Search results for: central venous access

Authors: M. C. Arcuri, L. Gai, F. Ielasi

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Italian Central Guarantee Fund (CGF) has the purpose to facilitate Small and Medium-sized Enterprises (SMEs)’ access to credit. The aim of the paper is to study the evaluation method adopted by the CGF with regard to SMEs requiring its intervention. This is even more important in the light of the recent CGF reform. We analyse an initial sample of more than 500.000 guarantees from 2012 to 2018. We distinguish between a counter-guarantee delivered to a mutual guarantee institution and a guarantee directly delivered to a bank. We investigate the impact of variables related to the operations and the SMEs on Altman Z’’-score and the score consistent with CGF methodology. We verify that the type of intervention affects the scores and the initial condition changes with the new assessment criterions. 

Keywords: banks, default risk, Italian guarantee fund, mutual guarantee institutions

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Authors: Monica Puri Sikka, Subrato Ghosh Arunangshu Mukhopadhyay

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Appropriate compression bandaging is important for compression therapeutic medical diseases. The high compression approach employed for treating venous leg ulcers should be used correctly so that sufficient (but not excessive) pressure is applied. Bandages used to treat venous disease by compression should achieve and sustain effective levels and gradients of pressure and minimise the risk of pressure trauma. To maintain graduated compression on the limb the bandage needs to be applied at same tension for each layer from ankle to the knee. In this paper the geometry for various bandaging procedures is used to wrap each layer of bandage by marking the relaxed length of the bandage. The relaxed length is calculated depending on the stretch, average circumference of the limb on which it is to be applied and the bandaging technique to be used. This paper aims at developing a scientific approach while applying the bandage to reduce the inter operator variability in applying same tension on each successive layer of bandage.

Keywords: bandaging, compression, inter operator variability, graduated, relaxed length, stretch

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Authors: Alireza Assareh, Fatemeh Havas Beigi, Mohammad Vafaee Yeganeh

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The present study is conducted to investigate the relationship between organizational culture and the establishment of knowledge management in the Central Insurance of Iran. The research results revealed that there is a significant positive relationship between organizational culture and its elements that include management support, organizational belonging, individual innovation, and leadership style and the establishment of knowledge management in the central insurance of Iran and that there isn’t any significant relationship between conflict resolution and the establishment of knowledge management in the central insurance of Iran.

Keywords: organizational culture, knowledge management, central insurance of Iran, individual innovation

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Authors: Aaron Zhang, Alimire Kahaer, Gerald Weber, Nalin Arachchilage

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Access control is an essential safeguard for the security of enterprise data, which controls users’ access to information resources and ensures the confidentiality and integrity of information resources [1]. Research shows that the more common types of access control now have shortcomings [2]. In this direction, to improve the existing access control, we have studied the current technologies in the field of data security, deeply investigated the previous data access control policies and their problems, identified the existing deficiencies, and proposed a new extension structure of SPBAC. SPBAC extension proposed in this paper aims to combine Policy-Based Access Control (PBAC) with semantics to provide logically connected, real-time data access functionality by establishing associations between enterprise data through semantics. Our design combines policies with linked data through semantics to create a "Semantic link" so that access control is no longer per-database and determines that users in each role should be granted access based on the instance policy, and improves the SPBAC implementation by constructing policies and defined attributes through the XACML specification, which is designed to extend on the original XACML model. While providing relevant design solutions, this paper hopes to continue to study the feasibility and subsequent implementation of related work at a later stage.

Keywords: access control, semantic policy-based access control, semantic link, access control model, instance policy, XACML

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Authors: Barbara Zapala, Marek Dziechciowski, Olaf Chmura, Monika Piwowar, Katarzyna Gawlik, Dorota Pawlicka-Gosiewska, Krzysztof Skotniczny, Bogdan Solnica, Kazimierz Pitynski

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BACKGROUND: Endometrial cancer is one of the most common gynecologic malignancy in developed countries.We hypothesized that amount of circulating micro-particles in blood may be connected with the development of endometrial hyperplasia and endometrial cancer. The aim of this study was to measure the micro-particles amount in uterine venous blood and in peripheral venous blood in women with atypical endometrial hyperplasia and endometrioid endometrial cancer. MATERIALS AND METHODS: By using flow cytometry (BD Canto II cytometer) we measured micro-particles amount in citrate plasma samples from peripheral and uterine venous blood of women with atypical hyperplasia of endometrium or endometrial cancer. We determined the amount of total (TF+), endothelial (CD144+) and monocytic (CD14+) micro- particles. RESULTS: Here we show statistically significant higher micro-particle levels in women with atypical hyperplasia of endometrium or endometrial cancer in comparison to healthy women. Performing measurements of the amounts of total, endothelial and monocytic microparticles allow for reliable differentiation between healthy, atypical hyperplasia and endometrial cancer groups. In blood samples from uterine veins the circulating micro-particle levels were significantly different from peripheral blood samples. The micro-particle levels in uterine blood samples were 7-fold higher than in those from peripheral blood of women with both atypical hyperplasia of endometrium and endometrial cancer when compared to the control group of healthy women. CONCLUSION: These results strongly suggested that the level of circulating micro-particles may be a sign of endometrial cancer development, however the detailed study is needed focusing on molecular processes passed through this small circulating molecules.

Keywords: endometrial cancer, endometrial hyperplasia, microvesicles, uterine blood

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Authors: Abu S. M. G. Kibria, Alison M. Behie, Robert Costanza, Colin Groves, Tracy Farrell

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This study is aimed to understand the level of access and the influence of livelihood capitals in maintaining access and control of ecosystem services (ESS) in the Sundarbans, Bangladesh. Besides the villagers, we consider other stakeholders including the forest department, coast guard, police, merchants, pirates and villagers who ‘controlled’ or ‘maintained’ access to ESS (crab catching, shrimp fry, honey, shrimp, mixed fish, fuel wood) in this region. Villagers used human, physical, natural and social capitals to gain access to ESS. The highest level of access was observed in crab catching and the lowest was found in honey collection, both of which were done when balancing the costs and benefits of accessing one ESS against another. The outcomes of these ongoing access negotiations were determined by livelihood capitals of the households. In addition, it was often found that the certain variables could have a positive effect on one ESS and a negative effect on another. For instance, human, social and natural capitals (eldest daughter’s education and No. of livelihood group membership and) had significant positive effects on honey collection while two components of human and social capitals including ‘eldest son’s education’ and ‘severity of pirate problem’ had exactly the opposite impact. These complex interactions were also observed in access to other ESS. It thus seems that access to ESS is not anything which is provided, but rather it is achieved by using livelihood capitals. Protecting any ecosystem from over exploitation and improve wellbeing can be achieved by properly balancing the livelihood capital-access nexus.

Keywords: provisioning services, access level, livelihood capital, interaction, access gain

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Authors: Mariam Shalaby, Kayla Krause, Raisha Ismail, Daniel George

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Introduction: The Pennsylvania State College of Medicine Refugee Initiative is a student-run organization that works with eleven Syrian and Congolese refugee families. Since 2016, it has used grant funding to make weekly produce purchases at a local market, provide tutoring services, and develop trusting relationships. This case study explains how the Refugee Initiative shifted focus to face new challenges due to the COVID-19 pandemic in 2020. Methodology: When refugees who had previously attained stability found themselves unable to pay the bills, the organization shifted focus from food security to direct assistance such as applying for unemployment compensation since many had recently lost jobs. When refugee families additionally struggled to access hygiene supplies, funding was redirected to purchase them. Funds were also raised from the community to provide financial relief from unpaid rent and bills. Findings: Systemic challenges were encountered in navigating federal/state unemployment and social welfare systems, and there was a conspicuous absence of affordable, language-accessible assistance that could help refugees. Finally, as struggling public schools failed to maintain adequate English as a Second Language (ESL) education, the group’s tutoring services were hindered by social distancing and inconsistent access to distance-learning platforms. Conclusion: Ultimately, the pandemic highlighted that a charity-based arrangement is helpful but not sustainable, and challenges persist for refugee families. Based on the Refugee Initiative's experiences over the past year of the COVID-19 pandemic, several needs must be addressed to aid refugee families at this time, including: increased access to affordable and language-accessible social services, educational resources, and simpler options for grant-based financial assistance. Interventions to increase these resources will aid refugee families in need in Central Pennsylvania and internationally

Keywords: COVID-19, health, pandemic, refugees

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Authors: Joshua Abraham, Craig Wales

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Abstract—SIGN Guideline 122 recommends that all patients who are admitted to hospital are assessed for venous thromboembolism risk within 24 hours of admission. NHS Greater Glasgow and Clyde provide guidance on this in the form of a proforma. Patients are then subsequently prescribed either thrombo-embolic-deterrent stockings (TEDS)/low molecular weight heparin (LMWH) for the prevention of VTE based on their score. A retrospective casenote audit of a random sample of fifty oncology and trauma inpatients at the QEUH in December 2019 was performed. 90% of patients had a risk assessment conducted as evidenced by a completed proforma. In 78% of these patients, the proforma fully completed. Overall 94% of patients had some for of thromboprophylaxis prescribed in the form of TEDS or LMWH. A lack of 100% compliance against the given standards highlighted potential implications for patient safety, but also medico-legal ramifications for staff. Clinical judgement can only be relied upon if there is written documentation as evidence. Further staff education and the suggestion of a written prompt to the clerk-in documentation will hopefully improve compliance, whilst a repeat audit should demonstrate any improvement.

Keywords: Maxillofacial , Thromboembolism, Thromboprophylaxis , Prescription

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Authors: P. Ghann, J. Shiguang, C. Zhou

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Access control is one of the most challenging issues facing information security. Access control is defined as, the ability to permit or deny access to a particular computational resource or digital information by an unauthorized user or subject. The concept of usage control (UCON) has been introduced as a unified approach to capture a number of extensions for access control models and systems. In UCON, an access decision is determined by three factors: Authorizations, obligations and conditions. Attribute mutability and decision continuity are two distinct characteristics introduced by UCON for the first time. An observation of UCON components indicates that, the components are predefined and static. In this paper, we propose a new and flexible model of usage control for the creation and elimination of some of these components; for example new objects, subjects, attributes and integrate these with the original UCON model. We also propose a model for concurrent usage scenarios in UCON.

Keywords: access control, concurrency, digital container, usage control

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Authors: Kamonwat Suksumek, Seeronk Prichanont

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Access block refers to the situation where Emergency Department (ED) patients requiring hospital admission spend an unreasonable holding time in an ED because their access to a ward is blocked by the full utilization of the ward’s beds. Not only it delays the proper treatments required by the patients, but access block is also the cause of ED’s overcrowding. Clearly, access block is an inter-departmental problem that needs to be brought to management’s attention. This paper focuses on the analysis of strategies to address the access block problem, both in the operational and intermediate levels. These strategies were analyzed through a simulation model with a real data set from a university hospital in Thailand. The paper suggests suitable variable levels for each strategy so that the management will make the final decisions.

Keywords: access block, emergency department, health system analysis, simulation

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Authors: Amir Reza Asnafi, Ehsan Tajabadi, Mohsen Hajizeinolabedini

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The purpose of this study is to identify the concept of knowledge flow in central libraries of Tehran universities in by the pattern of American Productivity & Quality Center (APQC). The present study is an applied and descriptive survey in terms of its purpose and the methodology used. In this study, APQC framework was used for data collection. The study population is managers and supervisors of central libraries’ departments of public universities of Tehran belonging to the Ministry of Science, Research and Technology. These libraries include: Central Libraries of Al-Zahra University, Amir Kabir, Tarbiat Modarres, Tehran, Khajeh Nasir Toosi University of Technology, Shahed, Sharif, Shahid Beheshti, Allameh Tabataba'i University, Iran University of Science and Technology. Due to the limited number of members of the community, sampling was not performed and the census was conducted instead. The study of knowledge flow in central libraries of public universities in Tehran showed that in seven dimensions of knowledge flow of APQC, these libraries are far from desirable level and to achieve the ideal point, many activities in the field of knowledge flow need to be made, therefore suggestions were made in this study to reach the desired level. One Sample t Test in this research showed that these libraries are at a poor level in terms of these factors: in the dimensions of creation, identification and use of knowledge at a medium level and in the aspects of knowledge acquisition, review, sharing and access and also Manova test or Multivariable Analyze of Variance proved that there was no significant difference between the dimensions of knowledge flow between these libraries and the status of the knowledge flow in these libraries is at the same level as well. Except for the knowledge creation aspect that is slightly different in this regard that was mentioned before.

Keywords: knowledge flow, knowledge management, APQC, Tehran’s academic university libraries

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Authors: Olga Andrianova, Lazar Jeifets

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The security issue has always been one of the most sensitive and significant in Latin American context, especially focused on Central American region. Despite the fact that the time of the civil wars has ended, violence, delinquency, insecurity, discrimination still exist and keep relevance in the 21st century. This article is dedicated to consider this kind of problems, to find out the main causes and to propose solution approaches.

Keywords: Central America, insecurity, instability, post-war countries, violence

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Authors: Olga Andrianova, Lazar Jeifets

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The security issue has always been one of the most sensitive and significant in Latin American context, especially focused on Central American region. Despite the fact that the time of the civil wars has ended, violence, delinquency, insecurity, discrimination still exist and keep relevance in the 21st century. This article is dedicated to consider this kind of problems, to find out the main causes and to propose solution approaches.

Keywords: Central America, insecurity, instability, violence

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Authors: O’Day Luke

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Purpose: To validate virtual non-contrast reconstructions generated from dual-layer spectral computed tomography (DL-CT) data as an alternative for the acquisition of a dedicated true non-contrast dataset during multiphase contrast studies. Material and methods: Thirty-three patients underwent a routine multiphase clinical CT examination, using Dual-Layer Spectral CT, from March to August 2021. True non-contrast (TNC) and virtual non-contrast (VNC) datasets, generated from both portal venous and arterial phase imaging were evaluated. For every patient in both true and virtual non-contrast datasets, a region-of-interest (ROI) was defined in aorta, liver, fluid (i.e. gallbladder, urinary bladder), kidney, muscle, fat and spongious bone, resulting in 693 ROIs. Differences in attenuation for VNC and TNV images were compared, both separately and combined. Consistency between VNC reconstructions obtained from the arterial and portal venous phase was evaluated. Results: Comparison of CT density (HU) on the VNC and TNC images showed a high correlation. The mean difference between TNC and VNC images (excluding bone results) was 5.5 ± 9.1 HU and > 90% of all comparisons showed a difference of less than 15 HU. For all tissues but spongious bone, the mean absolute difference between TNC and VNC images was below 10 HU. VNC images derived from the arterial and the portal venous phase showed a good correlation in most tissue types. The aortic attenuation was somewhat dependent however on which dataset was used for reconstruction. Bone evaluation with VNC datasets continues to be a problem, as spectral CT algorithms are currently poor in differentiating bone and iodine. Conclusion: Given the increasing availability of DL-CT and proven accuracy of virtual non-contrast processing, VNC is a promising tool for generating additional data during routine contrast-enhanced studies. This study shows the utility of virtual non-contrast scans as an alternative for true non-contrast studies during multiphase CT, with potential for dose reduction, without loss of diagnostic information.

Keywords: dual-layer spectral computed tomography, virtual non-contrast, true non-contrast, clinical comparison

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Authors: Bachir Chemani, Rachid Halfaoui

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The aim of study was to evaluate pressure distribution characteristics of the elastic textile bandages using two instrumental techniques: a prototype Instrument and a load Transference. The prototype instrument which simulates shape of real leg has pressure sensors which measure bandage pressure. Using this instrument, the results show that elastic textile bandages presents different pressure distribution characteristics and none produces a uniform distribution around lower limb. The load transference test procedure is used to determine whether a relationship exists between elastic textile bandage structure and pressure distribution characteristics. The test procedure assesses degree of load, directly transferred through a textile when loads series are applied to bandaging surface. A range of weave fabrics was produced using needle weaving machine and a sewing technique. A textile bandage was developed with optimal characteristics far superior pressure distribution than other bandages. From results, we find that theoretical pressure is not consistent exactly with practical pressure. It is important in this study to make a practical application for specialized nurses in order to verify the results and draw useful conclusions for predicting the use of this type of elastic band.

Keywords: textile, cotton, pressure, venous ulcers, elastic

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Authors: Raffaele A. Calogero

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RNAseq represents an attractive methodology for the detection of functional genomic variants. RNAseq results obtained from polyA+ RNA selection protocol (POLYA) and from exonic regions capturing protocol (ACCESS) indicate that ACCESS detects 10% more coding SNV/INDELs with respect to POLYA. ACCESS requires less reads for coding SNV detection with respect to POLYA. However, if the analysis aims at identifying SNV/INDELs also in the 5’ and 3’ UTRs, POLYA is definitively the preferred method. No particular advantage comes from ACCESS or POLYA in the detection of fusion transcripts.

Keywords: fusion transcripts, INDEL, RNA-seq, WES, SNV

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Authors: Xiaoying Guo, Xiangyun Wang

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Access rates is a key indicator of reflecting the popularity of web pages. Having high access rates are very important for web pages, especially for news web pages, online shopping sites and searching engines. In this paper, we analyzed the influences of visual fluency and cognitive fluency on access rates of Chinese web pages. Firstly, we conducted an experiment of scoring the web pages. Twenty-five subjects were invited to view top 50 web pages of China, and they were asked to give a score in a 5-point Likert-scale from four aspects, including complexity, comfortability, familiarity and usability. Secondly, the obtained results was analyzed by correlation analysis and factor analysis in R. By factor analysis; we analyzed the contributions of visual fluency and cognitive fluency to the access rates. The results showed that both visual fluency and cognitive fluency affect the access rate of web pages. Compared to cognitive fluency, visual fluency play a more important role in user’s accessing of web pages.

Keywords: visual fluency, cognitive fluency, visual complexity, usability

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Authors: Ritika Jain, Rajnish Kumar

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The Department of Public Enterprises had made submissions of Self Evaluation Reports, for the purpose of corporate governance, mandatory for all central government owned enterprises. Despite this, an alarming 40% of the enterprises did not do so. This study examines the impact of external policy tools and internal firm-specific factors on corporate governance of central public sector enterprises (CPSEs). We use a dataset of all manufacturing and non-financial services owned by the central government of India for the year 2010-11. Using probit, ordered logit and Heckman’s sample selection models, the study finds that the probability and quality of corporate governance is positively influenced by the CPSE getting into a Memorandum of Understanding (MoU) with the central government of India, and hence, enjoying more autonomy in terms of day to day operations. Besides these, internal factors, including bigger size and lower debt size contribute significantly to better corporate governance.

Keywords: corporate governance, central public sector enterprises (CPSEs), sample selection, Memorandum of Understanding (MoU), ordered logit, disinvestment

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Authors: Rupan Preet Kaur

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This article reviewed the potential of artificial intelligence in the field of identity and access management (IAM) and identity governance and administration (IGA), the most critical pillars of any organization. The power of leveraging AI in the most complex and huge user base environment was outlined by simplifying and streamlining the user access approvals and re-certifications without any impact on the user productivity and at the same time strengthening the overall compliance of IAM landscape. Certain challenges encountered in the current state were detailed where majority of organizations are still lacking maturity in the data integrity aspect. Finally, this paper concluded that within the realm of possibility, users and application owners can reap the benefits of unified approach provided by AI to improve the user experience, improve overall efficiency, and strengthen the risk posture.

Keywords: artificial intelligence, machine learning, user access review, access approval

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Authors: Sansanee Sansiribhan, Orrawan Rewthong, Anusorn Rattanathanaophat, Sarun Saensiriphan

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The objective of this work was to study potential of rice straw for power plant in the central region of Thailand. Provincial power plant capacity was studied. The results showed that provinces central region had potential for small power plants with a capacity of over 10 MW in 13 provinces, 1-10 MW in 6 provinces and less than 1 MW in 3 provinces.

Keywords: rice straw, power plant, central region, Thailand

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Authors: Elsayed Fath Khalifa, Samer Mohamed Daghash

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The aim of the current work study to increase the anatomical knowledge about the cattle egret which considered economically important for farmers. The study was carried out on ten adult, apparently healthy cattle egrets of both sexes. Each bird was exsanguinated; the caudal vena cava was cannulated and flushed with warm normal saline solution (0.9%) then injected with blue colored neoprine (60%) latex in order to study the tributaries of the hepatic portal vein. The origin, course and tributaries of the right and left hepatic portal veins were studied. The hepatic portal venous system collected venous blood from the abdominal viscera including; glandular and muscular stomachs, liver, pancreas, spleen, small intestine and large intestine. The hepatic portal vein was formed by the left and the right hepatic portal veins. The smaller left one drained blood from the glandular and muscular stomachs through the ventral and the left proventriculus as well as the left gastric veins. The most tributaries of the right hepatic portal vein drained blood from the rest of the gastrointestinal tract and the spleen by the proventriculosplenic, the gastropancreaticoduodenal and the common mesenteric veins.

Keywords: cattle egret, common mesenteric vein, hepatic portal vein, anatomy

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Authors: Ntaganda J.M., Maniraguha J.D., Mukeshimana S., Harelimana D, Bizimungu T., Ruataganda E.

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This paper presents the design of Graphic User Interface (GUI) in Matlab as interaction tool between human and machine. The designed GUI can be used by medical doctors and other experts particularly the physiologists. Matlab packages and estimated parameters of the mathematical model of cardiovascular-respiratory system developed in Rwandan context are used in GUI. The ordinary differential equations (ODE’s) govern a mathematical model in designing GUI in Matlab and a window that sets model estimated parameters and the measured parameters by any user. For healthy subject, these measured parameters include heart rate, systolic blood and diastolic blood pressure, partial pressure of oxygen in arterial blood, partial pressure of carbon dioxide in arterial blood, concentration of bound and dissolved oxygen in the mixed venous blood entering the lungs, and concentration of bound and dissolved carbon dioxide in the mixed venous blood entering the lungs. The results of numerical test give a consistent appearance as empirically known results.

Keywords: Graphic User Interface, mathematical model, cardiovascur-respiratory system, walking physical activity, blood pressure, oxygen

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Authors: Devika Tanna

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'Biometrics' means 'life measurement' but the term is usually associated with the use of unique physiological characteristics to identify an individual. It is important to secure the privacy of digital face image that is stored in central database. To impart privacy to such biometric face images, first, the digital face image is split into two host face images such that, each of it gives no idea of existence of the original face image and, then each cover image is stored in two different databases geographically apart. When both the cover images are simultaneously available then only we can access that original image. This can be achieved by using the XM2VTS and IMM face database, an adaptive algorithm for spatial greyscale. The algorithm helps to select the appropriate host images which are most likely to be compatible with the secret image stored in the central database based on its geometry and appearance. The encryption is done using GEVCS which results in a reconstructed image identical to the original private image.

Keywords: adaptive algorithm, database, host images, privacy, visual cryptography

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Authors: Ben Cheikh Asma, Bouafia Nabiha, Ammar Asma, Ezzi Olfa, Meddeb Khaoula, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Hospital Acquired Infection (HAI) constitutes an important worldwide health problem. It was associated with high mortality rate in intensive care units (ICU). This study aimed to determine HAI mortality rate in Tunisian intensive care units and identify its risk factors. Methods: We conducted a prospective observational cohort study over a 12 months period (September 15th 2015 to September 15 th 2016) in the adult medical ICU of University Hospital-Farhat Hached (Sousse-Tunisia). All patients admitted in the ICU for more than 48 hours were included in the study. We used an anonymous standardized survey record form to collect data by a medical hygienist assisted by an intensivist. We adopted definitions of Center for Diseases Control and prevention of Atlanta to detect HAI, Kaplan Meier survival analysis and Cox proportional hazard regression to identify independent risk factor of HAI mortality. Results: Of 171 patients, 67 developed ICU-acquired infection (global incidence rate=39.2%). The mean age of patients was 59 ± 21.2 years and 60.8% were male. The most frequently identified infections were pulmonary acquired infection (ventilator associated pneumonia (VAP) and infected atelectasis with density rates 21.4 VAP/1000 days of mechanical ventilation and 9.4 infected atelectasis /1000 days of mechanical ventilation; respectively) and central venous catheter associated infection (CVC - AI) with density rate 28.4 CVC-AI / 1000 CVC-days). HAI mortality rate was 66.7% (n=44). The median survival was 20 days 3.36, 95% Confidential Interval [13.39 – 26.60]. Specific mortality rates according to infectious site were 65.5%, 36.4% and 4.5% respectively for VAP, CVC associated infection and infected atelectasis. In univariate analysis, a significant associations between mortality and cardiovascular history (p=0.04) tracheotomy (p=0.00), peripheral venous catheterization (p=0.04), VAP (p=0.04) and infected atelectasis (p=0.04) were detected. Independent risk factors for HAI mortality were VAP with Hazard Ratio = 3.14, 95% Confidential Interval [1.63 – 6.05] (p=0.001) and tracheotomy (Hazard Ratio=0.22, 95% Confidential Interval [0.10 – 0.44], p=0.000). Conclusions: In the present study, hospital acquired infection mortality rate was relatively high. We need to intensify the fight against these infections especially ventilator-associated pneumonia that is associated with higher risk of mortality in many studies. Thus, more effective infection control interventions were necessary in our hospital.

Keywords: hospital acquired infection, intensive care unit, mortality, risk factors

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Authors: Narges Ebadi, Davod Ahmadi, Hiliary Monteith, Hugo Melgar-Quinonez

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Migration cannot necessarily relieve pressure on water resources in origin communities, and male out-migration can increase the water management burden of women. However, inflows of financial remittances seem to offer possibilities of investing in improving drinking-water access. Therefore, remittances may be an important pathway for migrants to support water security. This paper explores the association between water access and the receipt of remittances in households in sub-Saharan Africa. Data from round 6 of the 'Afrobarometer' surveys in 2016 were used (n= 49,137). Descriptive, bivariate and multivariate statistical analyses were carried out in this study. Regardless of country, findings from descriptive analyses showed that approximately 80% of the respondents never received remittance, and 52% had enough clean water. Only one-fifth of the respondents had piped water supply inside the house (19.9%), and approximately 25% had access to a toilet inside the house. Bivariate analyses revealed that even though receiving remittances was significantly associated with water supply, the strength of association was very weak. However, other factors such as the area of residence (rural vs. urban), cash income frequencies, electricity access, and asset ownership were strongly associated with water access. Results from unadjusted multinomial logistic regression revealed that the probability of having no access to piped water increased among remittance recipients who received financial support at least once a month (OR=1.324) (p < 0.001). In contrast, those not receiving remittances were more likely to regularly have a water access concern (OR=1.294) (p < 0.001), and not have access to a latrine (OR=1.665) (p < 0.001). In conclusion, receiving remittances is significantly related to water access as the strength of odds ratios for socio-demographic factors was stronger.

Keywords: remittances, water access, SSA, migration

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Authors: Maharjan Shree Kumar

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Climate change impacts are observed in all livelihood sectors primarily in agriculture and forestry. Multiple factors have influenced the climate vulnerabilities and adaptations in agricultural at the household level. This study focused on the factors affecting adaptation in agriculture in Madi and Deukhuri valleys of Central and Western Nepal. The systematic random sampling technique was applied to select 154 households in Madi and 150 households in Deukhuri. The main purpose of the study was to analyze the socio-economic factors that either influence or restrain the farmers’ adaptation to climate change at the household level by applying the linear probability model. Based on the analysis, it is revealed that crop diversity, education, training and total land holding (acre) were positively significant for adaptation choices the study sites. Rest of the variables were not significant though indicated positive as expected except age, occupation, ethnicity, family size, and access to credit.

Keywords: adaptation, agriculture, climate, factors, Nepal

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Authors: Jesus Argueta

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This study aims to explore the Business Demography Phenomena along the Central American context, through the examination of its theoretical background, and the revision of Central American corporations success stories, that will eventually guide this research towards the business Demography Key Performance Indicators, across the Central American Business Ambiance. Considering that this analysis will support the development of a Small and Medium Business Observatory over the Honduran commercial landscapes, as platform for the reinforcement of this global topic.

Keywords: business demography, economic dynamism, small, medium and large enterprises, corporate demography

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Authors: Michal Stelmach

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The aim of this paper is a critical analysis of the security policy in the field of the fight against transnational criminal groups in Central America in XXI century. We are analyzing all taken issues from several perspectives: political, anthropological, sociological and legal which allows me to confront behavior and the attitudes of the political elites against official legislative changes and declared actions, strategies and policies against practice. In the first part of paper we would like to present the genesis and characteristic of transnational gangs, called maras and next we would like to present their activities and roles within chosen sectors of organized crimes. In the second part we will analyze the government’s policy towards transnational criminal groups. The analysis will be concentrated on public safety policy implemented in specific Central American countries as well as regional international cooperation. The main intention of the author is to present the state of the security in Central America in XXI century by emphasizing failures and successes in the fight against transnational criminal organizations. Additionally we want to present and define the challenges currently facing the region now and to show the prediction of the situation’s development within next future and to define the recommendations on the design of public security policies in Central American countries.

Keywords: maras, public security, human rights, Central America

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Authors: Eni I. Eni, James Okon, Ashang J. Ashang

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The pre-degree programme of the University of Calabar was introduced to help increase access to tertiary Education in science related courses. This has become necessary due to population increase and public awareness. Its main objective was to provide access to candidates from educationally less developed states (ELDS) and states within its catchment area. To find out if this objective of the programme has been achieved, an impact evaluation of the programme was conducted, from where the aspect of providing access to University Education was reported here. It was reasoned that if this objective of the programme was properly implemented, there should be an evidence of increase in the access to University Education. To achieve the purpose of this study, two research questions were formulated; expost-facto research design and purposive sampling technique were adopted for the study. Data was collected from the Faculty of Science and analyzed using descriptive statistics in terms of frequencies and percentages. The result of data analysis showed that the pre-degree programme of the University of Calabar has provided educational access to Nigerians especially those from educationally less developed states in science related courses. It was therefore recommended that the programme be sustained and further be improved upon to facilitate its continued provision of access to University Education in Nigeria.

Keywords: higher education, pre-degree programme, University of Calabar, educationally less developed states

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Authors: Abdessamad Dali-Ali, Houaria Beldjillali, Fouzia Agag, Asmaa Oukebdane, Ramzi Tidjani, Arslane Bettayeb, Khadidja Meddeber, Radia Dali-Yahia, Nori Midoun

Abstract:

Healthcare-associated infections are a real public health problem, especially in intensive care units. The aim of our study was to describe the epidemiological profile and to estimate the incidence of these infections at the intensive care unit of our teaching hospital. A prospective study was conducted, from June 2012 to December 2013. During this period, 305 patients having a duration of hospitalization equal or more than 48 hours were included in the study. In terms of the incidence of healthcare associated infections, nosocomial pneumonia occupied the first position with a cumulative incidence rate of 20.0%, followed by bacteremia (5.6%), central venous catheter infections (4%), and urinary tract infections (3%). In the case of isolated microorganisms, Gram-negative bacilli not enterobacteriaceae occupied the first place with 48.5%, followed by enterobacteria (32.1%). Acinetobacter baumannii was the most common germ (27.6%). Our study showed that the rate of health-care-associated infections was relatively high in the intensive care unit. A control program to reduce all infections is a priority for the Infection Control Associated Committee.

Keywords: epidemiological profile, healthcare associated infections, intensive care units, teaching hospital of Oran, Algeria

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