Search results for: impact propagation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11762

Search results for: impact propagation

8522 Model for Calculating Traffic Mass and Deceleration Delays Based on Traffic Field Theory

Authors: Liu Canqi, Zeng Junsheng

Abstract:

This study identifies two typical bottlenecks that occur when a vehicle cannot change lanes: car following and car stopping. The ideas of traffic field and traffic mass are presented in this work. When there are other vehicles in front of the target vehicle within a particular distance, a force is created that affects the target vehicle's driving speed. The characteristics of the driver and the vehicle collectively determine the traffic mass; the driving speed of the vehicle and external variables have no bearing on this. From a physical level, this study examines the vehicle's bottleneck when following a car, identifies the outside factors that have an impact on how it drives, takes into account that the vehicle will transform kinetic energy into potential energy during deceleration, and builds a calculation model for traffic mass. The energy-time conversion coefficient is created from an economic standpoint utilizing the social average wage level and the average cost of motor fuel. Vissim simulation program measures the vehicle's deceleration distance and delays under the Wiedemann car-following model. The difference between the measured value of deceleration delay acquired by simulation and the theoretical value calculated by the model is compared using the conversion calculation model of traffic mass and deceleration delay. The experimental data demonstrate that the model is reliable since the error rate between the theoretical calculation value of the deceleration delay obtained by the model and the measured value of simulation results is less than 10%. The article's conclusion is that the traffic field has an impact on moving cars on the road and that physical and socioeconomic factors should be taken into account while studying vehicle-following behavior. The deceleration delay value of a vehicle's driving and traffic mass have a socioeconomic relationship that can be utilized to calculate the energy-time conversion coefficient when dealing with the bottleneck of cars stopping and starting.

Keywords: traffic field, social economics, traffic mass, bottleneck, deceleration delay

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8521 Relationship of Indoor and Outdoor Levels of Black Carbon in an Urban Environment

Authors: Daria Pashneva, Julija Pauraite, Agne Minderyte, Vadimas Dudoitis, Lina Davuliene, Kristina Plauskaite, Inga Garbariene, Steigvile Bycenkiene

Abstract:

Black carbon (BC) has received particular attention around the world, not only for its impact on regional and global climate change but also for its impact on air quality and public health. In order to study the relationship between indoor and outdoor BC concentrations, studies were carried out in Vilnius, Lithuania. The studies are aimed at determining the relationship of concentrations, identifying dependencies during the day and week with a further opportunity to analyze the key factors affecting the indoor concentration of BC. In this context, indoor and outdoor continuous real-time measurements of optical BC-related light absorption by aerosol particles were carried out during the cold season (from October to December 2020). The measurement venue was an office located in an urban background environment. Equivalent black carbon (eBC) mass concentration was measured by an Aethalometer (Magee Scientific, model AE-31). The optical transmission of carbonaceous aerosol particles was measured sequentially at seven wavelengths (λ= 370, 470, 520, 590, 660, 880, and 950 nm), where the eBC mass concentration was derived from the light absorption coefficient (σab) at 880 nm wavelength. The diurnal indoor eBC mass concentration was found to vary in the range from 0.02 to 0.08 µgm⁻³, while the outdoor eBC mass concentration - from 0.34 to 0.99 µgm⁻³. Diurnal variations of eBC mass concentration outdoor vs. indoor showed an increased contribution during 10:00 and 12:00 AM (GMT+2), with the highest indoor eBC mass concentration of 0.14µgm⁻³. An indoor/outdoor eBC ratio (I/O) was below one throughout the entire measurement period. The weekend levels of eBC mass concentration were lower than in weekdays for indoor and outdoor for 33% and 28% respectively. Hourly mean mass concentrations of eBC for weekdays and weekends show diurnal cycles, which could be explained by the periodicity of traffic intensity and heating activities. The results show a moderate influence of outdoor eBC emissions on the indoor eBC level.

Keywords: black carbon, climate change, indoor air quality, I/O ratio

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8520 A Sustainability Benchmarking Framework Based on the Life Cycle Sustainability Assessment: The Case of the Italian Ceramic District

Authors: A. M. Ferrari, L. Volpi, M. Pini, C. Siligardi, F. E. Garcia Muina, D. Settembre Blundo

Abstract:

A long tradition in the ceramic manufacturing since the 18th century, primarily due to the availability of raw materials and an efficient transport system, let to the birth and development of the Italian ceramic tiles district that nowadays represents a reference point for this sector even at global level. This economic growth has been coupled to attention towards environmental sustainability issues throughout various initiatives undertaken over the years at the level of the production sector, such as certification activities and sustainability policies. In this way, starting from an evaluation of the sustainability in all its aspects, the present work aims to develop a benchmarking helping both producers and consumers. In the present study, throughout the Life Cycle Sustainability Assessment (LCSA) framework, the sustainability has been assessed in all its dimensions: environmental with the Life Cycle Assessment (LCA), economic with the Life Cycle Costing (LCC) and social with the Social Life Cycle Assessment (S-LCA). The annual district production of stoneware tiles during the 2016 reference year has been taken as reference flow for all the three assessments, and the system boundaries cover the entire life cycle of the tiles, except for the LCC for which only the production costs have been considered at the moment. In addition, a preliminary method for the evaluation of local and indoor emissions has been introduced in order to assess the impact due to atmospheric emissions on both people living in the area surrounding the factories and workers. The Life Cycle Assessment results, obtained from IMPACT 2002+ modified assessment method, highlight that the manufacturing process is responsible for the main impact, especially because of atmospheric emissions at a local scale, followed by the distribution to end users, the installation and the ordinary maintenance of the tiles. With regard to the economic evaluation, both the internal and external costs have been considered. For the LCC, primary data from the analysis of the financial statements of Italian ceramic companies show that the higher cost items refer to expenses for goods and services and costs of human resources. The analysis of externalities with the EPS 2015dx method attributes the main damages to the distribution and installation of the tiles. The social dimension has been investigated with a preliminary approach by using the Social Hotspots Database, and the results indicate that the most affected damage categories are health and safety and labor rights and decent work. This study shows the potential of the LCSA framework applied to an industrial sector; in particular, it can be a useful tool for building a comprehensive benchmark for the sustainability of the ceramic industry, and it can help companies to actively integrate sustainability principles into their business models.

Keywords: benchmarking, Italian ceramic industry, life cycle sustainability assessment, porcelain stoneware tiles

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8519 The Impact of Organizational Culture on Internet Marketing Adoption

Authors: Hafiz Mushtaq Ahmad, Syed Faizan Ali Shah, Bushra Hussain, Muneeb Iqbal

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Purpose: The purpose of this study is to investigate the impact of organizational culture on internet marketing adoption. Moreover, the study intends to explore the role of organizational culture in the internet marketing adoption that helps business to achieve organizational growth and augmented market share. Background: With the enormous expansion of technology, organizations now need technology-based marketing paradigm in order to capture larger group of customers. Organizational culture plays a dominant and prominent role in the internet marketing adoption. Changes in the world economy have demolished current organizational competition and generating new technology standards and strategies. With all the technological advances, e-marketing has become one of the essential part of marketing strategies. Organizations require advance internet marketing strategies in order to compete in a global market. Methodology: The population of this study consists of telecom sector organizations of Pakistan. The sample size consists of 200 telecom sector employees. Data were gathered through the questionnaire instrument. The research strategy of this study is survey. The study uses a deductive approach. The sampling technique of this study is convenience sampling. Tentative Results: The study reveals that organizational culture played a vital role in the internet marketing adoption. The results show that there is a strong association between the organizational culture and internet marketing adoption. The results further show that flexible organizational culture helps organization to easily adopt internet marketing. Conclusion: The study discloses that flexible organizational culture helps organizations to easily adopt e-marketing. The study guides decision-makers and owners of organizations to recognize the importance of internet marketing strategy and help them to increase market share by using e-marketing. The study offers solution to the managers to develop flexible organizational culture that helps in internet marketing adoption.

Keywords: internet technology, internet marketing, marketing paradigm, organizational culture

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8518 The Musician as the Athlete: Psychological Response to Injury

Authors: Shulamit Sternin

Abstract:

Athletes experience injuries that can have both a physical and psychological impact on the individual. In such instances, athletes are able to rely on the established field of sports psychology to facilitate holistic rehabilitation. Musicians, like athletes rely on their bodies to perform in much the same way athletes do and are also susceptible to injury. Due to the similar performative nature of succeeding as an athletes or a musician, these careers share many of the same primary psychological concerns and therefore it is reasonable that athletes and musicians may require similar rehabilitation post-injury. However, musicians face their own unique psychological challenges and understanding the needs of an injured athlete can serve as a foundation for understanding the injured musician but is not enough to fully rehabilitate an injured musician. The current research surrounding musicians and their injuries is primarily focused on physiological aspects of injury and rehabilitation; the psychological aspects have not yet received adequate attention resulting in poor musician rehabilitation post- injury. This review paper uses current models of psychological response to injury in athletes to draw parallels with the psychological response to injury in musicians. Search engines such as Medline and PsycInfo were systematically searched using specific key words, such as psychological response, injury, athlete, and musician. Studies that focused on post-injury psychology of either the musician or the athlete were included. Within the literature there is evidence to support psychological responses, unique to the musician, that are not accounted for by current models of response in athletes. The models of psychological response to injury in athletes are inadequate tools for application to the musician. Future directions for performance arts research that can fill the gaps in our understanding and modeling of musicians’ response to injury are discussed. A better understanding of the psychological impact of injuries on musicians holds significant implications for health care practitioners working with injured musicians. Understanding the unique barriers musicians face post-injury, and how support for this population must be tailored to properly suit musicians’ needs will aid in more holistic rehabilitation and a higher likelihood of musician’s returning to pre-injury performance levels.

Keywords: athlete, injury, musician, psychological response

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8517 Analysis of Pavement Lifespan - Cost and Emissions of Greenhouse Gases: A Comparative Study of 10-year vs 30-year Design

Authors: Claudeny Simone Alves Santana, Alexandre Simas De Medeiros, Marcelino Aurélio Vieira Da Silva

Abstract:

The aim of the study was to assess the performance of pavements over time, considering the principles of Life Cycle Assessment (LCA) and the ability to withstand vehicle loads and associated environmental impacts. Within the study boundary, pavement design was conducted using the Mechanistic-Empirical Method, adopting criteria based on pavement cracking and wheel path rutting while also considering factors such as soil characteristics, material thickness, and the distribution of forces exerted by vehicles. The Ecoinvent® 3.6 database and SimaPro® software were employed to calculate emissions, and SICRO 3 information was used to estimate costs. Consequently, the study sought to identify the service that had the greatest impact on greenhouse gas emissions. The results were compared for design life periods of 10 and 30 years, considering structural performance and load-bearing capacity. Additionally, environmental impacts in terms of CO2 emissions per standard axle and construction costs in dollars per standard axle were analyzed. Based on the conducted analyses, it was possible to determine which pavement exhibited superior performance over time, considering technical, environmental, and economic criteria. One of the findings indicated that the mechanical characteristics of the soils used in the pavement layer directly influence the thickness of the pavement and the quantity of greenhouse gases, with a difference of approximately 7000 Kg CO2 Eq. The transportation service was identified as having the most significant negative impact. Other notable observations are that the study can contribute to future project guidelines and assist in decision-making regarding the selection of the most suitable pavement in terms of durability, load-bearing capacity, and sustainability.

Keywords: life cycle assessment, greenhouse gases, urban paving, service cost

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8516 Love Crystallized: The Significance of Divine Love Contemplation on Meaning and Purpose in Life in Islamic Psychology

Authors: Nur Farizah Binte Mohd Sedek

Abstract:

Divine love is ubiquitous in many religions and philosophies. In the Islamic Sufi tradition, it is recognized as an “intense yearning for unification” with God. Previous literature demonstrates that divine love plays a role in forming meaning and purpose in one’s life. However, previous research has not explored the effects of the Islamic practice of divine love contemplation on meaning and purpose in life. The current study used an experimental design to investigate whether a divine love contemplation intervention has an impact on meaning and purpose in life in Muslims through the framework of Islamic Psychology. The sample consisted of 34 participants (7 males and 27 females) who were randomly assigned to one of two groups: Intervention (n = 20) and Control (n = 14). Participants in the intervention group did a general litany and a divine love supplication and contemplation exercise, while participants in the control group did only a general litany exercise. Three hypotheses were tested using a mixed-design two-way (split-plot) Analysis of Variance (ANOVA) to determine whether participants in the intervention group will report a significant increase in 1) divine love, 2) meaning in life, and 3) purpose in life from before to after the intervention, whereas participants in the control group will not report a significant change in the mentioned constructs. The results supported Hypothesis 1, in that a significant interaction between group and time emerged for divine love. Specifically, the intervention group reported a significant increase in divine love from before to after the intervention, whereas the control group did not report a significant change in divine love. Furthermore, the effect size was large, even though the mean difference was negligible, indicating that this change was substantial enough to have a considerable effect on the sample. However, the tests of the second and third hypotheses were not significant, suggesting that the divine love contemplation intervention did not have a significant impact on meaning or purpose in life. Suggestions for future research include qualitative phenomenological studies that could be conducted to glean experiential insight into the constructs from the participants’ individual accounts.

Keywords: divine love, meaning in life, purpose in life, contemplation, islamic psychology

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8515 Anti-Graft Instruments and Their Role in Curbing Corruption: Integrity Pact and Its Impact on Indian Procurement

Authors: Jot Prakash Kaur

Abstract:

The paper aims to showcase that with the introduction of anti-graft instruments and willingness of the governments towards their implementation, a significant change can be witnessed in the anti-corruption landscape of any country. Since the past decade anti-graft instruments have been introduced by several international non-governmental organizations with the vision of curbing corruption. Transparency International’s ‘Integrity Pact’ has been one such initiative. Integrity Pact has been described as a tool for preventing corruption in public contracting. Integrity Pact has found its relevance in a developing country like India where public procurement constitutes 25-30 percent of Gross Domestic Product. Corruption in public procurement has been a cause of concern even though India has in place a whole architecture of rules and regulations governing public procurement. Integrity Pact was first adopted by a leading Oil and Gas government company in 2006. Till May 2015, over ninety organizations had adopted Integrity Pact, of which majority of them are central government units. The methodology undertaken to understand impact of Integrity Pact on Public procurement is through analyzing information received from important stakeholders of the instrument. Government, information was sought through Right to Information Act 2005 about the details of adoption of this instrument by various government organizations and departments. Contractor, Company websites and annual reports were used to find out the steps taken towards implementation of Integrity Pact. Civil Society, Transparency International India’s resource materials which include publications and reports on Integrity Pact were also used to understand the impact of Integrity Pact. Some of the findings of the study include organizations adopting Integrity pacts in all kinds of contracts such that 90% of their procurements fall under Integrity Pact. Indian State governments have found merit in Integrity Pact and have adopted it in their procurement contracts. Integrity Pact has been instrumental in creating a brand image of companies. External Monitors, an essential feature of Integrity Pact have emerged as arbitrators for the bidders and are the first line of procurement auditors for the organizations. India has cancelled two defense contracts finding it conflicting with the provisions of Integrity Pact. Some of the clauses of Integrity Pact have been included in the proposed Public Procurement legislation. Integrity Pact has slowly but steadily grown to become an integral part of big ticket procurement in India. Government’s commitment to implement Integrity Pact has changed the way in which public procurement is conducted in India. Public Procurement was a segment infested with corruption but with the adoption of Integrity Pact a number of clean up acts have been performed to make procurement transparent. The paper is divided in five sections. First section elaborates on Integrity Pact. Second section talks about stakeholders of the instrument and the role it plays in its implementation. Third section talks about the efforts taken by the government to implement Integrity Pact in India. Fourth section talks about the role of External Monitor as Arbitrator. The final section puts forth suggestions to strengthen the existing form of Integrity Pact and increase its reach.

Keywords: corruption, integrity pact, procurement, vigilance

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8514 Energy System Analysis Using Data-Driven Modelling and Bayesian Methods

Authors: Paul Rowley, Adam Thirkill, Nick Doylend, Philip Leicester, Becky Gough

Abstract:

The dynamic performance of all energy generation technologies is impacted to varying degrees by the stochastic properties of the wider system within which the generation technology is located. This stochasticity can include the varying nature of ambient renewable energy resources such as wind or solar radiation, or unpredicted changes in energy demand which impact upon the operational behaviour of thermal generation technologies. An understanding of these stochastic impacts are especially important in contexts such as highly distributed (or embedded) generation, where an understanding of issues affecting the individual or aggregated performance of high numbers of relatively small generators is especially important, such as in ESCO projects. Probabilistic evaluation of monitored or simulated performance data is one technique which can provide an insight into the dynamic performance characteristics of generating systems, both in a prognostic sense (such as the prediction of future performance at the project’s design stage) as well as in a diagnostic sense (such as in the real-time analysis of underperforming systems). In this work, we describe the development, application and outcomes of a new approach to the acquisition of datasets suitable for use in the subsequent performance and impact analysis (including the use of Bayesian approaches) for a number of distributed generation technologies. The application of the approach is illustrated using a number of case studies involving domestic and small commercial scale photovoltaic, solar thermal and natural gas boiler installations, and the results as presented show that the methodology offers significant advantages in terms of plant efficiency prediction or diagnosis, along with allied environmental and social impacts such as greenhouse gas emission reduction or fuel affordability.

Keywords: renewable energy, dynamic performance simulation, Bayesian analysis, distributed generation

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8513 Soil Reinforcement by Stone Columns

Authors: Saou Mohamed Amine

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The construction industry has been identified as a user of substantial amount of materials and energy resources that has an enormous impact on environment. The energy efficient in refurbishment project is being considered as one of the approaches to achieve sustainability in construction industry. The increasing concern for environment has made building owners and designers to incorporate the energy efficiency features into their building projects.

Keywords: construction industry, design team attributes, energy efficient performance, refurbishment projects characteristics

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8512 Effect of Microstructure on Transition Temperature of Austempered Ductile Iron (ADI)

Authors: A. Ozel

Abstract:

The ductile to brittle transition temperature is a very important criterion that is used for selection of materials in some applications, especially in low-temperature conditions. For that reason, in this study transition temperature of as-cast and austempered unalloyed ductile iron in the temperature interval from -60 to +100 degrees C have been investigated. The microstructures of samples were examined by light microscope. The impact energy values obtained from the experiments were found to depend on the austempering time and temperature.

Keywords: Austempered Ductile Iron (ADI), Charpy test, microstructure, transition temperature

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8511 Using the Ecological Analysis Method to Justify the Environmental Feasibility of Biohydrogen Production from Cassava Wastewater Biogas

Authors: Jonni Guiller Madeira, Angel Sanchez Delgado, Ronney Mancebo Boloy

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The use bioenergy, in recent years, has become a good alternative to reduce the emission of polluting gases. Several Brazilian and foreign companies are doing studies related to waste management as an essential tool in the search for energy efficiency, taking into consideration, also, the ecological aspect. Brazil is one of the largest cassava producers in the world; the cassava sub-products are the food base of millions of Brazilians. The repertoire of results about the ecological impact of the production, by steam reforming, of biohydrogen from cassava wastewater biogas is very limited because, in general, this commodity is more common in underdeveloped countries. This hydrogen, produced from cassava wastewater, appears as an alternative fuel to fossil fuels since this is a low-cost carbon source. This paper evaluates the environmental impact of biohydrogen production, by steam reforming, from cassava wastewater biogas. The ecological efficiency methodology developed by Cardu and Baica was used as a benchmark in this study. The methodology mainly assesses the emissions of equivalent carbon dioxide (CO₂, SOₓ, CH₄ and particulate matter). As a result, some environmental parameters, such as equivalent carbon dioxide emissions, pollutant indicator, and ecological efficiency are evaluated due to the fact that they are important to energy production. The average values of the environmental parameters among different biogas compositions (different concentrations of methane) were calculated, the average pollution indicator was 10.11 kgCO₂e/kgH₂ with an average ecological efficiency of 93.37%. As a conclusion, bioenergy production using biohydrogen from cassava wastewater treatment plant is a good option from the environmental feasibility point of view. This fact can be justified by the determination of environmental parameters and comparison of the environmental parameters of hydrogen production via steam reforming from different types of fuels.

Keywords: biohydrogen, ecological efficiency, cassava, pollution indicator

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8510 Effect of Volcanic Ash and Recycled Aggregates in Concrete

Authors: Viviana Letelier, Ester Tarela, Giacomo Moriconi

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The cement industry is responsible for around a 5% of the CO2 emissions worldwide and considering that concrete is one of the most used materials in construction its total effect is important. An alternative to reduce the environmental impact of concrete production is to incorporate certain amount of residuals in the dosing, limiting the replacement percentages to avoid significant losses in the mechanical properties of the final material. This study analyses the variation in the mechanical properties of structural concretes with recycled aggregates and volcanic ash as cement replacement to test the effect of the simultaneous use of different residuals in the same material. Analyzed concretes are dosed for a compressive strength of 30MPa. The recycled aggregates are obtained from prefabricated pipe debris with a compressive strength of 20MPa. The volcanic ash was obtained from the Ensenada (Chile) area after the Calbuco eruption in April 2015. The percentages of natural course aggregates that are replaced by recycled aggregates are of 0% and 30% and the percentages of cement replaced by volcanic ash are of 0%, 5%, 10% and 15%. The combined effect of both residuals in the mechanical properties of the concrete is evaluated through compressive strength tests after, 28 curing days, flexural strength tests after 28 days, and the elasticity modulus after 28 curing days. Results show that increasing the amount of volcanic ash used increases the losses in compressive strength. However, the use of up to a 5% of volcanic ash allows obtaining concretes with similar compressive strength to the control concrete, whether recycled aggregates are used or not. Furthermore, the pozzolanic reaction that occurs between the amorphous silica and the calcium hydroxide (Ca(OH)2) provokes an increase of a 10% in the compressive strength when a 5% of volcanic ash is combined with a 30% of recycled aggregates. Flexural strength does not show significant changes with neither of the residues. On the other hand, decreases between a 14% and a 25% in the elasticity modulus have been found. Concretes with up to a 30% of recycled aggregates and a 5% of volcanic ash as cement replacement can be produced without significant losses in their mechanical properties, reducing considerably the environmental impact of the final material.

Keywords: compressive strength of recycled concrete, mechanical properties of recycled concrete, recycled aggregates, volcanic ash as cement replacement

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8509 Acculturation Impact on Mental Health Among Arab Americans

Authors: Sally Kafelghazal

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Introduction: Arab Americans, who include immigrants, refugees, or U.S. born persons of Middle Eastern or North African descent, may experience significant difficulties during acculturation to Western society. Influential stressors include relocation, loss of social support, language barriers, and economic factors, all of which can impact mental health. There is limited research investigating the effects of acculturation on the mental health of the Arab American population. Objectives: The purpose of this study is to identify ways in which acculturation impacts the mental health of Arab Americans, specifically the development of depression and anxiety. Method: A literature search was conducted using PubMed and PsycArticles (ProQuest), utilizing the following search terms: “Arab Americans,” “Arabs,” “mental health,” “depression,” “anxiety,” “acculturation.” Thirty-nine articles were identified and of those, nine specifically investigated the relationship between acculturation and mental health in Arab Americans. Three of the nine focused exclusively on depression. Results: Several risk factors were identified that contribute to poor mental health associated with acculturation, which include immigrant or refugee status, facing discrimination, and religious ideology. Protective factors include greater levels of acculturation, being U.S. born, and greater heritage identity. Greater mental health disorders were identified in Arab Americans compared to normative samples, perhaps particularly depression; none of the articles specifically addressed anxiety. Conclusion: The current research findings support the potential association between the process of acculturation and greater levels of mental health disorders in Arab Americans. However, the diversity of the Arab American population makes it difficult to draw consistent conclusions. Further research needs to be conducted in order to assess which subgroups in the Arab American population are at highest risk for developing new or exacerbating existing mental health disorders in order to devise more effective interventions.

Keywords: arab americans, arabs, mental health, anxiety, depression, acculturation

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8508 Dislocation Density-Based Modeling of the Grain Refinement in Surface Mechanical Attrition Treatment

Authors: Reza Miresmaeili, Asghar Heydari Astaraee, Fereshteh Dolati

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In the present study, an analytical model based on dislocation density model was developed to simulate grain refinement in surface mechanical attrition treatment (SMAT). The correlation between SMAT time and development in plastic strain on one hand, and dislocation density evolution, on the other hand, was established to simulate the grain refinement in SMAT. A dislocation density-based constitutive material law was implemented using VUHARD subroutine. A random sequence of shots is taken into consideration for multiple impacts model using Python programming language by utilizing a random function. The simulation technique was to model each impact in a separate run and then transferring the results of each run as initial conditions for the next run (impact). The developed Finite Element (FE) model of multiple impacts describes the coverage evolution in SMAT. Simulations were run to coverage levels as high as 4500%. It is shown that the coverage implemented in the FE model is equal to the experimental coverage. It is depicted that numerical SMAT coverage parameter is adequately conforming to the well-known Avrami model. Comparison between numerical results and experimental measurements for residual stresses and depth of deformation layers confirms the performance of the established FE model for surface engineering evaluations in SMA treatment. X-ray diffraction (XRD) studies of grain refinement, including resultant grain size and dislocation density, were conducted to validate the established model. The full width at half-maximum in XRD profiles can be used to measure the grain size. Numerical results and experimental measurements of grain refinement illustrate good agreement and show the capability of established FE model to predict the gradient microstructure in SMA treatment.

Keywords: dislocation density, grain refinement, severe plastic deformation, simulation, surface mechanical attrition treatment

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8507 A Cross-Sectional Study of Knowledge and Attitudes among College Students in a South Indian City about Intimate Partner Violence

Authors: Krithika Lakshmi Sathiya Moorthy

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Introduction: Young people’s attitude towards Intimate partner violence (IPV) is likely to influence their indulgence in or abstinence from IPV in future. We aimed to assess the knowledge and attitudes of college students in a south Indian city regarding IPV, its associated factors and redressal mechanisms. Methods: A convenient sample of 247 students, pursuing medicine and engineering, participated in this analytical cross sectional study. They responded to a self-administered questionnaire developed and pretested for this study. The questionnaire comprises statements from a third person’s perspective and vignettes to reduce social desirability bias. Clearance was obtained from the Institute Ethical Committee of Velammal Medical College Hospital and Research Institute, Madurai, India. Data were entered in Epidata Entry v3.1, Odense, Denmark and analysed using SPSS v20.0. Results: Among 247 students, 116 (47%) were males and 59 (24.9%) hailed from rural areas. About 18% (43) of students believed that IPV was a problem only among females. Almost half of the students had witnessed IPV; at home between their parents (9.7%), other family members (13.4%), in their neighbourhood (13%) or public places (15%). Only 118 (47.8%) were aware that a law was in place in India to address IPV. The perceived risk factors for IPV were alcoholic spouse (78.9%), low income families (53.8%), personality traits (52.2%) and dowry system (51%). A sizeable number of students (38.4%) believed that some amount of physical violence was allowable in a marital relationship while 57.6% even considered IPV as an expression of love. Males as compared to females were more in agreement with negative gender stereotypes such as husband can– ‘threaten wife to ensure welfare of family’ (55% vs. 34%, p < 0.001), ‘spy on wife to check fidelity’ (41% vs. 27%, p < 0.001), ‘financially deprive housewife to punish’ (13% vs. 3.8%, p=0.001) and agreed with the statement that it is ‘duty of wife to comply with demands for sex from the husband’ (9.5% vs 4.6%, p=0.3). About 32% males and 25.6% females foresaw themselves as perpetrators of IPV in future. Conclusion: Knowledge about IPV and the associated risk factors among the study population was satisfactory. However, there was widespread acceptance of negative societal gender stereotypes, more so among males and some degrees of IPV were acceptable between married couples. The study advocates the need to halt the propagation of negative gender stereotypes in the impressionable young minds and the necessity to spread the awareness that no degree of IPV is acceptable. This knowledge is also required to plan the content and choose the appropriate media to effectively communicate the awareness about IPV among young persons.

Keywords: attitude, India, intimate partner violence, knowledge, students

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8506 The Impact of Simulation-based Learning on the Clinical Self-efficacy and Adherence to Infection Control Practices of Nursing Students

Authors: Raeed Alanazi

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Introduction: Nursing students have a crucial role to play in the inhibition of infectious diseases and, therefore, must be trained in infection control and prevention modules prior to entering clinical settings. Simulations have been found to have a positive impact on infection control skills and the use of standard precautions. Aim: The purpose of this study was to use the four sources of self-efficacy in explaining the level of clinical self-efficacy and adherence to infection control practices in Saudi nursing students during simulation practice. Method: A cross-sectional design with convenience sampling was used. This study was conducted in all Saudi nursing schools, with a total number of 197 students participated in this study. Three scales were used simulation self- efficacy Scale (SSES), the four sources of self-efficacy scale (SSES), and Compliance with Standard Precautions Scale (CSPS). Multiple linear regression was used to test the use of the four sources of self-efficacy (SSES) in explaining level of clinical self-efficacy and adherence to infection control in nursing students. Results: The vicarious experience subscale (p =.044) was statistically significant. The regression model indicated that for every one unit increase in vicarious experience (observation and reflection in simulation), the participants’ adherence to infection control increased by .13 units (β =.22, t = 2.03, p =.044). In addition, the regression model indicated that for every one unit increase in education level, the participants’ adherence to infection control increased by 1.82 units (beta=.34= 3.64, p <.001). Also, the mastery experience subscale (p <.001) and vicarious experience subscale (p = .020) were shared significant associations with clinical self-efficacy. Conclusion: The findings of this research support the idea that simulation-based learning can be a valuable teaching-learning method to help nursing students develop clinical competence, which is essential in providing quality and safe nursing care.

Keywords: simulation-based learning, clinical self-efficacy, infection control, nursing students

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8505 Assessment of Technical and Vocational Education and Training Training Quality Factors and Their Impact on Low Enrollment Rates in Ethiopian Technical and Vocational Education and Training Colleges

Authors: Abebe Tibebu

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This study investigates the quality of training factors in Ethiopian Technical and Vocational Education and Training (TVET) colleges and their impact on declining enrollment rates. Employing a descriptive survey design, both quantitative and qualitative data were collected from diverse stakeholders, including Grade 12 graduates, current TVET trainees, trainers, college deans, community members, high school directors, teachers, and officials from TVET government agencies. The sample included 20 TVET centers from various Ethiopian regions. Secondary data were obtained from college and government documents, while primary data were gathered through questionnaires, interviews, focus group discussions, and observations. Analysis was conducted using descriptive statistics with SPSS, capturing response frequencies and percentages. The study's findings highlight several key factors affecting TVET enrollment: limited infrastructure capacity, insufficient trainer competency, misaligned curriculum, low-quality training delivery particularly in cooperative training implementation and industry partnership and low success rates on Certification of Competency (CoC) exams. Many TVET institutions lack qualified trainers, adequate machinery, and timely provision of materials for practical skills training. Based on these findings, the study recommends enhanced infrastructure investment, professional development for trainers, curriculum adjustments to better align with industry needs, and standardized assessment practices. Addressing these areas through collaborative efforts with government bodies and industry stakeholders is essential to improving the quality and appeal of Ethiopian TVET programs, ultimately strengthening enrollment and outcomes.

Keywords: TVET, quality factors, enrollment, potentially enrolled

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8504 Analyzing the Impact of Indian Architecture on the Architecture of Cambodia, Thailand and Indonesia

Authors: Sriranjani Srinivasan

Abstract:

To appreciate Indian art and architecture by studying it in India alone will only lead to partial understanding of the whole story and the variety of the statement has been amply proved by subsequent decades of patient research. The results of the work of the Archaeological Survey of India forms only one half of the picture, the other half emerges with the studies of the archaeology and art of the Far East that progressed almost simultaneously under the Archaeological Survey of the Dutch East Indies, the École française d'Extrême-Orient (EFEO), or French School of Asian Studies, and allied institutions. The conclusions arrived at have only rendered the assertion that India produced her ultimate master pieces only through foreign influences and in foreign lands (the South-Eastern peninsular and archipelagic regions) almost axiomatic. Angkor in Cambodia and Borobudur in Java, undoubtedly the two greatest architectural marvels of Indian genius, for in content and spirit these (and other monuments of varying magnitudes), are purely Indian, would well illustrate the statement mentioned earlier. Stimulated research followed the discoveries and among the many studies and publications of such pioneers like Coedes, Parmentier, Coomaraswamy and many others in Dutch, French and English made growing contributions to the subject. This paper will discuss in detail the impact of India on the architecture of South East Asia by detailed comparison of architectural styles, elements, and construction materials of a few specific architectural master pieces, in both India and South East Asian countries. It will also analyze the reasoning behind the influence of India on South East Asian countries in spite of them being exposed to the equally culturally rich and civilized kingdoms of China. The intention of this paper is to understand that, conquest by war is not always the only reason for architectural influences and impacts.

Keywords: architectural influence, Buddhist architecture, Indian architecture, Southeast Asian architecture

Procedia PDF Downloads 308
8503 Climate Change Impact on Slope Stability: A Study of Slope Drainage Design and Operation

Authors: Elena Mugarza, Stephanie Glendinning, Ross Stirling, Colin Davies

Abstract:

The effects of climate change and increased rainfall events on UK-based infrastructure are observable, with an increasing number being reported on in the national press. The fatal derailment at Stonehaven in 2020 prompted a wider review of Network Rail-owned earthworks assets. The event was indicated by the Rail Accident Investigation Branch (RAIB) to be caused by mis-installed drainage on the adjacent cutting. The slope failure on Snake Pass (public highway A57) was reportedly caused by significant water ingress following numerous storm events and resulted in the road’s closure for several months. This problem is only projected to continue with greater intensity and more prolonged rainfall events forecasted in the future. Subsequently, this project is designed to evaluate effective drainage trench design within infrastructure embankments, considering the capillary barrier phenomenon that may govern their deterioration and resultant failure. Theoretically, the differential between grain sizes of the embankment clays and gravels, customarily used in drainage trenches, would have a limiting effect on infiltration. As such, it is anticipated that the inclusion of an additional material with an intermediate grain size should improve the hydraulic conductivity across the drainage boundary. Multiple drainage designs will be studied using instrumentation within the drain and surrounding clays. Data from the real-world installation at the BIONICS embankment will be collected and compared with laboratory and Finite Element (FE) simulations. This research aims to reduce the risk of infrastructure slope failures by improving the resilience of earthwork drainage and lessening the consequential impact on transportation networks.

Keywords: earthworks, slope drainage, transportation slopes, deterioration, capillary barriers, field study

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8502 Reliability Analysis in Power Distribution System

Authors: R. A. Deshpande, P. Chandhra Sekhar, V. Sankar

Abstract:

In this paper, we discussed the basic reliability evaluation techniques needed to evaluate the reliability of distribution systems which are applied in distribution system planning and operation. Basically, the reliability study can also help to predict the reliability performance of the system after quantifying the impact of adding new components to the system. The number and locations of new components needed to improve the reliability indices to certain limits are identified and studied.

Keywords: distribution system, reliability indices, urban feeder, rural feeder

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8501 The Role of Trust in Intention to Use Prescribed and Non-prescribed Connected Devices

Authors: Jean-michel Sahut, Lubica Hikkerova, Wissal Ben Arfi

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The Internet of Things (IoT) emerged over the last few decades in many fields. Healthcare can significantly benefit from IoT. This study aims to examine factors influencing the adoption of IoT in eHealth. To do so, an innovative framework has been developed which applies both the Technology Acceptance Model (TAM) and the United Theory of Acceptance and Use of Technology (UTAUT) model and builds on them by analyzing trust and perceived-risk dimensions to predict intention to use IoT in eHealth. In terms of methodology, a Partial Least Approach Structural Equation Modelling was carried out on a sample of 267 French users. The findings of this research support the significant positive effect of constructs set out in the TAM (perceived ease of use) on predicting behavioral intention by adding the effects identified for UTAUT variables. This research also demonstrates how perceived risk and trust are significant factors for models examining behavioral intentions to use IoT. Perceived risk enhanced by the trust has a significant effect on patients’ behavioral intentions. Moreover, the results highlight the key role of prescription as a moderator of IoT adoption in eHealth. Depending on whether an individual has a prescription to use connected devices or not, ease of use has a stronger impact on adoption, while trust has a negative impact on adoption for users without a prescription. In accordance with the empirical results, several practical implications can be proposed. All connected devices applied in a medical context should be divided into groups according to their functionality: whether they are essential for the patient’s health and whether they require a prescription or not. Devices used with a prescription are easily accepted because the intention to use them is moderated by the medical trust (discussed above). For users without a prescription, ease of use is a more significant factor than for users who have a prescription. This suggests that currently, connected e-Health devices and online healthcare systems have to take this factor into account to better meet the needs and expectations of end-users.

Keywords: internet of things, Healthcare, trust, consumer acceptance

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8500 Evaluation of the Impact of Telematics Use on Young Drivers’ Driving Behaviour: A Naturalistic Driving Study

Authors: WonSun Chen, James Boylan, Erwin Muharemovic, Denny Meyer

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In Australia, drivers aged between 18 and 24 remained at high risk of road fatality over the last decade. Despite the successful implementation of the Graduated Licensing System (GLS) that supports young drivers in their early phases of driving, the road fatality statistics for these drivers remains high. In response to these statistics, studies conducted in Australia prior to the start of the COVID-19 pandemic have demonstrated the benefits of using telematics devices for improving driving behaviour, However, the impact of COVID-19 lockdown on young drivers’ driving behaviour has emerged as a global concern. Therefore, this naturalistic study aimed to evaluate and compare the driving behaviour(such as acceleration, braking, speeding, etc.) of young drivers with the adoption of in-vehicle telematics devices. Forty-two drivers aged between 18 and 30 and residing in the Australian state of Victoria participated in this study during the period of May to October 2022. All participants drove with the telematics devices during the first 30-day. At the start of the second 30-day, twenty-one participants were randomised to an intervention group where they were provided with an additional telematics ray device that provided visual feedback to the drivers, especially when they committed to aggressive driving behaviour. The remaining twenty-one participants remined their driving journeys without the extra telematics ray device (control group). Such trustworthy data enabled the assessment of changes in the driving behaviour of these young drivers using a machine learning approach in Python. Results are expected to show participants from the intervention group will show improvements in their driving behaviour compared to those from the control group.Furthermore, the telematics data enable the assessment and quantification of such improvements in driving behaviour. The findings from this study are anticipated to shed some light in guiding the development of customised campaigns and interventions to further address the high road fatality among young drivers in Australia.

Keywords: driving behaviour, naturalistic study, telematics data, young drivers

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8499 Land Subsidence Monitoring in Semarang and Demak Coastal Area Using Persistent Scatterer Interferometric Synthetic Aperture Radar

Authors: Reyhan Azeriansyah, Yudo Prasetyo, Bambang Darmo Yuwono

Abstract:

Land subsidence is one of the problems that occur in the coastal areas of Java Island, one of which is the Semarang and Demak areas located in the northern region of Central Java. The impact of sea erosion, rising sea levels, soil structure vulnerable and economic development activities led to both these areas often occurs on land subsidence. To know how much land subsidence that occurred in the region needs to do the monitoring carried out by remote sensing methods such as PS-InSAR method. PS-InSAR is a remote sensing technique that is the development of the DInSAR method that can monitor the movement of the ground surface that allows users to perform regular measurements and monitoring of fixed objects on the surface of the earth. PS InSAR processing is done using Standford Method of Persistent Scatterers (StaMPS). Same as the recent analysis technique, Persistent Scatterer (PS) InSAR addresses both the decorrelation and atmospheric problems of conventional InSAR. StaMPS identify and extract the deformation signal even in the absence of bright scatterers. StaMPS is also applicable in areas undergoing non-steady deformation, with no prior knowledge of the variations in deformation rate. In addition, this method can also cover a large area so that the decline in the face of the land can cover all coastal areas of Semarang and Demak. From the PS-InSAR method can be known the impact on the existing area in Semarang and Demak region per year. The PS-InSAR results will also be compared with the GPS monitoring data to determine the difference in land decline that occurs between the two methods. By utilizing remote sensing methods such as PS-InSAR method, it is hoped that the PS-InSAR method can be utilized in monitoring the land subsidence and can assist other survey methods such as GPS surveys and the results can be used in policy determination in the affected coastal areas of Semarang and Demak.

Keywords: coastal area, Demak, land subsidence, PS-InSAR, Semarang, StaMPS

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8498 Minimum Wages and Its Impact on Agriculture and Non Agricultural Sectors with Special Reference to Recent Labour Reforms in India

Authors: Bikash Kumar Malick

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Labour reform is a most celebrated theme for policy makers, at the same time it is also a most misunderstood and skeptical concept even for the educated masses in India. One of the widely focused and discussed topics which needs an in-depth examination is India’s labour laws. It may actually help to reach points to understand the exact requirements in labour reforms by making the labour laws more simple and concise in form and its implementation. It is also a requirement to guide states in India in terms of making laws on it as Indian Constitution itself is federal in form and unitary in spirit. Recently, Codes of Wages Bill has been introduced in Indian Parliament while other three codes are waiting to come in the same line and those codes actually highlight the simplified features of labour laws to enable labour reform in a succinct manner. However, it still brings more confusion in minds of people. To wipe out the confusion and to bring a note and to put it for correlation among the labour reforms of both centre and states which both generates employment and make growth sustainable in India providing clear public understanding. This time is also ripe minimizing the apprehension about all the coming labour laws simplified in different codes in India. This article attempts to highlight the need of labour reform and its possible impact. It also examines the higher rates of minimum wages and its links with its coverage agriculture and nonagricultural sectors (including mines) over the period time. It also takes into consideration of central sphere and in states sphere minimum wage which are linked with Consumer Price Index to bring into account the living standard of workers and to examine the cause and effect between minimum wage and output in both agriculture and non agricultural sector with regression analysis. Increase in minimum wage has actually strengthened the sustainable output.

Keywords: codes of wages, indian constitution, minimum wage, labour laws, labour reforms

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8497 Indicators and Sustainability Dimensions of the Mediterranean Diet

Authors: Joana Margarida Bôto, Belmira Neto, Vera Miguéis, Manuela Meireles, Ada Rocha

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The Mediterranean diet has been recognized as a sustainable model of living with benefits for the environment and human health. However, a complete assessment of its sustainability, encompassing all dimensions and aspects, to our best knowledge, has not yet been realized. This systematic literature review aimed to fill this gap by identifying and describing the indicators used to assess the sustainability of the Mediterranean diet, looking at several dimensions, and presenting the results from their application. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines methodology was used, and searches were conducted in PubMed, Scopus, Web of Science, and GreenFile. There were identified thirty-two articles evaluating the sustainability of the Mediterranean diet. The environmental impact was quantified in twenty-five of these studies, the nutritional quality was evaluated in seven studies, and the daily cost of the diet was assessed in twelve studies. A total of thirty-three indicators were identified and separated by four dimensions of sustainability, specifically, the environmental dimension (ten indicators, namely carbon, water, and ecological footprint), the nutritional dimension (eight indicators, namely Health score and Nutrient Rich Food Index), the economic dimension (one indicator, the dietary cost), the sociocultural dimension (six indicators – with no results). Only eight of the studies used combined indicators. The Mediterranean diet was considered in all articles as a sustainable dietary pattern with a lower impact than Western diets. The carbon footprint ranged between 0.9 and 6.88 kg CO₂/d per capita, the water footprint between 600 and 5280 m³/d per capita, and the ecological footprint between 2.8 and 53.42 m²/d per capita. The nutritional quality was high, obtaining 122 points using the Health score and 12.95 to 90.6 points using the Nutrient Rich Food Index. The cost of the Mediterranean diet did not significantly differ from other diets and varied between 3.33 and 14.42€/d per capita. A diverse approach to evaluating the sustainability of the Mediterranean diet was found.

Keywords: Mediterranean diet, sustainability, environmental indicators, nutritional indicators

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8496 Exploring Gender-Based Violence in Indigenous Communities in Argentina and Costa Rica: A Review of the Current Literature

Authors: Jocelyn Jones

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The objective of this literature review is to provide an assessment of the current literature concerning gender-based violence (GBV) within indigenous communities in Argentina and Costa Rica, and various public intervention strategies that have been implemented to counter the increasing rates of violence within these populations. The review will address some of the unique challenges and contextual factors influencing the prevalence and response to such violence, including the enduring impact of colonialism on familial structures, community dynamics, and the perpetuation of violence. Drawing on indigenous feminist perspectives, the paper critically assesses the intersectionality of gender, ethnicity, and socio-economic status in shaping the experiences of indigenous women, men, and gender-diverse individuals. In comparing the two nations, the literature review identifies commonalities and divergences in policy frameworks, legal responses, and grassroots initiatives aimed at addressing GBV. Regarding the assessment of the efficacy of existing interventions, the paper will consider the role of cultural revitalization, community engagement, and collaborative efforts between indigenous communities and external agencies in the development of future policies. Moreover, the review will highlight the importance of decolonizing methodologies in research and intervention strategies, and the need to emphasise culturally sensitive approaches that respect and integrate indigenous worldviews and traditional knowledge systems. Additionally, the paper will explore the potential impact of colonial legacies, resource extraction, and land dispossession on exacerbating vulnerabilities to GBV within indigenous communities. The aim of this paper is to contribute to a more in-depth understanding of GBV in indigenous contexts in order to promote cross-cultural learning and inform future research. Ultimately, this review will demonstrate the necessity of adopting a holistic and context-specific approach to address gender-based violence in indigenous communities.

Keywords: gender based violence, indigenous, colonialism, literature review

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8495 Impact of Stress on Physical-Mental Wellbeing of Working Women in India: Awareness and Acceptability

Authors: Meera Shanker

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Excellent education and financial need have encouraged Indian women to go out and work in well-paid and high-status occupations. In the era of cutthroat competition, women are expected to work hard to produce the desired result; hence, workload and expectations haveincreased. At home, they are anticipated to take care of family members, children, and household work. Women are stretching themselves mechanically to remain in the job competition and try to give their best at home. Consequentially, they are under tremendous pressure, stressed, and having issues related to physical-mental wellness. Mental healthcare is often ignored and not accepted due to a lack of awareness and cultural barriers. These further compounds the problem, resulting in decreased productivity in economic terms and an increase in stress-related physical-mental ailments. The main objective of the study was to find out the impact of stress on the physical-mental wellbeing of working women in India, along with their awareness and acceptability related to mental health. Six hundred and one woman working at various levels took part in this study, responding to the items related to stress and physical-mental illness. Finally, 21 items were retained under four meaningful factors measuring stress dimensions along with 17 items with three factors measuring physical-mental wellbeing. Confirmatory Factor Analysis (CFA), path analysis, in Structural Equation Modeling (SEM), was used to get a relationship, validity of the instruments. The psychometric properties of items and Cronbach’s Alpha reliabilities calculated for the subscales were relatively acceptable. The subscale correlations, regression, and path analysis of stress dimensions with physical-mental illness were found to be positive, indicating the growing stress among working women in India, which is impacting their physical-mental health. Single item analysis revealed that 77 percent of women have never visited psychologists. However, 70 percent of working women were not ready to seek the help of a psychologist.

Keywords: working women, stress, physical-mental well-being, confirmatory factor analysis

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8494 Biorefinery Annexed to South African Sugar Mill: Energy Sufficiency Analysis

Authors: S. Farzad, M. Ali Mandegari, J. F. Görgens

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The South African Sugar Industry, which has a significant impact on the national economy, is currently facing problems due to increasing energy price and low global sugar price. The available bagasse is already combusted in low-efficiency boilers of the sugar mills while bagasse is generally recognized as a promising feedstock for second generation bioethanol production. Establishment of biorefinery annexed to the existing sugar mills, as an alternative for the revitalization of sugar industry producing biofuel and electricity has been proposed and considered in this study. Since the scale is an important issue in the feasibility of the technology, this study has taken into account a typical sugar mill with 300 ton/hr sugar cane capacity. The biorefinery simulation is carried out using Aspen PlusTM V8.6, in which the sugar mill’s power and steam demand has been considered. Hence, sugar mills in South Africa can be categorized as highly efficient, efficient, and not efficient with steam consumption of 33, 40, and 60 tons of steam per ton of cane and electric power demand of 10 MW; three different scenarios are studied. The sugar cane bagasse and tops/trash are supplied to the biorefinery process and the wastes/residues (mostly lignin) from the process are burnt in the CHP plant in order to produce steam and electricity for the biorefinery and sugar mill as well. Considering the efficient sugar mill, the CHP plant has generated 5 MW surplus electric powers, but the obtained energy is not enough for self-sufficiency of the plant (Biorefinery and Sugar mill) due to lack of 34 MW heat. One of the advantages of second generation biorefinery is its low impact on the environment and carbon footprint, thus the plant should be self-sufficient in energy without using fossil fuels. For this reason, a portion of fresh bagasse should be sent to the CHP plant to meet the energy requirements. An optimization procedure was carried out to find out the appropriate portion to be burnt in the combustor. As a result, 20% of the bagasse is re-routed to the combustor which leads to 5 tons of LP Steam and 8.6 MW electric power surpluses.

Keywords: biorefinery, sugarcane bagasse, sugar mill, energy analysis, bioethanol

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8493 Hormone Replacement Therapy (HRT) and Its Impact on the All-Cause Mortality of UK Women: A Matched Cohort Study 1984-2017

Authors: Nurunnahar Akter, Elena Kulinskaya, Nicholas Steel, Ilyas Bakbergenuly

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Although Hormone Replacement Therapy (HRT) is an effective treatment in ameliorating menopausal symptoms, it has mixed effects on different health outcomes, increasing, for instance, the risk of breast cancer. Because of this, many symptomatic women are left untreated. Untreated menopausal symptoms may result in other health issues, which eventually put an extra burden and costs to the health care system. All-cause mortality analysis may explain the net benefits and risks of the HRT therapy. However, it received far less attention in HRT studies. This study investigated the impact of HRT on all-cause mortality using electronically recorded primary care data from The Health Improvement Network (THIN) that broadly represents the female population in the United Kingdom (UK). The study entry date for this study was the record of the first HRT prescription from 1984, and patients were followed up until death or transfer to another GP practice or study end date, which was January 2017. 112,354 HRT users (cases) were matched with 245,320 non-users by age at HRT initiation and general practice (GP). The hazards of all-cause mortality associated with HRT were estimated by a parametric Weibull-Cox model adjusting for a wide range of important medical, lifestyle, and socio-demographic factors. The multilevel multiple imputation techniques were used to deal with missing data. This study found that during 32 years of follow-up, combined HRT reduced the hazard ratio (HR) of all-cause mortality by 9% (HR: 0.91; 95% Confidence Interval, 0.88-0.94) in women of age between 46 to 65 at first treatment compared to the non-users of the same age. Age-specific mortality analyses found that combined HRT decreased mortality by 13% (HR: 0.87; 95% CI, 0.82-0.92), 12% (HR: 0.88; 95% CI, 0.82-0.93), and 8% (HR: 0.92; 95% CI, 0.85-0.98), in 51 to 55, 56 to 60, and 61 to 65 age group at first treatment, respectively. There was no association between estrogen-only HRT and women’s all-cause mortality. The findings from this study may help to inform the choices of women at menopause and to further educate the clinicians and resource planners.

Keywords: hormone replacement therapy, multiple imputations, primary care data, the health improvement network (THIN)

Procedia PDF Downloads 170