Search results for: cost of illness

Authors: Steven G. Sclan

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Background: Since December 2019, the world has been afflicted by the spread of the Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2), which is responsible for the condition referred to as Covid-19. The illness has had a cataclysmic impact on the political, social, economic, and overall well-being of the population of the entire globe. While Covid-19 has had a substantial universal fatality impact, it may have an even greater effect on the socioeconomic, medical well-being, and healthcare planning for remaining societies. Significance: As these numbers illustrate, many more persons survive the infection than die from it, and many of those patients have noted ongoing, persistent symptoms after successfully enduring the acute phase of the illness. Recognition and understanding of these symptoms are crucial for developing and arranging efficacious models of care for all patients (whether or not having been hospitalized) surviving acute covid illness and plagued by post-acute symptoms. Furthermore, regarding Covid infection in children (< 18 y/o), although it may be that Covid “+” children are not major vectors of infective transmission, it now appears that many more children than initially thought are carrying the virus without accompanying obvious symptomatic expression. It seems reasonable to wonder whether viral effects occur in children – those children who are Covid “+” and now asymptomatic – and if, over time, they might also experience similar symptoms. An even more significant question is whether Covid “+” asymptomatic children might manifest increased multiple health problems as they grow – i.e., developmental complications (e.g., physical/medical, metabolic, neurobehavioral, etc.) – in comparison to children who had been consistently Covid “ - ” during the pandemic. Topics Addressed and Theoretical Importance: This review is important because of the description of both quantitative and qualitative methods for clinical and biomedical research. Topics reviewed will consider the importance of well-designed, comprehensive (i.e., quantitative and qualitative methods) longitudinal studies of Post Covid-19 symptoms in both adults and children. Also reviewed will be general characteristics of longitudinal studies and a presentation of a model for a proposed study. Also discussed will be the benefit of longitudinal studies for the development of efficacious interventions and for the establishment of cogent, practical, and efficacious community healthcare service planning for post-acute covid patients. Conclusion: Results of multi-dimensional, longitudinal studies will have important theoretical implications. These studies will help to improve our understanding of the pathophysiology of long COVID and will aid in the identification of potential targets for treatment. Such studies can also provide valuable insights into the long-term impact of COVID-19 on public health and socioeconomics.

Keywords: COVID-19, post-COVID-19, long COVID, longitudinal research, quantitative research, qualitative research

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Authors: Frank Aneke, Elizabeth Theron

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Demand for building materials in the last decade due to growing population, has caused scarcity of low-cost housing in South Africa. The investigation thoroughly examined dolomitic waste (DW), silica fume (SF) and River sand (RS) effects on the geotechnical behaviour of fly ash bricks. Bricks samples were prepared at different ratios as follows: I. FA1 contained FA70% + RS30%, II. FA2 contained FA60% + DW10%+RS30%, III. FA3 has a mix proportion of FA50% + DW20%+RS30%, IV. FA4 has a mix ratio FA40% + DW30%+RS30%, V. FA5 contained FA20% + DW40% + SF10%+RS30% by mass percentage of the FA material. However, utilization of this wastes in production of bricks, does not only produce a valuable commercial product that is cost effective, but also reduces a major waste disposal problem from the surrounding environment.

Keywords: bricks, dolomite, fly ash, industrial wastes

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Authors: Ebtisam A. Benomran, Abdurrauf M. Gusbi, Malak S. Elazarg, M. Sultan, Layla M. Kafu, Arwa M. Matoug, Esra E. Benamara

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Normal pregnancy is associated with metabolic changes leading to decreased insulin sensitivity and reduced glucose tolerance, however, 3-5% of pregnant women proceed to develop gestational diabetes mellitus (GDM). Researcher studied the use of metformin in many fields and the benefit to risk balance of using metformin during pregnancy and the risk of fetotoxic. In this study we examined the use of Metformin to control Glucose in pregnant Women with gestational diabetes mellitus (GDM) and evaluate its safety use during the first trimester of pregnancy.A group of pregnant patients with gestational diabetes mellitus from the first trimester of pregnancy, non smoking with no family history of congenital malformation disease, aged between (20-45 years) and have no liver diseases and who had indicating good compliance at more than one visit over several month until delivery put on Metformin were participated in this trial. Our study shown that all the studied group of pregnant women using metformin 500 mg daily delivered a healthy babies. Meta-analysis by mother risk program showed no increase in incidence of malformations by use Metformin during the first trimester of pregnancy. A hundred outpatients were participated in the survey on the general knowledge and awareness of diabetic patients to their illness and medication used their aged between 20-40 years old. In this survey we realize that 90% of the doctors are not giving the patient full information about their illness and the use of metformin during pregnancy, also about 65% of the patients did not know about the nutritionist in the hospital and the right control diet for diabetes. Courses on first aid, rapid diagnosis of poisoning and follow the written procedures to dealing with such cases.

Keywords: gestational diabetes, malformations, metformin, pregnancy

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Authors: Henry Lau, Dilupa Nakandala, Li Zhao

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All along the length of the supply chain, fresh food firms face the challenge of managing both product quality, due to the perishable nature of the products, and product cost. This paper develops a method to assist logistics managers upstream in the fresh food supply chain in making cost optimized decisions regarding transportation, with the objective of minimizing the total cost while maintaining the quality of food products above acceptable levels. Considering the case of multiple fresh food products collected from multiple farms being transported to a warehouse or a retailer, this study develops a total cost model that includes various costs incurred during transportation. The practical application of the model is illustrated by using several computational intelligence approaches including Genetic Algorithms (GA), Fuzzy Genetic Algorithms (FGA) as well as an improved Simulated Annealing (SA) procedure applied with a repair mechanism for efficiency benchmarking. We demonstrate the practical viability of these approaches by using a simulation study based on pertinent data and evaluate the simulation outcomes. The application of the proposed total cost model was demonstrated using three approaches of GA, FGA and SA with a repair mechanism. All three approaches are adoptable; however, based on the performance evaluation, it was evident that the FGA is more likely to produce a better performance than the other two approaches of GA and SA. This study provides a pragmatic approach for supporting logistics and supply chain practitioners in fresh food industry in making important decisions on the arrangements and procedures related to the transportation of multiple fresh food products to a warehouse from multiple farms in a cost-effective way without compromising product quality. This study extends the literature on cold supply chain management by investigating cost and quality optimization in a multi-product scenario from farms to a retailer and, minimizing cost by managing the quality above expected quality levels at delivery. The scalability of the proposed generic function enables the application to alternative situations in practice such as different storage environments and transportation conditions.

Keywords: cost optimization, food supply chain, fuzzy sets, genetic algorithms, product quality, transportation

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Authors: K. -H. Yang

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Supplier selection problem is one of the important issues of supply chain problems. Two categories of methodologies include qualitative and quantitative approaches which can be applied to supplier selection problems. However, due to the complexities of the problem and lacking of reliable and quantitative data, qualitative approaches are more than quantitative approaches. This study considers operational cost and supplier’s reliability factor and solves the problem by using a quantitative approach. A mixed integer programming model is the primary analytic tool. Analyses of different scenarios with variable cost and reliability structures show that the effectiveness of this approach to the supplier selection problem.

Keywords: mixed integer programming, quantitative approach, supplier’s reliability, supplier selection

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Authors: Garima Joshi, Pratap Sharan, V. Sreenivas, Nand Kumar, Kameshwar Prasad, Ashima N. Wadhawan

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Schizophrenia is a debilitating disorder and is marked by cognitive impairment, which deleteriously impacts the social and professional functioning along with the quality of life of the patients and the caregivers. Often the cognitive symptoms are in their prodromal state and worsen as the illness progresses; they have proven to have a good predictive value for the prognosis of the illness. It has been shown that intensive cognitive rehabilitation (CR) leads to improvements in the healthy as well as cognitively-impaired subjects. As the majority of population in India falls in the lower to middle socio-economic status and have low education levels, using the existing packages, a majority of which are developed in the West, for cognitive rehabilitation becomes difficult. The use of technology is also restricted due to the high costs involved and the limited availability and familiarity with computers and other devices, which pose as an impedance for continued therapy. Cognitive rehabilitation in India uses a plethora of retraining methods for the patients with schizophrenia targeting the functions of attention, information processing, executive functions, learning and memory, and comprehension along with Social Cognition. Psychologists often have to follow an integrative therapy approach involving social skills training, family therapy and psychoeducation in order to maintain the gains from the cognitive rehabilitation in the long run. This paper reviews the methodologies and cognitive retaining programs used in India. It attempts to elucidate the evolution and development of methodologies used, from traditional paper-pencil based retraining to more sophisticated neuroscience-informed techniques in cognitive rehabilitation of deficits in schizophrenia as home-based or supervised and guided programs for cognitive rehabilitation.

Keywords: schizophrenia, cognitive rehabilitation, neuropsychological interventions, integrated approached to rehabilitation

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Authors: Saurabh Gupta, Vanshdeep Parmar, Sri Harsha Reddy Yelly, Michele Baker, Elizabeth Bigler, Kunhee Choi

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It is known that the adoption of solar powered LED highway lighting systems or sensory LED highway lighting systems can dramatically reduce energy consumption by 55 percent when compared to conventional on-grid High Pressure Sodium (HPS) lamps that are widely applied to most highways. However, an initial high installation cost for building the infrastructure of solar photovoltaic devices hampers a wider adoption of such technologies. This research aims to examine currently available state-of-the-art solar photovoltaic and sensory technologies, identify major obstacles, and analyze each technology to create a benchmarking metrics from the benefit-cost analysis perspective. The on-grid HPS lighting systems will serve as the baseline for this study to compare it with other lighting alternatives such as solar and sensory LED lighting systems. This research will test the validity of the research hypothesis that alternative LED lighting systems produce more favorable benefit-cost ratios and the added initial investment costs are recouped by the savings in the operation and maintenance cost. The payback period of the excess investment and projected savings over the life-cycle of the selected lighting systems will be analyzed by utilizing the concept of Net Present Value (NPV). Researchers believe that if this study validates the research hypothesis, it can promote a wider adoption of alternative lighting systems that will eventually save millions of taxpayer dollars in the long-run.

Keywords: lighting systems, sensory and solar PV, benefit cost analysis, net present value

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Authors: Roman Asatryan

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The decision-making processes in Corporate Social Responsibility (CSR) among firms in general and airlines in particular have to do with the benefits that accrue through those investments. The crux of the matter is not whether to invest in CSR or not, but rather, how firms can quantify the benefits derived from such investments. This paper analyzes the cost benefit adjustment strategies for firms in the airline industry in their CSR strategy adoption and implementation. The adjustment strategies identified will enable firms in the airline industry to have a basis for determining the worth of such CSR investments. This paper discusses the cost and benefit analysis model in order to understand the ways airlines can reduce costs and increase returns on CSR, or balance the cost and benefits. The analysis from this study points to the fact that economic concepts especially the CBA are useful, though they are not without challenges. The challenge arises when it is problematic to express the real impact of the externality in monetary terms. The use of rational maximization of the gains may seem to be a rather optimistic goal mainly because of environmental variability, perceptual uncertainty, and imperfect knowledge about the potential externality. This paper concludes that the CBA model gives a basic understanding of the motivations for investing in intangible assets like CSR. Consequently, it sets the tone for formulating relevant hypothesis in empirical studies in investment in CSR in particular and other intangible assets in business operations.

Keywords: cost-benefit analysis, corporate social responsibility, airline industry

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Authors: Y. Jin, N. Zhang, X. Luo, W. Zhang

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China with annual increasing 0.5-0.6 billion squares city residence has brought in enormous energy consumption by HVAC facilities and other appliances. In this regard, governments and researchers are encouraging renewable energy like solar energy, geothermal energy using in houses. However, high cost of equipment and low energy conversion result in a very low acceptable to residents. So what’s the equilibrium point of eco-feedback to reach economic benefit and thermal comfort? That is the main question should be answered. In this paper, the objective is an on-site solar PV and heater house, which has been evaluated as a low energy building. Since HVAC system is considered as main energy consumption equipment, the residence with 24-hour monitoring system set to measure temperature, wind velocity and energy in-out value with no HVAC system for one month of summer and winter. Thermal comfort time period will be analyzed and confirmed; then the air-conditioner will be started within thermal discomfort time for the following one summer and winter month. The same data will be recorded to calculate the average energy consumption monthly for a purpose of whole day thermal comfort. Finally, two analysis work will be done: 1) Original building thermal simulation by computer at design stage with actual measured temperature after construction will be contrastive analyzed; 2) The cost of renewable energy facilities and power consumption converted to cost efficient rate to assess the feasibility of renewable energy input for residence. The results of the experiment showed that a certain deviation exists between actual measured data and simulated one for human thermal comfort, especially in summer period. Moreover, the cost-effectiveness is high for a house in targeting city Guilin now with at least 11 years of cost-covering. The conclusion proves that an eco-feedback of a low energy residence is never only consideration of its energy net value, but also the cost efficiency that is the critical factor to push renewable energy acceptable by the public.

Keywords: cost efficiency, eco-feedback, low energy residence, thermal comfort

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Authors: I.-A. Ciobotaru, I.-E. Ciobotaru, D.-I. Vaireanu

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Currently, an ascending trend of battery use may be observed, together with an increase of the generated amount of waste. Efforts have been focused on the recycling of batteries; however, extending their lifetime may be a more adequate alternative, and the development of such methods may prove to be more cost efficient as compared to recycling. In this context, this paper presents the analysis of a proposed process for the reconditioning of some lithium-ions batteries. The analysis is performed based on two criteria, the first one referring to the technical aspect of the reconditioning process and the second to the economic aspects. The main technical parameters taken into consideration are the values of capacitance and internal resistance of the lithium-ion batteries. The economic criterion refers to the evaluation of the efficiency of the reconditioning procedure reported to its total cost for the investigated lithium-ion batteries. Based on the cost analysis, one introduced a novel coefficient that correlates the efficiency of the aforementioned process and its corresponding costs. The reconditioning procedure for the lithium-ion batteries proposed in this paper proved to be valid, efficient, and with reasonable costs.

Keywords: cost assessment, lithium-ion battery, reconditioning coefficient, reconditioning procedure

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Authors: N. Anjana

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Worldwide, the prevalence of mental illnesses is increasing. The issues of persons with mental illness and their caregivers have been well documented in the literature. However, data regarding the factors affecting the caregiving experience of children with parental mental illnesses is sparse. This systematic review aimed to examine the existing literature of the factors affecting the caregiving experience of children of parents with mental illnesses. A comprehensive search of databases such as PubMed, EBSCO, JSTOR, ProQuest Central, Taylor and Francis Online, and Google Scholar were performed to identify peer-reviewed papers examining the factors associated with caregiving experiences of children with parental mental illnesses such as schizophrenia and major depression, for the 10-year period ending November 2019. Two researchers screened studies for eligibility. One researcher extracted data from eligible studies while a second performed verification of results for accuracy and completeness. Quality appraisal was conducted by both reviewers. Data describing major factors associated with caregiving experiences of children with parental mental illnesses were synthesized and reported in narrative form. Five studies were considered eligible and included in this review. Findings are organized under major themes such as the impact of parental mental illness on children’s daily life, how children provide care to their mentally ill parents as primary carers, social and relationship factors associated with their caregiving, positive and negative experiences in caregiving and how children cope with their experiences with parental mental illnesses. Literature relating to the caregiving experiences of children with parental mental illnesses is sparse. More research is required to better understand the children’s caregiving experiences related to parental mental illnesses so as to better inform management for enhancing their mental health, wellbeing, and caregiving practice.

Keywords: caregiving experience, children, parental mental illnesses, wellbeing

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Authors: Tamara Trček Pečak, Andrej Mohar, Denis Trček

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This article investigates the latest technological means, which deploy smart structures that are based on (advanced) wireless sensors technologies and ubiquitous computing in general in order to support the above mentioned decision making. Based on two years of in-field research experiences it gives their analysis for these kinds of purposes and provides appropriate architectures and architectural solutions. Moreover, the directions for future research are stated, because these technologies are currently the most promising ones to enable cost-effective preservation of cultural heritage not only in uncontrolled places, but also in general.

Keywords: smart structures, wireless sensors, sensors networks, green computing, cultural heritage preservation, monitoring, cost effectiveness

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Authors: Baris Can Yalcin

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Motion sensors have been commonly used as a valuable component in mechatronic systems, however, many mechatronic designs and applications that need motion sensors cost enormous amount of money, especially high-tech systems. Design of a software for communication protocol between data acquisition card and motion sensor is another issue that has to be solved. This study presents how to design a low cost motion data acquisition setup consisting of MPU 6050 motion sensor (gyro and accelerometer in 3 axes) and Arduino Mega2560 microcontroller. Design parameters are calibration of the sensor, identification and communication between sensor and data acquisition card, interpretation of data collected by the sensor.

Keywords: design, mechatronics, motion sensor, data acquisition

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Authors: Francis O. Iyoha, Daniel E. Gberevbie, Charles T. Iruonagbe, Matthew E. Egharevba

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Cost of governance in Nigeria has become a challenge to development and concern to practitioners and scholars alike in the field of business and social science research. It has been observed that it takes 70 percent of the nation’s revenue to maintain less than 20 percent of the Nigerian population that are public servants. Furthermore, it has been observed that on a consistent yearly basis, the recurrent expenditure of government from the national budget keeps rising, while capital expenditure meant for development keeps falling. The implication is that development is stagnated in the country. For instance, in the 2010 national budget of NGN4.60tn or USD28.75b, only NGN1.80tn or USD11.15b was set aside for capital expenditure. Also, in the 2013 national budget of NGN4.92tn or USD30.75b, only NGN1.50tn or USD9.38b was set aside for capital expenditure. Therefore, with the analysis of secondary data, this study examined the reasons for the high cost of governance in Nigeria. It observed that the high cost of governance in the country is in the interest of the ruling class, arising from their unethical behaviour – corrupt practices and the poor management of public resources. As a result, the study recommends the need to intensify the war against corruption and mismanagement of public resources by government officials as possible solution to overcome the high cost of governance in Nigeria. This could be achieved by strengthening the constitutional powers of the various anti-corruption agencies in the area of arrest, investigation and prosecution of offenders without the interference of the executive arm of government either at the local, state or federal level.

Keywords: cost of governance, capital expenditure, recurrent expenditure, unethical behavior, Nigeria

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Authors: D. M. Lewis, L. Frisby, U. Stead

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Objective: Many patients are receiving invasive treatments in acute care or are dying in hospital without having had comprehensive goals of care conversations. Some of these treatments may not align with the patient’s wishes, may be futile, and may cause unnecessary suffering. While many staff may recognize the benefits of engaging patients and families in Serious Illness Conversations (a goal of care framework developed by Ariadne Labs in Boston), few staff feel confident and/or competent in having these conversations in acute care. Another barrier to having these conversations may be due to a lack of incorporation in the current workflow. An educational exercise, titled the Two Question Challenge, was initiated on four medical units across two Vancouver Coastal Health (VCH) hospitals in attempt to engage the entire interdisciplinary team in asking patients and families questions around goals of care and to improve the documentation of these expressed wishes and preferences. Methods: Four acute care units across two separate hospitals participated in the Two Question Challenge. On each unit, over the course of two eight-hour shifts, all members of the interdisciplinary team were asked to select at least two questions from a selection of nine goals of care questions. They were asked to pose these questions of a patient or family member throughout their shift and then asked to document their conversations in a centralized Advance Care Planning/Goals of Care discussion record in the patient’s chart. A visual representation of conversation outcomes was created to demonstrate to staff and patients the breadth of conversations that took place throughout the challenge. Staff and patients were interviewed about their experiences throughout the challenge. Two palliative approach leads remained present on the units throughout the challenge to support, guide, or role model these conversations. Results: Across four acute care medical units, 47 interdisciplinary staff participated in the Two Question Challenge, including nursing, allied health, and a physician. A total of 88 questions were asked of patients, or their families around goals of care and 50 newly documented goals of care conversations were charted. Two code statuses were changed as a result of the conversations. Patients voiced an appreciation for these conversations and staff were able to successfully incorporate these questions into their daily care. Conclusion: The Two Question Challenge proved to be an effective way of having teams explore the goals of care of patients and families in an acute care setting. Staff felt that they gained confidence and competence. Both staff and patients found these conversations to be meaningful and impactful and felt they were notably different from their usual interactions. Documentation of these conversations in a centralized location that is easily accessible to all care providers increased significantly. Application of the Two Question Challenge in non-medical units or other care settings, such as long-term care facilities or community health units, should be explored in the future.

Keywords: advance care planning, goals of care, interdisciplinary, palliative approach, serious illness conversations

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Authors: Liping Yang, Curran Crawford, Jr. Ren, Zhengyi Ren

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Considering the cost evaluation and the stress analysis, a fuzzy satisfactory optimization (FSO) method has been developed for a hybrid composite flywheel. To evaluate the cost, the cost coefficients of the flywheel components are obtained through calculating the weighted sum of the scores of the material manufacturability, the structure character, and the material price. To express the satisfactory degree of the energy, the cost, and the mass, the satisfactory functions are proposed by using the decline function and introducing a satisfactory coefficient. To imply the different significance of the objectives, the object weight coefficients are defined. Based on the stress analysis of composite material, the circumferential and radial stresses are considered into the optimization formulation. The simulations of the FSO method with different weight coefficients and storage energy density optimization (SEDO) method of a flywheel are contrasted. The analysis results show that the FSO method can satisfy different requirements of the designer and the FSO method with suitable weight coefficients can replace the SEDO method.

Keywords: flywheel energy storage, fuzzy, optimization, stress analysis

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Authors: Pardhasaradhi Gudla, Imanual A.

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The generated electrical power in offshore needs to be transmitted to grid which is located in onshore by using subsea cables. Long subsea cables produce reactive power, which should be compensated in order to limit transmission losses, to optimize the transmission capacity, and to keep the grid voltage within the safe operational limits. Installation cost of wind farm includes the structure design cost and electrical system cost. India has targeted to achieve 175GW of renewable energy capacity by 2022 including offshore wind power generation. Due to sea depth is more in India, the installation cost will be further high when compared to European countries where offshore wind energy is already generating successfully. So innovations are required to reduce the offshore wind power project cost. This paper presents the optimized techniques to reduce the installation cost of offshore wind firm with respect to electrical transmission systems. This technical paper provides the techniques for increasing the current carrying capacity of subsea cable by decreasing the reactive power generation (capacitance effect) of the subsea cable. There are many methods for reactive power compensation in wind power plants so far in execution. The main reason for the need of reactive power compensation is capacitance effect of subsea cable. So if we diminish the cable capacitance of cable then the requirement of the reactive power compensation will be reduced or optimized by avoiding the intermediate substation at midpoint of the transmission network.

Keywords: offshore wind power, optimized techniques, power system, sub sea cable

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Authors: Muhammad Zafarullah Khan, Sumeera Abbasi

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The Farmers Field School (FFS) learning approach aims to improve knowledge of the farmers through integrated crop management and provide leadership in their decision making process. The study was conducted to assess the impact of FFS on vegetables production before and after FFS intervention in four villages of district Peshawar in cropping season 2012, by interviewing 80 FFS respondents, twenty from each selected village. It was observed from the study results that all the respondents were satisfied from the impact of FFS and they informed an increased in production in vegetables. It was further observed that after the implementation of FFS the sowing seed rate of tomato and cucumber were decreased from 0.185kg/kanal to 0.100 kg/ kanal and 0.120kg/kanal to 0.010kg/kanal where as the production of tomato and cucumber were increased from 8158.75kgs/kanal to 10302. 5kgs/kanal and 3230kgs/kanal to 5340kgs/kanal, respectively. The cost of agriculture inputs per kanal including seed cost, crop management, Farm Yard Manure, and weedicides in case of tomato were reduced by Rs.28, Rs. 3170, Rs.658and Rs 205 whereas in cucumber reduced by Rs.35, Rs.570, Rs 80 and Rs.430 respectively. Only fertilizers cost was increased by Rs. 2200 in case of tomato and Rs 465 in case of cucumber. Overall the cost was reduced to Rs 545 in tomato and Rs 490 in cucumber production.FFS provided a healthy vegetables and also reduced input cost by adopting integrated crop management. Therefore the promotion of FFS is needed to be planned for farmers to reduce cost of production, so that the more farmers should be benefited.

Keywords: impact, farmer field schools, vegetable production, Peshawar Khyber Pakhtunkhwa

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Authors: Dina Farran, Mark Ashworth, Fiona Gaughran

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Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is associated with an increased risk of stroke, contributing to heart failure and death. In this project, we aim to improve patient safety by screening for stroke risk among people with AF and co-morbid mental illness. To do so, we started by conducting a systematic review and meta-analysis on prevalence, management, and outcomes of AF in people with Serious Mental Illness (SMI) versus the general population. We then evaluated oral anticoagulation (OAC) prescription trends in people with AF and co-morbid SMI in King’s College Hospital. We also evaluated the association between mental illness severity and OAC prescription in eligible patients in South London and Maudsley (SLaM) NHS Foundation Trust. Next, we implemented an electronic clinical decision support system (eCDSS) consisting of a visual prompt on patient electronic Personal Health Records to screen for AF-related stroke risk in three Mental Health of Older Adults wards at SLaM. Finally, we assessed the feasibility and acceptability of the eCDSS by qualitatively investigating clinicians’ perspectives of the potential usefulness of the eCDSS (pre-intervention) and their experiences and their views regarding its impact on clinicians and patients (post-intervention). The systematic review showed that people with SMI had low reported rates of AF. AF patients with SMI were less likely to receive OAC than the general population. When receiving warfarin, people with SMI, particularly bipolar disorder, experienced poor anticoagulation control compared to the general population. Meta-analysis showed that SMI was not significantly associated with an increased risk of stroke or major bleeding when adjusting for underlying risk factors. The main findings of the first observational study were that among AF patients having a high stroke risk, those with co-morbid SMI were less likely than non-SMI to be prescribed any OAC, particularly warfarin. After 2019, there was no significant difference between the two groups. In the second observational study, patients with AF and co-morbid SMI were less likely to be prescribed any OAC compared to those with dementia, substance use disorders, or common mental disorders, adjusting for age, sex, stroke, and bleeding risk scores. Among AF patients with co-morbid SMI, warfarin was less likely to be prescribed to those having alcohol or substance dependency, serious self-injury, hallucinations or delusions, and activities of daily living impairment. In the intervention, clinicians were asked to confirm the presence of AF, clinically assess stroke and bleeding risks, record risk scores in clinical notes, and refer patients at high risk of stroke to OAC clinics. Clinicians reported many potential benefits for the eCDSS, including improving clinical effectiveness, better identification of patients at risk, safer and more comprehensive care, consistency in decision making and saving time. Identified potential risks included rigidity in decision-making, overreliance, reduced critical thinking, false positive recommendations, annoyance, and increased workload. This study presents a unique opportunity to quantify AF patients with mental illness who are at high risk of severe outcomes using electronic health records. This has the potential to improve health outcomes and, therefore patients' quality of life.

Keywords: atrial fibrillation, stroke, mental health conditions, electronic clinical decision support systems

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Authors: Chika Catherine Ayogu

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Rehabilitation plays an important and integral part in the life of roadway rehabilitation management system. It is a systematic method for inspection and rating the roadway condition in a given area. The system performs a cost effective analysis of various maintenance and rehabilitation strategies. Finally the system prioritize and recommend roadway rehabilitation and maintenance to maximize results within a given budget amount. During execution of maintenance activity, the system also tracks labour, materials, equipment and cost for activities performed. The system implements physical assessment field inspection and rating of each street segment which is then entered into a database. The information is analyzed using a software, and provide recommendations and project future conditions. The roadway management system provides a deterioration curve for each segment based on input then assigns the most cost-effective maintenance strategy based on conditions, surface type and functional classification, and available budget. This paper investigates the roadway management system and its capabilities to assist in applying the right treatment to the right roadway at the right time so that expected service life of the roadway is extended as long as possible with acceptable cost.

Keywords: effectiveness, rehabilitation, roadway, software system

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Authors: R.M. Asyraf, A. Norazah, S.M. Khairuddin, B. Noraziah

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Designing a system at present requires a vital, challenging task; to ensure the design philosophy is maintained in economical ways. This paper perceived the value engineering (VE) approach applied in infrastructure works, namely stormwater drainage. This method is adopted in line as consultants have completed the detailed design. Function Analysis System Technique (FAST) diagram and VE job plan, information, function analysis, creative judgement, development, and recommendation phase are used to scrutinize the initial design of stormwater drainage. An estimated cost reduction using the VE approach of 2% over the initial proposal was obtained. This cost reduction is obtained from the design optimization of the drainage foundation and structural system, where the pile design and drainage base structure are optimized. Likewise, the design of the on-site detention tank (OSD) pump was revised and contribute to the cost reduction obtained. This case study shows that the VE approach can be an important tool in optimizing the design to reduce costs.

Keywords: value engineering, function analysis system technique, stormwater drainage, cost reduction

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Authors: Katherine Carl Payne, Moshe Dror

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The problem of minimum cost routing has been extensively explored in a variety of contexts. While there is a prevalence of routing applications based on least distance, time, and related attributes, exertion-based routing has remained relatively unexplored. In particular, the network structures traditionally used to construct minimum cost paths are not suited to representing exertion or finding paths of least exertion based on road gradient. In this paper, we introduce a topographical network or “topograph” that enables minimum cost routing based on the exertion metric on each arc in a given road network as it is related to changes in road gradient. We describe an algorithm for topograph construction and present the implementation of the topograph on a road network of the state of California with ~22 million nodes.

Keywords: topograph, RPE, routing, GIS

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Authors: Arezoo Heidary, Abolfazl Mirzazadeh, Aref Gholami-Qadikolaei

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In the business environment it is very common that a lot received may not be equal to quantity ordered. in this work, a random disturbance in a received quantity is considered. It is assumed a maximum allowable limit for storage space and inventory investment.The impact of lead time and ordering cost reductions once they act dependently is also investigated. Further, considering a mixture of back order and lost sales for allowable shortage system, the effect of investment on reducing lost sale rate is analyzed. For the proposed control system, a Lagrangian method is applied in order to solve the problem and an algorithmic procedure is utilized to achieve optimal solution with the global minimum expected cost. Finally, proves on concavity and convexity of the model in the decision variables are shown.

Keywords: stochastic inventory system, lead time, ordering cost, lost sale rate, inventory constraints, random disturbance

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Authors: Getachew Tilahun, Oluwole Makinde, David Malonza

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We propose and analyze a non-linear mathematical model for the transmission dynamics of pneumonia disease in a population of varying size. The deterministic compartmental model is studied using stability theory of differential equations. The effective reproduction number is obtained and also the local and global asymptotically stability conditions for the disease free and as well as for the endemic equilibria are established. The model exhibit a backward bifurcation and the sensitivity indices of the basic reproduction number to the key parameters are determined. Using Pontryagin’s maximum principle, the optimal control problem is formulated with three control strategies; namely disease prevention through education, treatment and screening. The cost effectiveness analysis of the adopted control strategies revealed that the combination of prevention and treatment is the most cost effective intervention strategies to combat the pneumonia pandemic. Numerical simulation is performed and pertinent results are displayed graphically.

Keywords: cost effectiveness analysis, optimal control, pneumonia dynamics, stability analysis, numerical simulation

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Authors: Ke Fan, Edwin H. W. Chan

Abstract:

Economic incentives of green building (GB) have been implemented to promote green building and address the market barriers. However, if developers could gain from the incentives, why not all the buildings are green? This paper aims to study this problem and provide a new perspective to look at the economic incentives. The theories of Transitional Gains Trap (TGP) and Transaction Cost Economics (TCE) are employed to explain the developers’ gains and losses from the economic incentives. This paper takes the GFA (gross floor area) concession incentive in Hong Kong, which is one of the most popular incentives, as the case to conduct in-depth case study and it did interview to validate the results. The results show that after implementing the GFA concession scheme, the benefit of the GFA concession is capitalized into land value. Therefore, developers have to bear the increased land cost, which supports the theory of the TGP. Even though, some developers are still not willing to participate in the incentive scheme because of high transaction costs (TCs).

Keywords: green building, economic incentives, transitional gains trap, transaction cost

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Authors: Ming-Jong Yao, Chin-Sum Shui, Chih-Han Wang

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This paper is developed based on a real-world decision scenario that an industrial gas company that applies the Vendor Managed Inventory model and supplies liquid oxygen with a self-operated heterogeneous vehicle fleet to hospitals in nearby cities. We name it as a Joint Replenishment and Heterogeneous Vehicle Routing Problem with Cyclical Schedule and formulate it as a non-linear mixed-integer linear programming problem which simultaneously determines the length of the planning cycle (PC), the length of the replenishment cycle and the dates of replenishment for each customer and the vehicle routes of each day within PC, such that the average daily operation cost within PC, including inventory holding cost, setup cost, transportation cost, and overtime labor cost, is minimized. A solution method based on genetic algorithm, embedded with an encoding and decoding mechanism and local search operators, is then proposed, and the hash function is adopted to avoid repetitive fitness evaluation for identical solutions. Numerical experiments demonstrate that the proposed solution method can effectively solve the problem under different lengths of PC and number of customers. The method is also shown to be effective in determining whether the company should expand the storage capacity of a customer whose demand increases. Sensitivity analysis of the vehicle fleet composition shows that deploying a mixed fleet can reduce the daily operating cost.

Keywords: cyclic inventory routing problem, joint replenishment, heterogeneous vehicle, genetic algorithm

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Authors: Bonginkosi A. Thango, Jacobus A. Jordaan, Agha F. Nnachi

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In this day and age, there is a proliferate concern from all governments across the globe to barricade the environment from greenhouse gases, which absorb infrared radiation. As a result, solar photovoltaic (PV) electricity has been an expeditiously growing renewable energy source and will eventually undertake a prominent role in the global energy generation. The selection and purchasing of energy-efficient transformers that meet the operational requirements of the solar photovoltaic energy generation plants then become a part of the Independent Power Producers (IPP’s) investment plan of action. Taking these into account, this paper proposes a procedure that put into effect the intricate financial analysis necessitated to precisely evaluate the transformer service lifetime no-load and load loss factors. This procedure correctly set forth the transformer service lifetime loss factors as a result of a solar PV plant’s sporadic generation profile and related levelized costs of electricity into the computation of the transformer’s total ownership cost. The results are then critically compared with the conventional transformer total ownership cost unaccompanied by the emission costs, and demonstrate the significance of the sporadic energy generation nature of the solar PV plant on the total ownership cost. The findings indicate that the latter play a crucial role for developers and Independent Power Producers (IPP’s) in making the purchase decision during a tender bid where competing offers from different transformer manufactures are evaluated. Additionally, the susceptibility analysis of different factors engrossed in the transformer service lifetime cost is carried out; factors including the levelized cost of electricity, solar PV plant’s generation modes, and the loading profile are examined.

Keywords: solar photovoltaic plant, transformer, total ownership cost, loss factors

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Authors: Michelle Nighswander

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Suicide can be a tragic response to mental illness. It is difficult for people to disclose or discuss suicidal impulses. The stigma surrounding mental health can create a reluctance to seek help for mental illness. Patients may feel pressure to exhibit a socially desirable demeanor rather than reveal these issues, especially if they sense their healthcare provider is pressed for time or does not have an extensive history with their provider. Overcoming these barriers can be challenging. Although there are several validated depression and suicide risk instruments, varying processes used to administer these tools may impact the truthfulness of the responses. A literature review was conducted to find evidence of the impact of the environment on the accuracy of depression screening. Many investigations do not describe the environment and fewer studies use a comparison design. However, three studies demonstrated that computerized self-reporting might be more likely to elicit truthful and accurate responses due to increased privacy when responding compared to a face-to-face interview. These studies showed patients reported positive reactions to computerized screening for other stigmatizing health conditions such as alcohol use during pregnancy. Computerized self-screening for depression offers the possibility of more privacy and patient reflection, which could then send a targeted message of risk to the healthcare provider. This could potentially increase the accuracy while also increasing time efficiency for the clinic. Considering the persistent effects of mental health stigma, how these screening questions are posed can impact patients’ responses. This literature review analyzes trends in depression screening methodologies, the impact of setting on the results and how this may assist in overcoming one barrier caused by stigma.

Keywords: computerized self-report, depression, mental health stigma, suicide risk

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Authors: Helga Martins, Idália Matias

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Background:Multiple sclerosis is a chronic inflammatory autoimmune demyelinating disease that affects young adults. Multiple sclerosis is a chronic disease in which the patient needs to self-manage the disease and the therapeutic regimen. Consequently, the promotion of health literacy assumes a relevant role for the accessibility, understanding, and use of information in order to promote and maintain the health of patients with multiple sclerosis. Aim: To determine the impact of lower health literacy in the self-management of patients with a multiple sclerosis. Methods: Literature review based on a search on the following electronic databases: CINAHLand MEDLINE; comprising all results published between September 2016 and September 2021. The search strategy was: (“Self-management [MeSH]” AND “Multiple sclerosis[MeSH]”AND “Health literacy[MeSH]”). The inclusion criteria were: original papers reporting about multiple sclerosis patients; participants with age above 18 years old, written in English, Spanish, French, or Portuguese. Two independent reviewers have done the screening and analysis of the results. 38 citations were identified, and after duplicates removal, a total of 25 results were screened; 14 were included after the application of the inclusion criteria. Results: The lower health literacy in the self-management of patients with a multiple sclerosis is related toless healthy choices, riskier health behavior, poor health outcomes, decreased of adhering to the therapeutic regimen after discharge, less self-management of chronic illness, and increased the time of hospitalization. Conclusion: Inadequate levels of health literacy contribute to poor health outcomes, unsuccessful self-management of chronic illness, and inadequate adherence to the therapeutic regimen. Therefore, health literacy is important for health policy and the healthcare services, as it can be understood as a mediator of self-management of multiple sclerosis disease.

Keywords: health literacy, multiple sclerosis, review, self-management

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Authors: Nsimbe Allan

Abstract:

The study examines the impact of Building Information Modeling (BIM) on the cost management of engineering projects, focusing specifically on the Mombasa Port Area Development Project. The objective of this research venture is to determine the mechanisms through which Building Information Modeling (BIM) facilitates stakeholder collaboration, reduces construction-related expenses, and enhances the precision of cost estimation. Furthermore, the study investigates barriers to execution, assesses the impact on the project's transparency, and suggests approaches to maximize resource utilization. The study, selected for its practical significance and intricate nature, conducted a Systematic Literature Review (SLR) using credible databases, including ScienceDirect and IEEE Xplore. To constitute the diverse sample, 69 individuals, including project managers, cost estimators, and BIM administrators, were selected via stratified random sampling. The data were obtained using a mixed-methods approach, which prioritized ethical considerations. SPSS and Microsoft Excel were applied to the analysis. The research emphasizes the crucial role that project managers, architects, and engineers play in the decision-making process (47% of respondents). Furthermore, a significant improvement in cost estimation accuracy was reported by 70% of the participants. It was found that the implementation of BIM resulted in enhanced project visibility, which in turn optimized resource allocation and facilitated the process of budgeting. In brief, the study highlights the positive impacts of Building Information Modeling (BIM) on collaborative decision-making and cost estimation, addresses challenges related to implementation, and provides solutions for the efficient assimilation and understanding of BIM principles.

Keywords: cost management, resource utilization, stakeholder collaboration, project transparency

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