Search results for: risk factors for mental health

Authors: Jiaqian Yin, Ruoling Chen, David Churchill, Huijuan Zou, Peipei Guo, Chunmei Liang, Xiaoqing Peng, Zhikang Zhang, Weiju Zhou, Yunxia Cao

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Purpose: This study aimed to explore the interaction of male and female age on implantation failure from in vitro fertilisation (IVF)/ intracytoplasmic sperm injection (ICSI) treatments in couples following their first cycles using the Anhui Maternal-Child Health Study (AMCHS). Methods: The AMCHS recruited 2042 infertile couples who were physically fit for in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatment at the Reproductive Centre of the First Affiliated Hospital of Anhui Medical University between May 2017 to April 2021. This prospective cohort study analysed the data from 1910 cohort couples for the current paper data analysis. The multivariate logistic regression model was used to identify the effect of male and female age on implantation failure after controlling for confounding factors. Male age and female age were examined as continuous and categorical (male age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40; female age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40) predictors. Results: Logistic regression indicated that advanced maternal age was associated with increased implantation failure (P<0.001). There was evidence of an interaction between maternal age (30-<35 and ≥ 35) and paternal age (≥35) on implantation failure. (p<0.05). Only when the male was ≥35 years of increased maternal age was associated with the risk of implantation failure. Conclusion: In conclusion, there was an additive effect on implantation failure with advanced parental age. The impact of advanced maternal age was only seen in the older paternal age group. The delay of childbearing in both men and women will be a serious public issue that may contribute to a higher risk of implantation failure in patients needing assisted reproductive technology (ART).

Keywords: parental age, infertility, cohort study, IVF

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Authors: Misagh Faezipour

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System dynamics is a systems engineering approach that can help address the complex challenges in different systems. Little is known about how the brain represents people to predict behavior. This work is based on how the brain simulates different personal behavior and responds to them in the case of young children ages one to five. As we know, children’s minds/brains are just as clean as a crystal, and throughout time, in their surroundings, families, and education center, they grow to develop and have different kinds of behavior towards the world and the society they live in. Hence, this work aims to identify how young children respond to various personality behavior and observes their reactions towards them from a system dynamics perspective. We will be exploring the Big Five personality traits in young children. A causal model is developed in support of the system dynamics approach. These models graphically present the factors and factor relationships that contribute to the big five personality traits and provide a better understanding of the entire behavior model. A simulator will be developed that includes a set of causal model factors and factor relationships. The simulator models the behavior of different factors related to personality traits and their impacts and can help make more informed decisions in a risk-free environment.

Keywords: personality traits, systems engineering, system dynamics, causal model, behavior model

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Authors: Jasna Prester, Ivana Rašić Bakarić, Božidar Matijević

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Various prominent scholars and substantial practitioner-oriented literature on innovation orientation have shown positive effects on firm performance. There is a myriad of factors that influence and enhance innovation but it has been found in the literature that new product innovations accounted for an average of 14 percent of sales revenues for all firms. If there is one thing that has changed in innovation management during the last decade, it is the growing reliance on external partners. As a consequence, a new task for purchasing arises, as firms need to understand which suppliers actually do have high potential contributing to the innovativeness of the firm and which do not. Purchasing function in an organization is extremely important as it deals on an average of 50% or more of a firm's expenditures. In the nineties the purchasing department was largely seen as a transaction-oriented, clerical function but today purchasing integration provides a formal interface mechanism between purchasing and other firm functions that services other functions within the company. Purchasing function has to be organized differently to enable firm innovation potential. However, innovations are inherently risky. There are behavioral risk (that some partner will take advantage of the other party), technological risk in terms of complexity of products and processes of manufacturing and incoming materials and finally market risks, which in fact judge the value of the innovation. These risks are investigated in this work since it has been found in the literature that the higher the technological risk, higher will be the centralization of the purchasing function as an interface with other supply chain members. Most researches on organization of purchasing function were done by case study analysis of innovative firms. This work actually tends to prove or discard results found in the literature based on case study method. A large data set of 1493 companies, from 25 countries collected in the GMRG 4 survey served as a basis for analysis.

Keywords: purchasing function organization, innovation, technological risk, GMRG 4 survey

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity and weight gain are associated with increased risk of developing cardiovascular diseases and the progression of liver fibrosis. Aspartate transaminase–to-platelet count ratio index (AST-to-PLT, APRI) and fibrosis-4 (FIB-4) were primarily considered as the formulas capable of differentiating hepatitis from cirrhosis. Recently, they have found clinical use as measures of liver fibrosis and cardiovascular risk. However, their status in children has not been evaluated in detail yet. The aim of this study is to determine APRI and FIB-4 status in obese (OB) children and compare them with values found in children with normal body mass index (N-BMI). A total of sixty-eight children examined in the outpatient clinics of the Pediatrics Department in Tekirdag Namik Kemal University Medical Faculty were included in the study. Two groups were constituted. In the first group, thirty-five children with N-BMI, whose age- and sex-dependent BMI indices vary between 15 and 85 percentiles, were evaluated. The second group comprised thirty-three OB children whose BMI percentile values were between 95 and 99. Anthropometric measurements and routine biochemical tests were performed. Using these parameters, values for the related indices, BMI, APRI, and FIB-4, were calculated. Appropriate statistical tests were used for the evaluation of the study data. The statistical significance degree was accepted as p<0.05. In the OB group, values found for APRI and FIB-4 were higher than those calculated for the N-BMI group. However, there was no statistically significant difference between the N-BMI and OB groups in terms of APRI and FIB-4. A similar pattern was detected for triglyceride (TRG) values. The correlation coefficient and degree of significance between APRI and FIB-4 were r=0.336 and p=0.065 in the N-BMI group. On the other hand, they were r=0.707 and p=0.001 in the OB group. Associations of these two indices with TRG have shown that this parameter was strongly correlated (p<0.001) both with APRI and FIB-4 in the OB group, whereas no correlation was calculated in children with N-BMI. Triglycerides are associated with an increased risk of fatty liver, which can progress to severe clinical problems such as steatohepatitis, which can lead to liver fibrosis. Triglycerides are also independent risk factors for cardiovascular disease. In conclusion, the lack of correlation between TRG and APRI as well as FIB-4 in children with N-BMI, along with the detection of strong correlations of TRG with these indices in OB children, was the indicator of the possible onset of the tendency towards the development of fatty liver in OB children. This finding also pointed out the potential risk for cardiovascular pathologies in OB children. The nature of the difference between APRI vs FIB-4 correlations in N-BMI and OB groups (no correlation versus high correlation), respectively, may be the indicator of the importance of involving age and alanine transaminase parameters in addition to AST and PLT in the formula designed for FIB-4.

Keywords: APRI, children, FIB-4, obesity, triglycerides

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Authors: Belayet Hossain, Laura Lamb

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The study investigates the importance of health and social capital in determining the labour force status of Canada’s Indigenous population using data from 2006 Aboriginal Peoples Survey. An instrumental variable ordered probit model has been specified and estimated. The study finds that health status and social capital are important in determining Indigenous peoples’ employment status along with other factors. The results of the study imply that human resource development initiatives of Indigenous Peoples need to be broadened by including health status and social capital. Poor health and low degree of inclusion of the Indigenous Peoples need to be addressed in order to improve employment status of Canada’s Indigenous Peoples.

Keywords: labour force, human capital, social capital, aboriginal people, Canada

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Authors: Takaharu Hirai, Yuta Mitobe, Hiromi Hirai

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Introduction: Eating disorders (ED) are serious psychiatric disorders that affect individuals, especially adolescents. It has been suggested that nonclinical ED-like characteristics are related to sleep problems. However, studies exploring the association between potential ED and sleep disorders have primarily been conducted in Europe and the United States. We conducted a survey of Japanese adolescents to investigate this claim. Method: In this cross-sectional study, 398 school-aged adolescents, aged 12–18 years old, matched for gender ratio, responded to a self-administered questionnaire survey. We used the Eating Attitudes Test-26 (EAT-26) and the Athens Insomnia Scale (AIS) to measure potential ED and sleep problems, respectively. In this study, participants with an EAT-26 total score of 0–19 points were classified as non-ED, while those with scores of 20 points or higher were classified as potential ED. Result: Of the 398 participants, 17 (4.3%) had an EAT-26 total score of 20 or higher. Among boys, the rate was 6 of 199 participants (3%), and among girls, the rate was 11 of 182 participants (6%). There were 89 participants (22.4%) with an AIS score of 6 points or higher, of which 36 (17.6%) were boys, and 53 (27.5%) were girls. Adolescents with potential ED had significantly higher rates of daytime sleep problems than those without ED. Further, while examining the types of sleep problems, adolescents with potential ED had greater problems with a sense of well-being and physical and mental functioning during the day. In contrast, no significant associations were found between potential ED and sleep initiation, awakenings during the night, early morning awakening, total sleep duration, or overall quality of sleep. Finally, nocturnal and daytime sleep scores were significantly associated with dieting, bulimia, and oral control EAT-26 sub-scores. Discussion: While Japanese adolescents with possible ED do not experience nighttime sleep problems, they do experience problems related to well-being and mental and physical functioning, which are indicators of daytime sleep problems. This may assist with early detection of disordered eating in adolescents. The study suggested that professionals working towards adolescent mental health issues need an approach that comprehensively integrates both sleep problems and potential ED.

Keywords: adolescents, potential eating disorders, sleep problems, eating attitudes test-26

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Authors: Fakunle Egbo, Kammalchukwu A., Akinremi T.

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Physical activity and nutritional status influence the health status and cognition of young adults. Lack of physical activity increases the likelihood of developing obesity which leads to the risk of heart diseases and other risk factors like high blood pressure, high blood cholesterol, diabetes etc. The study employed a cross-sectional study design. The study used a multi stage sampling technique multi- stage sampling technique; Purposive, for the selection of colleges that would be used, stratified random sampling for stratifying the colleges into departments and the simple random sampling for the selection of each respondent from the departments. Structured questionnaires were used to obtain data from the respondents and pre-tested anthropometric instruments were used to get the weight and height of the respondents and statistically analyzed using SPSS version 22.0 and the TDA (Total dietary allowance) software which was used to analyze the nutrient intake of the respondents. This study showed that they comprised of 50.1% males and 40.9% females. Slightly above average 51.8% were between ages of 15-19 with mean age being 19.57 years; ages 20-24 were slightly below average at 45.7%. The male students 58.7% had vigorous physical activity, whereas majority of females 76.5% had light physical activity level. 39.1% of the male students carried out physical activity 2-3 times per week while One third of the female students (38.3%) carried out physical activity 6-7 times per week. Majority of the respondents had Inadequate Protein- 63.8%, Carbohydrate- 60.2%, and Dietary fiber- 88.8. 36% eat rice 4-6 times per week. Majority of the respondents had inadequate fruit and vegetables (Efo, Banana,) at 47.7%, 40.6% respectively. Using Body mass index, (63.2%) have normal weight. 22.9% are overweight, 6.8% are underweight, 5.4% have grade 1 obesity and 1.6% have grade II obesity. There was a statistically significant association between the physical activity of the respondents with their nutritional status (p=0.037), physical activity and sex (p=0.000), nutritional status and amount spent on food daily (p=0.007). The study concluded that the physical activity level of the respondents, most especially the females were low; One third of the students were malnourished therefore, there should be an urgent need for improving the overall health status of students by providing the students with well-equipped gyms and other sporting equipment’s that would make them participate actively and keep fit.

Keywords: physical activity, nutritional status, undergraduates, dietary pattern

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Authors: Todd Jackson

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In this randomized control trial, we tested the effectiveness of a peer-facilitated version of the Body Project (BP) intervention among body-dissatisfied young women in China. Participants were randomly assigned to a peer-facilitator BP condition (N = 94) versus an educational video minimal intervention control condition (N = 89). Questionnaire measures of two primary outcomes (i.e., disordered eating and body dissatisfaction) and six secondary outcomes (thin-ideal internalization, pressure to be thin, negative affect, body surveillance, body shame, body appreciation and interest in cosmetic surgery) were administered at a pre-treatment baseline, a post-treatment assessment, and at a 12-month follow-up. A series of 2 (Group) x 2 (Time) analyses of variance indicated women in the peer-facilitated BP condition reported significant improvements in primary outcome measures of disordered eating and body dissatisfaction compared to women in the educational video control condition following treatment and at the 12-month follow-up. Furthermore, women in the peer-facilitated BP condition reported significant improvements in measures of body surveillance, body shame and body appreciation) compared to educational video controls that extended to the 12-month follow-up. Finally, although women in the peer-facilitated BP condition showed significant post-treatment improvements in thin-ideal internalization, negative affect, perceived pressure to be thin, and interest in cosmetic surgery compared to video controls, these differences were no longer statistically significant at the 12-month follow-up. In conclusion, findings supported the overall effectiveness of a peer-facilitated group version of the BP as an intervention for reducing disordered eating and several associated risk factors among at-risk young women in China.

Keywords: body project, disordered eating, body dissatisfaction, risk factors, prevention, China

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Authors: Ping Xu, Gregory T. Golm, Guanghan (Frank) Liu

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In the presence of competing events, traditional survival analysis may not be appropriate and can result in biased estimates, as it assumes independence between competing events and the event of interest. Instead, competing risk analysis should be considered to correctly estimate the survival probability of the event of interest and the hazard ratio between treatment groups. The COVID-19 pandemic has provided a potential source of competing risks in clinical trials, as participants in trials may experienceCOVID-related competing events before the occurrence of the event of interest, for instance, death due to COVID-19, which can affect the incidence rate of the event of interest. We have performed simulation studies to compare multiple competing risk analysis models, including the cumulative incidence function, the sub-distribution hazard function, and the cause-specific hazard function, to the traditional survival analysis model under various scenarios. We also provide a general recommendation on conducting competing risk analysis in randomized clinical trials during the era of the COVID-19 pandemic based on the extensive simulation results.

Keywords: competing risk, survival analysis, simulations, randomized clinical trial, COVID-19 pandemic

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Authors: Shan Li, Qiuwen Ma

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Integrated project delivery (IPD) is a project delivery method distinguished by a shared risk/rewards mechanism and multiparty agreement. IPD has drawn increasing attention from construction industry due to its reliability to deliver high-performing buildings. However, unavailable IPD specific insurance concerns the industry participants who are interested in IPD implementation. Even though the risk management capability can be enhanced using shared risk mechanism, some risks may occur when the partners do not commit themselves into the integrated practices in a desired manner. This is because the intense collaboration and close integration can not only create added value but bring new opportunistic behaviors and disputes. The study is aimed to investigate the risks of implementing IPD using Bayesian theory. IPD risk taxonomy is presented to identify all potential risks of implementing IPD and a risk network map is developed to capture the interdependencies between IPD risks. The conditional relations between risk occurrences and the impacts of IPD risks on project performances are evaluated and simulated based on Bayesian theory. The probability of project outcomes is predicted by simulation. In addition, it is found that some risks caused by integration are most possible occurred risks. This study can help the IPD project participants identify critical risks of adopting IPD to improve project performances. In addition, it is helpful to develop IPD specific insurance when the pertinent risks can be identified.

Keywords: Bayesian theory, integrated project delivery, project risks, project performances

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Authors: Thidathit Prachanukool, Chaiyaporn Yuksen, Welawat Tienpratarn, Sorravit Savatmongkorngul, Panvilai Tangkulpanich, Chetsadakon Jenpanitpong, Yuranan Phootothum, Malivan Phontabtim, Promphet Nuanprom

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Background: Ruptured appendicitis has a high morbidity and mortality and requires immediate surgery. The Alvarado Score is used as a tool to predict the risk of acute appendicitis, but there is no such score for predicting rupture. This study aimed to developed the prediction score to determine the likelihood of ruptured appendicitis in an Asian population. Methods: This study was diagnostic, retrospectively cross-sectional and exploratory model at the Emergency Medicine Department in Ramathibodi Hospital between March 2016 and March 2018. The inclusion criteria were age >15 years and an available pathology report after appendectomy. Clinical factors included gender, age>60 years, right lower quadrant pain, migratory pain, nausea and/or vomiting, diarrhea, anorexia, fever>37.3°C, rebound tenderness, guarding, white blood cell count, polymorphonuclear white blood cells (PMN)>75%, and the pain duration before presentation. The predictive model and prediction score for ruptured appendicitis was developed by multivariable logistic regression analysis. Result: During the study period, 480 patients met the inclusion criteria; of these, 77 (16%) had ruptured appendicitis. Five independent factors were predictive of rupture, age>60 years, fever>37.3°C, guarding, PMN>75%, and duration of pain>24 hours to presentation. A score > 6 increased the likelihood ratio of ruptured appendicitis by 3.88 times. Conclusion: Using the Ramathibodi Welawat Ruptured Appendicitis Score. (RAMA WeRA Score) developed in this study, a score of > 6 was associated with ruptured appendicitis.

Keywords: predictive model, risk score, ruptured appendicitis, emergency room

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Authors: Shoufeng Cao, Kim Bryceson, Damian Hine

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The existing supply chain risk management (SCRM) research is currently chaotic and somewhat disorganized, and the topic has been addressed conceptually more often than empirically. This paper, using both qualitative and quantitative data, employs a modified Meta-study method to investigate the SCRM empirical research published in quality journals over the period of 12 years (2004-2015). The purpose is to outline the extent research trends and the employed research methodologies (i.e., research method, data collection and data analysis) across the sub-field that will guide future research. The synthesized findings indicate that empirical study on risk ripple effect along an entire supply chain, industry-specific supply chain risk management and global/export supply chain risk management has not yet given much attention than it deserves in the SCRM field. Besides, it is suggested that future empirical research should employ multiple and/or mixed methods and multi-source data collection techniques to reduce common method bias and single-source bias, thus improving research validity and reliability. In conclusion, this paper helps to stimulate more quality empirical research in the SCRM field via identifying promising research directions and providing some methodology guidelines.

Keywords: empirical research, meta-study, methodology guideline, research direction, supply chain risk management

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Authors: C. Lalitha, R. Sayee, D. Apoorva

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Reproductive failure or infertility may be due to several factors that are not limited to one sex. It remains a common problem causing significant psychological distress to those affected individuals and who are increasingly seeking medical advice. Male infertility means inability to induce conception in normal woman within a year. The etiological factors associated with male infertility are anatomical, developmental, seminal, hormonal, immunological and environmental factors. The paper was aimed to highlight the environmental factors and its association to male infertility and seasonality of birth and its influence. The data was collected from the 75 male patients referred with infertility for karyotyping and counseling. Their age ranged from 21 to 45 years. It is opined that certain occupations are preferentially associated with male infertility.

Keywords: environmental, occupational, seasonal, male infertility

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Authors: Nditsheni Ramakuela, Sonto Maputle, Base Khoza, Augustine Tugli

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Inadequate health literacy can cause difficulties in understanding and compliance to treatment plan. With diabetic condition, self-care activities include behaviours of following a diet plan, avoiding high fat foods, increased exercise, self-glucose monitoring, and foot care. Patients with poor health literacy have difficulty interpreting medication warning labels, following directions on a prescription label and identifying their medications. Difficulties in understanding and performing self-care and health-related activities may ultimately lead to poor health outcomes. The study explored and described factors affecting health literacy and self-care to diabetic regimen by female patients at selected hospital in Limpopo Province of South Africa. Qualitative and explorative research design was used. Female patients who were admitted and diagnosed with diabetes in female medical ward constituted the study population. Non-probability, purposive sampling was used to select 20 female patients diagnosed with diabetes, who were above 18 years and admitted during April–November 2014. An in-depth face-to-face, unstructured interview was used to collect data. Data were analysed using open coding method. Measures to ensure trustworthiness and ethical considerations were adhered to. Findings revealed factors affecting health literacy for diabetic self-care activities amongst patients were; patient, family, disease and facility related. Proposed recommendations were; to strengthen diabetes education and patient-provider partnership. This is important and must be transferred to strengthen self-care activities to fully benefit the patient.

Keywords: compliance, diabetes mellitus, diabetic regimen, health literacy, self activities

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Authors: Farideh Gheitasi, Amir Hossain Jaberansari, Payam Abedini

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The World Health Organization (WHO) Manifesto for Safe Communities states that "All human beings have an equal right to health and safety". The purpose of a safe Community is to minimize the damages threatening people. It seems that not sufficient attention has been given to relate environment and objectives of the safe Community. The reason for that can be assigned to the lack of enough information about environmental parameters and their relation with indices of the safe community like type and effect time of damages resulting from air pollution. Air pollution can be characterized as one of main environmental problems of Tehran. This problem is mostly due to the special geographic and climate situation, high population density and irregular growth in the number of vehicles. This paper is aimed at investigating the necessity of considering environmental factors to obtain a safe community through determining the effects of environmental pollution, particularly air pollution, on 490000 elders (+65) of Tehran. The methodology used in this study was on the basis of Random sampling and social surveying. The number of questionnaires was determined to be 321 through using Cochran method and the questionnaires were filled out by elders during personal interviews. The analysis of obtained results indicated that elders believe the major effects of air pollution include heart and respiratory diseases, obligation to stay at home on polluted days and its associated mental problems. Moreover, it was found that there is direct link between the number of polluted days and mortality frequency of elders. Having an environmental view may have an appreciable influence on the qualitative and quantitative development of activities and also facilitate obtaining the goals of the Safe Communities. In addition to reduce damages caused by pollutions, this view will encourage friends of the environment to cooperate with authorities of the safe community.

Keywords: air pollution, elderly people, environment, waste management

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Authors: Esther Moraleda Sepúlveda, Soraya Delgado Matute, Paula Salido Escudero, Raquel Mimoso García, M Cristina Alcón Lancho

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Although there is some consensus when it comes to establishing the lexicon as one of the strengths of language in people with Down Syndrome (DS), little is known about its evolution throughout development and changes based on age. The objective of this study was to find out if there are differences in receptive vocabulary between adolescence and adulthood. In this research, 30 people with DS between 11 and 40 years old, divided into two age ranges (11-18; 19 - 30) and matched in mental age, were evaluated through the Peabody Vocabulary Test. The results show significant differences between both groups in favor of the group with the oldest chronological age and a direct correlation between chronological age and receptive vocabulary development, regardless of mental age. These data support the natural evolution of the passive lexicon in people with DS.

Keywords: down syndrome, language, receptive vocabulary, adolescents, adults

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Authors: Ming Ma, Rui Li

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In the highly urbanized district, green open space is playing an important role in human’s health and wellbeing as a physical, aesthetic and natural environment resources. The aim of this paper is to close this gap through providing a comprehensive, qualitative meta-analysis of existing studies related to this issue. A systematic scoping of current quantitative research is conducted which mostly focused on cross-sectional survey and experimental studies. Health benefits from contact with green open space could be categorized into physical health, psychological health and social wellbeing. Mechanism for the health related to green open space could be clearly identified with the regard to natural restoration, physical activities and social capital. These results indicate a multiple pathways framework between the health benefits and mechanism. In order to support design and planning, the most evident relationship was picked up that people could psychologically benefit from green open space through outdoors physical activities. Additionally, three design and planning strategies are put forward. Various and multi-level contacts with green open space would be considered as an explanation of the pathway results and tie to bridge the health to design and planning. There is a need to carry out long-term research emphasizing on causal relationship between health and green open space through excluding cofounding factors such as self-selection.

Keywords: urban green open space, planning and design, health benefit, mechanism, pathway framework

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

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

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

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Authors: P. Uma Devi, S. Sujith, K. Rahul, T. S. Dipu, V. Anil Kumar , Vidya Menon

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Introduction: Candida is an important cause of bloodstream infections (BSIs), causing significant mortality and morbidity. The epidemiology of Candida infection is also changing, mainly in relation to the number of episodes caused by species Candida non-albicans. However, in India, the true burden of candidemia is not clear. Thus, this study was conducted to evaluate the clinical characteristics, species distribution, antifungal susceptibility and outcome of candidemia at our hospital. Methodology: Between January 2012 and April 2014, adult patients with at least one positive blood culture for Candida species were identified through the microbiology laboratory database (for each patient only the first episode of candidemia was recorded). Patient data was collected by retrospective chart review of clinical characteristics including demographic data, risk factors; species distribution, resistance to antifungals and survival. Results: A total of 165 episodes of Candida BSI were identified, with 115 episodes occurring in adult patients. Most of the episodes occurred in males (69.6%). Nearly 82.6% patients were between 41 to 80 years and majority of the patients were in the intensive care unit (65.2%) at the time of diagnosis. On admission, 26.1% and 18.3% patients had pneumonia and urinary tract infection, respectively. Majority of the candidemia episodes were found in the general medicine department (23.5%) followed by gastrointestinal surgery (13.9%) and medical oncology & haematology (13%). Risk factors identified were prior hospitalization within one year (83.5%), antibiotic therapy within the last one month (64.3%), indwelling urinary catheter (63.5%), central venous catheter use (59.1%), diabetes mellitus (53%), severe sepsis (45.2%), mechanical ventilation (43.5%) and surgery (36.5%). C. tropicalis (30.4%) was the leading cause of infection followed by C. parapsilosis (28.7%) and C. albicans (13%). Other non-albicans species isolated included C. haemulonii (7.8%), C. glabrata (7%), C. famata (4.3%) and C. krusei (1.7%). Antifungal susceptibility to fluconazole was 87.9% (C. parapsilosis), 100% (C. tropicalis) and 93.3% (C. albicans). Mortality was noted in 51 patients (44.3%). Early mortality (within 7 days) was noted in 32 patients while late mortality (between 7 and 30 days) was noted in 19 patients. Conclusion: In recent years, candidemia has been flourishing in critically ill patients. Comparison of data from our own hospital from 2005 shows a doubling of the incidence. Rapid changes in the rate of infection, potential risk factors, and emergence of non-albicans Candida demand continued surveillance of this serious BSI. High index of suspicion and sensitive diagnostics are essential to improve outcomes in resource limited settings with emergence of non-albicans Candida.

Keywords: antifungal susceptibility, candida albicans, candidemia, non-albicans candida

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Authors: McKenzie S. Braley, Lesley Jessiman

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If language reveals internal psychological processing, then it is also likely that language use in autobiographical memory transcripts may be used as a window into attachment style and related personality features. The current study, therefore, examined the possible associations between attachment style, negative affectivity, social inhibition, and linguistic features extracted from autobiographical memory transcripts. Young adult participants (n = 61) filled out attachment and personality questionnaires, and orally reported a relationship-related memory. Memories were audio-recorded and later transcribed verbatim. Using a computerized linguistic extraction tool, positive affect words, negative affect words, and cognition words were extracted. Spearman’s rank correlation coefficients revealed that attachment anxiety was negatively correlated with cognition words (r2 = -0.26, p = 0.047) and that negative affectivity was negatively correlated with positive affect words (r2 = -0.32, p = 0.012). The findings suggest that attachment style and personality are associated with speech styles indicative of both emotionality and depth of processing. Because attachment styles, negative affectivity, and social inhibition are associated with poor mental health outcomes, analyses of key linguistics features in autobiographical memory narratives may provide reliable screening tools for mental wellbeing.

Keywords: attachment style, autobiographical memory, language, negative affectivity, social inhibition

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Authors: Kaisy Xinhong Ye, Su Lin Lim, Jialiang Li, Lei Feng

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background: Multiple healthful dietary patterns have been linked with dementia, but limited studies have looked at the role of diet in cognitive health in Asians whose eating habits are very different from their counterparts in the west. This study aimed to derive a dietary pattern that is associated with the risk of cognitive impairment (CI) in the Singaporean population. Method: The analysis was based on 719 community older adults aged 60 and above. Dietary intake was measured using a validated semi-quantitative food-frequency questionnaire (FFQ). Reduced rank regression (RRR) was used to extract dietary pattern from 45 food groups, specifying sugar, dietary fiber, vitamin A, calcium, and the ratio of polyunsaturated fat to saturated fat intake (P:S ratio) as response variables. The RRR-derived dietary patterns were subsequently investigated using multivariate logistic regression models to look for associations with the risk of CI. Results: A dietary pattern characterized by greater intakes of green leafy vegetables, red-orange vegetables, wholegrains, tofu, nuts, and lower intakes of biscuits, pastries, local sweets, coffee, poultry with skin, sugar added to beverages, malt beverages, roti, butter, and fast food was associated with reduced risk of CI [multivariable-adjusted OR comparing extreme quintiles, 0.29 (95% CI: 0.11, 0.77); P-trend =0.03]. This pattern was positively correlated with P:S ratio, vitamin A, and dietary fiber and negatively correlated with sugar. Conclusion: A dietary pattern providing high P:S ratio, vitamin A and dietary fiber, and a low level of sugar may reduce the risk of cognitive impairment in old age. The findings have significance in guiding local Singaporeans to dementia prevention through food-based dietary approaches.

Keywords: dementia, cognitive impairment, diet, nutrient, elderly

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Authors: A. Bere, H. G. Sithuba, K. Kyei, C. Sigauke

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We employ a discrete logit survival model to investigate the risk factors for early alcohol intake among students at two tertiary institutions in Thohoyandou, South Africa. Data were collected from a sample of 744 students using a self-administered questionnaire. Significant covariates were arrived at through a regularization algorithm implemented using the glmmLasso package. The tuning parameter was determined using a five-fold cross-validation algorithm. The baseline hazard was modelled as a smooth function of time through the use of spline functions. The results show that the hazard of initial alcohol intake peaks at the age of about 16 years and that at any given time, being of a male gender, prior use of other drugs, having drinking peers, having experienced negative life events and physical abuse are associated with a higher risk of alcohol intake debut.

Keywords: cross-validation, discrete hazard model, LASSO, smooth baseline hazard

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Authors: Fatemeh Noughani, Seyd Mehdi Sadat

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Medical tourism or travel therapy is travelling from one country to another to be under medical treatment, utilizing the health factors of natural sector like mineral water springs and so on. From 1990s medical tourism around the world developed and grew because of different factors like globalization and free trade in the fields of health services, changes in exchange rates in the world economy (which caused the desirability of Asian countries as a medical tourist attraction) in a way that currently there is a close competition in this field among famous countries in medical services to make them find a desirable place in medical tourism market of the world as a complicated and growing industry in a short time. Perhaps tourism is an attractive industry and a good support for the economy of Iran, if we try to merge oil earnings and tourism industry it would be better and more constructive than putting them in front of each other. Moving from oil toward tourism economy especially medical tourism, must be one of the prospects of Iran's government for the oil industry to provide a few percent of the yearly earnings of the country. Among the achievements in medical tourism we can name the prevention of brain drain to other countries and an increase in employment rate for healthcare staff, increase in foreign exchange earnings of the country because of the tourists' staying and followed by increasing the quality of life and cultural transmission as well as empowering the medical human resources.

Keywords: developing countries, health tourism, quality of life, cultural transmission

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Authors: Dedjo Yao Simon, Takahiro Saito, Norikazu Inuzuka, Ikuo Sugiyama

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Abidjan city (Republic of Ivory Coast) is an emerging megacity and an urban coastal area where the number of floods reported is on a rapid increase due to climate change and unplanned urbanization. However, comprehensive disaster mitigation plans, policies, and financial resources are still lacking as the population ignores the extent and location of the flood zones; making them unprepared to mitigate the damages. Considering the existing condition, this paper aims to discuss an approach for flood risk reduction in Cocody Commune through value capture strategy and flood risk communication. Using geospatial techniques and hydrological simulation, we start our study by delineating flood zones and depths under several return periods in the study area. Then, through a questionnaire a field survey is conducted in order to validate the flood maps, to estimate the flood risk and to collect some sample of the opinion of residents on how the flood risk information disclosure could affect the values of property located inside and outside the flood zones. The results indicate that the study area is highly vulnerable to 5-year floods and more, which can cause serious harm to human lives and to properties as demonstrated by the extent of the 5-year flood of 2014. Also, it is revealed there is a high probability that the values of property located within flood zones could decline, and the values of surrounding property in the safe area could increase when risk information disclosure commences. However in order to raise public awareness of flood disaster and to prevent future housing promotion in high-risk prospective areas, flood risk information should be disseminated through the establishment of an early warning system. In order to reduce the effect of risk information disclosure and to protect the values of property within the high-risk zone, we propose that property tax increments in flood free zones should be captured and be utilized for infrastructure development and to maintain the early warning system that will benefit people living in flood prone areas. Through this case study, it is shown that combination of value capture strategy and risk communication could be an effective tool to educate citizen and to invest in flood risk reduction in emerging countries.

Keywords: Cocody-Abidjan, flood, geospatial techniques, risk communication, value capture

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Authors: Soo-Bi Lee, Jun Young Jeong, Zehgn Lin, Chenminxi

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Background: In South Korea, a problematic phenomenon has recently arisen whereby adult children continue to receive parentalcaregivingin some cases. These phenomena has been shown to affect the mental health of mothers. Study Goals: The purposes of this study are to verify whether the mediating effects of stress on the relationship between a woman’s care burden for their adult children and depression are moderated by their satisfaction about their husbands’ sharing of the caregiving. Methodology: This study analyzed 3,053 married women with adult children using the most recent data from the “Korean Longitudinal Survey of Women & Families 7th(2018)" conducted at the national level. The analysis was conducted using the SPSS Process Macro Model 7 to verify the moderated mediating effects and subsequently confirm their significance based on the bootstrapping method. Results and Implications: (1) Stress was identified a mediating factor in the relationship between the care burden for adult children and depression; and (2) the mediating effects of stress on depression from the burden of caring for adult children are modulated by the woman's satisfaction with her husband’s sharing of the care burden. In other words, the higher the caring burden of adult children, the higher the mother's stress, which increases depression. At this time, the higher the their satisfaction with the husband's share of care in the path of mother's care burden and stress, the lower the mother's stress and, ultimately, the depression be alleviated. Conclusion: Programs that promote the mental health of married women heavily with the caring burden for their adult children, as well as those that improve social awareness regarding husbands' sharing of the care burden, should be implemented. Also, social welfare policy alternatives are needed at the national level to reduce the caring burden caused by adult children.

Keywords: married women, adult children care burden, stress, depression, satisfaction with husbands sharing of the care

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Authors: M. V. Shivaani, P. K. Jain, Surendra S. Yadav

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Public Sector Undertakings (PSUs), being government-owned organizations have commitments for the economic and social wellbeing of the society; this commitment needs to be reflected in their risk-taking, decision-making and governance structures. Therefore, the primary objective of the study is to suggest measures that may lead to improvement in performance of PSUs. To achieve this objective two normative frameworks (one relating to risk levels and other relating to governance structure) are being put forth. The risk index is based on nine risks, such as, solvency risk, liquidity risk, accounting risk, etc. and each of the risks have been scored on a scale of 1 to 5. The governance index is based on eleven variables, such as, board independence, diversity, risk management committee, etc. Each of them are scored on a scale of 1 to five. The sample consists of 39 PSUs that featured in Nifty 500 index and, the study covers a 10 year period from April 1, 2005 to March, 31, 2015. Return on assets (ROA) and return on equity (ROE) have been used as proxies of firm performance. The control variables used in the model include, age of firm, growth rate of firm and size of firm. A dummy variable has also been used to factor in the effects of recession. Given the panel nature of data and possibility of endogeneity, dynamic panel data- generalized method of moments (Diff-GMM) regression has been used. It is worth noting that the corporate governance index is positively related to both ROA and ROE, indicating that with the improvement in governance structure, PSUs tend to perform better. Considering the components of CGI, it may be suggested that (i). PSUs ensure adequate representation of women on Board, (ii). appoint a Chief Risk Officer, and (iii). constitute a risk management committee. The results also indicate that there is a negative association between risk index and returns. These results not only validate the framework used to develop the risk index but also provide a yardstick to PSUs benchmark their risk-taking if they want to maximize their ROA and ROE. While constructing the CGI, certain non-compliances were observed, even in terms of mandatory requirements, such as, proportion of independent directors. Such infringements call for stringent penal provisions and better monitoring of PSUs. Further, if the Securities and Exchange Board of India (SEBI) and Ministry of Corporate Affairs (MCA) bring about such reforms in the PSUs and make mandatory the adherence to the normative frameworks put forth in the study, PSUs may have more effective and efficient decision-making, lower risks and hassle free management; all these ultimately leading to better ROA and ROE.

Keywords: PSU, risk governance, diff-GMM, firm performance, the risk index

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Authors: Najma Najam, Rukhsana Kausar, Rabia Hussain Kanwal, Saira Batool, Anum Javed

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In Pakistan, elderly population though increasing but it has been neglected by the researchers and policy makers which resulted in compromised quality of life of the ageing population. Two regions, Punjab and Gilgit-Baltistan (GB) were selected for comparison as Lahore and Multan (Punjab) are highly urbanized, large cities whereas Gilgit and Skardu are remote and mountain bounded valleys in GB. This study focuses on psychological and emotional functioning of elderly and a series of measures translated and adapted in Urdu language was used to assess quality of life, psychological and mental well-being, actual and perceived social support, attachment patterns, forgiveness, affects, geriatric depression, and emotional disturbance patterns (depression, anxiety, and stress) in elderly. A gender-equated sample of 201 elderly participants, 93 from GB (60 from Gilgit, 33 from Skardu) and 108 from Punjab (61 from Lahore, 47 from Multan) with over 60 years age was collected from the multiethnic community of Punjab and GB through purposive convenient sampling technique. Findings revealed that elderly from Multan have better psychological and emotional functioning, higher levels of social support, tendency to forgive, better mental wellbeing and quality of life and lower levels of stress, anxiety, depression, negative affect and attachment avoidance and anxiety related to partner as compared to the elderly from Lahore. Furthermore, both elderly male of Gilgit & Skardu have adequate mental well-being including subjective well-being and psychological functioning which showed positive aspects of mental health but elderly female are more attached to their home and neighbourhood which shows their social and environmental mastery. Gilgiti elderly male reported more degree of positive affect such as enthusiasm, active, alertness, excitement and strong whereas among elderly from Skardu shows more negative affect i.e. aversive mood states, irritability, hostility, and general distress. The need of psychosocial therapy and family counseling for the elderly in urban areas has been identified, which can facilitate in reducing or preventing the depressive and stressful tendencies. The findings are expected to have implications for improving quality of life of the elderly, designing interventions, support system and rehabilitation services to help them. However, findings may attract attention of policy makers and researchers as currently this is the most neglected population in Pakistan.

Keywords: psychological, emotional, aging, elderly, quality of life

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Authors: Haftay Abraha Tadesse

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Background: Staphylococcus is a genus of worldwide distributed bacteria correlated to several infectious of different sites in human and animals. They are among the most important causes of infection that are associated with the consumption of contaminated food. Objective: The objective of this study was to determine the isolates, antimicrobial susceptibility patterns and public health significance for Staphylococcus aureus in raw meat from butchery and abattoir houses of Mekelle, Northern Ethiopia. Methodology: A cross-sectional study was conducted from April to October 2019. Sociodemographic data and public health significance were collected using predesigned questionnaire. The raw meat samples were collected aseptically in the butchery and abattoir houses and transported using ice box to Mekelle University, College of Veterinary Sciences for isolating and identification of Staphylococcus aureus. Antimicrobial susceptibility tests were determined by disc diffusion method. Data obtained were cleaned and entered in to STATA 22.0 and logistic regression model with odds ratio were calculated to assess the association of risk factors with bacterial contamination. P-value < 0.05 was considered as statistically significant. Results: In present study, 88 out of 250 (35.2%) were found to be contamination with Staphylococcus aureus. Among the raw meat specimens to be positivity rate of Staphylococcus aureus were 37.6% (n=47) and (32.8% (n=41), butchery and abattoir houses, respectively. Among the associated risk factories not using gloves reduces risk was found to (AOR=0.222; 95% CI: 0.104-0.473), Strict Separation b/n clean & dirty (AOR= 1.37; 95% CI: 0.66-2.86) and poor habit of hand washing (AOR=1.08; 95%CI: 0.35-3.35) were found to be statistically significant and ha ve associated with Staphylococcus aureus contamination. All isolates thirty sevevn of Staphyloco ccus aureus were checked displayed (100%) sensitive to doxycycline, trimethoprim, gentamicin, sulphamethoxazole, amikacin, CN, Co trimoxazole and nitrofurantoi. whereas the showed resistance of cefotaxime (100%), ampicillin (87.5%), Penicillin (75%), B (75%), and nalidixic acid (50%) from butchery houses. On the other hand, all isolates of Staphylococcus aur eu isolate 100% (n= 10) showed sensitive chloramphenicol, gentamicin and nitrofurantoin whereas the showed 100% resistance of Penicillin, B, AMX, ceftriaxone, ampicillin and cefotaxime from abattoirs houses. The overall multi drug resistance pattern for Staphylococcus aureus were 90% and 100% of butchery and abattoirs houses, respectively. Conclusion: 35.3% Staphylococcus aureus isolated were recovered from the raw meat samples collected from the butchery and abattoirs houses. More has to be done in the developed of hand washing behavior, and availability of safe water in the butchery houses to reduce burden of bacterial contamination. The results of the present finding highlight the need to implement protective measures against the levels of food contamination and alternative drug options. The development of antimicrobial resistance is nearly always as a result of repeated therapeutic and/or indiscriminate use of them. Regular antimicrobial sensitivity testing helps to select effective antibiotics and to reduce the problems of drug resistance development towards commonly used antibiotics. Key words: abattoir houses, antimicrobial resistance, butchery houses, Ethiopia,

Keywords: abattoir houses, antimicrobial resistance, butchery houses, Ethiopia, staphylococcus aureuse, MDR

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Authors: Yulia V. Krasavtseva, Tatiana V. Kornilova

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Risk-taking behaviors are not only dictated by cognitive components but also involve emotional aspects. Anticipatory emotions, involving both cognitive and affective mechanisms, are involved in decision-making in general, and risk-taking in particular. Affective reactions are prompted when an expectation or prediction is either validated or invalidated in the achieved result. This study aimed to combine predictions, anticipatory emotions, affective reactions, and personality traits in the context of risk-taking behaviors. An experimental online method Emotion and Prediction In a Casino (EPIC) was used, based on a casino-like roulette game. In a series of choices, the participant is presented with progressively riskier roulette combinations, where the potential sums of wins and losses increase with each choice and the participant is given a choice: to 'walk away' with the current sum of money or to 'play' the displayed roulette, thus accepting the implicit risk. Before and after the result is displayed, participants also rate their emotions, using the Self-Assessment Mannequin [Bradley, Lang, 1994], picking a picture, representing the intensity of pleasure, arousal, and dominance. The following personality measures were used: 1) Personal Decision-Making Factors [Kornilova, 2003] assessing risk and rationality; 2) I7 – Impulsivity Questionnaire [Kornilova, 1995] assessing impulsiveness, risk readiness, and empathy and 3) Subjective Risk Intelligence Scale [Craparo et al., 2018] assessing negative attitude toward uncertainty, emotional stress vulnerability, imaginative capability, and problem-solving self-efficacy. Two groups of participants took part in the study: 1) 98 university students (Mage=19.71, SD=3.25; 72% female) and 2) 94 online participants (Mage=28.25, SD=8.25; 89% female). Online participants were recruited via social media. Students with high rationality rated their pleasure and dominance before and after choices as lower (ρ from -2.6 to -2.7, p < 0.05). Those with high levels of impulsivity rated their arousal lower before finding out their result (ρ from 2.5 - 3.7, p < 0.05), while also rating their dominance as low (ρ from -3 to -3.7, p < 0.05). Students prone to risk-rated their pleasure and arousal before and after higher (ρ from 2.5 - 3.6, p < 0.05). High empathy was positively correlated with arousal after learning the result. High emotional stress vulnerability positively correlates with arousal and pleasure after the choice (ρ from 3.9 - 5.7, p < 0.05). Negative attitude to uncertainty is correlated with high anticipatory and reactive arousal (ρ from 2.7 - 5.7, p < 0.05). High imaginative capability correlates negatively with anticipatory and reactive dominance (ρ from - 3.4 to - 4.3, p < 0.05). Pleasure (.492), arousal (.590), and dominance (.551) before and after the result were positively correlated. Higher predictions positively correlated with reactive pleasure and arousal. In a riskier scenario (6/8 chances to win), anticipatory arousal was negatively correlated with the pleasure emotion (-.326) and vice versa (-.265). Correlations occur regardless of the roulette outcome. In conclusion, risk-taking behaviors are linked not only to personality traits but also to anticipatory emotions and affect in a modeled casino setting. Acknowledgment: The study was supported by the Russian Foundation for Basic Research, project 19-29-07069.

Keywords: anticipatory emotions, casino game, risk taking, impulsiveness

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Authors: Ahmed O. Babaleye, Rafet E. Kurt

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The global oil and gas industry is beginning to witness an increase in the number of installations moving towards decommissioning. Decommissioning of offshore installations is a complex, costly and hazardous activity, making safety one of the major concerns. Among existing removal options, complete and partial removal options pose the highest risks. Therefore, a dynamic risk model of the accidents from the two options is important to assess the risks on an overall basis. In this study, a risk-based safety model is developed to conduct quantitative risk analysis (QRA) for jacket structure systems failure. Firstly, bow-tie (BT) technique is utilised to model the causal relationship between the system failure and potential accident scenarios. Subsequently, to relax the shortcomings of BT, Bayesian Belief Networks (BBNs) were established to dynamically assess associated uncertainties and conditional dependencies. The BBN is developed through a similitude mapping of the developed bow-tie. The BBN is used to update the failure probabilities of the contributing elements through diagnostic analysis, thus, providing a case-specific and realistic safety analysis method when compared to a bow-tie. This paper presents the application of dynamic safety analysis to guide the allocation of risk control measures and consequently, drive down the avoidable cost of remediation.

Keywords: Bayesian belief network, offshore decommissioning, dynamic safety model, quantitative risk analysis

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