Search results for: healthcare waste disposal

Authors: Madhvi Bhayani

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Introduction: Due to the rapid pace of urbanization, the urban health issues have become one of the significant threats to future development in India. It also poses serious repercussions on the citizen’s health. As urbanization in India is increasing at an unprecedented rate and it has generated the urban health crisis among the city dwellers especially the urban poor. The increasing proportion of the urban poor and vulnerable to the health indicators worse than the rural counterparts, they face social and financial barriers in accessing healthcare services and these conditions make human health at risk. The Local as well as the State and National governments are alike tackling with the challenges of urbanization as it has become very essential for the government to provide the basic necessities and better infrastructure that make life in cities safe and healthy. Thus, the paper argues that if no major realistic steps are taken with immediate effect, the citizens will face a huge burden of health hazards. Aim: This paper attempts to analyze the current infrastructure, government planning, and its future policy, it also discusses the challenges and outcomes of urbanization on health and its impact on it and it will also predict the future trend with regard to disease burden in the urban areas. Methods: The paper analyzes on the basis of the secondary data by taking into consideration the connection between the Rapid Urbanization and Public Health Challenges, health and health care system and its services delivery to the citizens especially to the urban poor. Extensive analyses of government census reports, health information and policy, the government health-related schemes, urban development and based on the past trends, the future status of urban infrastructure and health outcomes are predicted. The social-economic and political dimensions are also taken into consideration from regional, national and global perspectives, which are incorporated in the paper to make realistic predictions for the future. Findings and Conclusion: The findings of the paper show that India suffers a lot due to the double burden of rapidly increasing in diseases and also growing health inequalities and disparities in health outcomes. Existing tools of governance of urban health are falling short to provide the better health care services. They need to strengthen the collaboration and communication among the state, national and local governments and also with the non-governmental partners. Based on the findings the policy implications are then described and areas for future research are defined.

Keywords: health care, urbanization, urban health, service delivery

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Authors: Kanik Sharma

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In the year of 2011, the global production of carbon nano-materials (CNMs) was around 3,500 tons, and it is projected to expand at a compound annual growth rate of 30.6%. Expanding markets for applications of CNMs, such as carbon nano-tubes (CNTs) and carbon nano-fibers (CNFs), place ever-increasing demands on lowering their production costs. Current technologies for CNM generation require intensive premium feedstock consumption and employ costly catalysts; they also require input of external energy. Industrial-scale CNM production is conventionally achieved through chemical vapor deposition (CVD) methods which consume a variety of expensive premium chemical feedstocks such as ethylene, carbon monoxide (CO) and hydrogen (H2); or by flame synthesis techniques, which also consume premium feedstock fuels. Additionally, CVD methods are energy-intensive. Renewable and replenishable feedstocks, such as those found in municipal, industrial, agricultural recycling streams have a more judicious reason for usage, in the light of current emerging needs for sustainability. Agricultural sugarcane bagasse and corn residues, scrap tire chips as well as post-consumer polyethylene (PE) and polyethylene terephthalate (PET) bottle shreddings when either thermally treated by sole pyrolysis or by sequential pyrolysis and partial oxidation result in the formation of gaseous carbon-bearing effluents which when channeled into a heated reactor, produce CNMs, including carbon nano-tubes, catalytically synthesized therein on stainless steel meshes. The structure of the nano-material synthesized depends on the type of feedstock available for pyrolysis, and can be determined by analysing the feedstock. These feedstocks could supersede the use of costly and often toxic or highly-flammable chemicals such as hydrocarbon gases, carbon monoxide and hydrogen, which are commonly used as feedstocks in current nano-manufacturing process for CNMs.

Keywords: nanomaterials, waste plastics, sugarcane bagasse, pyrolysis

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Authors: Bridgette Merriman, Wen Fan

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Background: Existing cancer survivorship literature explores varying physical, psychosocial, and psychological late effects experienced by survivors of childhood cancer. However, adolescent and young adult (AYA) survivors of childhood cancer are understudied compared to their adult and pediatric cancer counterparts. Furthermore, existing quality of life (QoL) research fails to account for how cancer survivorship affects survivors across the lifespan. Given that prior research suggests positive cognitive appraisals of adverse events - such as cancer - mitigate detrimental psychosocial symptomologies later in life; it is crucial to understand cancer’s impacts on AYA survivors of childhood malignancies across the life course in order to best support these individuals and prevent maladaptive psychosocial outcomes. Methods: This qualitative study adopted the life-course perspective to investigate the experiences of AYA survivors of childhood malignancies. Eligible patients included AYA 21-30 years old who were diagnosed with cancer <18 years old and off active treatment for >2 years. Participants were recruited through social media posts. Study fulfillment included taking part in one semi-structured video interview to explore areas of survivorship previously identified as being specific to AYA survivors. Interviews were transcribed, coded, and analyzed in accordance with narrative analysis and life-course theory. This study was approved by the Boston College Institutional Review Board. Results: Of 28 individuals who met inclusion criteria and expressed interest in the study, nineteen participants (12 women, 7 men, mean age 25.4 years old) completed the study. Life course theory analysis revealed that events relating to childhood cancer are interconnected throughout the life course rather than isolated events. This “trail of survivorship” includes age at diagnosis, transitioning to life after cancer, and relationships with other childhood survivors. Despite variability in objective characteristics surrounding these events, participants recalled positive experiences regarding at least one checkpoint, ultimately finding positive meaning from their cancer experience. Conclusions: These findings suggest that favorable subjective experiences at these checkpoints are critical in fostering positive conceptions of childhood malignancy for AYA survivors of childhood cancer. Ultimately, healthcare professionals and communities may use these findings to guide support resources and interventions for childhood cancer patients and AYA survivors, therein minimizing detrimental psychosocial effects and maximizing resiliency.

Keywords: medical sociology, pediatric oncology, survivorship, qualitative, life course perspective

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Authors: Jessica Ding

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The field of global health is currently advocating for a resurgence in the use of traditional medicines to improve people-centered care. Healthcare policies are rapidly changing in response; in China, the increasing presence of TCM in the same spaces as biomedicine has led to a new term: integrative medicine. However, the existence of TCM as a part of integrative medicine creates a pressing paradoxical tension where TCM is both seen as a marginalized system within ‘modern’ hospitals and as a modality worth integrating. Additionally, the impact of such shifts has not been fully explored: the World Health Organization for one focuses only on three angles —practices, products, and practitioners— with regards to traditional medicines. Through ten weeks of fieldwork conducted at an urban hospital in Shanghai, China, this research expands the perspective of existing strategies by looking at integrative care through a fourth lens: patients and families. The understanding of self-care, health-seeking behavior, and non-professional caregiving structures are critical to grasping the significance of traditional medicine for people-centered care. Indeed, those individual and informal health care expectations align with the very spaces and needs that traditional medicine has filled before such ideas of integration. It specifically looks at this issue via three processes that operationalize experiences of care: (1) how aspects of TCM are valued within integrative medicine, (2) how negotiations of care occur between patients and doctors, and (3) how 'good quality' caregiving presents in integrative clinical spaces. This research hopes to lend insight into how culturally embedded traditions, bureaucratic and institutional rationalities, and social patterns of health-seeking behavior influence care to shape illness experiences at the intersection of two medical modalities. This analysis of patients’ clinical and illness experiences serves to enrich the narratives of integrative medical care’s ability to provide patient-centered care to determine how international policies are realized at the individual level. This anthropological study of the integration of Traditional Chinese medicine in local contexts can reveal the extent to which global strategies, as promoted by the WHO and the Chinese government actually align with the expectations and perspectives of patients receiving care. Ultimately, this ethnographic analysis of a local Chinese context hopes to inform global policies regarding the future use and integration of traditional medicines.

Keywords: emergent systems, global health, integrative medicine, traditional Chinese medicine, TCM

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Authors: Selin Tosun

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The improvements in technology have started to transform the way we live, work, play, and commute in our cities. The emerging smart city understanding has been paving the way for more efficient, more useful, and more profitable cities. Smart sensors, smart lighting, smart waste, water and electricity management, smart transportation and communication systems are introduced to cities at a rapid pace. In today's world, innovation is often correlated with start-up companies and technological pioneers seeking broader economic objectives such as production and competitiveness. The government's position is primarily that of an enabler, with creativity mostly coming from the private sector. The paper argues that to achieve sustainable development, the ways in which smart and sustainable city approaches are being applied to cities need to be redefined. The research aims to address common discussions in the discourse of smart and sustainable cities criticizing the priority of lifestyle sterilization over human-centered sustainable interventions and social innovation strategies. The dichotomy between the fact that smart cities are mostly motivated by the competitive global market and the fact that the delocalization is, in fact, their biggest problem in the way of becoming authentic, sustainable cities is the main challenge that we face today. In other words, the key actors in smart cities have different and somewhat conflicting interests and demands. By reviewing the roles of the public and private actors in smart city making, the paper aspires to reconceptualize the understanding of “smartness” in achieving sustainable development in which the “smartness” is understood as a multi-layered complex phenomenon that can be channeled through different dynamics. The case cities around the world are explored and compared in terms of their technological innovations, governance and policy innovations, public-private stakeholder relationships, and the understanding of the public realm. The study aims to understand the current trends and general dynamics in the field, key issues that are being addressed, the scale that is preferred to reflect upon and the projects that are designed for the particular issues.

Keywords: smart city, sustainable development, technological innovation, social innovation

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Authors: Areti Angeliki Veroniki, Sofia Tsokani, Evangelos Paraskevaidis, Dimitris Mavridis

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The plethora of diagnostic test accuracy (DTA) studies has led to the increased use of systematic reviews and meta-analysis of DTA studies. Clinicians and healthcare professionals often consult DTA meta-analyses to make informed decisions regarding the optimum test to choose and use for a given setting. For example, the human papilloma virus (HPV) DNA, mRNA, and cytology can be used for the cervical intraepithelial neoplasia grade 2+ (CIN2+) diagnosis. But which test is the most accurate? Studies directly comparing test accuracy are not always available, and comparisons between multiple tests create a network of DTA studies that can be synthesized through a network meta-analysis of diagnostic tests (DTA-NMA). The aim is to summarize the DTA-NMA methods for at least three index tests presented in the methodological literature. We illustrate the application of the methods using a real data set for the comparative accuracy of HPV DNA, HPV mRNA, and cytology tests for cervical cancer. A search was conducted in PubMed, Web of Science, and Scopus from inception until the end of July 2019 to identify full-text research articles that describe a DTA-NMA method for three or more index tests. Since the joint classification of the results from one index against the results of another index test amongst those with the target condition and amongst those without the target condition are rarely reported in DTA studies, only methods requiring the 2x2 tables of the results of each index test against the reference standard were included. Studies of any design published in English were eligible for inclusion. Relevant unpublished material was also included. Ten relevant studies were finally included to evaluate their methodology. DTA-NMA methods that have been presented in the literature together with their advantages and disadvantages are described. In addition, using 37 studies for cervical cancer obtained from a published Cochrane review as a case study, an application of the identified DTA-NMA methods to determine the most promising test (in terms of sensitivity and specificity) for use as the best screening test to detect CIN2+ is presented. As a conclusion, different approaches for the comparative DTA meta-analysis of multiple tests may conclude to different results and hence may influence decision-making. Acknowledgment: This research is co-financed by Greece and the European Union (European Social Fund- ESF) through the Operational Programme «Human Resources Development, Education and Lifelong Learning 2014-2020» in the context of the project “Extension of Network Meta-Analysis for the Comparison of Diagnostic Tests ” (MIS 5047640).

Keywords: colposcopy, diagnostic test, HPV, network meta-analysis

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Authors: Daniel Karthik, Vijay Baheti, Jiri Militky, Sundaramurthy Palanisamy

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Fibre based nano particles are presently considered as one of the potential filler materials for the improvement of mechanical and physical properties of polymer composites. Due to high matrix-filler interfacial area there will be uniform and homogeneous dispersion of nanoparticles. In micro/nano filler reinforced composites, resin material is usually tailored by organic or inorganic nanoparticles to have improved matrix properties. The objective of this study was to compare the potential of reinforcement of different organic and inorganic micro/nano fillers in epoxy composites. Industrial and agricultural waste of fibres like Agave Americana, cornhusk, jute, basalt, carbon, glass and fly ash was utilized to prepare micro/nano particles. Micro/nano particles were obtained using high energy planetary ball milling process in dry condition. Milling time and ball size were kept constant throughout the ball milling process. Composites were fabricated by hand lay method. Particle loading was kept constant to 3% wt. for all composites. In present study, loading of fillers was selected as 3 wt. % for all composites. Dynamic mechanical properties of the nanocomposite films were performed in three-point bending mode with gauge length and sample width of 50 mm and 10 mm respectively. The samples were subjected to an oscillating frequency of 1 Hz, 5 Hz and 10 Hz and 100 % oscillating amplitude in the temperature ranges of 30°C to 150°C at the heating rate of 3°C/min. Damping was found to be higher with the jute composites. Amongst organic fillers lowest damping factor was observed with Agave Americana particles, this means that Agave americana fibre particles have betters interface adhesion with epoxy resin. Basalt, fly ash and glass particles have almost similar damping factors confirming better interface adhesion with epoxy.

Keywords: ball milling, damping factor, matrix-filler interface, particle reinforcements

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Authors: Mitchell De Sousa

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The city of Buenos Aires and its agglomeration concentrates more than the thirty percent of the Argentine population. Historically, the political governments (essentially during the neoliberal ones) focused all the equipment, investment, progress on the north of the city since it is the place where all the financial, core services, and the main country harbor is. The south part of the town and all the cities around the south portion of it is has been, historically, where are concentrated the more vital unfulfilled needs of this population. The river that cross over the urban agglomeration of Buenos Aires, the Matanza-Riachuelo, has been historically a place of urban segregation since it is located south of the main town. From the post-colonial times, the river has been officially a place that separates the jurisdiction of the city of Buenos Aires with some of the towns that were built around the urban agglomeration. Since its place has never been treated as a whole and has always been treated as a boundary, there is always been a focus for factories to dispose its waste and an attractive place for a large portion of the underclasses to settled down there, occupying illegally the previous terrains that were once from the railway, now abandoned. Regarding those issues and adding a one more problematic one, those who lives beyond the boundary has few access to enter the main capital city. A few bridges connect some portions of it over the Matanza Riachuelo River, which there is also a limited accessibility to the main city from the south. Because of such, the main entrances to the town are always collapsed by all the services that the urban agglomeration offer (from buses to trains and individual cars). Beyond all the enlisted problems, the contamination of the river makes it one of the most contaminated rivers on the entire world. Those who lives in the settlements are in there for themselves, so the fight from them to their right of the city and their claims to the state for intervention in the urban coast is one of the most promising discussions surrounding this place of this urban agglomeration. The study focuses on the perception of those who lives in this boundary through interviews and collective experiences and is a part of a more developed project in the University of Buenos Aires study called ‘Urban landscape and a sustainable study through the interdisciplinary. Urban strategies on city borders’.

Keywords: Buenos Aires, landscape, mobility, popular sectors, urban segregation

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Authors: Warner Woodworth

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While the explosion of autocratic governments is growing globally, perhaps nowhere is it more obvious than in the United States since 2015. In that nation, democracy is increasingly caving to extreme Right-wing movements, especially after Donald Trump lost to Joe Biden in the 2020 election. Angered by that rejection, he and his support groups that foster extremism began an all-out assault on freedom, beginning with the attack on the US Capitol itself on January 6, 2021. Since then, following Trump’s two presidential impeachments, 34 felony convictions, 88 impending court cases by the Department of Justice, and crimes by some of his most ardent co-conspirators, the rule of law, traditional political values, and even the Constitution became threatened. Now, since his Nov. 5, 2024, campaign victory, the dark clouds of autocracies loom larger every day. To wit: Appointments to Trump’s cabinet are all extremists promising to eliminate major beneficiary citizen programs such as healthcare, civil rights, education, justice, and a massive move to drive millions of immigrants from the country. The political divide is at its highest extreme since the 1861 Civil War between North and South. Autocratization is manifest daily in fake news media, as well as traditional conspiracy organizations such as politically violent motorcycle gangs, the John Birch Society, Eagle Forum, and Anti-Constitutional Sheriffs and other law enforcement groups. Even worse is the expansion of violent groups such as the Proud Boys, Aryan Nations, Patriot Front, White Nationalists, Stormfront, Oath Keepers, Three Percenters, Ku Klux Klan, Moms for Liberty, American Nazi Party, Operation Homeland, Skinhead organizations, America First, Veterans on Patrol, hundreds of militia groups from coast to coast, and of course, hundreds more under the banner of Trump’s movement, ‘Make America Great Again.’ This paper will draw on the author’s decades of researching these groups and Trump's new authoritarian agenda. Qualitative data will include expert analysis from multiple academic disciplines as Americans, and the larger world seek to understand these dangerous U.S. trends and future prospects. The paper concludes by sharing the prospects of America’s future over the next four years, or longer if Trump’s vow to be a dictator is extended.

Keywords: American authoritarianism, trump, fascism, conspiracies, extremism

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Authors: Jovana Petrovic, Biljana Pajin, Ivana Loncarevic, Aleksandar Fistes, Antun Jozinivic, Durdica Ackar, Drago Subaric

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Recovery of food wastes and their conversion to economically viable products will play a vital role for the management strategies in the years to come. Apple pomace may be considered as wastes, but they contain considerable amounts of high value reusable materials. Apple pomace, the by-product of apple juice and cider production, is a good source of fibre, particularly insoluble one. The remaining apple pulp contains 12% dry residue, which is half dietary fibre. Another remarkable aspect is its richness in polyphenols, components with antioxidant activity. Apple pomace could be an interesting alternative source for fibre and polyphenols in extruded corn meals. The extruded corn meals with the addition of finely ground apple pomace were prepared (the ratio of corn meal: apple pomace was 85:15 and 70:30). Characterization of the extrudates in terms of determining the chemical composition and colour was performed. The color of samples was measured by MINOLTA Chroma Meter CR-400 (Minolta Co., Ltd., Osaka, Japan) using D 65 lighting, a 2º standard observer angle and an 8-mm aperture in the measuring head. The following CIELab color coordinates were determined: L* – lightness, a* – redness to greenness and b* – yellowness to blueness. Protein content decreased significantly from 7.91% to 5.19% with increase in pomace from 0% to 30%, while total fibre content increase from 3.39% to 16.62%. The apple pomace addition produced extrudates with a significantly lower L* value and significantly higher a* value. This study has been fully supported by the Provincial Secretariat for High Education and Scientific Research of the Government of Autonomous Province of Vojvodina, Republic of Serbia, project 142-451-2483/2017 and the Ministry of Science and Technological Development of the Republic of Serbia (Project no. 31014).

Keywords: apple pomace, chemical composition, colour, extruded corn snack products, food waste recovery

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Authors: Renee Yi-Mond Yuan

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The fast development of tourism industries around the world, has largely contributed to many cities, and countries economical and social progress. Past year Taiwan in particular was ranked among one of fastest raise growth country. Thanks to the prominent importance of this phenomenon; seasonal mobility or multipurpose trips have reached more than 1 Billion tourists crossing International borders and more than 4 billion intramural travelers that have nourished the economy and employment in the service sector in most attractive regions, representing about one tenth of World GDP amount, including trade, research, cultural or journalistic purposes. Then the increased activities are giving pressure to the consumption of energy, water, resources, and Greenhouse Gas emissions. The further concentration of tourists in most beautiful sites of the World with consistent supply and reduced pollutions and means for waste control and risks management are challenging the preservation and protection of the natural original environment, including species and their ecosystems, ethnics and their cultures or languages, protection of inherited landscapes and monuments for the future generations to come. In this article, few projects will be analyzed, methods and directions in the EU sustainable development scheme giving way to economical and social activities and preserve rural areas and remote countryside as well as smarter cities development. EU ETS forecasting escalation in the next few decades for road and air, and will reconsider investments and reliance on Biobased alternatives that may turn out solutions and contributions to sustain popularization of tourism development. Study of Examples of Stakeholders practices and Governments efforts, consumer’s attitude to bring new forms of more responsible holidays models: ecotourism, eco-certification, partnerships, investment in technologies and facilities, and possibly create greener perceptions and less impacting demands for the longer term through association, organizations and awards.

Keywords: tourism, sustainability, protection, risks management, change in rural/urban environment

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Authors: Sara S. Fouad, Omneya Messallam

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In 1818, a seventy-five kilometer long canal was dug (called the Mahmoudiyah canal) connecting between Alexandria city in Egypt and the western branch of the Nile. It was a productive resource and vital to its environment, context, transportation, and recreation. It played a significant role in people’s lives and Alexandria city’s shape. The canal, which was the main vein of goods’ transporting from Alexandria’s seaport to the different parts of Egypt, was still in use today as a major source of clear water in the city. But nowadays, Mahmoudiyah canal is converting into ‘dead waterway’. The canal became sources of pollution as a result of solid and industrial waste thus causing many diseases, destroying communities and biodiversity, with urban invasion, the loss of community aesthetic value and healthy environment. Therefore, this paper aims to propose an urban strategy, as a solution to revive the forgotten canal, through recreating a cultural promenade on its shore. The main aim of this research is to formulate decent quality of life, unpolluted space, an area gathering the city space for nature, tourism and investments. As a case study, this paper investigates Mahmoudiyah canal through urban and ecological analyses, aiming to design an urban strategy for reviving it by creating a cultural promenade enriched with public spaces and green areas, which can most probably enhance the quality of life, city re-living and development. Community participation is also considered as vital and intrinsic implementation stage. The empirical research involved using several data assembly methods such as interviews, mental mapping, structural observations and questionnaires. The paper ends with a set of conclusions leading to proposals for the Mahmoudiyah canal revitalization considering the complex challenges and processes of sustainable regeneration focusing on city’s rehabilitation and lost identity.

Keywords: Mahmoudiyah canal, community aesthetic value, city re-living, cultural promenade

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Authors: Ajved Ahmed

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This research paper explores the intricate relationship between sports activities and disability, aiming to shed light on the multifaceted impacts of sports participation on individuals with disabilities. As the world grapples with the challenges posed by the growing population of people with disabilities, understanding the role of sports in their lives becomes increasingly important. The paper begins by providing a comprehensive overview of the diverse forms of disabilities, emphasizing the wide spectrum of physical, sensory, and cognitive impairments. It then delves into the benefits of sports activities for individuals with disabilities, highlighting the profound physical, psychological, and social advantages that engagement in sports can offer. These benefits encompass improved physical fitness, enhanced self-esteem and mental well-being, increased social integration, and a sense of empowerment and independence. Furthermore, the paper examines the barriers and challenges that individuals with disabilities often encounter when attempting to participate in sports activities, ranging from inaccessible facilities to societal prejudices and stereotypes. It underscores the critical role of inclusive sports programs, adaptive equipment, and policy initiatives in overcoming these barriers and fostering an environment where everyone can enjoy the benefits of sports. Through a comprehensive review of existing research and case studies, the paper also explores specific sports and their suitability for various types of disabilities. It discusses adapted sports like wheelchair basketball, blind soccer, and para-swimming, showcasing how these tailored activities not only accommodate disabilities but also promote excellence and competition at the highest levels. Additionally, the research paper delves into the economic and societal implications of increased sports participation among individuals with disabilities. It explores the potential for greater inclusion in the workforce, reduced healthcare costs, and the fostering of a more inclusive and accepting society. This research paper underscores the profound impact of sports activities on individuals with disabilities, highlighting their potential to improve physical health, mental well-being, and social integration. It calls for continued efforts to break down barriers and promote inclusive sports programs to ensure that everyone, regardless of their abilities, can access the transformative power of sports. Ultimately, this study contributes to a broader understanding of disability and sports, emphasizing the importance of inclusivity and accessibility in creating a more equitable and healthier society.

Keywords: sports and health, sports and disability, curing disability through sports, health benefits of sports

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Authors: Philip T. Broughton, Mark P. Bettney, Isla L. Smail

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Effective treatment of ground instability is essential when managing the impacts associated with historic mining. A field trial was undertaken by the Coal Authority to investigate the geotechnical performance and potential use of composite materials comprising resin and fill or stone to safely treat surface collapses, such as crown-holes, associated with shallow mining. Test pits were loosely filled with various granular fill materials. The fill material was injected with commercially available silicate and polyurethane resin foam products. In situ and laboratory testing was undertaken to assess the geotechnical properties of the resultant composite materials. The test pits were subsequently excavated to assess resin permeation. Drilling and resin injection was easiest through clean limestone fill materials. Recycled building waste fill material proved difficult to inject with resin; this material is thus considered unsuitable for use in resin composites. Incomplete resin permeation in several of the test pits created irregular ‘blocks’ of composite. Injected resin foams significantly improve the stiffness and resistance (strength) of the un-compacted fill material. The stiffness of the treated fill material appears to be a function of the stone particle size, its associated compaction characteristics (under loose tipping) and the proportion of resin foam matrix. The type of fill material is more critical than the type of resin to the geotechnical properties of the composite materials. Resin composites can effectively support typical design imposed loads. Compared to other traditional treatment options, such as cement grouting, the use of resin composites is potentially less disruptive, particularly for sites with limited access, and thus likely to achieve significant reinstatement cost savings. The use of resin composites is considered a suitable option for the future treatment of shallow mining collapses.

Keywords: composite material, ground improvement, mining legacy, resin

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Authors: Erick C. Valverde, Wansu Lim

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Facial emotion recognition (FER) system has been recently developed for more advanced computer vision applications. The ability to identify human emotions would enable smart healthcare facility to diagnose mental health illnesses (e.g., depression and stress) as well as better human social interactions with smart technologies. The FER system involves two steps: 1) face detection task and 2) facial emotion recognition task. It classifies the human expression in various categories such as angry, disgust, fear, happy, sad, surprise, and neutral. This system requires intensive research to address issues with human diversity, various unique human expressions, and variety of human facial features due to age differences. These issues generally affect the ability of the FER system to detect human emotions with high accuracy. Early stage of FER systems used simple supervised classification task algorithms like K-nearest neighbors (KNN) and artificial neural networks (ANN). These conventional FER systems have issues with low accuracy due to its inefficiency to extract significant features of several human emotions. To increase the accuracy of FER systems, deep learning (DL)-based methods, like convolutional neural networks (CNN), are proposed. These methods can find more complex features in the human face by means of the deeper connections within its architectures. However, the inference speed and computational costs of a DL-based FER system is often disregarded in exchange for higher accuracy results. To cope with this drawback, an optimized DL-based FER system is proposed in this study.An extreme version of Inception V3, known as Xception model, is leveraged by applying different network optimization methods. Specifically, network pruning and quantization are used to enable lower computational costs and reduce memory usage, respectively. To support low resource requirements, a 68-landmark face detector from Dlib is used in the early step of the FER system.Furthermore, a DL compiler is utilized to incorporate advanced optimization techniques to the Xception model to improve the inference speed of the FER system. In comparison to VGG-Net and ResNet50, the proposed optimized DL-based FER system experimentally demonstrates the objectives of the network optimization methods used. As a result, the proposed approach can be used to create an efficient and real-time FER system.

Keywords: deep learning, face detection, facial emotion recognition, network optimization methods

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Authors: Navven Desai, Veena Soraganvi

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Heavy metals such as lead, cadmium and mercury do not have biological significance hence they are known to be extremely toxic heavy metals. Water contains various heavy metals like Cadmium (Cd), Chromium (Cr), Copper (Cu), Nickel (Ni), Arsenic (As), Lead (Pb), and Zinc (Zn) etc., when it gets polluted with industrial waste water. These heavy metals cause various health effects even at low concentration when consumed by humans. Most of the heavy metals are poisonous to living organisms. Heavy metals are non-degradable and are preserved in the environment through bioaccumulation. Therefore removal of heavy metals from water is necessary. In recent years, a great deal of attentions has been focused on to the application of nanosized metal oxides to treat heavy metals, especially titanium oxides, ferric oxides, manganese oxides, aluminium oxides and magnesium oxides as adsorbent and photocatalyst. TiO2 based photocatalysts have attracted continuously increasing attention because of the excellent properties such as high light -conversion efficiency, chemical stability, nontoxic nature, low cost. The catalyst displays high photocatalytic activity because of its large surface area. In this study, the photocatalytic degradation of Lead (Pb) from aqueous solution was investigated in natural sunlight by using TiO2 as Nanomaterial. This study was performed at laboratory scale. All the experiments were carried out in the batch process. The concentration of lead was constant (25mg/lit) in the experiment and effect of titanium dioxide dose and pH were varied to study the removal efficiency of the lead by adsorption. Further study was performed on the dependence of photocatalytic reaction on the reaction temperature. The aqueous solution was prepared by Lead metal powder. TiO2 photo catalyst nanopowder used was Sisco-74629 grade. The heavy metal is analyzed with VARIAN AA 240 atomic adsorption spectrophotometer. The study shows, with increasing TiO2 dose and pH the lead removal increases. According to study, it can be concluded that the utilization of titanium dioxide accounted for higher efficiency in the removal of lead from aqueous solution.

Keywords: adsorption, heavy metals, nanomaterial, photocatalysis

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Authors: Athena Pedro, Zandile Batweni, Laura Bradfield, Michael Dare, Ashley Nyman

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The rapid growth and development of an infant in the first 1000 days of life means that this time period provides the greatest opportunity for a positive developmental impact on a child’s life socially, emotionally, cognitively and physically. Current research is being focused on children in the first 1000 days, but there is a lack of research and understanding of mothers and their experiences during this crucial time period. Thus, it is imperative that more research is done to help better understand the experiences of mothers during the first 1000 days of their child’s life, as well as gain more insight into mothers’ knowledge regarding this time period. The first 1000 days of life, from conception to two years, is a critical period, and the child’s attachment to his or her mother or primary caregiver during this period is crucial for a multitude of future outcomes. The aim of this study was to explore mothers’ understanding and experience of the first 1000 days of their child’s life, specifically looking at attachment in the context of Bowlby and Ainsworths’ attachment theory. Using a qualitative methodological framework, data were collected through semi-structured individual interviews with 12 first-time mothers from low-income communities in Cape Town. Thematic analysis of the data revealed that mothers articulated the importance of attachment within the first 1000 days of life and shared experiences of how they bond and form attachment with their babies. Furthermore, these mothers expressed their belief in the long-term effects of early attachment of responsive positive parenting as well as the lasting effects of poor attachment and non-responsive parenting. This study has implications for new mothers and healthcare staff working with mothers of new-born babies, as well as for future contextual research. By gaining insight into the mothers’ experiences, policies and intervention efforts can be formulated in order to assist mothers during this time, which ultimately promote the healthy development of the nation’s children and future adult generation. If researchers are also able to understand the extent of mothers’ general knowledge regarding the first 1000 days and attachment, then there will be a better understanding of where there may be gaps in knowledge and thus, recommendations for effective and relevant intervention efforts may be provided. These interventions may increase knowledge and awareness of new mothers and health care workers at clinics and other service providers, creating a high impact on positive outcome. Thus, improving the developmental trajectory for many young babies allows them the opportunity to pursue optimal development by reaching their full potential.

Keywords: attachment, experience, first 1000 days, knowledge, mothers

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Authors: Francesca Nicolosi, Teresa Cosola

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Climate changes in Mediterranean areas, such as the increase of average seasonal temperatures, the urban heat island phenomenon, the intensification of solar radiation and the extreme weather threats, cause disruption events, so that climate adaptation has become a pressing issue. Due to the strategic role that the built heritage holds in terms of environmental impact and energy waste and its potentiality, it is necessary to assess the vulnerability and the adaptive capacity of the existing building to climate change, in order to define different mitigation scenarios. The aim of this research work is to define an optimized and integrated methodology for the assessment of resilience levels and adaptation scenarios for existing buildings in Mediterranean urban areas. Moreover, the study of resilience indicators allows us to define building environmental and energy performance in order to identify the design and technological solutions for the improvement of the building and its urban area potentialities. The methodology identifies step-by-step different phases, starting from the detailed study of characteristic elements of urban system: climatic, natural, human, typological and functional components are analyzed in their critical factors and their potential. Through the individuation of the main perturbing factors and the vulnerability degree of the system to the risks linked to climate change, it is possible to define mitigation and adaptation scenarios. They can be different, according to the typological, functional and constructive features of the analyzed system, divided into categories of intervention, and characterized by different analysis levels (from the single building to the urban area). The use of software simulations allows obtaining information on the overall behavior of the building and the urban system, to generate predictive models in the medium and long-term environmental and energy retrofit and to make a comparative study of the mitigation scenarios identified. The studied methodology is validated on a case study.

Keywords: climate impact mitigation, energy efficiency, existing building heritage, resilience

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Authors: Chia-Ying Lin

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This paper explains how to enhance doctor-patient communication and nurse-patient communication through multiple intelligence signing methods and user-centered. It is hoped that through the implementation of the "electronic consent", the problems faced by the paper consent can be solved: storage methods, resource utilization, convenience, correctness of information, integrated management, statistical analysis and other related issues. Make better use and allocation of resources to provide better medical quality. First, invite the ｍedical records department to assist in the inventory of paper consent in the hospital: organising, classifying, merging, coding, and setting. Second, plan the electronic consent configuration file: set the form number, consent form group, fields and templates, and the corresponding doctor's order code. Next, Summarize four types of rapid methods of electronic consent: according to the doctor's order, according to the medical behavior, according to the schedule, and manually generate the consent form. Finally, system promotion and adjustment: form an "electronic consent promotion team" to improve, follow five major processes: planning, development, testing, release, and feedback, and invite clinical units to raise the difficulties faced in the promotion, and make improvements to the problems. The electronic signature rate of the whole hospital will increase from 4% in January 2022 to 79% in November 2022. Use the saved resources more effectively, including: reduce paper usage (reduce carbon footprint), reduce the cost of ink cartridges, re-plan and use the space for paper medical records, and save human resources to provide better services. Through the introduction of information technology and technology, the main spirit of "lean management" is implemented. Transforming and reengineering the process to eliminate unnecessary waste is also the highest purpose of this project.

Keywords: smart signature, electronic consent, electronic medical records, user-centered, doctor-patient communication, nurse-patient communication

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Authors: Demmiele Matu Kiiza, Constantine Steven Labongo Loum, Julaina Obika Asinasi

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Background: The use of traditional medicine in Uganda forms the preliminary therapeutic approaches among many people. Traditional medicines have been used in Uganda for many years, not only for the management of pregnancy-related complications but also for the management of other physical and psychological illnesses. Traditional medicines are always considered the first line of treatment by a considerable number of people. This study, therefore, sought to explore the lived experiences of pregnant women by assessing their perceptions of the transitional use of traditional medicine. Methods: Ethnography was used to capture data from an emic perspective. The ethnographic approach involved visiting a few selected pregnant women to observe and participate in the identification of traditional medicines. The ethnographic fieldwork was carried out within a period of three months. In-depth interviews were carried out and audio recorded and later transcribed verbatim. Data was thereafter analyzed thematically. The thematic analysis involved identifying statements made by research participants by transcribing audio and reading through field notes, coding was done, and themes were generated according to commonly mentioned experiences of using traditional medicine. Results: The findings revealed that women performed a ritual of ‘cutting the cord’ by making a small horizontal incision on the belly across the linea Nigra (also known as a pregnancy line) at around six months of pregnancy to avoid producing a baby with an umbilical cord tied around the baby’s neck. They also used crushed egg shells, crushed snail shells and herbs such as pawpaw roots, Entarahompo (crassocephalum vitelline), Ekyoganyanja (Erlangea tomentose), to manage Omushohokye (a term used by the study participants to refer to a situation where women pass out too much water when giving birth, producing a child with mold and oozing out of a milky liquid through the breasts before giving births); prepare for safe delivery and also to manage pregnancy-related complications. The study recommends the implementation of a traditional medicine use policy using a bottom-up approach. Designing and implementing of culturally sensitive maternal healthcare intervention programs and involving village health teams and the elderly in health education.

Keywords: traditional medicine, pregnant women, uganda, perceptions

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Authors: Kailas L. Wasewar

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Biobutanol has been considered as a potential and alternative biofuel relative to the most popular biodiesel and bioethanol. End product toxicity is the major problems in commercialization of fermentation based process which can be reduce to some possible extent by removing biobutanol simultaneously. Several techniques have been investigated for removing butanol from fermentation broth such as stripping, adsorption, liquid–liquid extraction, pervaporation, and membrane solvent extraction. Liquid–liquid extraction can be performed with high selectivity and is possible to carry out inside the fermenter. Conventional solvents have few drawbacks including toxicity, loss of solvent, high cost etc. Hence alternative solvents must be explored for the same. Room temperature ionic liquids (RTILs) composed entirely of ions are liquid at room temperature having negligible vapor pressure, non-flammability, and tunable physiochemical properties for a particular application which term them as “designer solvents”. Ionic liquids (ILs) have recently gained much attention as alternatives for organic solvents in many processes. In particular, ILs have been used as alternative solvents for liquid–liquid extraction. Their negligible vapor pressure allows the extracted products to be separated from ILs by conventional low pressure distillation with the potential for saving energy. Morpholinium, imidazolium, ammonium, phosphonium etc. based ionic liquids have been employed for the separation biobutanol. In present chapter, basic concepts of ionic liquids and application in separation have been presented. Further, type of ionic liquids including, conventional, functionalized, polymeric, supported membrane, and other ionic liquids have been explored. Also the effect of various performance parameters on separation of biobutanol by ionic liquids have been discussed and compared for different cation and anion based ionic liquids. The typical methodology for investigation have been adopted such as contacting the equal amount of biobutanol and ionic liquids for a specific time say, 30 minutes to confirm the equilibrium. Further, biobutanol phase were analyzed using GC to know the concentration of biobutanol and material balance were used to find the concentration in ionic liquid.

Keywords: biobutanol, separation, ionic liquids, sustainability, biorefinery, waste biomass

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Authors: T. R. Bandara, H. Jaelani, G. J. Griffin

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The conversion of lignocellulosic waste materials, such as sugar cane bagasse, to biofuels such as ethanol has attracted significant interest as a potential element for transforming transport fuel supplies to totally renewable sources. However, the refractory nature of the cellulosic structure of lignocellulosic materials has impeded progress on developing an economic process, whereby the cellulose component may be effectively broken down to glucose monosaccharides and then purified to allow downstream fermentation. Ionic liquid (IL) treatment of lignocellulosic biomass has been shown to disrupt the crystalline structure of cellulose thus potentially enabling the cellulose to be more readily hydrolysed to monosaccharides. Furthermore, conventional hydrolysis of lignocellulosic materials yields byproducts that are inhibitors for efficient fermentation of the monosaccharides. However, selective extraction of monosaccharides from an aqueous/IL phase into an organic phase utilizing a combination of boronic acids and quaternary amines has shown promise as a purification process. Hydrolysis of sugar cane bagasse immersed in an aqueous solution with IL (1-ethyl-3-methylimidazolium acetate) was conducted at different pH and temperature below 100 ºC. It was found that the use of a high concentration of hydrochloric acid to acidify the solution inhibited the hydrolysis of bagasse. At high pH (i.e. basic conditions), using sodium hydroxide, catalyst yields were reduced for total reducing sugars (TRS) due to the rapid degradation of the sugars formed. For purification trials, a supported liquid membrane (SLM) apparatus was constructed, whereby a synthetic solution containing xylose and glucose in an aqueous IL phase was transported across a membrane impregnated with phenyl boronic acid/Aliquat 336 to an aqueous phase. The transport rate of xylose was generally higher than that of glucose indicating that a SLM scheme may not only be useful for purifying sugars from undesirable toxic compounds, but also for fractionating sugars to improve fermentation efficiency.

Keywords: biomass, bagasse, hydrolysis, monosaccharide, supported liquid membrane, purification

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Authors: Adha Bayu Wijaya, A. Zainal Abidin, Naufal Baihaqi, Joko Suprayitno, Astika Titistiti, Muslim Adi Wijaya, Endah Tri Lestari, Agung Wibowo

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Sulfur is a non-metallic chemical element in the form of a yellow crystalline solid with the chemical formula, and is formed from several types of natural and artificial chemical reactions. Commercial applications of sulfur processed products can be found in various aspects of life, for example in the use of processed sulfur as paving blocks. The Gundih Central Processing Plant (CPP) is capable of producing 14 tons/day of sulfur pellets. This amount comes from the high H2S content of the wells with a total concentration of 20,000 ppm and a volume accumulation of 14 MMSCFD acid gas. H2S is converted to sulfur using the thiobacillus microbe in the Biological Sulfur Recovery Unit (BSRU) with a sulfur product purity level greater than 95%. In 2018 sulfur production at Gundih CPP was recorded at 4044 tons which could potentially trigger serious problems from an environmental aspect. The use of sulfur as material for making paving blocks is an alternative solution in addressing the potential impact on the environment, as regulated by Government Regulation No.22 of Year 2021 concerning the Waste Management of Non-Hazardous and Toxic Substances (B3), and the high cost of handling sulfur by third parties. The design mix of ratio sulfur paving blocks is 22% cements, rock ash 67%, and 11% of sulfur pellets. The sulfur used in making the paving mixture is pure sulfur, namely the side product category without any contaminants, thereby eliminating the potential for environmental pollution when implementing sulfur paving. Strength tests of sulfur paving materials have also been confirmed by external laboratories. The standard used in making sulfur paving blocks refers to the SNI 03-0691-1996 standard. With the results of sulfur paving blocks made according to quality B. Currently, sulfur paving blocks are used in building access to wells locations and in public roads in the Cepu Field area as a contribution from Corporate Social Responsibility (CSR).

Keywords: sulphur, innovation, paving block, CSR, sulphur paving

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Authors: Ravi Ande, Mousumi Hazari

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One of the common geophysical techniques for mapping subsurface geo-electrical structures, extensive hydro-geological research, and engineering and environmental geophysics applications is the use of time domain electromagnetic (TDEM)/transient electromagnetic (TEM) soundings. A large transmitter loop for energising the ground and a small receiver loop or magnetometer for recording the transient voltage or magnetic field in the air or on the surface of the earth, with the receiver at the center of the loop or at any random point inside or outside the source loop, make up a large loop TEM system. In general, one can acquire data using one of the configurations with a large loop source, namely, with the receiver at the center point of the loop (central loop method), at an arbitrary in-loop point (in-loop method), coincident with the transmitter loop (coincidence-loop method), and at an arbitrary offset loop point (offset-loop method), respectively. Because of the mathematical simplicity associated with the expressions of EM fields, as compared to the in-loop and offset-loop systems, the central loop system (for ground surveys) and coincident loop system (for ground as well as airborne surveys) have been developed and used extensively for the exploration of mineral and geothermal resources, for mapping contaminated groundwater caused by hazardous waste and thickness of permafrost layer. Because a proper analytical expression for the TEM response over the layered earth model for the large loop TEM system does not exist, the forward problem used in this inversion scheme is first formulated in the frequency domain and then it is transformed in the time domain using Fourier cosine or sine transforms. Using the EMLCLLER algorithm, the forward computation is initially carried out in the frequency domain. As a result, the EMLCLLER modified the forward calculation scheme in NLSTCI to compute frequency domain answers before converting them to the time domain using Fourier Cosine and/or Sine transforms.

Keywords: time domain electromagnetic (TDEM), TEM system, geoelectrical sounding structure, Fourier cosine

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Authors: Da Tao, Mingfu Qin, Wenkai Li, Tieyan Wang

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While the use of electronic personal health portals has gained increasing popularity in the healthcare industry, users usually experience difficulty in comprehending and correctly responding to personal health information, partly due to inappropriate or poor presentation of the information. The way personal health information is visualized may affect how users perceive and assess their personal health information. This study was conducted to examine the effects of information visualization format and visualization mode on the comprehension and perceptions of personal health information among personal health information users with eye tracking techniques. A two-factor within-subjects experimental design was employed, where participants were instructed to complete a series of personal health information comprehension tasks under varied types of visualization mode (i.e., whether the information visualization is static or dynamic) and three visualization formats (i.e., bar graph, instrument-like graph, and text-only format). Data on a set of measures, including comprehension performance, perceptions, and eye movement indicators, were collected during the task completion in the experiment. Repeated measure analysis of variance analyses (RM-ANOVAs) was used for data analysis. The results showed that while the visualization format yielded no effects on comprehension performance, it significantly affected users’ perceptions (such as perceived ease of use and satisfaction). The two graphic visualizations yielded significantly higher favorable scores on subjective evaluations than that of the text format. While visualization mode showed no effects on users’ perception measures, it significantly affected users' comprehension performance in that dynamic visualization significantly reduced users' information search time. Both visualization format and visualization mode had significant main effects on eye movement behaviors, and their interaction effects were also significant. While the bar graph format and text format had similar time to first fixation across dynamic and static visualizations, instrument-like graph format had a larger time to first fixation for dynamic visualization than for static visualization. The two graphic visualization formats yielded shorter total fixation duration compared with the text-only format, indicating their ability to improve information comprehension efficiency. The results suggest that dynamic visualization can improve efficiency in comprehending important health information, and graphic visualization formats were favored more by users. The findings are helpful in the underlying comprehension mechanism of visualized personal health information and provide important implications for optimal design and visualization of personal health information.

Keywords: eye tracking, information comprehension, personal health information, visualization

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Authors: Lali Kutateladze, Tamar Urushadze, Tamar Dudauri, Besarion Metreveli, Nino Zakariashvili, Izolda Khokhashvili, Maya Jobava

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Lignocellulosic waste streams from agriculture, paper and wood industry are renewable, plentiful and low-cost raw materials that can be used for large-scale production of liquid and gaseous biofuels. As opposed to prevailing multi-stage biotechnological processes developed for bioconversion of cellulosic substrates to ethanol where high-cost cellulase preparations are used, Consolidated Bioprocessing (CBP) offers to accomplish cellulose and xylan hydrolysis followed by fermentation of both C6 and C5 sugars to ethanol in a single-stage process. Syntrophic microbial consortium comprising of anaerobic, thermophilic, cellulolytic, and saccharolytic bacteria in the genus Clostridia with improved ethanol productivity and high tolerance to fermentation end-products had been proposed for achieving CBP. 65 new strains of anaerobic thermophilic cellulolytic and saccharolytic Clostridia were isolated from different wetlands and hot springs in Georgia. Using new isolates, fermentation of mechanically pretreated wheat straw and corn stalks was done under oxygen-free nitrogen environment in thermophilic conditions (T=550C) and pH 7.1. Process duration was 120 hours. Liquid and gaseous products of fermentation were analyzed on a daily basis using Perkin-Elmer gas chromatographs with flame ionization and thermal detectors. Residual cellulose, xylan, xylose, and glucose were determined using standard methods. Cellulolytic and saccharolytic bacteria strains degraded mechanically pretreated herbaceous cellulosic wastes and fermented glucose and xylose to ethanol, acetic acid and gaseous products like hydrogen and CO2. Specifically, maximum yield of ethanol was reached at 96 h of fermentation and varied between 2.9 – 3.2 g/ 10 g of substrate. The content of acetic acid didn’t exceed 0.35 g/l. Other volatile fatty acids were detected in trace quantities.

Keywords: anaerobic bacteria, cellulosic wastes, Clostridia sp, ethanol

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Authors: Rim Ben Amor, Myriam Abidi, Moncef Gueddari

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The purpose of the present study is to assess the level and the distribution of CaO, SO3, Cd, Cu, Pb and Zn incore sediments of Ghannouch-Gabes coast, Gulf of Gabes, Tunisian Mediterranean coast. The XRD analyses indicate that the sediments of Ghannouch-Gabes coast are mainly composed of quartz, calcite, gypsum and fluorine reflecting the impact of the phosphate fertilizer industrial waste. The vertical distribution of surface sediments shows for all the elements analyzed, that the area located between the commercial and the fishing port of Gabes, is the most polluted zone, where the two harbors acted as barriers and limited the dispersion of phosphogypsum discharge. The abundance order of metals was found to be Zn > Cd > Cu >Pb and that the highest levels of heavy metals were found in the uppermost segment of the sediment core compared to lower depth subsurface due to a continuous input of PG release and showed that the area between the two harbor suffered from several types of pollutants compared to reference core C1, collected from non-industrialized area. The level of pollution was evaluated using contamination factor (Cf), pollution load index (PLI) and the geoaccumulation index (Igeo). The obtained results of Igeo allowed us to distinguish that the area between the commercial harbor of Ghannouch and the fishing harbor of Gabes is the most polluted where sediments are strongly contaminated for Pb, Cu and Cd. The pollution load index (PLI) of all sediments collected classified them as "polluted". According to contamination factor (Cf), the sediments can be considered as ‘considerable’ to ‘very high’ contaminated for Pb, ‘very high to moderate’ for Cd, ‘ moderate’ for Zn, between ‘moderate’ and ‘considerable’ for Cu. Statistical analyses show that heavy metals, fluoride, calcium and sulphate are resulting from the same anthropogenic origin. The metallic pollution status of sediments of Ghanouch -Gabes coast is worrying and requires a serious intervention.

Keywords: trace metals, phosphogypsum, core sediments, accumulation factor, contamination factor

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Authors: Sameh S. Namnqani, Yaqoob Y. Abobakar, Ahmed M. Alsewehri, Khaled M. AlQethami

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The main objective of this research is to know the impact of the application of the electronic supply system on the performance of the supply department of health organizations. To reach this goal, the study adopted independent variables to measure the dependent variable (performance of the supply department), namely: integration with suppliers, integration with intermediaries and distributors and knowledge of supply size, inventory, and demand. The study used the descriptive method and was aided by the questionnaire tool that was distributed to a sample of workers in the Supply Chain Management Department of King Abdullah Medical City. After the statistical analysis, the results showed that: The 70 sample members strongly agree with the (electronic integration with suppliers) axis with a p-value of 0.001, especially with regard to the following: Opening formal and informal communication channels between management and suppliers (Mean 4.59) and exchanging information with suppliers with transparency and clarity (Mean 4.50). It also clarified that the sample members agree on the axis of (electronic integration with brokers and distributors) with a p-value of 0.001 and this is represented in the following elements: Exchange of information between management, brokers and distributors with transparency, clarity (Mean 4.18) , and finding a close cooperation relationship between management, brokers and distributors (Mean 4.13). The results also indicated that the respondents agreed to some extent on the axis (knowledge of the size of supply, stock, and demand) with a p-value of 0.001. It also indicated that the respondents strongly agree with the existence of a relationship between electronic procurement and (the performance of the procurement department in health organizations) with a p-value of 0.001, which is represented in the following: transparency and clarity in dealing with suppliers and intermediaries to prevent fraud and manipulation (Mean 4.50) and reduce the costs of supplying the needs of the health organization (Mean 4.50). From the results, the study recommended several recommendations, the most important of which are: that health organizations work to increase the level of information sharing between them and suppliers in order to achieve the implementation of electronic procurement in the supply management of health organizations. Attention to using electronic data interchange methods and using modern programs that make supply management able to exchange information with brokers and distributors to find out the volume of supply, inventory, and demand. To know the volume of supply, inventory, and demand, it recommended the application of scientific methods of supply for storage. Take advantage of information technology, for example, electronic data exchange techniques and documents, where it can help in contact with suppliers, brokers, and distributors, and know the volume of supply, inventory, and demand, which contributes to improving the performance of the supply department in health organizations.

Keywords: healthcare supply chain, performance, electronic system, ERP

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Authors: Eliane Ferreira da Silva

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This paper aims to mobilize and sensitize public administration leaders to good practices and encourage investment in the PV system in Brazil. It presents a case study methodology for dimensioning the PV system in the roofs of the public buildings of the Esplanade of the Ministries, Brasilia, capital of the country, with predefined resources, starting with the Sustainable Esplanade Project (SEP), of the exponential growth of photovoltaic solar energy in the world and making a comparison with the solar power plant of the Ministry of Mines and Energy (MME), active since: 6/10/2016. In order to do so, it was necessary to evaluate the energy efficiency of the buildings in the period from January 2016 to April 2017, (16 months) identifying the opportunities to reduce electric energy expenses, through the adjustment of contracted demand, the tariff framework and correction of existing active energy. The instrument used to collect data on electric bills was the e-SIC citizen information system. The study considered in addition to the technical and operational aspects, the historical, cultural, architectural and climatic aspects, involved by several actors. Identifying the reductions of expenses, the study directed to the following aspects: Case 1) economic feasibility for exchanges of common lamps, for LED lamps, and, Case 2) economic feasibility for the implementation of photovoltaic solar system connected to the grid. For the case 2, PV*SOL Premium Software was used to simulate several possibilities of photovoltaic panels, analyzing the best performance, according to local characteristics, such as solar orientation, latitude, annual average solar radiation. A simulation of an ideal photovoltaic solar system was made, with due calculations of its yield, to provide a compensation of the energy expenditure of the building - or part of it - through the use of the alternative source in question. The study develops a methodology for public administration, as a major consumer of electricity, to act in a responsible, fiscalizing and incentive way in reducing energy waste, and consequently reducing greenhouse gases.

Keywords: energy efficiency, esplanade of ministries, photovoltaic solar energy, public buildings, sustainable building

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Authors: Chick Loveline Ayoh Epse Ndi

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Our cultural stance has deep implications for the psychological and physical well-being of the old. Cameroon is still rooted on the traditional belief that stipulates that; the aged are best catered for in the family setting where the children and grandchildren are supposed to give in return for services invested on them by the former. This is why up till date, there are no “Rest Homes” or “Convalescent hospitals” despite the rising challenges faced by the aged in this context. Beside the special measure set aside to cater for the aged, such as “Rest Homes” for the healthy, “Convalescent hospitals” are created set to cater for the health of the aged in the Western context with other facilities such as geriatric units. The health care practitioners are aware of aging diseases and have trained human resources like Gerontologists to cater for the aged and aging diseases. Meanwhile, in Africa and Cameroon in particular, such infrastructural and human resources are still to be considered in the health care system. It can be assumed that the aged and aging diseases are still to be considered in the health care system in this context. This is why we talk of therapeutic nihilism, where the aged are mixed up with other categories of patients with no special attention given to them. This qualitative study carried out in the Yaounde, the capital city of Cameroon, with their best referent hospitals, reveal that; the aged and aging diseases are still a myth in this context. Data collected in both private and public health institutions show that there is only one public institution in Cameroon that has a geriatric unit with no specialists. Patients who aretreated in this unit are considered as aged with terminal diseases that need palliative care and not intensive care. Cameroon is still lacking in terms of health care to the aged and ageing diseases. Like other patients, the aged are treated with a lot of laxity and no value. There is an emergency to create special health care units for geriatrics and and train gerontologist. Mentally or physically ill aged faced medical rational with psychodynamic treatment considered as waste of time. The aged are less likely to be regarded salvageable when they enter a hospital in serious conditions due to the lack of specialists and geriatric units for them. The implication of this study is to sensitization the stake holders for an urgent need to extend special care units for the aged and aging diseases in this context.

Keywords: challeng, therapy, agtng, diseases cameroon

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