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  • ISSN: 2378-9328
    Semiparametric Spatial Autoregressive Model: A Two-Step Bayesian Approach
    Authors: Jiaqing Chen, Renfu Wang and Yangxin Huang
    Abstract: Spatial data arise frequently in econometric studies and it is a common practice to analyze such data with spatial autoregressive (SAR) models. This paper proposes a two-step Bayesian approach for inference in the semiparametric spatial autoregressive (SPSAR) model, including the cases for mixed data.
    Role of the Neighbourhood Deprivation in the Adverse Effect of Air Pollution on Congenital Abnormalities
    Authors: Maxime Jeanjean, Kihal Wahida, Cindy Padilla, Esther Kai-Chieh Chen and Severine Deguen
    Abstract: Congenital abnormalities (CAs) remain a major cause of stillbirth and neonatal mortality. The literature has shown that congenital malformations are suggested to have multifactorial determinants, including environmental exposures and socioeconomic patterns.
    Latest Articles
    Research Article
    Motasem Said Salah* and Gehad El Gaeedy
    Background: The complexities of the critical ill patients in the Intensive care unit (ICU) require huge resources with high level of care. Assess the trends of outcome of an ICU on a regular basis, we not only analyses the profile of patients getting admitted to a particular ICU but also the quality of care given to them.
    Objectives: To provide information about the trend of admissions to the ICU and to compare mortality rate from different etiologies in Al Shifa Medical Complex (SMC) in Gaza Strip (GS).
    Methods: From January 2017 to December 2017, ICU records of all admissions, discharges, and deaths were utilized for the purpose of this study. Data extracted from the records included age, gender, diagnosis and outcome.
    Results: A total of 711 patients were admitted to ICU, males were 453 (63.7%) and females were 258 (36.3%). About 668 (93.9%) were survived and 43 (6.1%) were died. Most of the patients (57.9%) were between 19-65 years. The mortality rate in surgical hospital (58.1%), medical hospital (41.9%) and in obstetrics and gynecology hospital was zero.The majority of patients 144 (59.7%) were shifted from emergency of medical hospital to ICU. A sever traumatic brain injury accounted for 202 (47.0%) of all surgical admission to ICU. Falling down and road traffic accidents accounted 82 (40.6%) and 46 (22.8%) respectively from neurosurgical cases.
    Conclusions: Majority patients admitted to ICU were of surgical hospital and neurosurgical cases. The survival rate is higher than in the past years. The mortality rate in our ICU decreased from 8.6% towas6.1% and in obstetrics and gynecology hospital zero. Increase awareness of the community and enhanced commitment among policy makers to prevent falling down and road traffic injury.
    Mahmoud A. Himaid*
    Background: This study aimed to identify the relationship between severity of pain and socio-demographic characteristics such as gender, age, and work place among operating room nurses at governmental hospitals in Gaza governorates.
    Methods: The design of this study is a quantitative, descriptive, analytical, cross-sectional one. The sample consisted of 143 nurses. Constructed self-administered questionnaire was used to collect data. Different statistical procedures were used for data analysis. To ensure the reliability of the instrument, split half (0.812), and Cronbachs Alpha coefficient tests (0.763) were used. Results: The results revealed that 70.6% of the operating room nurses complaining of low back pain (68.2% males and 78.8 females). Also the result revealed that 35.0% of the participants complained of moderate pain and 19.6% complained of acute pain. Nearly half reported complaining of an intermittent pain, while 6.9% had a continuous pain. The highest complaint of pain severity was among age group 41-47 years (24.1%), about thirty-three (33.3%) of them were female nurses. There was significant difference between place of work regarding severity of pain in favor of Alemaraty hospital (P-value = 0.002). More over the study showed the need to modify work environment (providing adequate staffing, comfortable chairs, repairing floor, providing wheels to move equipments, mechanical devices for patient lifting and minimizing noise) in order to decrease low back pain.
    Conclusion: The study concluded that work related low back pain was high among operating room nurses and this reflects on productivity and quality of care among operating room nurses.
    Zeina Mikhael, Tarek Wehbe*, and Elizabeth Abou Jaoude
    Design: This is a cross-sectional, descriptive and correlation study that was conducted between June 1st and September 20th, 2014.
    Setting: Four Universities were chosen to collect this data. Eating behaviors were assessed by a questionnaire adapted to the Lebanese diet. A measure of weight, height, and waist circumference was conducted to determine the nutritional status of these students.
    Subjects: A sample of 400 students was selected randomly at the four universities.
    Results: Students living independently were significantly more likely to be obese compared to students living at their parental home (17.5 vs 3 %), more likely to smoke (52 vs 36%), more likely to skip breakfast (34 vs 22%), and to eat cake and sugar based foods (69 vs 28%). Furthermore, the students living at the parental home were more likely to exercise regularly (78 vs 58%), eat at regular meal times (51 vs 20%) and less likely to binge on food in response to stress.
    Conclusions: This study shows a correlation between obesity and eating behaviors with the place of residence during the university years. Students living at the parental home displayed healthier nutritional habits and less likelihood of obesity.
    Fufa Abunna*, Hable Worku, Fikru Gizaw, Fikru Ragassa, Dinka Ayana, Kebede Amenu, Reta Duguma, and Girma Gebresenbet
    Background: Unpasteurized raw milk consumption can contribute for the the risk of ingestion and transmission of food-borne pathogens and ingestion of potentially harmful toxins. Many microorganisms can get access to milk and products, among these E.coli is one of food born pathogen which is found in unpasteurized milk . Coliforms and E. coli are often used as marker organisms. The presence of E. coli in milk is consideredas a reliable indicator of fecal contamination and indicates a possible presence of enteropathogenic and/or toxigenic microorganisms which constitute a public health hazard.
    Objectives: To assess post-harvest handling practices of milk in dairy farms, milk vendors, milk collection centers and restaurant/kiosk and isolate and evaluate antimicrobial susceptibility profiles of Escherichia coli O157:H7 isolated from milk in and around Asella town, Ethiopia.
    Methods: A cross-sectional study was conducted from November 2016 to April 2017, a total of 112 samples (87 dairy farms, 16 restaurants/kiosks, 5 milk venders and 4 milk collectors) with a single visit were interviewed to collect the required information using a semi-structured questionnaire.
    Results: The result shows (66%) farmers in the study areas were kept their cattle under closed type barn. More than (48%) farmer did not wash their hands between milking and did not practice udder drying. (37.8%) farmers did not wash udder before milking. More than (75%) respondents venders, milk collectors and milk restaurant uses plastic containers for raw milk handling and storage. Of 112 samples tested only 38 (33.9%) were found to be positive for E. coli and from 38 samples which were positive for E. coli only 10 (8.9%) were found E. coli O157:H7 on latex agglutination test. No positive E. coli O157:H7 isolate was isolated from both milk collection center and restaurant. All E. coli O157:H7 isolates were checked for their susceptibility pattern by 10 selected antibiotics. The isolated strains were found to be 100% susceptible to chloramphenicol, norfloxacin, oxytetracycline, tetracycline, sulfamethoxazole, trimethoprim, streptomycin, and 30% susceptible to Erytromycin. However, 100% resistance to amoxicillin and vancomycin and 60% for cloxacillin and 40% for erythromycin. Intermediate susceptibility was observed in cloxacillin (40%). The indiscriminate use of antimicrobial agents might account, at least in part, for such a high resistance.
    Conclusion: In this study, unhygienic practices of milking and post-harvest handling along the dairy value chain possibly contributed to microbial contamination of milk. Detection of E. coli in milk is of public health importance due to its zoonotic potential. It is recommended that veterinary/extension services be provided to livestock farmers on proper animal husbandry and control of zoonotic animal diseases. Awareness creation to the dairy farmers and all stakeholders at different levels regarding to milk handling practices should be given so as to reduce the milk rejection rate because of spoiled milk and milk borne pathogens resulting from contamination of milk.
    Steven M. Baule, Heidi Monroe, and Kathy A. Baule
    The Council for Children with Behavioral Disorders (CCBD) proposed that the Positive Behavior Intervention Supports (PBIS) should be integrating into school mental health services to be the most impactful. PBIS provides a positive aspirational approach to student discipline instead of taking a more penal-based approach. This paper reviews the implementation of PBIS along with the embedding of mental health clinicians within the school setting in a midsized Midwest urban school district in Muncie, Indiana. The two pronged implementation had a significant impact on reducing inappropriate student behavior as measured by the school district. Additionally, the schools involved in the implementation saw a reduction in student suspensions which did lead to increased student achievement and better student attendance.
    Review Article
    German Malaga*, MariaSofia Cuba-Fuentes, Leonardo Rojas-Mezarina, Zoila Romero-Albino, Alexandra Hamb, and Valerie A. Paz Soldn
    Health literacy is associated with improved health outcomes. Primary care providers usually provide the majority of care to patients and are also usually the first point of contact for patients within a health system. Wediscuss four strategies to improve health literacy in the primary care setting: 1) Improve clinician communication skills, 2) Usee-Health tools, 3) Promote patient self-management, and 4) Develop supportive systems and caring environments. These strategies are then discussed within the context of low-middle income country realities, such as the case of Peru. There are unique challenges to improving health literacy in low and middle-income countries, but working towards this objective also provides opportunities to strengthen systems and empower patients, and conduct research to determine the impact of different approaches.
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