Measuring neighbourhood sustainability : a comparative analysis of residential types in Malaysia

The expansion of city-regions, the increase in the standard of living and changing lifestyles have collectively led to an increase in housing demand. New residential areas are encroaching onto the city fringes including suburban and green field areas. Large and small developers are actively building houses ranging from a few blocks to master-planned style projects. These residential developments, particularly in major urban areas, represent a large portion of urban land use in Malaysia, and, thus, have become a major contributor to overall urban sustainability. There are three main types that comprise the mainstream, and form integral parts to contemporary urban residential developments, namely, subdivision developments, piecemeal developments, and master-planned developments. Many new master-planned developments market themselves as environmentally friendly, and provide layouts that encompass sustainable design and development. To date, however, there have been limited studies conducted to examine such claims or to ascertain which of these three residential development layouts is more sustainable. To fill this gap, this research was undertaken to develop a framework for assessing the level of sustainability of residential developments, focusing on their layouts at the neighbourhood level. The development of this framework adopted a mixed method research strategy and embedded research design to achieve the study aim and objectives. Data were collected from two main sources, where quantitative data were gathered from a three-round Delphi survey and spatial data from a layout plan. Sample respondents for surveys were selected from among experts in the field of the built environment, both from Malaysia and internationally. As for spatial data, three case studies – master-planned, piecemeal and subdivision developments representing different types of neighbourhood developments in Malaysia have been selected. Prior to application on the case studies, the appropriate framework was subjected to validation to ascertain its robustness for application in Malaysia. Following the application of the framework on the three case studies the results revealed that master-planned development scored a better level of sustainability compared to piecemeal and subdivision developments. The results generated from this framework are expected to provide evidence to the policy makers and development agencies as well as provide an awareness of the level of sustainability and the necessary collective efforts required for developing sustainable neighbourhoods. Continuous assessment can facilitate a comparison of sustainability over time for neighbourhoods as a means to monitor changes in the level of sustainability. In addition, the framework is able to identify any particular indicator (issue) that causes a significant impact on sustainability.

Hepatitis B knowledge, testing, and vaccination among Chinese and Vietnamese adults in Australia

Hepatitis B is a significant public health challenge within some subpopulations in Australia, including Chinese and Vietnamese migrants. There has been limited research on hepatitis B knowledge and actions in these communities. The authors conducted a self-administered survey among 442 Chinese and 433 Vietnamese in Brisbane. Generally, the knowledge is best described as “moderate.” One in 2 could not identify the sexual transmission risk and less than one third knew that sharing foods or drinks did not spread the disease. The majority of Vietnamese (80%) and 60% of Chinese respondents indicated prior testing. Vaccination was reported in 60% of the Vietnamese and in 52% of the Chinese. Knowledge was better among Chinese people who had been tested and vaccinated compared with those who were nontested and nonvaccinated. Only 3.5% of the Chinese, but 11.6% of the Vietnamese, indicated having a positive test result hepatitis B virus. This study helps identify strategies for programs targeting both communities and practitioners.

The influence of family history of hypertension on disease prevalence and associated metabolic risk factors among Sri Lankan adults

Background Hypertension is a major contributor to the global non-communicable disease burden. Family history is an important non-modifiable risk factor for hypertension. The present study aims to describe the influence of family history (FH) on hypertension prevalence and associated metabolic risk factors in a large cohort of South Asian adults, from a nationally representative sample from Sri Lanka. Methods A cross-sectional survey among 5,000 Sri Lankan adults, evaluating FH at the levels of parents, grandparents, siblings and children. A binary logistic regression analysis was performed in all patients with ‘presence of hypertension’ as dichotomous dependent variable and using family history in parents, grandparents, siblings and children as binary independent variables. The adjusted odds ratio controlling for confounders (age, gender, body mass index, diabetes, hyperlipidemia and physical activity) are presented below. Results In all adults the prevalence of hypertension was significantly higher in patients with a FH (29.3 %, n = 572/1951) than those without (24.4 %, n = 616/2530) (p < 0.001). Presence of a FH significantly increased the risk of hypertension (OR:1.29; 95 % CI:1.13-1.47), obesity (OR:1.36; 95 % CI: 1.27–1.45), central obesity (OR:1.30; 95 % CI 1.22–1.40) and metabolic syndrome (OR:1.19; 95 % CI: 1.08–1.30). In all adults presence of family history in parents (OR:1.28; 95 % CI: 1.12–1.48), grandparents (OR:1.34; 95 % CI: 1.20–1.50) and siblings (OR:1.27; 95 % CI: 1.21–1.33) all were associated with significantly increased risk of developing hypertension. Conclusions Our results show that the prevalence of hypertension was significantly higher in those with a FH of hypertension. FH of hypertension was also associated with the prevalence of obesity, central obesity and metabolic syndrome. Individuals with a FH of hypertension form an easily identifiable group who may benefit from targeted interventions.

ISPCAN child abuse screening tool children's version (ICAST-C): Instrument development and multi-national pilot testing

Objective To develop a child victimization survey among a diverse group of child protection experts and examine the performance of the instrument through a set of international pilot studies. Methods The initial draft of the instrument was developed after input from scientists and practitioners representing 40 countries. Volunteers from the larger group of scientists participating in the Delphi review of the ICAST P and R reviewed the ICAST C by email in 2 rounds resulting in a final instrument. The ICAST C was then translated and back translated into six languages and field tested in four countries using a convenience sample of 571 children 12–17 years of age selected from schools and classrooms to which the investigators had easy access. Results The final ICAST C Home has 38 items and the ICAST C Institution has 44 items. These items serve as screeners and positive endorsements are followed by queries for frequency and perpetrator. Half of respondents were boys (49%). Endorsement for various forms of victimization ranged from 0 to 51%. Many children report violence exposure (51%), physical victimization (55%), psychological victimization (66%), sexual victimization (18%), and neglect in their homes (37%) in the last year. High rates of physical victimization (57%), psychological victimization (59%), and sexual victimization (22%) were also reported in schools in the last year. Internal consistency was moderate to high (alpha between .685 and .855) and missing data low (less than 1.5% for all but one item). Conclusions In pilot testing, the ICAST C identifies high rates of child victimization in all domains. Rates of missing data are low, and internal consistency is moderate to high. Pilot testing demonstrated the feasibility of using child self-report as one strategy to assess child victimization. Practice implications The ICAST C is a multi-national, multi-lingual, consensus-based survey instrument. It is available in six languages for international research to estimate child victimization. Assessing the prevalence of child victimization is critical in understanding the scope of the problem, setting national and local priorities, and garnering support for program and policy development aimed at child protection.

Political Risk in Credit Evaluation: Empirical Studies and Survey Results

Financing trade between economic agents located in different countries is affected by many types of risks, resulting from incomplete information about the debtor, the problems of enforcing international contracts, or the prevalence of political and financial crises. Trade is important for economic development and the availability of trade finance is essential, especially for developing countries. Relatively few studies treat the topic of political risk, particularly in the context of international lending. This thesis explores new ground to identify links between political risk and international debt defaults. The core hypothesis of the study is that the default probability of debt increases with increasing political risk in the country of the borrower. The thesis consists of three essays that support the hypothesis from different angles of the credit evaluation process. The first essay takes the point of view of an international lender assessing the credit risk of a public borrower. The second investigates creditworthiness assessment of companies. The obtained results are substantiated in the third essay that deals with an extensive political risk survey among finance professionals in developing countries. The financial instruments of core interest are export credit guaranteed debt initiated between the Export Credit Agency of Finland and buyers in 145 countries between 1975 and 2006. Default events of the foreign credit counterparts are conditioned on country-specific macroeconomic variables, corporate-specific accounting information as well as political risk indicators from various international sources. Essay 1 examines debt issued to government controlled institutions and conditions public default events on traditional macroeconomic fundamentals, in addition to selected political and institutional risk factors. Confirming previous research, the study finds country indebtedness and the GDP growth rate to be significant indicators of public default. Further, it is shown that public defaults respond to various political risk factors. However, the impact of the risk varies between countries at different stages of economic development. Essay 2 proceeds by investigating political risk factors as conveivable drivers of corporate default and uses traditional accounting variables together with new political risk indicators in the credit evaluation of private debtors. The study finds links between corporate default and leverage, as well as between corporate default and the general investment climate and measeures of conflict in the debtor country. Essay 3 concludes the thesis by offering survey evidence on the impact of political risk on debt default, as perceived and experienced by 103 finance professionals in 38 developing countries. Taken together, the results of the thesis suggest that various forms of political risk are associated with international debt defaults and continue to pose great concerns for both international creditors and borrowers in developing countries. The study provides new insights on the importance of variable selection in country risk analysis, and shows how political risk is actually perceived and experienced in the riskier, often lower income countries of the global economy.

Economic Valuation of Coastal Wetlands: A Study of Cochin Back waters in Kerala

The major objective of this chapter was to estimate the indirect benefits provided by the Cochin wetlands to direct, indirect and non-user populations.This chapter gives the details of the Contingent valuation survey that was executed in the study area. Section one described the actual survey and its execution. Section two undertook a detailed discussion of the methodological issues involved in the survey. Section three contained some discussion on the study.This analysis has demonstrated the feasibility of extending the use of contingent valuation methods to local populations in developing countries like India. Certain issues emerge from these applications. Income is strongly related to willingness to pay in these surveys, yet income levels are often low.Secondly, education is not a factor that influences willingness to pay in the coastal belt very much. Rather, relation of individual occupation to any wetland based activity very much influenced their willingness to pay. The study revealed that people very much valued the indirect function performed by wetlands, in fact as much as they valued the direct benefits provided by the system. There still exist differences of opinions among experts when undertaking such valuation studies. However, in the absence of a better technique for valuing environmental services that have no markets, this is definitely a first step

Social Structural Determinants of Education among Tribes in Kerala

The study is focused on education of tribes particularly the problem of high dropout rate existing among the tribal students at school level. Scheduled Tribe is one of the marginalized communities experiencing high level of educational deprivation. The analysis of the study shows that the extent of deprivation existing among STs of Kerala is much higher compared to that of other communities. The present study covered tribes of three tribal predominant districts of Kerala such as Idukki, Palakkad and Wayanad. Out of the 35 tribal communities in the State, 17 of them are concentrated in these districts. Tribes concentrated in Idukki include Muthuvans, Malai Arayan, Uraly, Mannan and Hill Pulaya. The present study analyzed dropouts situation in tribal areas of Kerala by conducting Field Survey among dropout and non-dropout students at school level. High dropouts among STs persist due to many problems which are of structural in nature. Important problems faced by the tribal students that have been analyzed, this can be classified as economic, social, cultural and institutional. It is found that there exists high correlation between Income and expenditure of the family with the well-being of individuals. Significant economic factors are poverty and financial indebtedness of the family. Some of the common cultural factors of tribes are Nature of Habitation, Difference in Dialect and Medium of Instruction etc. Social factors analyzed in the study are illiteracy of parents, migration of family, family environment, motivation by parents, activities engaged in for helping the family and students’ lack of interest in studies. The analysis showed that all these factors except migration of the family, are affecting the education of tribal students. Apart from social, economic and cultural factors, there are a few institutional factors which will also influence the education of tribal students. Institutional factors analyzed in the study include students’ absenteeism, irregularity of teachers, attitude of non-tribal teachers and non-tribal students, infrastructure facilities and accessibility to school. The study found irregularity of students and accessibility to school as significant factors which determine the dropout of the students.

Brand Awareness among Customers : A case study of ICA-Kvantum

This research paper has been prepared by Bachelor students from Dalarna University in Borlänge. The project is centered on a case study of ICA – Kvantum and its brand awareness among customers. The purpose of this study is to find out that which measures can help ICA-Kvantum to create brand awareness among its current and potential customers by looking in to the importance of information of its offerings and use of effective communication tools to convey this information. Further, to recommend them what they need to do, to increase brand awareness among their customers with the help of managerial implications. The research question was formulated as what actions could be seen effective for ICA-Kvantum to maintain or improve brand awareness among its current and potential customers.The project was created with the help of theoretical concepts of brand awareness, brand loyalty, perceived quality, consumer decision model, integrated marketing communication approach and strategic planning process. These theories were applied in this thesis in order to find out the most effective communication measures to maintain or improve brand awareness among current and potential customers of ICA-Kvantum.The primary and secondary data was collected. Primary data was gathered through the survey among ICA-Kvantum customers in the front of the store in Borlänge. The personal interview with manager was conducted in the office of ICA-Kvantum store located in Borlänge. Secondary data was gathered from textbooks, academic journals, theses and websites.The empirical findings have been presented in detail and then analyzed with the help of theoretical concepts. The analysis and further results from survey and interview focused on importance of information, marketing communication tools, brand awareness and loyalty, perceived quality and implementation of strategic planning process. Moreover, the main weaknesses and strengths of ICA-Kvantun have been evaluated. The conclusion including short summary of analysis and its results have been provided at the end. Each weakness of issues related to brand awareness i.e. importance of information, effectiveness of marketing communication tools and strengths and weaknesses of ICA-Kvantum discussed in the paper, has been pointed out along with solutions and managerial implications.

Prioridades estratégicas de um departamento de pós-venda: um estudo de caso em uma corretora de benefício no segmento de seguros privados de saúde

O papel estratégico do departamento de pós-venda de uma corretora de benefícios, assim como qualquer outro segmento, torna-se cada vez mais importante e, consequentemente, a priorização dos seus serviços é fundamental para o relacionamento, retenção e fidelização dos clientes. Nesse sentido, o presente trabalho tem como objetivo principal construir uma estrutura de indicadores (temas estratégicos) em serviços de pós-venda de uma corretora de benefícios, no segmento de seguro saúde, permitindo identificar as prioridades estratégicas e favorecer a alocação de recursos, visando obter vantagem competitiva em relação aos seus concorrentes. A metodologia compreendeu, inicialmente, uma pesquisa qualitativa com especialistas no segmento de seguro saúde, de onde se originou uma estrutura de quatro indicadores (temas estratégicos) e dezoito fatores de competição. A estrutura foi testada através da aplicação de questionário quantitativo respondido pelos colaboradores (clientes internos) da corretora, que foram convocados a responderem sobre o grau de importância com relação aos indicadores e os respectivos fatores de competição da estrutura. Após a execução da pesquisa, verificou-se que o indicador ‘Gestão de Saúde’ apresentou o melhor resultado, enquanto que ‘o envio de fatura no prazo’ foi o fator de competição que mereceu maior importância entre os entrevistados. Pretende-se que os resultados obtidos sirvam de base para formulação de estratégias de marketing de relacionamento mais próximas da realidade da corretora, respeitando seus recursos e limitações.

Estudo da influência da adoção das práticas de manufatura enxuta na definição de prioridades competitivas: uma pesquisa survey em empresas da região de Bauru-SP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Different anticoagulation strategies in off-pump coronary artery bypass operations: a European survey

In order to determine anticoagulation strategies in OPCAB a questionnaire survey among 750 European cardio-thoracic surgeons was performed. Questions addressed volume of OPCAB procedures performed, intra- and perioperative heparinization and antiplatelet therapy, as well as perioperative management. A total of 325 (43.7%) questionnaires were returned and validated. Perioperative protocols for administration of antiplatelets differed among the respondent surgeons. Perioperative prophylaxis of thrombosis (low or high molecular weight heparin) is performed by 78%. Intraoperative heparin dosage range between 70 U/kg to 500 U/kg, 60% of respondents prefer a low-dose regimen (< or = 150 U/kg). Correspondingly, the lowest activated clotting time (ACT) during surgery is accepted to be 200 s by 24%, 250 s by 18% and 300 s by 26% of surgeons. Protamine is used by 91% of respondents, while 52% perform a 1:1 reversal. A cell-saver and antifibrinolytics are used by 70% and 40%, respectively. Interestingly, 56% of respondents think bleeding in OPCAB patients is not reduced when compared to on-pump CABG. In addition, 34% of respondents believe there is an increased risk of early graft occlusion following OPCAB. This survey demonstrates widely different intra- and perioperative anticoagulation strategies for OPCAB procedures among European surgeons.

The significant effect of endometriosis on physical, mental and social wellbeing: results from an international cross-sectional survey.

STUDY QUESTION To what extent do the management of endometriosis and the symptoms that remain after treatment affect the quality of life in women with the disease? SUMMARY ANSWER Many women with endometriosis had impaired quality of life and continued to suffer from endometriosis-associated symptoms even though their endometriosis has been managed in tertiary care centres. WHAT IS KNOWN ALREADY The existing literature indicates that quality of life and work productivity is reduced in women with endometriosis. However, most studies have small sample sizes, are treatment related or examine newly diagnosed patients only. STUDY DESIGN, SIZE, DURATION A cross-sectional questionnaire-based survey among 931 women with endometriosis treated in 12 tertiary care centres in 10 countries. PARTICIPANTS/MATERIALS, SETTING, METHODS Women diagnosed with endometriosis who had at least one contact related to endometriosis-associated symptoms during 2008 with a participating centre were enrolled into the study. The study investigated the effect of endometriosis on education, work and social wellbeing, endometriosis-associated symptoms and health-related quality of life, by using questions obtained from the World Endometriosis Research Foundation (WERF) GSWH instrument (designed and validated for the WERF Global Study on Women's Health) and the Short Form 36 version 2 (SF-36v2). MAIN RESULTS AND THE ROLE OF CHANCE Of 3216 women invited to participate in the study, 1450 (45%) provided informed consent and out of these, 931 (931/3216 = 29%) returned the questionnaires. Endometriosis had affected work in 51% of the women and affected relationships in 50% of the women at some time during their life. Dysmenorrhoea was reported by 59%, dyspareunia by 56% and chronic pelvic pain by 60% of women. Quality of life was decreased in all eight dimensions of the SF-36v2 compared with norm-based scores from a general US population (all P < 0.01). Multivariate regression analysis showed that number of co-morbidities, chronic pain and dyspareunia had an independent negative effect on both the physical and mental component of the SF-36v2. LIMITATIONS, REASONS FOR CAUTION The fact that women were enrolled in tertiary care centres could lead to a possible over-representation of women with moderate-to-severe endometriosis, because the participating centres typically treat more complex and referred cases of endometriosis. The response rate was relatively low. Since there was no Institute Review Board approval to do a non-responder investigation on basic characteristics, some uncertainty remains regarding the representativeness of the investigated population. WIDER IMPLICATIONS OF THE FINDINGS This international multicentre survey represents a large group of women with endometriosis, in all phases of the disease, which increases the generalizability of the data. Women still suffer from frequent symptoms, despite tertiary care management, in particular chronic pain and dyspareunia. As a result their quality of life is significantly decreased. A patient-centred approach with extensive collaboration across disciplines, such as pain specialists, psychologists, sexologists and social workers, may be a valuable strategy to improve the long-term care of women with endometriosis. STUDY FUNDING/COMPETING INTEREST(S) The WERF EndoCost study is funded by the World Endometriosis Research Foundation (WERF) through grants received from Bayer Schering Pharma AG, Takeda Italia Farmaceutici SpA, Pfizer Ltd and the European Society of Human Reproduction and Embryology. The sponsors did not have a role in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review or approval of the manuscript. L.H. is the chief executive and T.D. was a board member of WERF at the time of funding. T.D. holds the Merck-Serono Chair in Reproductive Medicine and Surgery, and the Ferring Chair in Reproductive Medicine at the Katholieke Universiteit Leuven in Belgium and has served as consultant/research collaborator for Merck-Serono, Schering-Plough, Astellas and Arresto.

Dental erosive wear assessment among adolescents and adults utilizing the basic erosive wear examination (BEWE) scoring system.

OBJECTIVES To investigate erosive tooth wear and related variables among adolescents and adults in Israel, utilizing the new basic erosive wear examination (BEWE) scoring system, in an attempt to contribute to the ongoing review, evaluation, and further development of an international standardized index. MATERIAL AND METHODS A cross-sectional, descriptive, and analytic survey was conducted among 500 subjects of five age groups. Dental erosion was measured according to the new BEWE scoring system. Independent variables included gender, age, origin, education, employment status, and diet. A backward stepwise linear regression model was applied to identify significantly associated variables. RESULTS Fifty percent of the survey subjects demonstrated erosive tooth wear; among them, 10 % had distinct erosion of over 50 % of the dental surface. Total BEWE score differences by age groups were statistically significant; as the age increased, the mean total BEWE scores increased (p < 0.001). The association between acidic foods and erosion was evident among the younger population (p = 0.038). In a multiple regression model, age (p < 0.001) and diet (p = 0.044) achieved statistical significance as variables associated with dental erosive wear. CONCLUSIONS Our study is one of the first to use the BEWE scoring system in an epidemiological survey among adolescents and adults. It was found that the BEWE index is straightforward, easy to conduct, and comfortably accepted by the examinees. CLINICAL RELEVANCE The present findings, together with further international research, should contribute toward continued evaluation of the BEWE system as an international standard and thereby, toward more optimal understanding, evidence-based treatment, and prevention of dental erosive wear.

Predicting the "usefulness" of 5-ALA-derived tumor fluorescence for fluorescence-guided resections in pediatric brain tumors: a European survey.

BACKGROUND Five-aminolevulinic acid (Gliolan, medac, Wedel, Germany, 5-ALA) is approved for fluorescence-guided resections of adult malignant gliomas. Case reports indicate that 5-ALA can be used for children, yet no prospective study has been conducted as of yet. As a basis for a study, we conducted a survey among certified European Gliolan users to collect data on their experiences with children. METHODS Information on patient characteristics, MRI characteristics of tumors, histology, fluorescence qualities, and outcomes were requested. Surgeons were further asked to indicate whether fluorescence was "useful", i.e., leading to changes in surgical strategy or identification of residual tumor. Recursive partitioning analysis (RPA) was used for defining cohorts with high or low likelihoods for useful fluorescence. RESULTS Data on 78 patients <18 years of age were submitted by 20 centers. Fluorescence was found useful in 12 of 14 glioblastomas (85 %), four of five anaplastic astrocytomas (60 %), and eight of ten ependymomas grades II and III (80 %). Fluorescence was found inconsistently useful in PNETs (three of seven; 43 %), gangliogliomas (two of five; 40 %), medulloblastomas (two of eight, 25 %) and pilocytic astrocytomas (two of 13; 15 %). RPA of pre-operative factors showed tumors with supratentorial location, strong contrast enhancement and first operation to have a likelihood of useful fluorescence of 64.3 %, as opposed to infratentorial tumors with first surgery (23.1 %). CONCLUSIONS Our survey demonstrates 5-ALA as being used in pediatric brain tumors. 5-ALA may be especially useful for contrast-enhancing supratentorial tumors. These data indicate controlled studies to be necessary and also provide a basis for planning such a study.

Prevalence of HIV risk-related behaviors among undocumented Central American immigrant women in Houston, Texas, 2010

The primary aim of this dissertation research is to provide epidemiological data on HIV risk-related behaviors among undocumented Central American immigrant women living in Houston, Texas. Between February and May 2010, we used respondent driven sampling (RDS) to recruit 230 Guatemalan, Honduran, and El Salvadoran women, ages 18 to 50 years, living in Houston without a valid United States visa or residency papers. RDS is a probability-based sampling method that utilizes social networks to access members of hidden populations that lack a sampling frame. Participants completed an interview regarding their demographics, access to and utilization of healthcare services, HIV testing, and sexual behaviors. Data from this study were used 1) to describe the prevalence of sexual HIV risk-related behaviors among undocumented Central American immigrant women, comparing those who recently immigrated to the U.S. (within the past five years) to those with more established residency (of over five years); 2) to describe the prevalence of lifetime HIV testing and evaluate its associated factors in this target population; and 3) to describe the effectiveness of RDS to access members of this target population. ^ As described in Paper 1, there was a generally low prevalence of individual HIV risk-related behaviors (i.e., multiple, concurrent, convenience, and casual sexual partnerships) among the undocumented Central American immigrant women in this study. However, there was evidence of HIV risk due to unprotected sex with male partners who have concurrent sexual partnerships. We identified recent immigrants as the subpopulation at greatest risk, as they were significantly more likely than established immigrants to have multiple and/or concurrent sexual partners. As described in Paper 2, the lifetime prevalence of HIV testing was almost 70%. After adjusting for age, number of years living in the U.S., income security, and resource barriers, lifetime HIV testing was significantly associated with being from Honduras, having more than a sixth grade education, having a regular healthcare provider, and having knowledge of available healthcare resources. Finally, as described in Paper 3, RDS was an effective method for obtaining a diverse sample of Central American immigrant women in Houston. ^ This project is the first to use RDS to conduct an HIV behavioral survey among undocumented Central American immigrant women. Our results will inform the design of future research studies and the implementation of HIV prevention activities among undocumented Central American immigrants in the U.S.^