory compliance can translate into higher premiums for policyholders, affecting the overall affordability and accessibility of cyber insurance. Despite these challenges, the potential economic benefits of AI integration in cyber insurance are significant. AI-enhanced risk assessment models can provide more accurate pricing, reduce the incidence of fraudulent claims, and expedite claims processing, leading to overall cost savings and increased efficiency. These efficiencies can improve the competitiveness of insurers and drive innovation in product offerings. However, balancing these benefits with regulatory compliance is crucial to avoid legal penalties and reputational damage. The paper also explores the potential risks associated with AI integration, such as algorithmic biases that could lead to unfair discrimination in policy underwriting and claims adjudication. Regulatory frameworks need to evolve to address these issues, promoting fairness and transparency in AI applications. Policymakers play a critical role in creating a balanced regulatory environment that fosters innovation while protecting consumer rights and ensuring market stability. In conclusion, the integration of AI in cyber insurance presents both regulatory and economic challenges that require a coordinated approach involving regulators, insurers, and other stakeholders. By navigating these challenges effectively, the industry can harness the transformative potential of AI, driving advancements in risk management and enhancing the resilience of the cyber insurance market. This paper provides insights and recommendations for policymakers and industry leaders to achieve a balanced and sustainable integration of AI technologies in cyber insurance.

Keywords: artificial intelligence (AI), cyber insurance, regulatory compliance, economic impact, risk assessment, fraud detection, cyber liability insurance, risk management, ransomware

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4221 Investigating the Determinants and Growth of Financial Technology Depth of Penetration among the Heterogeneous Africa Economies

Authors: Tochukwu Timothy Okoli, Devi Datt Tewari

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The high rate of Fintech adoption has not transmitted to greater financial inclusion and development in Africa. This problem is attributed to poor Fintech diversification and usefulness in the continent. This concept is referred to as the Fintech depth of penetration in this study. The study, therefore, assessed its determinants and growth process in a panel of three emergings, twenty-four frontiers and five fragile African economies disaggregated with dummies over the period 2004-2018 to allow for heterogeneity between groups. The System Generalized Method of Moments (GMM) technique reveals that the average depth of Mobile banking and automated teller machine (ATM) is a dynamic heterogeneity process. Moreover, users' previous experiences/compatibility, trial-ability/income, and financial development were the major factors that raise its usefulness, whereas perceived risk, financial openness, and inflation rate significantly limit its usefulness. The growth rate of Mobile banking, ATM, and Internet banking in 2018 is, on average 41.82, 0.4, and 20.8 per cent respectively greater than its average rates in 2004. These greater averages after the 2009 financial crisis suggest that countries resort to Fintech as a risk-mitigating tool. This study, therefore, recommends greater Fintech diversification through improved literacy, institutional development, financial liberalization, and continuous innovation.

Keywords: depth of fintech, emerging Africa, financial technology, internet banking, mobile banking

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4220 The Use of Venous Glucose, Serum Lactate and Base Deficit as Biochemical Predictors of Mortality in Polytraumatized Patients: Acomparative with Trauma and Injury Severity Score and Acute Physiology and Chronic Health Evalution IV

Authors: Osama Moustafa Zayed

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Aim of the work: To evaluate the effectiveness of venous glucose, levels of serum lactate and base deficit in polytraumatized patients as simple parameters to predict the mortality in these patients. Compared to the predictive value of Trauma and injury severity (TRISS) and Acute Physiology And Chronic Health Evaluation IV (APACHE IV). Introduction: Trauma is a serious global health problem, accounting for approximately one in 10 deaths worldwide. Trauma accounts for 5 million deaths per year. Prediction of mortality in trauma patients is an important part of trauma care. Several trauma scores have been devised to predict injury severity and risk of mortality. The trauma and injury severity score (TRISS) was most common used. Regardless of the accuracy of trauma scores, is based on an anatomical description of every injury and cannot be assigned to the patients until a full diagnostic procedure has been performed. So we hypothesized that alterations in admission glucose, lactate levels and base deficit would be an early and easy rapid predictor of mortality. Patient and Method: a comparative cross-sectional study. 282 Polytraumatized patients attended to the Emergency Department(ED) of the Suez Canal university Hospital constituted. The period from 1/1/2012 to 1/4/2013 was included. Results: We found that the best cut off value of TRISS probability of survival score for prediction of mortality among poly-traumatized patients is = 90, with 77% sensitivity and 89% specificity using area under the ROC curve (0.89) at (95%CI). APACHE IV demonstrated 67% sensitivity and 95% specificity at 95% CI at cut off point 99. The best cutoff value of Random Blood Sugar (RBS) for prediction of mortality was>140 mg/dl, with 89%, sensitivity, 49% specificity. The best cut off value of base deficit for prediction of mortality was less than -5.6 with 64% sensitivity, 93% specificity. The best cutoff point of lactate for prediction of mortality was > 2.6 mmol/L with 92%, sensitivity, 42% specificity. Conclusion: According to our results from all evaluated predictors of mortality (laboratory and scores) and mortality based on the estimated cutoff values using ROC curves analysis, the highest risk of mortality was found using a cutoff value of 90 in TRISS score while with laboratory parameters the highest risk of mortality was with serum lactate > 2.6 . Although that all of the three parameter are accurate in predicting mortality in poly-traumatized patients and near with each other, as in serum lactate the area under the curve 0.82, in BD 0.79 and 0.77 in RBS.

Keywords: APACHE IV, emergency department, polytraumatized patients, serum lactate

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4219 Optimal Portfolio of Multi-service Provision based on Stochastic Model Predictive Control

Authors: Yifu Ding, Vijay Avinash, Malcolm McCulloch

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As the proliferation of decentralized energy systems, the UK power system allows small-scale entities such as microgrids (MGs) to tender multiple energy services including energy arbitrage and frequency responses (FRs). However, its operation requires the balance between the uncertain renewable generations and loads in real-time and has to fulfill their provision requirements of contract services continuously during the time window agreed, otherwise it will be penalized for the under-delivered provision. To hedge against risks due to uncertainties and maximize the economic benefits, we propose a stochastic model predictive control (SMPC) framework to optimize its operation for the multi-service provision. Distinguished from previous works, we include a detailed economic-degradation model of the lithium-ion battery to quantify the costs of different service provisions, as well as accurately describe the changing dynamics of the battery. Considering a branch of load and generation scenarios and the battery aging, we formulate a risk-averse cost function using conditional value at risk (CVaR). It aims to achieve the maximum expected net revenue and avoids severe losses. The framework will be performed on a case study of a PV-battery grid-tied microgrid in the UK with real-life data. To highlight its performance, the framework will be compared with the case without the degradation model and the deterministic formulation.

Keywords: model predictive control (MPC), battery degradation, frequency response, microgrids

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4218 Newborn Hearing Screening: Experience from a Center in South part of Iran

Authors: Marzieh Amiri, Zahra Iranpour Mobarakeh, Fatemeh Mehrbakhsh, Mehran Amiri

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Introduction: Early diagnosis and intervention of congenital hearing loss is necessary to minimize the adverse effects of hearing loss. The aim of the present study was to report the results of newborn hearing screening in a centerin the south part of Iran, Fasa. Material and methods: In this study, the data related to 6,144 newbornsduring September 2018 up to September2021, was analyzed. Hearing screening was performed using transient evoked otoacoustic emissions (TEOAEs) and automated auditory brainstem response (AABR) tests. Results: From all 6144 newborns,3752 and 2392referred to the center from urban and rural part of Fasa, respectively. There were 2958 female and 3186 male in this study. Of 6144 newborns, 6098 ones passed the screening tests, and 46 neonates were referred to a diagnostic audiology clinic. Finally, nine neonates were diagnosed with congenital hearing loss (seven with sensorineural hearing loss and two with conductive hearing loss). The severity of all the hearing impaired neonates was moderate and above. The most important risk factors were family history of hearing loss, low gestational age, NICU hospitalization, and hyperbilirubinemia. Conclusion: Our results showed that the prevalence of hearing loss was 1.46 per 1000 infants. Boosting public knowledge by providing families with proper education appears to be helpful in preventing the negative effects of delayed implementation of health screening programs.

Keywords: newborn hearing screening, hearing loss, risk factor, prevalence

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4217 Role of Surfactant Protein D (SP-D) as a Biomarker of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection

Authors: Lucia Salvioni, Pietro Giorgio Lovaglio, Valerio Leoni, Miriam Colombo, Luisa Fiandra

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The involvement of plasmatic surfactant protein-D (SP-D) in pulmonary diseases has been long investigated, and over the last two years, more interest has been directed to determine its role as a marker of COVID-19. In this direction, several studies aimed to correlate pulmonary surfactant proteins with the clinical manifestations of the virus indicated SP-D as a prognostic biomarker of COVID-19 pneumonia severity. The present work has performed a retrospective study on a relatively large cohort of patients of Hospital Pio XI of Desio (Lombardia, Italy) with the aim to assess differences in the hematic SP-D concentrations among COVID-19 patients and healthy donors and the role of SP-D as a prognostic marker of severity and/or of mortality risk. The obtained results showed a significant difference in the mean of log SP-D levels between COVID-19 patients and healthy donors, so as between dead and survived patients. SP-D values were significantly higher for both hospitalized COVID-19 and dead patients, with threshold values of 150 and 250 ng/mL, respectively. SP-D levels at admission and increasing differences among follow-up and admission values resulted in the strongest significant risk factors of mortality. Therefore, this study demonstrated the role of SP-D as a predictive marker of SARS-CoV-2 infection and its outcome. A significant correlation of SP-D with patient mortality indicated that it is also a prognostic factor in terms of mortality, and its early detection should be considered to design adequate preventive treatments for COVID-19 patients.

Keywords: SARS-CoV-2 infection, COVID-19, surfactant protein-D (SP-D), mortality, biomarker

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4216 Enhanced Model for Risk-Based Assessment of Employee Security with Bring Your Own Device Using Cyber Hygiene

Authors: Saidu I. R., Shittu S. S.

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As the trend of personal devices accessing corporate data continues to rise through Bring Your Own Device (BYOD) practices, organizations recognize the potential cost reduction and productivity gains. However, the associated security risks pose a significant threat to these benefits. Often, organizations adopt BYOD environments without fully considering the vulnerabilities introduced by human factors in this context. This study presents an enhanced assessment model that evaluates the security posture of employees in BYOD environments using cyber hygiene principles. The framework assesses users' adherence to best practices and guidelines for maintaining a secure computing environment, employing scales and the Euclidean distance formula. By utilizing this algorithm, the study measures the distance between users' security practices and the organization's optimal security policies. To facilitate user evaluation, a simple and intuitive interface for automated assessment is developed. To validate the effectiveness of the proposed framework, design science research methods are employed, and empirical assessments are conducted using five artifacts to analyze user suitability in BYOD environments. By addressing the human factor vulnerabilities through the assessment of cyber hygiene practices, this study aims to enhance the overall security of BYOD environments and enable organizations to leverage the advantages of this evolving trend while mitigating potential risks.

Keywords: security, BYOD, vulnerability, risk, cyber hygiene

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4215 Performance of Visual Inspection Using Acetic Acid for Cervical Cancer Screening as Compared to HPV DNA Testingin Ethiopia: A Comparative Cross-Sectional Study

Authors: Agajie Likie Bogale, Tilahun Teklehaymanot, Getnet Mitike Kassie, Girmay Medhin, Jemal Haidar Ali, Nega Berhe Belay

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Objectives: The aim of this study is to evaluate the performance of visual inspection using acetic acid compared with HPV DNA testing among women living with HIV in Ethiopia. Methods: Acomparative cross-sectional study was conducted to address the aforementioned objective. Data were collected from January to October 2021 to compare the performance of these two screening modalities. Trained clinicians collected cervical specimens and immediately applied acetic acid for visual inspection. The HPV DNA testing was done using Abbott m2000rt/SP by trained laboratory professionals in accredited laboratories. A total of 578 HIV positive women with age 25-49 years were included. Results: Test positivity was 8.9% using VIA and 23.3% using HPV DNA test. The sensitivity and specificity of the VIA test were 19.2% and 95.1%, respectively, while the positive and negative predictive values of the VIA test were 54.4% and 79.4%, respectively. The strength of agreement between the two screening methods was poor (k=0.184), and the area under the curve was 0.572. The burden of genetic distribution of high risk HPV16 was 3.8%, and mixed HPV16& other HR HPV was 1.9%. Other high risk HPV types were predominant in this study (15.7%). Conclusion: The high positivity result using HPV DNA testing compared with VIA, and low sensitivity of VIA are indicating that the implementation of HPV DNA testing as the primary screening strategy is likely to reduce cervical cancer cases and deaths of women in the country.

Keywords: cervical cancer screening, HPV DNA, VIA, Ethiopia

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4214 Use of Proton Pump Inhibitors Medications during the First Years of Life and Late Complications

Authors: Kamelia Hamza

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Background: Proton pump inhibitors (PPIs) are the most prescribed drug classes for pediatric gastroesophageal reflux disease (GERD).Many patients are treated with these drugs for atypical manifestations attributed to gastroesophageal reflux (GER), even in the absence of proved causal relationship. There is an impression of increase use of PPI's treatment for reflux in "clalit health services," the largest health organization in Israel. In the recent years, the medicine is given without restriction, it's not limited to pediatric gastroenterologists only, but pediatricians and family doctors. The objective of this study is to evaluate the hypothesis that exposure to PPIs during the first year of life is associated with an increased risk of developing late adverse diseases: pneumonia, asthma, AGE, IBD, celiac disease, allergic disorders, obesity, attention deficit hyperactivity disorders (ADHD), autism spectrum disorders (ASD). Methods: The study is a retrospective case-control cohort study based on a computerized database of Clalit Health Services (CHS). It includes 9844 children born between 2002-2018 and reported to complain of at least one of the symptoms (reflux/ spitting up, irritability, feeding difficulties, colics). The study population included the study group (n=4922) of children exposed to PPIs at any time prior to the first year of life and a control group (n=4922) child not exposed to PPIs who were matched to each case of the study group on age, race, socioeconomic status, and year of birth. The prevalence of late complications/diseases in the study group was compared with the prevalence of late complications/diseases diagnosis between 2002-2020 in the control group. Odds ratios and 95% confidence intervals were calculated by using logistic regression models. Results: We found that compared to the control group, children exposed to PPIs in the first year of life had an increased risk of developing several late complications/ disorders: pneumonia, asthma, various allergies (urticaria, allergic rhinitis, or allergic conjunctivitis) OR, inhalant allergies, and food allergies. In addition, they showed an increased risk of being diagnosed with ADHD or ASD, but children exposed to PPIs in the first year of life had decrease the risk of obesity by 17% (OR 0.825, 95%CI 0.697-0.976). Conclusions: We found significant associations between the use of PPIs during the first year of life and subsequent development of late complications/diseases such as respiratory diseases, allergy diseases, ADHD, and ASD. More studies are needed to prove causality and determine the mechanism behind the effect of PPIs and the development of late complications.

Keywords: acid suppressing medications, proton pump inhibitors, histamine 2 blocker, late complications, gastroesophageal reflux, gastroesophageal reflux disease, acute gastroenteritis, community acquired pneumonia, asthma, allergic diseases, obesity, inflammatory bowel diseases, ulcerative colitis, crohn disease, attention deficit hyperactivity disorders, autism spectrum disorders

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4213 Occupational Safety and Health in the Wake of Drones

Authors: Hoda Rahmani, Gary Weckman

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The body of research examining the integration of drones into various industries is expanding rapidly. Despite progress made in addressing the cybersecurity concerns for commercial drones, knowledge deficits remain in determining potential occupational hazards and risks of drone use to employees’ well-being and health in the workplace. This creates difficulty in identifying key approaches to risk mitigation strategies and thus reflects the need for raising awareness among employers, safety professionals, and policymakers about workplace drone-related accidents. The purpose of this study is to investigate the prevalence of and possible risk factors for drone-related mishaps by comparing the application of drones in construction with manufacturing industries. The chief reason for considering these specific sectors is to ascertain whether there exists any significant difference between indoor and outdoor flights since most construction sites use drones outside and vice versa. Therefore, the current research seeks to examine the causes and patterns of workplace drone-related mishaps and suggest possible ergonomic interventions through data collection. Potential ergonomic practices to mitigate hazards associated with flying drones could include providing operators with professional pieces of training, conducting a risk analysis, and promoting the use of personal protective equipment. For the purpose of data analysis, two data mining techniques, the random forest and association rule mining algorithms, will be performed to find meaningful associations and trends in data as well as influential features that have an impact on the occurrence of drone-related accidents in construction and manufacturing sectors. In addition, Spearman’s correlation and chi-square tests will be used to measure the possible correlation between different variables. Indeed, by recognizing risks and hazards, occupational safety stakeholders will be able to pursue data-driven and evidence-based policy change with the aim of reducing drone mishaps, increasing productivity, creating a safer work environment, and extending human performance in safe and fulfilling ways. This research study was supported by the National Institute for Occupational Safety and Health through the Pilot Research Project Training Program of the University of Cincinnati Education and Research Center Grant #T42OH008432.

Keywords: commercial drones, ergonomic interventions, occupational safety, pattern recognition

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4212 Enhancing Rupture Pressure Prediction for Corroded Pipes Through Finite Element Optimization

Authors: Benkouiten Imene, Chabli Ouerdia, Boutoutaou Hamid, Kadri Nesrine, Bouledroua Omar

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Algeria is actively enhancing gas productivity by augmenting the supply flow. However, this effort has led to increased internal pressure, posing a potential risk to the pipeline's integrity, particularly in the presence of corrosion defects. Sonatrach relies on a vast network of pipelines spanning 24,000 kilometers for the transportation of gas and oil. The aging of these pipelines raises the likelihood of corrosion both internally and externally, heightening the risk of ruptures. To address this issue, a comprehensive inspection is imperative, utilizing specialized scraping tools. These advanced tools furnish a detailed assessment of all pipeline defects. It is essential to recalculate the pressure parameters to safeguard the corroded pipeline's integrity while ensuring the continuity of production. In this context, Sonatrach employs symbolic pressure limit calculations, such as ASME B31G (2009) and the modified ASME B31G (2012). The aim of this study is to perform a comparative analysis of various limit pressure calculation methods documented in the literature, namely DNV RP F-101, SHELL, P-CORRC, NETTO, and CSA Z662. This comparative assessment will be based on a dataset comprising 329 burst tests published in the literature. Ultimately, we intend to introduce a novel approach grounded in the finite element method, employing ANSYS software.

Keywords: pipeline burst pressure, burst test, corrosion defect, corroded pipeline, finite element method

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4211 Early-Stage Venture Investment Model: Evidence from Saudi Arabia

Authors: Tibah Alharbi, Renzo Cordina, David Power

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Relatively few studies have explored how venture capitalist investors (VCs) make investment decisions and the information they rely on when taking an equity stake in an investee company. In addition, little is known about how much investors monitor start-ups after the decision to invest has been made. The VC scene in the US or European context is understood better than that of developing countries such as those in the Middle East. Although some differences among VC investors have been identified, the reasons behind such differences have not been fully explored – especially in a country such as Saudi Arabia. Therefore, this research seeks to understand the impact of external factors on the VC investor’ behaviour. The unique cultural and legal environments in the Kingdom of Saudi Arabia, the growing VC sector in the country, and the increasing importance attached to start-ups under the Saudi Government’s Vision 2030 program make such an investigation timely. Ascertaining the perceptions of VC investors in such a context will provide a deeper understanding of the determinants of VC investment in a novel setting. Using semi-structured interviews with over 20 participants, the research explores the structure of VC funds, the cycle of the VC investment in a start-up from the sourcing of deals, the screening and evaluation of such deals, the closing of such deals, and finally, the monitoring of such investments before the decision to exit such deals at the appropriate time. The results show some similarities to the VC model, which characterizes such investment in the US and Europe, but several differences emerge given the unique cultural and legal settings within the Kingdom. The results provide an in-depth understanding of the VC investors’ mindset relative to the existing studies in the literature.

Keywords: exit, monitoring, start-ups, venture capital

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4210 Assessment of Heavy Metal Contamination in Soil and Groundwater Due to Leachate Migration from an Open Dumping Site

Authors: Kali Prasad Sarma

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Indiscriminate disposal of municipal solid waste (MSW) in open dumping site is a common scenario in developing countries like India which poses a risk to the environment as well as human health. The objective of the present investigation was to find out the concentration of heavy metals (Pb, Cr, Ni, Mn, Zn, Cu, and Cd) and other physicochemical parameters of leachate and soil collected from an open dumping site of Tezpur town, Assam, India and its associated potential ecological risk. Tezpur is an urban agglomeration coming under the category of Class I UAs/Towns with a population of 105,377 as per data released by Government of India for Census 2011. Impact of the leachate on the groundwater was also addressed in our study. The concentrations of heavy metals were determined using ICP-OES. Energy dispersive X-Ray (SEM-EDS) microanalysis was also conducted to see the presence of the studied metals in the soil. X-Ray diffraction analysis (XRD) and Fourier Transform Infrared (FTIR) spectroscopy were also used to identify dominant minerals present in the soil samples. The trend of measured heavy metals in the soil samples was found in the following order: Mn > Pb > Cu > Zn > Cr > Ni > Cd. The assessment of heavy metal contamination in the soil was carried out by calculating enrichment factor (EF), geo-accumulation index (Igeo), contamination factor (Cfi), degree of contamination (Cd), pollution load index (PLI) and ecological risk factor (Eri). The study showed that the concentrations of Pb, Cu, and Cd were much higher than their respective average shale value and the EF of the soil samples depicted very severe enrichment for Pb, Cu, and Cd; moderate enrichment for Cr and Zn. Calculated Igeo values indicated that the soil is moderate to strongly contaminated with Pb and uncontaminated to moderately contaminated with Cd and Cu. The Cfi value for Pb indicates a very strong contamination level of the metal in the soil. The Cfi values for Cu and Cd were 2.37 and 1.65 respectively indicating moderate contamination level. To apportion the possible sources of heavy metal contamination in soil, principal components analysis (PCA) has been adopted. From the leachate, heavy metals are accumulated at the dumping site soil which could easily percolate through the soil and reach the groundwater. The possible relation of groundwater contamination due to leachate percolation was examined by analyzing the heavy metal concentrations in groundwater with respect to distance from the dumping site. The concentrations of Cd and Pb in groundwater (at a distance of 20m from dumping site) exceeded the permissible limit for drinking water as set by WHO. Occurrence of elevated concentration of potentially toxic heavy metals such as Pb and Cd in groundwater and soil are much environmental concern as it is detrimental to human health and ecosystem.

Keywords: groundwater, heavy metal contamination, leachate, open dumping site

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4209 High School Youth and College Freshmen Comparison Towards the Psychological Health Status under the Influence of Sleep Hygiene and Quality from a Chinese Second-Tier City Sample during the COVID-19 Pandemic

Authors: Ziyu Zhang, Xuanyu Ren, Fei Wu, Qinfei Lu, Yongmei Li, Xinyue Zhi

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Introduction: Adolescents experience a critical period of physical and psychological growth. Few studies focus on the influence of sleep hygiene on psychological health from the high school period to freshmen year. Also, the influence of the COVID-19 pandemic has public health significance. Methods: Totally 698 students from high school and college were included in the manuscript, and a cross-sectional procedure was conducted; the objective was to make the epidemiological comparison of the social phobia/depression prevalence and discuss the effects of potential determinants. Results: Psychological problems, including social phobia and depression, are prevalent, especially among high school students, with gender differences. The current results indicated that the association between sleep status and social phobia is most obvious among high school students, while the higher MMR risk was found both for high school social phobia students and college depressive freshmen. Moreover, the interaction between social phobia and depression was also obvious for both populations. Conclusions: Psychological problems, including social phobia and depression, are more prevalent among high school girls when compared with their male and freshmen peers. Important influenced factors for the risk of psychological problems among the two populations were different, but media multitasking status should be paid attention to for both.

Keywords: adolescence, psychological health, epidemiology, social culture

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4208 The Effect of Varying Cone Beam Computed Tomography Image Resolution and Field-of-View Centralization on the Effective Radiation Dose

Authors: Fatima M. Jadu, Asmaa A. Alzahrani, Maha A. Almutairi, Salma O. Al-Amoudi, Mawya A. Khafaji

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Introduction: Estimating the potential radiation risk for a widely used imaging technique such as cone beam CT (CBCT) is crucial. The aim of this study was to examine the effect of varying two CBCT technical factors, the voxel size (VOX) and the Field-of-View (FOV) centralization, on the radiation dose. Methodology: The head and neck slices of a RANDO® man phantom (Alderson Research Laboratories) were used with nanoDot™ OSLD dosimeters to measure the absorbed radiation dose at 25 predetermined sites. Imaging was done using the i-CAT® (Imaging Science International, Hatfield, PA, USA) CBCT unit. The VOX was changed for every three cycles of exposures from 0.2mm to 0.3mm and then 0.4mm. Then the FOV was centered on the maxilla and mandible alternatively while holding all other factors constant. Finally, the effective radiation dose was calculated for each view and voxel setting. Results: The effective radiation dose was greatest when the smallest VOX was chosen. When the FOV was centered on the maxilla, the highest radiation doses were recorded in the eyes and parotid glands. While on the mandible, the highest radiation doses were recorded in the sublingual and submandibular glands. Conclusion: Minor variations in the CBCT exposure factors significantly affect the effective radiation dose and thus the radiation risk to the patient. Therefore, extreme care must be taken when choosing these parameters especially for vulnerable patients such as children.

Keywords: CBCT, cone beam CT, effective dose, field of view, mandible, maxilla, resolution, voxel

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4207 Pattern and Risk Factors of Menstrual Regulation Service Use among Ever-married Women in Bangladesh: Evidence from a Nationally Representative Cross-sectional Study

Authors: Md. Rashed Aalm, Md. Nuruzzaman Khan, Yothin Sawangdee

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Background: Around 47% of the total pregnancies are unintended in Bangladesh, which lead to several adverse consequences, including maternal and child mortality. Use of menstrual regulation (MR) can help women to reduce unintended pregnancy related adverse consequences. We explored the prevalence and determinants of MR services among ever-married women in Bangladesh. Methods: Total of 14,346 ever-married women data were analysed from the 2017 Bangladesh Demographic and Health Survey. Our study variable was use or non-use of MR services. Individual, household, and community level factors were the explanatory factors. Multilevel mixed-effect Poisson regression model was used to determine the factors associated with MR services in Bangladesh. Results: Nearly 7% of the total women in Bangladesh use MR services. Use of MR services was found higher among women who were aged 20-30 ages (IRR 1.60, 95% CI: 1.17–2.17), who were overweight (IRR 1.43, 95% CI: 1.13–1.81), had at least 1 child (IRR 2.97, 95% CI: 2.34– 3.77) or > 2 children (IRR 3.22, 95% CI: 2.45–4.20), and the birth preceding birth interval was(2 – 4) years (IRR 1.56, 95% CI: 1.13–2.15). Around 1.39 times (95% CI: 1.11–1.73) higher likelihood of MR was found among women whose husbands were engage with business. At the community level, MR service was found lower among the women who resided in the community with higherilliteracy (IRR 0.67, 95% CI: 0.42–0.96) and the Mymensingh division (IRR 0.39, 95% CI: 0.31–0.91). Conclusion: Use of MR service is comparatively low, which indicate a significant proportion of unintended pregnancy continued toward life-birth. This could be responsible for higher adverse maternal and child health outcomes in Bangladesh. Initiatives should be taken to ensure MR services is available when women need this service.

Keywords: menstrual regulation, pattern, risk, maternal health, Bangladesh

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4206 Human Immunodeficiency Virus Infection/AIDS Abandoned Children in Kenya

Authors: Ruth Muturi Wanjiku

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HIV/AIDS in Kenya for unborn and young kids. HIV/AIDS is a significant health concern in Kenya, with an estimated 1.5 million people living with the disease. Unfortunately, many of these individuals are unaware of their HIV status, and the disease continues to spread among the population or unborn kids. HIV/AIDS can be transmitted from an infected mother during pregnancy, childbirth, or breastfeeding. However, with early testing and treatment, the risk of mother-to-child transmission can be significantly reduced. Therefore, it is crucial for pregnant women to get tested and receive appropriate medical care. For young kids, HIV/AIDS education is critical to preventing the spread of the disease. It is essential to teach children about the importance of safe sex practices, avoiding risky behaviors such as sharing needles and getting tested regularly. Additionally, children should be taught about the stigma surrounding HIV/AIDS and encouraged to treat individuals living with the disease with compassion and respect. In conclusion, HIV/AIDS is a significant health concern in Kenya that affects individuals of all ages. For unborn kids, early testing and treatment are critical to reducing the risk of mother-to-child transmission. For young kids, education about HIV/AIDS and safe sex practices is essential to preventing the spread of the disease and reducing stigma. It is essential to promote awareness and encourage individuals to get tested and seek medical care if they believe they may be infected with HIV/AIDS.

Keywords: AIDS, HIV, children, pregnant

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4205 Delay in the Diagnosis of Tuberculosis and Initiation of TB Treatment in the Private and Public Health Sectors, Udaipur District, Rajasthan, India, Nov 2013

Authors: Yogita Tulsian, R. S. Gupta, K. F. Laserson

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Background: Delays in the diagnosis and treatment of TB facilitates disease transmission in the community, so we conducted a study to evaluate the burden of and risk factors for delay in TB diagnosis and initiation of TB treatment among patients in the private and public sectors in Udaipur district, Rajasthan, India. Methods: A retrospective cohort study was conducted among 100 new sputum-positive TB. Patients were interviewed in the intensive phase of treatment September 2013-November 2013 Long total diagnosis delay (TDD) was defined as a time interval between first symptom to confirmed diagnosis > 30 days. Long health treatment delay (HTD) was defined as a time interval between confirmed diagnosis to treatment initiation > 7 days. Results: We observed a median TDD of 55 days (range: 7-136 days) in the public sector and of 92 days (11-380 days) in the private sector. Long TDD in the private sector was significantly associated with middle-higher socio-economic status (Risk Ratio (RR): 2;95% CI: 1.3-3). The reasons reported from the private sector for long TDD were suspect TB patients not advised for sputum examination (RR: 42; 95% CI:2.6-660), practise of self-medication (RR: 17.4; 95% CI: 1.1-267), or lack of awareness (RR: 9.7;95% CI: 0.6-145). The median HTD in the public sector was 3 days (range: 0-14 days), and in the private sector, 2 days (range: 0-11 days) (non-significant difference). Conclusions: Long TDD in private sector may be improved through sputum referral for all suspect TB cases and better education to all regarding TB.

Keywords: diagnosis delay, treatment delay, privatesector, public sector

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4204 Psychosocial Risks and Occupational Health in a Mexican Small and Medium-Sized Enterprises

Authors: Magdalena Escamilla Quintal, Thelma Cetina Canto, Cecilia Aguilar Ortega

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Due to the importance that people represent for companies, the setting of a clear control of the risks that threaten the health and the material and financial resources of workers is essential. It is irrelevant if the company is a small and medium-sized enterprise (SME) or a large multinational, or if it is in the construction or service sector. The risk prevention importance is related to a constitutional and human right that all people have; working in a risk-free environment to prevent accidents or illnesses that may influence their quality of life and the tranquility of their family. Therefore, the objective of this study was to determine the level of psychosocial risks (physical and emotional) of the employees of an SME. The participants of this study were 186 employees of a productive sector SME; 151 men and 35 women, all with an average age of 31.77 years. Their seniority inside the SME was between one month and 19.91 years. Ninety-six workers were from the production area, 28 from the management area, as well as 25 from the sales area and 40 from the supplies area. Ninety-three workers were found in Uman, 78 in Playa del Carmen, 11 in Cancun and seven in Cd. del Carmen. We found a statistically significant relationship between the burnout variable and the engagement and psychosomatic complaints as well as between the variables of sex, burnout and psychosomatic complaints. We can conclude that, for benefit of the SME, that there are low levels of burnout and psychosomatic complaints, the women experience major levels of burnout and the men show major levels of psychosomatic complaints. The findings, contributions, limitations and future proposals will be analyzed.

Keywords: psychosocial risks, SME, burnout, engagement, psychosomatic complaints

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4203 Adoptability of Digital Payment for Community Health Workers in Wakiso District, Uganda

Authors: Veronica Kembabazi, Arnold Tigaiza, Juliet Aweko, Charles Opio, Michael Ediau, Elizabeth Ekirapa, Andrew Tusubira, Peter Waiswa

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Background: Digital payments have been branded as key in solving health payment challenges, evidence on their adoptability is still limited especially among Community Health Workers (CHWs), yet vital for ensuring sustainability. We therefore assessed the adoptability of digital payments for CHWs in Wakiso district, Uganda. Methods: In December 2022, we conducted a convergent parallel mixed-methods study among 150 randomly selected CHWs in Wakiso district. Supplementary qualitative data were collected from the Digital payment coordinators as Key Informants (KIs). We adopted the Technology Acceptance Model (TAM) framework to assess the adoptability of digital payments among CHWS. Factor analysis was performed to extract composite variables from the original constituting variables. Kaiser-Meyer-Olkin statistics were assessed for each construct to determine appropriateness for data reduction. Using logistic regression for multivariate analysis, we assessed the association between adoptability constructs and the CHW intention to use digital payments. Quantitative data was analyzed using STATA, while qualitative data was transcribed verbatim and analyzed using ATLAS.ti software. Results: Overall, 150 respondents were interviewed and nearly all participants (98.0%) had previously received payments through mobile money, a digital-payment method. The majority (52%) of CHWs said they intend to use digital payment modalities. Perceived risk had an 83% negative influence on the adoptability of digital payment modalities (OR= 0.167, p < 0.01), perceived trust had an almost three times positive influence on the adoptability of digital payment modalities (OR= 2.823, p < 0.01). Qualitative interviews showed that most CHWs reported good experiences in their use of digital health payment modalities except for delays associated with mobile money payments. Mobile money was reported to be easy to use, in addition to fostering financial responsibility compared to cash. Conclusion: CHWs in Wakiso district intend to use digital payment modalities, particularly mobile money/e-cash, and the perceived risk of the payment method and trust are key determinants of its adoptability. Synergized efforts by both payment providers and service operators to manage payment delays and identified risks among mobile money operators could attenuate perceived risk and build trust in digital payment modalities.

Keywords: digital health payments, community health workers, adoptability, technology acceptance model

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4202 Finding the Theory of Riba Avoidance: A Scoping Review to Set the Research Agenda

Authors: Randa Ismail Sharafeddine

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The Islamic economic system is distinctive in that it implicitly recognizes money as a separate, independent component of production capable of assuming risk and so entitled to the same reward as other Entrepreneurial Factors of Production (EFP). Conventional theory does not identify money capital explicitly as a component of production; rather, interest is recognized as a reward for capital, the interest rate is the cost of money capital, and it is also seen as a cost of physical capital. The conventional theory of production examines how diverse non-entrepreneurial resources (Land, Labor, and Capital) are selected; however, the economic theory community is largely unaware of the reasons why these resources choose to remain as non-entrepreneurial resources as opposed to becoming entrepreneurial resources. Should land, labor, and financial asset owners choose to work for others in return for rent, income, or interest, or should they engage in entrepreneurial risk-taking in order to profit. This is a decision made often in the actual world, but it has never been effectively treated in economic theory. This article will conduct a critical analysis of the conventional classification of factors of production and propose a classification for resource allocation and income distribution (Rent, Wages, Interest, and Profits) that is more rational, even within the conventional theoretical framework for evaluating and developing production and distribution theories. Money is an essential component of production in an Islamic economy, and it must be used to sustain economic activity.

Keywords: financial capital, production theory, distribution theory, economic activity, riba avoidance, institution of participation

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4201 The Role of Teacher Candidates' Beliefs in Their Development of Inclusive Teaching Practices

Authors: Charlotte Brenner, Fisayo Latilo, McKenna Causey

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This study explores the transformation of teacher candidates' beliefs regarding inclusion and inclusive teaching practices during their instructional and practicum experiences in the Canadian context. With the increasing diversity of schools, the study investigates how teacher candidates' beliefs impact their implementation of inclusive teaching practices, which are essential for meeting diverse student needs. The research examines the influence of teacher education programs, transformative learning experiences, and inclusive practicum placements on teacher candidates' beliefs about inclusion. Using a multiple case study approach, the study assesses teacher candidates' initial beliefs, documents changes in these beliefs after coursework on inclusion, and explores the supports and constraints affecting belief development in both university and practicum settings. Preliminary findings suggest that teacher candidates generally hold positive beliefs about inclusion at the outset of their teacher education programs. However, coursework and practicum experiences significantly shape their understanding of diversity, strategies for inclusion, and awareness of broader social issues related to inclusive classrooms. The research underscores the critical role of teacher education programs in shaping teacher candidates' beliefs about inclusion and highlights the value of transformative learning experiences and inclusive practicum placements in enhancing their understanding of equity and inclusion. Continued research is necessary to identify specific elements within courses and practicum experiences that promote positive beliefs about inclusive teaching practices, ultimately contributing to the creation of more equitable classrooms and improved student outcomes.

Keywords: inclusion, beliefs, teacher candidates, inclusive teaching practices

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4200 Injury Prevention among Construction Workers: A Case Study on Iranian Steel Bar Bending Workers

Authors: S. Behnam Asl, H. Sadeghi Naeini, L. Sadat Ensaniat, R. Khorshidian, S. Alipour, S. Behnam Asl

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Nowadays, the construction industry is growing, especially among developing countries. Iran also has a critical role in these industries in terms of workers disorders. Work-related musculoskeletal disorders (WMSDs) account for 7% of the whole diseases in the society, which makes some limitations. One of the main factors which causes WMSDs is awkward posture. Steel bar bending is considered as one of the prominent performance among construction workers. In this case study, we aimed to find the major tasks of bar benders and the most important risk factors related to it. This study was carried out among twenty workers (18-45 years) as our volunteer samples in some construction sites with less than 6 floors in two regions of Tehran municipality. The data was gathered through in depth observation, interview and questionnaire. Also postural analysis was done by OWAS method. In another part of study we used NMQ for gathering some data about psychosocial effects of work related disorders. Our findings show that 64% of workers were not aware of work risks, about 59% of workers had troubles in their wrists, hands, especially workers who worked in steel bar bending. In 46% cases lower back pain was in prevalence. Considering gathered data and results, awkward postures and long term tasks and their duration are known as the main risk factors of WMSDs among construction workers, meaning that work-rest schedule and tools design should be reconsidered to make an ergonomic condition for the mentioned workers.

Keywords: bar benders, construction workers, musculoskeletal disorders (WMSDs), OWAS method

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4199 Non-Burn Treatment of Health Care Risk Waste

Authors: Jefrey Pilusa, Tumisang Seodigeng

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This research discusses a South African case study for the potential of utilizing refuse-derived fuel (RDF) obtained from non-burn treatment of health care risk waste (HCRW) as potential feedstock for green energy production. This specific waste stream can be destroyed via non-burn treatment technology involving high-speed mechanical shredding followed by steam or chemical injection to disinfect the final product. The RDF obtained from this process is characterised by a low moisture, low ash, and high calorific value which means it can be potentially used as high-value solid fuel. Due to the raw feed of this RDF being classified as hazardous, the final RDF has been reported to be non-infectious and can blend with other combustible wastes such as rubber and plastic for waste to energy applications. This study evaluated non-burn treatment technology as a possible solution for on-site destruction of HCRW in South African private and public health care centres. Waste generation quantities were estimated based on the number of registered patient beds, theoretical bed occupancy. Time and motion study was conducted to evaluate the logistics viability of on-site treatment. Non-burn treatment technology for HCRW is a promising option for South Africa, and successful implementation of this method depends upon the initial capital investment, operational cost and environmental permitting of such technology; there are other influencing factors such as the size of the waste stream, product off-take price as well as product demand.

Keywords: autoclave, disposal, fuel, incineration, medical waste

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4198 A Cros Sectional Observational Study of Prescription Pattern of Gastro-Protective Drugs with Non-Steroidal Anti-Inflammatory Drugs in Nilgiris, India

Authors: B.S. Roopa

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Objectives: To investigate the prevalence of concomitant use of GPDs in patients treated with NSAIDs and GPDs in recommended dose and frequency as prophylaxis. And also to know the association between risk factors and prescription of GPDs in patients treated with NSAIDs. Methods: Study was a prospective, observational, cross-sectional survey. Data from patients with prescription of NSAIDs at the out-patient departments of secondary care Hospital, Nilgiris, India were collected in a specially designed proforma for a period of 45 days. Analysis using χ2 tests for discrete variables. Factors that might be associated with prescription of GPD with NSIADs were assessed in multiple logistic regression models. Results: Three hundred and three patients were included in this study, and the rate of GPD prescription was 89.1%. Most of the patients received H2-receptor antagonist, and, to a lesser degree, antacid and proton pump inhibitor. Patients with history of GI ulcer/bleeding were much more likely to be co-prescribed GPD than those who had no history of GI disorders .Compared with patients who were managed in general outpatient clinic, those managed in Secondary care hospital in Nilgrisis, India were more likely to receive GPD. Conclusions: The prescription rate of GPD with NSAIDs is high. Patients were prescribed with H2RA with dose of 150mg twice daily, which are not effective in reducing the risk of NSAIDs induced gastric ulcer. Only the frequency of NSAIDs prescription was considered significant determinant for the co-prescription with GPAs in patients who are < 65 years and ≥ 65 years old.

Keywords: gastro protective agents, non steridol anti inlfammatory agents

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