Search results for: consumer risk
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6982

Search results for: consumer risk

4672 When Sex Matters: A Comparative Generalized Structural Equation Model (GSEM) for the Determinants of Stunting Amongst Under-fives in Uganda

Authors: Vallence Ngabo M., Leonard Atuhaire, Peter Clever Rutayisire

Abstract:

The main aim of this study was to establish the differences in both the determinants of stunting and the causal mechanism through which the identified determinants influence stunting amongst male and female under-fives in Uganda. Literature shows that male children below the age of five years are at a higher risk of being stunted than their female counterparts. Specifically, studies in Uganda indicate that being a male child is positively associated with stunting, while being a female is negatively associated with stunting. Data for 904 males and 829 females under-fives was extracted form UDHS-2016 survey dataset. Key variables for this study were identified and used in generating relevant models and paths. Structural equation modeling techniques were used in their generalized form (GSEM). The generalized nature necessitated specifying both the family and link functions for each response variable in the system of the model. The sex of the child (b4) was used as a grouping factor and the height for age (HAZ) scores were used to construct the status for stunting of under-fives. The estimated models and path clearly indicated that the set of underlying factors that influence male and female under-fives respectively was different and the path through which they influence stunting was different. However, some of the determinants that influenced stunting amongst male under-fives also influenced stunting amongst the female under-fives. To reduce the stunting problem to the desirable state, it is important to consider the multifaceted and complex nature of the risk factors that influence stunting amongst the under-fives but, more importantly, consider the different sex-specific factors and their causal mechanism or paths through which they influence stunting.

Keywords: stunting, underfives, sex of the child, GSEM, causal mechanism

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4671 COVID-19 Impact: How the Pandemic Changed the Fashion Industry

Authors: Akshata Patel, Reenu Singh

Abstract:

This paper focuses on current and upcoming fashion trends and global impact on the fashion industry due to the COVID-19 pandemic. The pandemic has had a major impact on the fashion industry worldwide. At the same time, the fashion market also faces challenges in consumer demand. As the supply chain and distribution channels are interconnected, this outbreak has a global impact due to travel restrictions and raw materials shortages. Given that this particular period represents an unprecedented market situation with almost no prior research on how the industry will recover from such a crisis and mold back to its original form, this research aims to propose new possibilities by evaluating the framework of specific segments. Based on the analysis and extensive literature review, the study develops a conceptual model that will illustrate the various connections among the different segments of the fashion industry. The findings provide actionable considerations for fashion industry pupils when implementing appropriate strategies to prevent unfavourable outcomes during times of crisis, such as the COVID-19 outbreak.

Keywords: COVID-19, fashion industry, global impact, new possibilities, pandemic

Procedia PDF Downloads 277
4670 The Yield of Neuroimaging in Patients Presenting to the Emergency Department with Isolated Neuro-Ophthalmological Conditions

Authors: Dalia El Hadi, Alaa Bou Ghannam, Hala Mostafa, Hana Mansour, Ibrahim Hashim, Soubhi Tahhan, Tharwat El Zahran

Abstract:

Introduction: Neuro-ophthalmological emergencies require prompt assessment and management to avoid vision or life-threatening sequelae. Some would require neuroimaging. Most commonly used are the CT and MRI of the Brain. They can be over-used when not indicated. Their yield remains dependent on multiple factors relating to the clinical scenario. Methods: A retrospective cross-sectional study was conducted by reviewing the electronic medical records of patients presenting to the Emergency Department (ED) with isolated neuro-ophthalmologic complaints. For each patient, data were collected on the clinical presentation, whether neuroimaging was performed (and which type), and the result of neuroimaging. Analysis of the performed neuroimaging was made, and its yield was determined. Results: A total of 211 patients were reviewed. The complaints or symptoms at presentation were: blurry vision, change in the visual field, transient vision loss, floaters, double vision, eye pain, eyelid droop, headache, dizziness and others such as nausea or vomiting. In the ED, a total of 126 neuroimaging procedures were performed. Ninety-four imagings (74.6%) were normal, while 32 (25.4%) had relevant abnormal findings. Only 2 symptoms were significant for abnormal imaging: blurry vision (p-value= 0.038) and visual field change (p-value= 0.014). While 4 physical exam findings had significant abnormal imaging: visual field defect (p-value= 0.016), abnormal pupil reactivity (p-value= 0.028), afferent pupillary defect (p-value= 0.018), and abnormal optic disc exam (p-value= 0.009). Conclusion: Risk indicators for abnormal neuroimaging in the setting of neuro-ophthalmological emergencies are blurred vision or changes in the visual field on history taking. While visual field irregularities, abnormal pupil reactivity with or without afferent pupillary defect, or abnormal optic discs, are risk factors related to physical testing. These findings, when present, should sway the ED physician towards neuroimaging but still individualizing each case is of utmost importance to prevent time-consuming, resource-draining, and sometimes unnecessary workup. In the end, it suggests a well-structured patient-centered algorithm to be followed by ED physicians.

Keywords: emergency department, neuro-ophthalmology, neuroimaging, risk indicators

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4669 Utilising Indigenous Knowledge to Design Dykes in Malawi

Authors: Martin Kleynhans, Margot Soler, Gavin Quibell

Abstract:

Malawi is one of the world’s poorest nations and consequently, the design of flood risk management infrastructure comes with a different set of challenges. There is a lack of good quality hydromet data, both in spatial terms and in the quality thereof and the challenge in the design of flood risk management infrastructure is compounded by the fact that maintenance is almost completely non-existent and that solutions have to be simple to be effective. Solutions should not require any further resources to remain functional after completion, and they should be resilient. They also have to be cost effective. The Lower Shire Valley of Malawi suffers from frequent flood events. Various flood risk management interventions have been designed across the valley during the course of the Shire River Basin Management Project – Phase I, and due to the data poor environment, indigenous knowledge was relied upon to a great extent for hydrological and hydraulic model calibration and verification. However, indigenous knowledge comes with the caveat that it is ‘fuzzy’ and that it can be manipulated for political reasons. The experience in the Lower Shire valley suggests that indigenous knowledge is unlikely to invent a problem where none exists, but that flood depths and extents may be exaggerated to secure prioritization of the intervention. Indigenous knowledge relies on the memory of a community and cannot foresee events that exceed past experience, that could occur differently to those that have occurred in the past, or where flood management interventions change the flow regime. This complicates communication of planned interventions to local inhabitants. Indigenous knowledge is, for the most part, intuitive, but flooding can sometimes be counter intuitive, and the rural poor may have a lower trust of technology. Due to a near complete lack of maintenance of infrastructure, infrastructure has to be designed with no moving parts and no requirement for energy inputs. This precludes pumps, valves, flap gates and sophisticated warning systems. Designs of dykes during this project included ‘flood warning spillways’, that double up as pedestrian and animal crossing points, which provide warning of impending dangerous water levels behind dykes to residents before water levels that could cause a possible dyke failure are reached. Locally available materials and erosion protection using vegetation were used wherever possible to keep costs down.

Keywords: design of dykes in low-income countries, flood warning spillways, indigenous knowledge, Malawi

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4668 Risk of Fatal and Non-Fatal Coronary Heart Disease and Stroke Events among Adult Patients with Hypertension: Basic Markov Model Inputs for Evaluating Cost-Effectiveness of Hypertension Treatment: Systematic Review of Cohort Studies

Authors: Mende Mensa Sorato, Majid Davari, Abbas Kebriaeezadeh, Nizal Sarrafzadegan, Tamiru Shibru, Behzad Fatemi

Abstract:

Markov model, like cardiovascular disease (CVD) policy model based simulation, is being used for evaluating the cost-effectiveness of hypertension treatment. Stroke, angina, myocardial infarction (MI), cardiac arrest, and all-cause mortality were included in this model. Hypertension is a risk factor for a number of vascular and cardiac complications and CVD outcomes. Objective: This systematic review was conducted to evaluate the comprehensiveness of this model across different regions globally. Methods: We searched articles written in the English language from PubMed/Medline, Ovid/Medline, Embase, Scopus, Web of Science, and Google scholar with a systematic search query. Results: Thirteen cohort studies involving a total of 2,165,770 (1,666,554 hypertensive adult population and 499,226 adults with treatment-resistant hypertension) were included in this scoping review. Hypertension is clearly associated with coronary heart disease (CHD) and stroke mortality, unstable angina, stable angina, MI, heart failure (HF), sudden cardiac death, transient ischemic attack, ischemic stroke, subarachnoid hemorrhage, intracranial hemorrhage, peripheral arterial disease (PAD), and abdominal aortic aneurism (AAA). Association between HF and hypertension is variable across regions. Treatment resistant hypertension is associated with a higher relative risk of developing major cardiovascular events and all-cause mortality when compared with non-resistant hypertension. However, it is not included in the previous CVD policy model. Conclusion: The CVD policy model used can be used in most regions for the evaluation of the cost-effectiveness of hypertension treatment. However, hypertension is highly associated with HF in Latin America, the Caribbean, Eastern Europe, and Sub-Saharan Africa. Therefore, it is important to consider HF in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment in these regions. We do not suggest the inclusion of PAD and AAA in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment due to a lack of sufficient evidence. Researchers should consider the effect of treatment-resistant hypertension either by including it in the basic model or during setting the model assumptions.

Keywords: cardiovascular disease policy model, cost-effectiveness analysis, hypertension, systematic review, twelve major cardiovascular events

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4667 Comet Assay: A Promising Tool for the Risk Assessment and Clinical Management of Head and Neck Tumors

Authors: Sarim Ahmad

Abstract:

The Single Cell Gel Electrophoresis Assay (SCGE, known as comet assay) is a potential, uncomplicated, sensitive and state-of-the-art technique for quantitating DNA damage at individual cell level and repair from in vivo and in vitro samples of eukaryotic cells and some prokaryotic cells, being popular in its widespread use in various areas including human biomonitoring, genotoxicology, ecological monitoring and as a tool for research into DNA damage or repair in different cell types in response to a range of DNA damaging agents, cancer risk and therapy. The method involves the encapsulation of cells in a low-melting-point agarose suspension, lysis of the cells in neutral or alkaline (pH > 13) conditions, and electrophoresis of the suspended lysed cells, resulting in structures resembling comets as observed by fluorescence microscopy; the intensity of the comet tail relative to the head reflects the number of DNA breaks. The likely basis for this is that loops containing a break lose their supercoiling and become free to extend towards the anode. This is followed by visual analysis with staining of DNA and calculating fluorescence to determine the extent of DNA damage. This can be performed by manual scoring or automatically by imaging software. The assay can, therefore, predict an individual’s tumor sensitivity to radiation and various chemotherapeutic drugs and further assess the oxidative stress within tumors and to detect the extent of DNA damage in various cancerous and precancerous lesions of oral cavity.

Keywords: comet assay, single cell gel electrophoresis, DNA damage, early detection test

Procedia PDF Downloads 287
4666 Dynamic Risk Identification Using Fuzzy Failure Mode Effect Analysis in Fabric Process Industries: A Research Article as Management Perspective

Authors: A. Sivakumar, S. S. Darun Prakash, P. Navaneethakrishnan

Abstract:

In and around Erode District, it is estimated that more than 1250 chemical and allied textile processing fabric industries are affected, partially closed and shut off for various reasons such as poor management, poor supplier performance, lack of planning for productivity, fluctuation of output, poor investment, waste analysis, labor problems, capital/labor ratio, accumulation of stocks, poor maintenance of resources, deficiencies in the quality of fabric, low capacity utilization, age of plant and equipment, high investment and input but low throughput, poor research and development, lack of energy, workers’ fear of loss of jobs, work force mix and work ethic. The main objective of this work is to analyze the existing conditions in textile fabric sector, validate the break even of Total Productivity (TP), analyze, design and implement fuzzy sets and mathematical programming for improvement of productivity and quality dimensions in the fabric processing industry. It needs to be compatible with the reality of textile and fabric processing industries. The highly risk events from productivity and quality dimension were found by fuzzy systems and results are wrapped up among the textile fabric processing industry.

Keywords: break even point, fuzzy crisp data, fuzzy sets, productivity, productivity cycle, total productive maintenance

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4665 Avidity and IgE versus IgG and IgM in Diagnosis of Maternal Toxoplasmosis

Authors: Ghada A. Gamea, Nabila A. Yaseen, Ahmed A. Othman, Ahmed S. Tawfik

Abstract:

Infection with Toxoplasma gondii can cause serious complications in pregnant women, leading to abortion, stillbirth, and congenital anomalies in the fetus. Definitive diagnosis of T. gondii acute infection is therefore critical for the clinical management of a mother and her fetus. This study was conducted on 250 pregnant females in the first trimester who were inpatients or outpatients at Obstetrics and Gynaecology Department at Tanta University Hospital. Screening of the selected females was done for the detection of immunoglobulin (IgG and IgM), and all subjects were submitted to history taking through a questionnaire including personal data, risk factors for Toxoplasma, complaint and history of the present illness. Thirty-eight samples, including 18 IgM +ve and 20 IgM-ve cases were further investigated by the avidity and IgE ELISA tests. The seroprevalence of toxoplasmosis in pregnant women was (42.8%) based on the presence of IgG antibodies in their sera. Contact with cats and consumption of raw or undercooked meat are important risk factors that were associated with toxoplasmosis in pregnant women. By serology, it could be observed that in the IgM +ve group, only one case (5.6%) showed an acute pattern by using the avidity test, though 10 (55.6%) cases were found to be acute by the IgE assay. On the other hand, in the IgM –ve group, 3 (15%) showed low avidity, but none of them was positive by using the IgE assay. In conclusion, there is no single serological test that can be used to confirm whether T. gondii infection is recent or was acquired in the distant past. A panel of tests for detection of toxoplasmosis will certainly have higher discriminatory power than any test alone.

Keywords: diagnosis, serology, seroprevalence, toxoplasmosis

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4664 COVID-19 Impact on Online Digital Marketing Business Activities

Authors: Balwinder Singh, Veerpaul Kaur Mann

Abstract:

The COVID-19 had a dramatic impact on several countries across the world. National governments have imposed widespread restrictions to prevent the growth of this pandemic. The new health competitive scenario induced by the COVID-19 crisis raised many issues on how business activities should be reorganized due to the difficulties of physical interactions with distributors, suppliers and customers. The pandemic has particularly affected the whole marketing processes because of the relevant issues emerged in managing physical sale channels and interactions with one another, both in the Business-to-Consumer and in the Business-to-Business markets. Recent research about the appropriate actions and strategies that could help firms overcome the crisis has highlighted the key role of digital technologies that may ensure connections and, thus, help business activities to run smoothly. This could be true, especially with the emergence of strong limitations on physical interactions during the COVID-19 pandemic. In such a scenario, the online channel becomes the most important conducive for online customers to get in contact with the firm and carry out online purchasing activities.

Keywords: COVID-19, business, digital marketing, online customers

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4663 Enhancing the Implementation Strategy of Simultaneous Operations (SIMOPS) for the Major Turnaround at Pertamina Plaju Refinery

Authors: Fahrur Rozi, Daniswara Krisna Prabatha, Latief Zulfikar Chusaini

Abstract:

Amidst the backdrop of Pertamina Plaju Refinery, which stands as the oldest and historically less technologically advanced among Pertamina's refineries, lies a unique challenge. Originally integrating facilities established by Shell in 1904 and Stanvac (originally Standard Oil) in 1926, the primary challenge at Plaju Refinery does not solely revolve around complexity; instead, it lies in ensuring reliability, considering its operational history of over a century. After centuries of existence, Plaju Refinery has never undergone a comprehensive major turnaround encompassing all its units. The usual practice involves partial turnarounds that are sequentially conducted across its primary, secondary, and tertiary units (utilities and offsite). However, a significant shift is on the horizon. In the Q-IV of 2023, the refinery embarks on its first-ever major turnaround since its establishment. This decision was driven by the alignment of maintenance timelines across various units. Plaju Refinery's major turnaround was scheduled for October-November 2023, spanning 45 calendar days, with the objective of enhancing the operational reliability of all refinery units. The extensive job list for this turnaround encompasses 1583 tasks across 18 units/areas, involving approximately 9000 contracted workers. In this context, the Strategy of Simultaneous Operations (SIMOPS) execution emerges as a pivotal tool to optimize time efficiency and ensure safety. A Hazard Effect Management Process (HEMP) has been employed to assess the risk ratings of each task within the turnaround. Out of the tasks assessed, 22 are deemed high-risk and necessitate mitigation. The SIMOPS approach serves as a preventive measure against potential incidents. It is noteworthy that every turnaround period at Pertamina Plaju Refinery involves SIMOPS-related tasks. In this context, enhancing the implementation strategy of "Simultaneous Operations (SIMOPS)" becomes imperative to minimize the occurrence of incidents. At least four improvements have been introduced in the enhancement process for the major turnaround at Refinery Plaju. The first improvement involves conducting systematic risk assessment and potential hazard mitigation studies for SIMOPS tasks before task execution, as opposed to the previous on-site approach. The second improvement includes the completion of SIMOPS Job Mitigation and Work Matrices Sheets, which was often neglected in the past. The third improvement emphasizes comprehensive awareness to workers/contractors regarding potential hazards and mitigation strategies for SIMOPS tasks before and during the major turnaround. The final improvement is the introduction of a daily program for inspecting and observing work in progress for SIMOPS tasks. Prior to these improvements, there was no established program for monitoring ongoing activities related to SIMOPS tasks during the turnaround. This study elucidates the steps taken to enhance SIMOPS within Pertamina, drawing from the experiences of Plaju Refinery as a guide. A real actual case study will be provided from our experience in the operational unit. In conclusion, these efforts are essential for the success of the first-ever major turnaround at Plaju Refinery, with the SIMOPS strategy serving as a central component. Based on these experiences, enhancements have been made to Pertamina's official Internal Guidelines for Executing SIMOPS Risk Mitigation, benefiting all Pertamina units.

Keywords: process safety management, turn around, oil refinery, risk assessment

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4662 Interpretive Structural Modeling Technique for Hierarchal Ranking of Barriers in Implementation ofGreen Supply Chain Management-Case of Indian Petroleum Industry

Authors: Kavish Kejriwal, Richa Grover

Abstract:

Consumer awareness and pending legislation have pushed environmental issues into the spotlight, making it imperative for organizations to have a plan of action for “going green.” This is the reason why Green Supply Chain Management has become the integral part of many organization with a goal to reduce cost, increase efficiency and be environmental friendly. Implementation of GSCM involves many factors which act as barriers, making it a tedious task. These barriers have different relationship among themselves creating different impact on implementation Green Supply Chain Management. This work focuses on determining those barriers which have essentially to be removed in the initial stages of GSCM adoption. In this work, the author has taken the case of a petroleum industry in order to come up with a solution. A DEMATEL approach is used to reach the solution.

Keywords: barriers, environment, green supply chain management, impact, interpretive structural modeling

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4661 Surface Water Pollution by Open Refuse Dumpsite in North Central of Nigeria

Authors: Abimbola Motunrayo Folami, Ibironke Titilayo Enitan, Feroz Mohomed Swalaha

Abstract:

Water is a vital resource that is important in ensuring the growth and development of any country. To sustain the basic human needs and the demands for agriculture, industry, conservational and ecosystem, enough quality and quantity water is needed. Contamination of water resources is now a global and public health concern. Hence, this study assessed the water quality of Ndawuse River by measuring the physicochemical parameters and heavy metals concentrations of the river using standard methods. In total, 16 surface water samples were obtained from five locations along the river, from upstream to downstream as well as samples from the dumpsite. The results obtained were compared with the standard limits set by both the World Health Organization and the Federal Environmental Protection Agency for domestic purposes. The results of the measured parameters indicated that biological oxygen demand (85.88 mg/L), turbidity (44.51 NTU), Iron (0.014 - 3.511 mg /L) and chromium (0.078 - 0.14 mg /L) were all above the standard limits. The results further showed that the quality of surface water is being significantly affected by human activities around the Ndawuse River which could pose an adverse health risk to several communities that rely on this river as their primary source of water. Therefore, there is a need for strict enforcement of environmental laws to protect the aquatic ecosystem and to avoid long term cumulative exposure risk that heavy metals may pose on human health.

Keywords: Abuja, contaminants, heavy metals, Ndawuse River, Nigeria, surface water

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4660 An Investigation of the Determinants of Discount Rate Manipulation in Swedish and Finnish Listed Companies

Authors: Fredrik Hartwig, Peter Lindberg

Abstract:

In 2004, the International Accounting Standards Board (IASB) issued new accounting standards for impairment testing of goodwill. IFRS 3 Business Combinations and IAS 36 Impairment of Assets prohibited amortization of acquired goodwill and instead required companies to test goodwill for impairment annually or more often if necessary. The goodwill impairment test is based on management’s judgement and estimations, making the impairment-only-approach subjective and unreliable. Management can use the discretion opportunistically by managing goodwill impairments. The IASB’s remedy to the reliability problem has been to demand transparent financial reports. IAS 36 paragraph 134 requires detailed disclosures regarding the impairment test in order to make potentially unreasonable assumptions and estimations visible. The disclosure requirements should thus (in theory) make it more difficult for management to ‘choose’ assumptions and estimations that suit an agenda. Whether the requirement to disclose detailed disclosures regarding the impairment test leads to less opportunism is however an empirical question. This work analyses whether one of the required disclosures in IAS 36 paragraph 134, the reported discount rate, differs from an independently estimated risk-adjusted discount rate. Estimates of discount rates that are either lower or higher than the independently estimated discount rate are here defined as opportunism. In the former case - i.e. when the reported discount rate is lower - the objective may be to avoid profit reducing impairment charges. In the latter case - i.e. when the reported discount rate is higher - the objective may be to reduce profits or take ‘big baths’. This paper differs in one important respect from previous similar studies, the majority of which are based on purely descriptive statistics; we use multivariate regression analysis to analyze what factors affect deviations between disclosed discount rates and independently estimated discount rates. The sample consists of Swedish and Finnish listed companies. Swedish and Finnish listed companies are analysed since the accounting oversight bodies differ between the two countries. The results show that discount rate deviations in Swedish and Finnish listed companies are significantly related to accounting oversight, size and industry but not financial risk, business risk and goodwill intensity.

Keywords: discount rate, manipulation, goodwill impairment test, disclosures

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4659 The Relationship between Brand Recall and Brand Attitude in Advergame

Authors: Azaze-Azizi Abdul Adis, Hyung Jun Kim, Mohamad Rizwan Abdul Majid, Zaiton Osman, Izyanti Awang Razli

Abstract:

The increase of online advertising, specifically advergame has become a popular method of strengthening consumer brand recognition by inserting attractive characters and enhancing entertainment value. There have been several remarkable studies on spokes-characters in advertising effectiveness. However, few studies have examined the link between character presence and consumers' brand recall and attitude in advergame. Moreover, how the entertainment value of an advergame influences brand recall and brand attitude and the mediating role of brand recall in influencing character presence and entertainment on brand attitude are still lacking in the advergaming literature. An online survey was conducted with 366 Malaysian gamers. Using structural equation modeling, the results showed that character presence had no influence but entertainment value had a positive influence on brand recall and brand attitude. This study confirmed the role of brand recall as a mediator of the effect of between entertainment and brand attitude in advergame.

Keywords: character presence, entertainment, brand recall, brand attitude, advergame

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4658 Stakeholder-Driven Development of a One Health Platform to Prevent Non-Alimentary Zoonoses

Authors: A. F. G. Van Woezik, L. M. A. Braakman-Jansen, O. A. Kulyk, J. E. W. C. Van Gemert-Pijnen

Abstract:

Background: Zoonoses pose a serious threat to public health and economies worldwide, especially as antimicrobial resistance grows and newly emerging zoonoses can cause unpredictable outbreaks. In order to prevent and control emerging and re-emerging zoonoses, collaboration between veterinary, human health and public health domains is essential. In reality however, there is a lack of cooperation between these three disciplines and uncertainties exist about their tasks and responsibilities. The objective of this ongoing research project (ZonMw funded, 2014-2018) is to develop an online education and communication One Health platform, “eZoon”, for the general public and professionals working in veterinary, human health and public health domains to support the risk communication of non-alimentary zoonoses in the Netherlands. The main focus is on education and communication in times of outbreak as well as in daily non-outbreak situations. Methods: A participatory development approach was used in which stakeholders from veterinary, human health and public health domains participated. Key stakeholders were identified using business modeling techniques previously used for the design and implementation of antibiotic stewardship interventions and consisted of a literature scan, expert recommendations, and snowball sampling. We used a stakeholder salience approach to rank stakeholders according to their power, legitimacy, and urgency. Semi-structured interviews were conducted with stakeholders (N=20) from all three disciplines to identify current problems in risk communication and stakeholder values for the One Health platform. Interviews were transcribed verbatim and coded inductively by two researchers. Results: The following key values were identified (but were not limited to): (a) need for improved awareness of veterinary and human health of each other’s fields, (b) information exchange between veterinary and human health, in particularly at a regional level; (c) legal regulations need to match with daily practice; (d) professionals and general public need to be addressed separately using tailored language and information; (e) information needs to be of value to professionals (relevant, important, accurate, and have financial or other important consequences if ignored) in order to be picked up; and (f) need for accurate information from trustworthy, centrally organised sources to inform the general public. Conclusion: By applying a participatory development approach, we gained insights from multiple perspectives into the main problems of current risk communication strategies in the Netherlands and stakeholder values. Next, we will continue the iterative development of the One Health platform by presenting key values to stakeholders for validation and ranking, which will guide further development. We will develop a communication platform with a serious game in which professionals at the regional level will be trained in shared decision making in time-critical outbreak situations, a smart Question & Answer (Q&A) system for the general public tailored towards different user profiles, and social media to inform the general public adequately during outbreaks.

Keywords: ehealth, one health, risk communication, stakeholder, zoonosis

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4657 The Impact of a Five-Day Basic Disaster Management Training on Disaster Risk Reduction: Case Study of Indonesia Defense University

Authors: Jazmi Adlan Bohari, I. Dewa Ketut Kerta Widana

Abstract:

Education on disaster management has been made as a mainstream focus of many countries. In Indonesia, this has been emphasized with the direct order of the President of Indonesia to implement disaster education at all levels in both formal and informal education. Indonesia Defense University (IDU) executes this order through Three Pillars of Higher Education, which consists of research, education, and community service. One of them is a five-day disaster management training for 105 participants divided into three batches that consist of faculty members and graduate students. This training uses the 2018 Basic Disaster Management Training Modul issued by the Indonesia National Disaster Management Agency (BNPB). This research aims to analyze the impact of this short training on the trainee’s knowledge and understanding of basic disaster management. This study is a qualitative research with case study approach. The research shows that after five days of training, there as a significant increase in knowledge and understanding of basic disaster management experienced by the trainees with a 61,73% overall increase. The post-training data shows that 61% of the trainees have a very good understanding, 24% with good understanding, 13% with adequate understanding, and 2% with poor understanding. The result suggests that a short-time education with a structured curriculum can successfully increase the knowledge and understanding of disaster management on a basic level and can hypothetically contribute to the effort to reduce disaster risks.

Keywords: disaster education, basic disaster management training, three Pillars of Higher Education, disaster risk reduction

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4656 The Effect of Particulate Matter on Cardiomyocyte Apoptosis Through Mitochondrial Fission

Authors: Tsai-chun Lai, Szu-ju Fu, Tzu-lin Lee, Yuh-Lien Chen

Abstract:

There is much evidence that exposure to fine particulate matter (PM) from air pollution increases the risk of cardiovascular morbidity and mortality. According to previous reports, PM in the air enters the respiratory tract, contacts the alveoli, and enters the blood circulation, leading to the progression of cardiovascular disease. PM pollution may also lead to cardiometabolic disturbances, increasing the risk of cardiovascular disease. The effects of PM on cardiac function and mitochondrial damage are currently unknown. We used mice and rat cardiomyocytes (H9c2) as animal and in vitro cell models, respectively, to simulate an air pollution environment using PM. These results indicate that the apoptosis-related factor PUMA, a regulator of apoptosis upregulated by p53, is increased in mice treated with PM. Apoptosis was aggravated in cardiomyocytes treated with PM, as measured by TUNEL assay and Annexin V/PI. Western blot results showed that CASPASE3 was significantly increased and BCL2 (B-cell lymphoid 2) was significantly decreased under PM treatment. Concurrent exposure to PM increases mitochondrial reactive oxygen species (ROS) production by MitoSOX Red staining. Furthermore, using Mitotracker staining, PM treatment significantly shortened mitochondrial length, indicating mitochondrial fission. The expression of mitochondrial fission-related proteins p-DRP1 (phosphodynamics-related protein 1) and FIS1 (mitochondrial fission 1 protein) was significantly increased. Based on these results, the exposure to PM worsens mitochondrial function and leads to cardiomyocyte apoptosis.

Keywords: particulate matter, cardiomyocyte, apoptosis, mitochondria

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4655 Perception of Consumer Behavior on Mobile Banking Offered by the National and Multinational Banks in UAE with Special Reference to Emirates NBD and Citibank

Authors: Aarohi Surya

Abstract:

The number of mobile banking users continues to climb across the world due to its increasing popularity, and UAE is no exception. This type of banking is part of the core strategy of most of the financial institutions that allows its customers to conduct a range of financial transactions through mobile apps to cash in the high demand from the bankers. This study aims at evaluating service quality of online banking in Dubai, one of the swiftly growing cities of Middle East. The paper mainly compares online banking services of Multinational bank and National Bank with special reference to Citibank and Emirates NBD. A structured questionnaire survey is conducted among various target groups. The research has been focused on mainly 4 significant areas of online banking, i.e. Privacy, Responsiveness, Reliability, and Efficiency of customer data. Information was analyzed statistically on SPSS to investigate the service quality of e-banking.

Keywords: customer satisfaction, service quality, responsiveness, online banking

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4654 Clinical Impact of Delirium and Antipsychotic Therapy: 10-Year Experience from a Referral Coronary Care Unit

Authors: Niyada Naksuk, Thoetchai Peeraphatdit, Vitaly Herasevich, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham

Abstract:

Introduction: Little is known about the safety of antipsychotic therapy for delirium in the coronary care unit (CCU). Our aim was to examine the effect of delirium and antipsychotic therapy among CCU patients. Methods: Pre-study Confusion Assessment Method-Intensive Care Unit (CAM–ICU) criteria were implemented in screening consecutive patients admitted to Mayo Clinic, Rochester, the USA from 2004 through 2013. Death status was prospectively ascertained. Results: Of 11,079 study patients, the incidence of delirium was 8.3% (n=925). Delirium was associated with an increased risk of in-hospital mortality (adjusted OR 1.49; 95% CI, 1.08-2.08; P=.02) and one-year mortality among patients who survived from CCU admission (adjusted HR 1.46; 95% CI, 1.12-1.87; P=.005). A total of 792 doses of haloperidol (5 IQR [3-10] mg/day) or quetiapine (25 IQR [13-50] mg/day) were given to 244 patients with delirium. The clinical characteristics of patients with delirium who did and did not receive antipsychotic therapy were not different (baseline corrected QT [QTc] interval 460±61 ms vs. 457±58 ms, respectively; P = 0.57). In comparison to baseline, mean QTc intervals after the first and third doses of the antipsychotics were not significantly prolonged in haloperidol (448±56, 458±57, and 450±50 ms, respectively) or quetiapine groups (459±54, 467±68, and 462±46 ms, respectively) (P > 0.05 for all). Additionally, in-hospital mortality (adjusted OR 0.67; 95% CI, 0.42-1.04; P=.07), ventricular arrhythmia (adjusted OR 0.87; 95% CI, 0.17-3.62; P=.85) and one-year mortality among the hospital survivors (adjusted HR 0.86; 95% CI 0.62-1.17; P = 0.34) were not different in patients with delirium irrespective of whether or not they received antipsychotics. Conclusions: In patients admitted to the CCU, delirium was associated with an increase in both in-hospital and one-year mortality. Low doses of haloperidol and quetiapine appeared to be safe, without an increase in risk of sudden cardiac death, in-hospital mortality, or one-year mortality in carefully monitored patients.

Keywords: arrhythmias, haloperidol, mortality, qtc interval, quetiapine

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4653 Reduction of the Number of Traffic Accidents by Function of Driver's Anger Detection

Authors: Masahiro Miyaji

Abstract:

When a driver happens to be involved in some traffic congestion or after traffic incidents, the driver may fall in a state of anger. State of anger may encounter decisive risk resulting in severer traffic accidents. Preventive safety function using driver’s psychosomatic state with regard to anger may be one of solutions which would avoid that kind of risks. Identifying driver’s anger state is important to create countermeasures to prevent the risk of traffic accidents. As a first step, this research figured out root cause of traffic incidents by means of using Internet survey. From statistical analysis of the survey, dominant psychosomatic states immediately before traffic incidents were haste, distraction, drowsiness and anger. Then, we replicated anger state of a driver while driving, and then, replicated it by means of using driving simulator on bench test basis. Six types of facial expressions including anger were introduced as alternative characteristics. Kohonen neural network was adopted to classify anger state. Then, we created a methodology to detect anger state of a driver in high accuracy. We presented a driving support safety function. The function adapts driver’s anger state in cooperation with an autonomous driving unit to reduce the number of traffic accidents. Consequently, e evaluated reduction rate of driver’s anger in the traffic accident. To validate the estimation results, we referred the reduction rate of Advanced Safety Vehicle (ASV) as well as Intelligent Transportation Systems (ITS).

Keywords: Kohonen neural network, driver’s anger state, reduction of traffic accidents, driver’s state adaptive driving support safety

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4652 Barbie in India: A Study of Effects of Barbie in Psychological and Social Health

Authors: Suhrita Saha

Abstract:

Barbie is a fashion doll manufactured by the American toy company Mattel Inc and it made debut at the American International Toy Fair in New York in 9 March 1959. From being a fashion doll to a symbol of fetishistic commodification, Barbie has come a long way. A Barbie doll is sold every three seconds across the world, which makes the billion dollar brand the world’s most popular doll for the girls. The 11.5 inch moulded plastic doll has a height of 5 feet 9 inches at 1/6 scale. Her vital statistics have been estimated at 36 inches (chest), 18 inches (waist) and 33 inches (hips). Her weight is permanently set at 110 pounds which would be 35 pounds underweight. Ruth Handler, the creator of Barbie wanted a doll that represented adulthood and allowed children to imagine themselves as teenagers or adults. While Barbie might have been intended to be independent, imaginative and innovative, the physical uniqueness does not confine the doll to the status of a play thing. It is a cultural icon but with far reaching critical implications. The doll is a commodity bearing more social value than practical use value. The way Barbie is produced represents industrialization and commodification of the process of symbolic production. And this symbolic production and consumption is a standardized planned one that produce stereotypical ‘pseudo-individuality’ and suppresses cultural alternatives. Children are being subject to and also arise as subjects in this consumer context. A very gendered, physiologically dissected sexually charged symbolism is imposed upon children (both male and female), childhood, their social worlds, identity, and relationship formation. Barbie is also very popular among Indian children. While the doll is essentially an imaginative representation of the West, it is internalized by the Indian sensibilities. Through observation and questionnaire-based interview within a sample population of adolescent children (primarily female, a few male) and parents (primarily mothers) in Kolkata, an Indian metropolis, the paper puts forth findings of sociological relevance. 1. Barbie creates, recreates, and accentuates already existing divides between the binaries like male- female, fat- thin, sexy- nonsexy, beauty- brain and more. 2. The Indian girl child in her associative process with Barbie wants to be like her and commodifies her own self. The male child also readily accepts this standardized commodification. Definition of beauty is thus based on prejudice and stereotype. 3. Not being able to become Barbie creates health issues both psychological and physiological varying from anorexia to obesity as well as personality disorder. 4. From being a plaything Barbie becomes the game maker. Barbie along with many other forms of simulation further creates a consumer culture and market for all kind of fitness related hyper enchantment and subsequent disillusionment. The construct becomes the reality and the real gets lost in the play world. The paper would thus argue that Barbie from being an innocuous doll transports itself into becoming social construct with long term and irreversible adverse impact.

Keywords: barbie, commodification, personality disorder, sterotype

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4651 'I'm in a Very Safe Place': Webcam Sex Workers in Aotearoa, New Zealand and Their Perceptions of Danger and Risk

Authors: Madeline V. Henry

Abstract:

Sex work is a contested subject in academia. Many authors now argue that the practice should be recognized as a legitimate and rationally chosen form of labor, and that decriminalization is necessary to ensure the safety of sex workers and reduce their stigmatization. However, a prevailing argument remains that the work is inherently violent and oppressive and that all sex workers are directly or indirectly coerced into participating in the industry. This argument has been complicated by the recent proliferation of computer-mediated technologies that allow people to conduct sex work without the need to be physically co-present with customers or pimps. One example of this is the practice of ‘camming’, wherein ‘webcam models’ stream themselves stripping and/or performing autoerotic stimulation in an online chat-room for payment. In this presentation, interviews with eight ‘camgirls’ (aged 22-34) will be discussed. Their talk has been analyzed using Foucauldian discourse analysis, focusing on common discursive threads in relation to the work and their subjectivities. It was found that the participants demonstrated appreciation for the lack of physical danger they were in, but emphasized the unique and significant dangers of online-based sex work (their images and videos being recorded and shared without their consent, for example). Participants also argued that their largest concerns were based around stigma, which they claimed remained prevalent despite the decriminalized legal model in Aotearoa/New Zealand (which has been in place for over 14 years). Overall, this project seeks to challenge commonplace academic approaches to sex work, adding further research to support sex workers’ rights and highlighting new issues to consider in a digital environment.

Keywords: camming, sex work, stigma, risk

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4650 Performance of the Abbott RealTime High Risk HPV Assay with SurePath Liquid Based Cytology Specimens from Women with Low Grade Cytological Abnormalities

Authors: Alexandra Sargent, Sarah Ferris, Ioannis Theofanous

Abstract:

The Abbott RealTime High Risk HPV test (RealTime HPV) is one of five assays clinically validated and approved by the English NHS Cervical Screening Programme (CSP) for HPV triage of low grade dyskaryosis and test-of-cure of treated Cervical Intraepithelial Neoplasia. The assay is a highly automated multiplex real-time PCR test for detecting 14 high risk (hr) HPV types, with simultaneous differentiation of HPV 16 and HPV 18 versus non-HPV 16/18 hrHPV. An endogenous internal control ensures sample cellularity, controls extraction efficiency and PCR inhibition. The original cervical specimen collected in SurePath (SP) liquid-based cytology (LBC) medium (BD Diagnostics) and the SP post-gradient cell pellets (SPG) after cytological processing are both CE marked for testing with the RealTime HPV test. During the 2011 NHSCSP validation of new tests only the original aliquot of SP LBC medium was investigated. Residual sample volume left after cytology slide preparation is low and may not always have sufficient volume for repeat HPV testing or for testing of other biomarkers that may be implemented in testing algorithms in the future. The SPG samples, however, have sufficient volumes to carry out additional testing and necessary laboratory validation procedures. This study investigates the correlation of RealTime HPV results of cervical specimens collected in SP LBC medium from women with low grade cytological abnormalities observed with matched pairs of original SP LBC medium and SP post-gradient cell pellets (SPG) after cytology processing. Matched pairs of SP and SPG samples from 750 women with borderline (N = 392) and mild (N = 351) cytology were available for this study. Both specimen types were processed and parallel tested for the presence of hrHPV with RealTime HPV according to the manufacturer´s instructions. HrHPV detection rates and concordance between test results from matched SP and SPGCP pairs were calculated. A total of 743 matched pairs with valid test results on both sample types were available for analysis. An overall-agreement of hrHPV test results of 97.5% (k: 0.95) was found with matched SP/SPG pairs and slightly lower concordance (96.9%; k: 0.94) was observed on 392 pairs from women with borderline cytology compared to 351 pairs from women with mild cytology (98.0%; k: 0.95). Partial typing results were highly concordant in matched SP/SPG pairs for HPV 16 (99.1%), HPV 18 (99.7%) and non-HPV16/18 hrHPV (97.0%), respectively. 19 matched pairs were found with discrepant results: 9 from women with borderline cytology and 4 from women with mild cytology were negative on SPG and positive on SP; 3 from women with borderline cytology and 3 from women with mild cytology were negative on SP and positive on SPG. Excellent correlation of hrHPV DNA test results was found between matched pairs of SP original fluid and post-gradient cell pellets from women with low grade cytological abnormalities tested with the Abbott RealTime High-Risk HPV assay, demonstrating robust performance of the test with both specimen types and reassuring the utility of the assay for cytology triage with both specimen types.

Keywords: Abbott realtime test, HPV, SurePath liquid based cytology, surepath post-gradient cell pellet

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4649 Landfill Failure Mobility Analysis: A Probabilistic Approach

Authors: Ali Jahanfar, Brajesh Dubey, Bahram Gharabaghi, Saber Bayat Movahed

Abstract:

Ever increasing population growth of major urban centers and environmental challenges in siting new landfills have resulted in a growing trend in design of mega-landfills some with extraordinary heights and dangerously steep slopes. Landfill failure mobility risk analysis is one of the most uncertain types of dynamic rheology models due to very large inherent variabilities in the heterogeneous solid waste material shear strength properties. The waste flow of three historic dumpsite and two landfill failures were back-analyzed using run-out modeling with DAN-W model. The travel distances of the waste flow during landfill failures were calculated approach by taking into account variability in material shear strength properties. The probability distribution function for shear strength properties of the waste material were grouped into four major classed based on waste material compaction (landfills versus dumpsites) and composition (high versus low quantity) of high shear strength waste materials such as wood, metal, plastic, paper and cardboard in the waste. This paper presents a probabilistic method for estimation of the spatial extent of waste avalanches, after a potential landfill failure, to create maps of vulnerability scores to inform property owners and residents of the level of the risk.

Keywords: landfill failure, waste flow, Voellmy rheology, friction coefficient, waste compaction and type

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4648 Factors Associated with Risky Sexual Behaviour in Adolescent Girls and Young Women in Cambodia: A Systematic Review

Authors: Farwa Rizvi, Joanne Williams, Humaira Maheen, Elizabeth Hoban

Abstract:

There is an increase in risky sexual behavior and unsafe sex in adolescent girls and young women aged 15 to 24 years in Cambodia, which negatively affects their reproductive health by increasing the risk of contracting sexually transmitted infections and unintended pregnancies. Risky sexual behavior includes ‘having sex at an early age, having multiple sexual partners, having sex while under the influence of alcohol or drugs, and unprotected sexual behaviors’. A systematic review of quantitative research conducted in Cambodia was undertaken, using the theoretical framework of the Social Ecological Model to identify the personal, social and cultural factors associated with risky sexual behavior and unsafe sex in young Cambodian women. PRISMA guidelines were used to search databases including Medline Complete, PsycINFO, CINAHL Complete, Academic Search Complete, Global Health, and Social Work Abstracts. Additional searches were conducted in Science Direct, Google Scholar and in the grey literature sources. A risk-of-bias tool developed explicitly for the systematic review of cross-sectional studies was used. Summary item on the overall risk of study bias after the inter-rater response showed that the risk-of-bias was high in two studies, moderate in one study and low in one study. The search strategy included a combination of subject terms and free text terms. The medical subject headings (MeSH) terms included were; contracept* or ‘birth control’ or ‘family planning’ or pregnan* or ‘safe sex’ or ‘protected intercourse’ or ‘unprotected intercourse’ or ‘protected sex’ or ‘unprotected sex’ or ‘risky sexual behaviour*’ or ‘abort*’ or ‘planned parenthood’ or ‘unplanned pregnancy’ AND ( barrier* or obstacle* or challenge* or knowledge or attitude* or factor* or determinant* or choic* or uptake or discontinu* or acceptance or satisfaction or ‘needs assessment’ or ‘non-use’ or ‘unmet need’ or ‘decision making’ ) AND Cambodia*. Initially, 300 studies were identified by using key words and finally, four quantitative studies were selected based on the inclusion criteria. The four studies were published between 2010 and 2016. The study participants ranged in age from 10-24 years, single or married, with 3 to 10 completed years of education. The mean age at sexual debut was reported to be 18 years. Using the perspective of the Social Ecological Model, risky sexual behavior was associated with individual-level factors including young age at sexual debut, low education, unsafe sex under the influence of alcohol and substance abuse, multiple sexual partners or transactional sex. Family level factors included living away from parents, orphan status and low levels of family support. Peer and partner level factors included peer delinquency and lack of condom use. Low socioeconomic status at the society level was also associated with risky sexual behaviour. There is scant research on sexual and reproductive health of adolescent girls and young women in Cambodia. Individual, family and social factors were significantly associated with risky sexual behaviour. More research is required to inform potential preventive strategies and policies that address young women’s sexual and reproductive health.

Keywords: adolescents, high-risk sex, sexual activity, unplanned pregnancies

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4647 A Review on the Use of Herbal Alternatives to Antibiotics in Poultry Diets

Authors: Sasan Chalaki, Seyed Ali Mirgholange, Touba Nadri, Saman Chalaki

Abstract:

In the current world, proper poultry nutrition has garnered special attention as one of the fundamental factors for enhancing their health and performance. Concerns related to the excessive use of antibiotics in the poultry industry and their role in antibiotic resistance have transformed this issue into a global challenge in public health and the environment. On the other hand, poultry farming plays a vital role as a primary source of meat and eggs in human nutrition, and improving their health and performance is crucial. One effective approach to enhance poultry nutrition is the utilization of the antibiotic properties of plant-based ingredients. The use of plant-based alternatives as natural antibiotics in poultry nutrition not only aids in improving poultry health and performance but also plays a significant role in reducing the consumption of synthetic antibiotics and preventing antibiotic resistance-related issues. Plants contain various antibacterial compounds, such as flavonoids, tannins, and essential oils. These compounds are recognized as active agents in combating bacteria. Plant-based antibiotics are compounds extracted from plants with antibacterial properties. They are acknowledged as effective substitutes for chemical antibiotics in poultry diets. The advantages of plant-based antibiotics include reducing the risk of resistance to chemical antibiotics, increasing poultry growth performance, and lowering the risk of disease transmission.

Keywords: poultry, antibiotics, essential oils, plant-based

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4646 Cyber Bullying, Online Risks and Parental Mediation: A Comparison between Adolescent Reports and Parent Perceptions in South Africa

Authors: Masa Popovac, Philip Fine

Abstract:

Information and Communication Technologies (ICTs) have altered our social environments, and young people in particular have immersed themselves in the digital age. Despite countless benefits, younger ICT users are being exposed to various online risks such as contact with strangers, viewing of risky content, sending or receiving sexually themed images or comments (i.e. ‘sexting’) as well as cyber bullying. Parents may not be fully aware of the online spaces their children inhabit and often struggle to implement effective mediation strategies. This quantitative study explored (i) three types of online risks (contact risks, content risks and conduct risks), (ii) cyber bullying victimization and perpetration, and (iii) parental mediation among a sample of 689 South African adolescents aged between 12-17 years. Survey data was also collected for 227 of their parents relating to their perceptions of their child’s online experiences. A comparison between adolescent behaviors and parental perceptions was examined on the three variables in the study. Findings reveal various online risk taking behaviors. In terms of contact risks, 56% of adolescents reported having contact with at least one online stranger, with many meeting these strangers in person. Content risks included exposure to harmful information such as websites promoting extreme diets or self-harm as well as inappropriate content: 84% of adolescents had seen violent content and 75% had seen sexual content online. Almost 60% of adolescents engaged in conduct risks such as sexting. Eight online victimization behaviors were examined in the study and 79% of adolescents had at least one of these negative experiences, with a third (34%) defining this experience as cyber bullying. A strong connection between victimization and perpetration was found, with 63% of adolescents being both a victim and perpetrator. Very little parental mediation of ICT use was reported. Inferential statistics revealed that parents consistently underestimated their child’s online risk taking behaviors as well as their cyber bullying victimization and perpetration. Parents also overestimated mediation strategies in the home. The generational gap in the knowledge and use of ICTs is a barrier to effective parental mediation and online safety, since many negative online experiences by adolescents go undetected and can continue for extended periods of time thereby exacerbating the potential psychological and emotional distress. The study highlights the importance of including parents in online safety efforts.

Keywords: cyber bullying, online risk behaviors, parental mediation, South Africa

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4645 Consumer Attitude and Purchase Intention towards Organic Food: Insights from Pakistan

Authors: Muneshia Maheshwar, Kanwal Gul, Shakira Fareed, Ume-Amama Areeb Gul

Abstract:

Organic food is commonly known for its healthier content without the use of pesticides, herbicides, inorganic fertilizers, antibiotics and growth hormones. The aim of this research is to examine the effect of health consciousness, environmental concern and organic food knowledge on both the intention to buy organic foods and the attitude towards organic foods and the effect of attitude towards organic foods on the intention to buy organic foods in Pakistan. Primary data was used which was collected through adopted questionnaire from previous research. Non- probability convenience sampling was used to select sample size of 200 consumers based on Karachi. The data was analyzed through Descriptive statistics and Multi regression method. The findings of the study showed that the attitude and the intention to buy organic food were affected by health consciousness, environmental concern, and organic food knowledge. The results also revealed that attitude also affects the intention to buy organic food.

Keywords: health consciousness, attitude, intention to purchase, environmental concern, organic food knowledge

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4644 Effect of Preconception Picture-Based Nutrition Education on Knowledge and Adherence to Iron-Folic Acid Supplementation Among Women Planning to Be Pregnant in Ethiopia

Authors: Anteneh Berhane Yeyi, Tefera Belachew

Abstract:

Any woman who could become pregnant is at risk of having a baby with neural tube defects (NTDs). A spontaneous aborted women with immediately preceding pregnancy may have an increased risk of develop NTDs. Ethiopia has one of the highest rates of micronutrient deficiencies, including folate and iron deficiency. Currently, in Ethiopia, NTDs is emerged as a public health concern. Even if Ethiopia, has implement different strategies for reducing maternal and neonatal mortality and morbidity, there is no room in the health care system and lack of integration for preventing the risk of NTDs for those women who aborted spontaneously and women who discontinue long acting contraception to become pregnant. The purpose of this study was to evaluate the effect of preconception picture-based nutrition education on knowledge and adherence to iron-folic acid supplement (IFAS) intake to reduce the risk of developing neural tube defects (NTDs) and iron deficiency anemia (IDA) among women who had a planned to pregnancy in Ethiopia, a country with a high burden of NTDs. Methodology: This study was conducted in Eastern Ethiopia. A double blinded parallel randomized controlled trial design was employed among women in the age group of 18-45 years who requested to interrupt modern contraceptive who have an intention to be pregnant and women with spontaneous abortion who refused to take a contraceptive. The interventional arm (n=122) received a preconception picture-based nutrition education with iron-folic acid supplement, and the control arm (n=122) received only preconception IFAS. In this study male partners were participated. Result: After three months of intervention the proportion of adherence to IFAS was 23% (n=56). With regard to adherence within the groups, 42.6% (n=52) in the intervention group and 3.3% (n=4) in the control group and the intervention group were significantly higher than in control group. In the intervention group the proportion of adherence to IFAS intake among participants increased by 40.1% and there were statistically difference (P<0.0001). The difference in difference between the two groups of adherence to IFAS intake was 37.6% and there were a statistical significance (P<0.0001). Level of knowledge between the groups did differ before and after intervention (P= 0.87 Vs P<0.0001). The overall the mean change in knowledge Mean (+SE) between group was 0.9 (+3.04 SE) and there were significant differences between two groups (P<0.001). Conclusion: In general this intervention is effective toward adherence to IFAS and a critical milestone to improve maternal health and reduce the neonate mortality due to NTDs and other advert effect of pregnancy and birth outcomes. This intervention is very short, simple, and cost effective and has potential for adaptation, feasible development to large-scale implementation in the existing health care system. Furthermore, this type of interventional approach has the potential to reduce the country's ANC program dropout rates and increase male partner’s participation on reproductive health.

Keywords: NTDs, IFAS, WRA, Ethiopia

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4643 Prevalence and Determinants of Depression among Orphans and Vulnerable Children in Child Care Homes in Nepal

Authors: Kumari Bandana Bhatt, Navin Bhatt

Abstract:

Background: Orphans and vulnerable children (OVC) are high risk of physical, mental, sexual and emotional abuse and face social stigma and discrimination which significantly increase the risk of mental and behavioral disorders such as anxiety, depression or emotional problems even they stay in well run child care homes. The objective of this study was to estimate the prevalence of depression and determine the determinants among OVC in child care homes in Nepal. Methods: An institutional-based analytical cross-sectional study was conducted in twenty orphanages of five districts of Nepal. Six hundred two children were recruited into the study. After the informed consent form obtaining, the guardian and assent were interviewed by a semi-structured questionnaire and Beck Depression Inventory-II (BDI-II). Logistic regression was used for detecting the association between variables at the significant level of =0.05. Results: The study revealed that 33.20% of OVC had depression. Among them 66.80% of children experienced minimal depression, 17.40% had mild depression, 11.30% had moderate depression 4.50% had severe depression. Sex, alcohol drinking, congenital problem, social support and bully were the main variables associated with depression among OVC of the child care homes in Nepal. Conclusion: Prevalence of depression was high among the orphans and vulnerable children living in child care homes especially among the female children in Nepal. Therefore, early identification and instituting of preventive measures of depression are essential to reduce this problem in this special group of children living in child care homes.

Keywords: Mental health, Depression, Orphans and vulnerable children, child care homes

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