Search results for: building services

Authors: Rosemary Saunders, Courtney Glass, Karla Seaman, Karen Gullick, Julie Andrew, Anne Wilkinson, Ashwini Davray

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Current literature demonstrates that most Australians receive end-of-life care in a hospital setting, despite most hoping to die within their own home. The necessity for high quality end-of-life care has been emphasised by the Australian Commission on Safety and Quality in Health Care and the National Safety and Quality in Health Services Standards depict the requirement for comprehensive care at the end of life (Action 5.20), reinforcing the obligation for continual organisational assessment to determine if these standards are suitably achieved. Limited research exploring clinical staff perspectives of end-of-life care delivery has been conducted within an Australian private health context. This study aimed to investigate clinical staff member perceptions of end-of-life care delivery at a private hospital in Western Australia. The study comprised of a multi-faceted mixed-methods methodology, part of a larger study. Data was obtained from clinical staff utilising surveys and focus groups. A total of 133 questionnaires were completed by clinical staff, including registered nurses (61.4%), enrolled nurses (22.7%), allied health professionals (9.9%), non-palliative care consultants (3.8%) and junior doctors (2.2%). A total of 14.7% of respondents were palliative care ward staff members. Additionally, seven staff focus groups were conducted with physicians (n=3), nurses (n=26) and allied health professionals including social workers (n=1), dietitians (n=2), physiotherapists (n=5) and speech pathologists (n=3). Key findings from the surveys highlighted that the majority of staff agreed it was part of their role to talk to doctors about the care of patients who they thought may be dying, and recognised the importance of communication, appropriate training and support for clinical staff to provide quality end-of-life care. Thematic analysis of the qualitative data generated three key themes: creating the setting which highlighted the importance of adequate resourcing and conducive physical environments for end-of-life care and to support staff and families; planning and care delivery which emphasised the necessity for collaboration between staff, families and patients to develop care plans and treatment directives; and collaborating in end-of-life care, with effective communication and teamwork leading to achievable care delivery expectations. These findings contribute to health professionals better understanding of end-of-life care provision and the importance of collaborating with patients and families in care delivery. It is crucial that health care providers implement strategies to overcome gaps in care, so quality end-of-life care is provided. Findings from this study have been translated into practice, with the development and implementation of resources, training opportunities, support networks and guidelines for the delivery of quality end-of-life care.

Keywords: clinical staff, end-of-life care, mixed-methods, private hospital.

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Authors: Tak Mau Simon Chan, Ying Chuen Lance Chan

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Homelessness has been a popular and controversial debate in Hong Kong, a city which is densely populated and well-known for very expensive housing. The constitution of the homeless as threats to the community and environmental hygiene is ambiguous and debatable in the Hong Kong context. The lack of an intervention model is the critical research gap thus far, aside from the tangible services delivered. The life story approach (LSA), with its unique humanistic orientation, has been well applied in recent decades to depict the needs of various target groups, but not the homeless. It is argued that the life story approach (LSA), which has been employed by health professionals in the landscape of dementia, and health and social care settings, can be used as a reference in the local Chinese context through indigenization. This study, therefore, captures the viewpoints of service providers and users by constructing an indigenous intervention model that refers to the LSA in serving the chronically homeless. By informing 13 social workers and 27 homeless individuals in 8 focus groups whilst 12 homeless individuals have participated in individual in-depth interviews, a framework of LSA in homeless people is proposed. Through thematic analysis, three main themes of their life stories was generated, namely, the family, negative experiences and identity transformation. The three domains solidified framework that not only can be applied to the homeless, but also other disadvantaged groups in the Chinese context. Based on the three domains of family, negative experiences and identity transformation, the model is applied in the daily practices of social workers who help the homeless. The domain of family encompasses familial relationships from the past to the present to the speculated future with ten sub-themes. The domain of negative experiences includes seven sub-themes, with reference to the deviant behavior committed. The last domain, identity transformation, incorporates the awareness and redefining of one’s identity and there are a total of seven sub-themes. The first two domains are important components of personal histories while the third is more of an unknown, exploratory and yet to-be-redefined territory which has a more positive and constructive orientation towards developing one’s identity and life meaning. The longitudinal temporal dimension of moving from the past – present - future enriches the meaning making process, facilitates the integration of life experiences and maintains a more hopeful dialogue. The model is tested and its effectiveness is measured by using qualitative and quantitative methods to affirm the extent that it is relevant to the local context. First, it contributes to providing a clear guideline for social workers who can use the approach as a reference source. Secondly, the framework acts as a new intervention means to address problem saturated stories and the intangible needs of the homeless. Thirdly, the model extends the application to beyond health related issues. Last but not least, the model is highly relevant to the local indigenous context.

Keywords: homeless, indigenous intervention, life story approach, social work practice

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Authors: Obed Asamoah

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Forests are very vital for human survival and our well-being. During the past years, the world has taken an increasingly significant role in the modification of the global environment. The high rate of deforestation in Ghana is of primary national concern as the forests provide many ecosystem services and functions that support the country’s predominantly agrarian economy and foreign earnings. Ghana forest is currently major source of carbon sink that helps to mitigate climate change. Ghana forests, both the reserves and off-reserves, are under pressure of deforestation. The causes of deforestation are varied but can broadly be categorized into anthropogenic and natural factors. For the anthropogenic factors, increased wood fuel collection, clearing of forests for agriculture, illegal and poorly regulated timber extraction, social and environmental conflicts, increasing urbanization and industrialization are the primary known causes for the loss of forests and woodlands. Mineral exploitation in the forest areas is considered as one of the major causes of deforestation in Ghana. Mining activities especially mining of gold by both the licensed mining companies and illegal mining groups who are locally known as "gallantly mining" also cause damage to the nation's forest reserves. Several works have been conducted regarding the causes of the high rate of deforestation in Ghana, major attention has been placed on illegal logging and using forest lands for illegal farming and mining activities. Less emphasis has been placed on the timber production companies on their harvesting methods in the forests in Ghana and other activities that are carried out in the forest. The main objective of the work is to find out the harvesting methods and the activities of the timber production companies and their effects on the forests in Ghana. Both qualitative and quantitative research methods were engaged in the research work. The study population comprised of 20 Timber industries (Sawmills) forest areas of Ghana. These companies were selected randomly. The cluster sampling technique was engaged in selecting the respondents. Both primary and secondary data were employed. In the study, it was observed that most of the timber production companies do not know the age, the weight, the distance covered from the harvesting to the loading site in the forest. It was also observed that old and heavy machines are used by timber production companies in their operations in the forest, which makes the soil compact prevents regeneration and enhances soil erosion. It was observed that timber production companies do not abide by the rules and regulations governing their operations in the forest. The high rate of corruption on the side of the officials of the Ghana forestry commission makes the officials relax and do not embark on proper monitoring on the operations of the timber production companies which makes the timber companies to cause more harm to the forest. In other to curb this situation the Ghana forestry commission with the ministry of lands and natural resources should monitor the activities of the timber production companies and sanction all the companies that make foul play in their activities in the forest. The commission should also pay more attention to the policy “fell one plant 10” to enhance regeneration in both reserves and off-reserves forest.

Keywords: companies, deforestation, forest, Ghana, timber

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Authors: A. M. Andriano, M. Lombardi, A. Lopolito, M. Prosperi, A. Stasi, E. Iannuzzi

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In according to the scientific debate on the definition of Social Innovation (SI), the present paper identifies SI as new ideas (products, services, and models) that simultaneously meet social needs and create new social relationships or collaborations. This concept offers important tools to unravel the difficult condition for the agricultural sector in marginalized areas, characterized by the abandonment of activities, low level of farmer education, and low generational renewal, hampering new territorial strategies addressed at and integrated and sustainable development. Models of SI in agriculture, starting from bottom up approach or from the community, are considered to represent the driving force of an ecological and digital revolution. A system based on SI may be able to grasp and satisfy individual and social needs and to promote new forms of entrepreneurship. In this context, Vazapp ('Go Hoeing') is an emerging SI model in southern Italy that promotes solutions for satisfying needs of farmers and facilitates their relationships (creation of network). The Vazapp’s initiative, considered in this study, is the Contadinners ('Farmer’s dinners'), a dinner held at farmer’s house where stakeholders living in the surrounding area know each other and are able to build a network for possible future professional collaborations. The aim of the paper is to identify the evolution of farmers’ relationships, both quantitatively and qualitatively, because of the Contadinner’s initiative organized by Vazapp. To this end, the study adopts the Social Network Analysis (SNA) methodology by using UCINET (Version 6.667) software to analyze the relational structure. Data collection was realized through a questionnaire distributed to 387 participants in the twenty 'Contadinners', held from February 2016 to June 2018. The response rate to the survey was about 50% of farmers. The elaboration data was focused on different aspects, such as: a) the measurement of relational reciprocity among the farmers using the symmetrize method of answers; b) the measurement of the answer reliability using the dichotomize method; c) the description of evolution of social capital using the cohesion method; d) the clustering of the Contadinners' participants in followers and not-followers of Vazapp to evaluate its impact on the local social capital. The results concern the effectiveness of this initiative in generating trustworthy relationships within the rural area of southern Italy, typically affected by individualism and mistrust. The number of relationships represents the quantitative indicator to define the dimension of the network development; while the typologies of relationships (from simple friendship to formal collaborations, for branding new cooperation initiatives) represents the qualitative indicator that offers a diversified perspective of the network impact. From the analysis carried out, Vazapp’s initiative represents surely a virtuous SI model to catalyze the relationships within the rural areas and to develop entrepreneurship based on the real needs of the community.

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Authors: Evangelos Kaisar, Anika Tabassum, Taraneh Ardalan, Majed Al-Ghandour

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The economy of any country is dependent on its ability to accommodate the movement and delivery of goods. The demand for goods movement and services increases truck traffic on highways and inside the cities. The livability of most cities is directly affected by the congestion and environmental impacts of trucks, which are the backbone of the urban freight system. Better operation of heavy vehicles on highways and arterials could lead to the network’s efficiency and reliability. In many cases, roundabouts can respond better than at-level intersections to enable traffic operations with increased safety for both cars and heavy vehicles. Recently emerged, the concept of turbo-roundabout is a viable alternative to the two-lane roundabout aiming to improve traffic efficiency. The primary objective of this study is to evaluate the operation and performance level of an at-grade intersection, a conventional two-lane roundabout, and a basic turbo roundabout for freight movements. To analyze and evaluate the performances of the signalized intersections and the roundabouts, micro simulation models were developed PTV VISSIM. The networks chosen for this analysis in this study are to experiment and evaluate changes in the performance of the movement of vehicles with different geometric and flow scenarios. There are several scenarios that were examined when attempting to assess the impacts of various geometric designs on vehicle movements. The overall traffic efficiency depends on the geometric layout of the intersections, which consists of traffic congestion rate, hourly volume, frequency of heavy vehicles, type of road, and the ratio of major-street versus side-street traffic. The traffic performance was determined by evaluating the delay time, number of stops, and queue length of each intersection for varying truck percentages. The results indicate that turbo-roundabouts can replace signalized intersections and two-lane roundabouts only when the traffic demand is low, even with high truck volume. More specifically, it is clear that two-lane roundabouts are seen to have shorter queue lengths compared to signalized intersections and turbo-roundabouts. For instance, considering the scenario where the volume is highest, and the truck movement and left turn movement are maximum, the signalized intersection has 3 times, and the turbo-roundabout has 5 times longer queue length than a two-lane roundabout in major roads. Similarly, on minor roads, signalized intersections and turbo-roundabouts have 11 times longer queue lengths than two-lane roundabouts for the same scenario. As explained from all the developed scenarios, while the traffic demand lowers, the queue lengths of turbo-roundabouts shorten. This proves that turbo roundabouts perform well for low and medium traffic demand. The results indicate that turbo-roundabouts can replace signalized intersections and two-lane roundabouts only when the traffic demand is low, even with high truck volume. Finally, this study provides recommendations on the conditions under which different intersections perform better than each other.

Keywords: At-grade intersection, simulation, turbo-roundabout, two-lane roundabout

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Authors: Arin Salamah Qudsi

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Female piety and the roles that female mystics played in Muslim landscapes of the period between the ninth and thirteenth centuries are topics that attracted many scholarly endeavors. However, personal aspects of both male and female Sufis were not thoroughly investigated. It would be of a great significance to examine the different roles of Sufi women as spouses, household supporters, and, mothers based on Sufi and non Sufi sources. Sisters and mothers, rather than wives and daughters, are viewed in anthropological studies of different cultures as women who could enjoy a high social status and thus play influential roles. Sufi hagiographies, which are our main sources, have long been regarded in a negative light, and their value for our understanding of the early history of Sufism is held in doubt. More recently, however, a new scholarly voice has begun to reclaim the historical value of hagiographies. We need to approach the narrative structures and styles of the anecdotal segments, which are the building blocks of the hagiographical body of writing. The image of a particular Sufi figure as portrayed by his near-contemporaries can provide a more useful means to sketch the components of his unique piety than his real life. However, in certain cases, whenever singular and unique appearances of particular stories occur, certain historical and individual conclusions could be sought. As for women in Sufi hagiographies, we know about sisters who acted as a solid support for their renowned Sufi brothers. Some of those sisters preferred not to be married until a late age in order to "serve" their brothers, while others supported their brothers while pursuing their own spiritual careers. Data of this type should be carefully considered and its historical context should be thoroughly investigated. The reference here is to women, mostly married women, who offered to maintain their brothers or male relatives despite social norms or generic prohibitions, which undoubtedly gave them strong authority over them. As for mothers, we should differentiate between mothers who were Sufis themselves, and those who were the mothers of Sufi figures. It seems most likely that in both types, mothers were not always unquestionably the effective lightening trigger. Mothers of certain Sufi figures denied their sons free mobility, taking advantage of the highly esteemed principle of gratifying the wishes of one's mother and the seminal ideal of ḥaqq al-wālida (lit. mother's right). Drawing on the anecdotes provided by a few sources leads to the suggestion that many Sufis actually strove to reduce their mothers' authority in order to establish their independent careers. In light of women's authority over their brothers and sons in Sufi spheres, maternal uncles could enjoy a crucial position of influence over their nephews. The roles of Sufi mothers and of Sufi maternal uncles in the lives of early Sufi figures are topics that have not yet been dealt with in modern scholarship on classical Sufism.

Keywords: female Sufis, hagiographies, maternal uncles, mother's right

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Authors: Kamlesh Shashikant Dave

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The global financial crisis is rooted in the sub-prime crisis in U.S.A. During the boom years, mortgage brokers attracted by the big commission, encouraged buyers with poor credit to accept housing mortgages with little or no down payment and without credit check. A combination of low interest rates and large inflow of foreign funds during the booming years helped the banks to create easy credit conditions for many years. Banks lent money on the assumptions that housing price would continue to rise. Also the real estate bubble encouraged the demand for houses as financial assets .Banks and financial institutions later repackaged these debts with other high risk debts and sold them to worldwide investors creating financial instruments called collateral debt obligations (CDOs). With the rise in interest rate, mortgage payments rose and defaults among the subprime category of borrowers increased accordingly. Through the securitization of mortgage payments, a recession developed in the housing sector and consequently it was transmitted to the entire US economy and rest of the world. The financial credit crisis has moved the US and the global economy into recession. Indian economy has also affected by the spill over effects of the global financial crisis. Great saving habit among people, strong fundamentals, strong conservative and regulatory regime have saved Indian economy from going out of gear, though significant parts of the economy have slowed down. Industrial activity, particularly in the manufacturing and infrastructure sectors decelerated. The service sector too, slow in construction, transport, trade, communication, hotels and restaurants sub sectors. The financial crisis has some adverse impact on the IT sector. Exports had declined in absolute terms in October. Higher inputs costs and dampened demand have dented corporate margins while the uncertainty surrounding the crisis has affected business confidence. To summarize, reckless subprime lending, loose monetary policy of US, expansion of financial derivatives beyond acceptable norms and greed of Wall Street has led to this exceptional global financial and economic crisis. Thus, the global credit crisis of 2008 highlights the need to redesign both the global and domestic financial regulatory systems not only to properly address systematic risk but also to support its proper functioning (i.e financial stability).Such design requires: 1) Well managed financial institutions with effective corporate governance and risk management system 2) Disclosure requirements sufficient to support market discipline. 3)Proper mechanisms for resolving problem institution and 4) Mechanisms to protect financial services consumers in the event of financial institutions failure.

Keywords: FIIs, BSE, sensex, global impact

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Authors: Tanima Bhattacharya, Joy Sen

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To transform a space into a better livable and sustainable zone, United Nations Summit in New York 2015, has decided upon 17 sustainable development goals (SDGs) that approach directly to achieve inclusive, people-centric, sustainable developments. Though sustainability has been majorly constructed by four pillars, namely, Ecological, Economic, Social and Cultural, but it is essentially reduced to economic and ecological consideration in the context of developing countries. Therefore, in most cases planning has reduced its ambit to concentrate around the tangible infrastructure, ignoring the fundamentals of socio-cultural heritage. With the accentuating hype of infrastructural augmentation, lack of emphasis of traditional concerns like ethnicity and social connection have further diluted the situation, disintegrating cultural continuity. As cultural continuity lacks its cohesion, it’s growing absence increasingly acts as a catalyst to degrade the heritage structures, spaces around and linking these structures, and the ability of stakeholders in identifying themselves rooted in that particular space. Hence, this paper will argue that sustainability depends on the people and their interaction with their surroundings, their culture and livelihood. The interaction between people and their surroundings strengthen community building and social interaction that abides by stakeholders reverting back to their roots. To assess the socio-cultural sustainability of the city of Kolkata, two study areas are selected, namely, an old settlement from the northern part of the city of Kolkata (KMA), imbued with social connection, age-old cultural and ethnic bonding and, another cluster of new high-rises coming up in the Newtown area having portions of planned city extension on the eastern side of the city itself. Whereas, Newtown prioritizes the surging post-industrial trends of economic aspiration and ecological aspects of urban sustainability; the former settlements of northern Kolkata still continue to represent the earliest community settlement of the British-colonial-cum native era and even the pre-colonial era, permeated with socio-cultural reciprocation. Thus, to compare and assess the inlayed organizational structure of both the spaces in the two cases, selected areas have been surveyed to portray their current imageability. The argument of this paper is structured in 5parts. First, an introduction of the idea has been forwarded, Secondly, a literature review has been conducted to ground the proposed ideas, Thirdly, methodology has been discussed and appropriate case study areas have been selected, Fourthly, surveys and analyses has been forwarded and lastly, the paper has arrived at a set of conclusions by suggesting a threefold development to create happy, healthy and sustainable community.

Keywords: art innovation, current scenario assessment, heritage, imageability, socio-cultural sustainability

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Authors: Mary Deyo, Zmara Harrison

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This study reports the outcomes of an 8-week experiential learning program for 6 adults with Intellectual and Developmental Disabilities (IDD) at a day habilitation program. The intervention foci for this program include executive function, language learning in the domains of expressive, receptive, and pragmatic language, and quality of life. The interprofessional collaboration aimed at supporting adults with IDD to reach person-centered, functional goals across skill domains is critical. This study is a significant addition to the speech-language pathology literature in that it examines a therapy method that potentially meets this need while targeting domains within the speech-language pathology scope of practice. Communication therapy was provided during highly valued and meaningful hands-on learning experiences, referred to as the Garden Club, which incorporated all aspects of planting and caring for a garden as well as related journaling, sensory, cooking, art, and technology-based activities. Direct care staff and an undergraduate research assistant were trained by SLP to be impactful language guides during their interactions with participants in the Garden Club. SLP also provided direct therapy and modeling during Garden Club. Research methods used in this study included a mixed methods analysis of a literature review, a quasi-experimental implementation of communication therapy in the context of experiential learning activities, Quality of Life participant surveys, quantitative pre- post- data collection and linear mixed model analysis, qualitative data collection with qualitative content analysis and coding for themes. Outcomes indicated overall positive changes in expressive vocabulary, following multi-step directions, sequencing, problem-solving, planning, skills for building and maintaining meaningful social relationships, and participant perception of the Garden Project’s impact on their own quality of life. Implementation of this project also highlighted supports and barriers that must be taken into consideration when planning similar projects. Overall findings support the use of experiential learning projects in day habilitation programs for adults with IDD, as well as additional research to deepen understanding of best practices, supports, and barriers for implementation of experiential learning with this population. This research provides an important contribution to research in the fields of speech-language pathology and other professions serving adults with IDD by describing an interprofessional experiential learning program with positive outcomes for executive function, language learning, and quality of life.

Keywords: experiential learning, adults, intellectual and developmental disabilities, expressive language, receptive language, pragmatic language, executive function, communication therapy, day habilitation, interprofessionalism, quality of life

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Authors: Befekadu Urga Wakayo

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Introduction: Bacterial infections represent major human and animal health problems in Ethiopia. In the face of poor antibiotic regulatory mechanisms, development of antimicrobial resistance (AMR) to commonly used drugs has become a growing health and livelihood threat in the country. Monitoring and control of AMR demand close coloration between human and veterinary services as well as other relevant stakeholders. However, risk of AMR transfer from animal to human population’s remains poorly explored in Ethiopia. This systematic research literature review attempted to give an overview on AMR challenges of bovine mastitis bacteria in Ethiopia. Methodology: A web based research literature search and analysis strategy was used. Databases are considered including; PubMed, Google Scholar, Ethiopian Veterinary Association (EVA) and Ethiopian Society of Animal Production (ESAP). The key search terms and phrases were; Ethiopia, dairy, cattle, mastitis, bacteria isolation, antibiotic sensitivity and antimicrobial resistance. Ultimately, 15 research reports were used for the current analysis. Data extraction was performed using a structured Microsoft Excel format. Frequency AMR prevalence (%) was registered directly or calculated from reported values. Statistical analysis was performed on SPSS – 16. Variables were summarized by giving frequencies (n or %), Mean ± SE and demonstrative box plots. One way ANOVA and independent t test were used to evaluate variations in AMR prevalence estimates (Ln transformed). Statistical significance was determined at p < 0.050). Results: AMR in bovine mastitis bacteria was investigated in a total of 592 in vitro antibiotic sensitivity trials involving 12 different mastitis bacteria (including 1126 Gram positive and 77 Gram negative isolates) and 14 antibiotics. Bovine mastitis bacteria exhibited AMR to most of the antibiotics tested. Gentamycin had the lowest average AMR in both Gram positive (2%) and negative (1.8%) bacteria. Gram negative mastitis bacteria showed higher mean in vitro resistance levels to; Erythromycin (72.6%), Tetracycline (56.65%), Amoxicillin (49.6%), Ampicillin (47.6%), Clindamycin (47.2%) and Penicillin (40.6%). Among Gram positive mastitis bacteria higher mean in vitro resistance was observed in; Ampicillin (32.8%), Amoxicillin (32.6%), Penicillin (24.9%), Streptomycin (20.2%), Penicillinase Resistant Penicillin’s (15.4%) and Tetracycline (14.9%). More specifically, S. aurues exhibited high mean AMR against Penicillin (76.3%) and Ampicillin (70.3%) followed by Amoxicillin (45%), Streptomycin (40.6%), Tetracycline (24.5%) and Clindamycin (23.5%). E. coli showed high mean AMR to Erythromycin (78.7%), Tetracycline (51.5%), Ampicillin (49.25%), Amoxicillin (43.3%), Clindamycin (38.4%) and Penicillin (33.8%). Streptococcus spp. demonstrated higher (p =0.005) mean AMR against Kanamycin (> 20%) and full sensitivity (100%) to Clindamycin. Overall, mean Tetracycline (p = 0.013), Gentamycin (p = 0.001), Polymixin (p = 0.034), Erythromycin (p = 0.011) and Ampicillin (p = 0.009) resistance increased from the 2010’s than the 2000’s. Conclusion; the review indicated a rising AMR challenge among bovine mastitis bacteria in Ethiopia. Corresponding, public health implications demand a deeper, integrated investigation.

Keywords: antimicrobial resistance, dairy cattle, Ethiopia, Mastitis bacteria

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Authors: Manaranjan Pradhan, Shailaja Grover, U. Dinesh Kumar

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Farming community in India, as well as other parts of the world, is one of the highly stressed communities due to reasons such as increasing input costs (cost of seeds, fertilizers, pesticide), droughts, reduced revenue leading to farmer suicides. Lack of integrated farm advisory system in India adds to the farmers problems. Farmers need right information during the early stages of crop’s lifecycle to prevent damage and loss in revenue. In this paper, we use deep learning techniques to develop an early warning system for detection of crop diseases using images taken by farmers using their smart phone. The research work leads to building a smart assistant using analytics and big data which could help the farmers with early diagnosis of the crop diseases and corrective actions. The classical approach for crop disease management has been to identify diseases at crop level. Recently, ImageNet Classification using the convolutional neural network (CNN) has been successfully used to identify diseases at individual plant level. Our model uses convolution filters, max pooling, dense layers and dropouts (to avoid overfitting). The models are built for binary classification (healthy or not healthy) and multi class classification (identifying which disease). Transfer learning is used to modify the weights of parameters learnt through ImageNet dataset and apply them on crop diseases, which reduces number of epochs to learn. One shot learning is used to learn from very few images, while data augmentation techniques are used to improve accuracy with images taken from farms by using techniques such as rotation, zoom, shift and blurred images. Models built using combination of these techniques are more robust for deploying in the real world. Our model is validated using tomato crop. In India, tomato is affected by 10 different diseases. Our model achieves an accuracy of more than 95% in correctly classifying the diseases. The main contribution of our research is to create a personal assistant for farmers for managing plant disease, although the model was validated using tomato crop, it can be easily extended to other crops. The advancement of technology in computing and availability of large data has made possible the success of deep learning applications in computer vision, natural language processing, image recognition, etc. With these robust models and huge smartphone penetration, feasibility of implementation of these models is high resulting in timely advise to the farmers and thus increasing the farmers' income and reducing the input costs.

Keywords: analytics in agriculture, CNN, crop disease detection, data augmentation, image recognition, one shot learning, transfer learning

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Authors: E. Omanya, E. Mueni, G. Makau, M. Kariuki

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HIV infection is the strongest risk factor for a person to develop TB. Isoniazid preventive therapy (IPT) for People Living with HIV (PLWHIV) not only reduces the individual patients’ risk of developing active TB but mitigates cross infection. In Kenya, IPT for six months was recommended through the National TB, Leprosy and Lung Disease Program to treat latent TB. In spite of this recommendation by the national government, uptake of IPT among PLHIV remained low in Kenya by the end of 2015. The USAID/Kenya and East Africa Afya Jijini project, which supports 42 TBHIV health facilities in Nairobi County, began addressing low uptake of IPT through Quality Improvement (QI) teams set up at the facility level. Quality is characterized by WHO as one of the four main connectors between health systems building blocks and health systems outputs. Afya Jijini implements the Kenya Quality Model for Health, which involves QI teams being formed at the county, sub-county and facility levels. The teams review facility performance to identify gaps in service delivery and use QI tools to monitor and improve performance. Afya Jijini supported the formation of these teams in 42 facilities and built the teams’ capacity to review data and use QI principles to identify and address performance gaps. When the QI teams began working on improving IPT uptake among PLHIV, uptake was at 31.8%. The teams first conducted a root cause analysis using cause and effect diagrams, which help the teams to brainstorm on and to identify barriers to IPT uptake among PLHIV at the facility level. This is a participatory process where program staff provides technical support to the QI teams in problem identification and problem-solving. The gaps identified were inadequate knowledge and skills on the use of IPT among health care workers, lack of awareness of IPT by patients, inadequate monitoring and evaluation tools, and poor quantification and forecasting of IPT commodities. In response, Afya Jijini trained over 300 health care workers on the administration of IPT, supported patient education, supported quantification and forecasting of IPT commodities, and provided IPT data collection tools to help facilities monitor their performance. The facility QI teams conducted monthly meetings to monitor progress on implementation of IPT and took corrective action when necessary. IPT uptake improved from 31.8% to 61.2% during the second year of the Afya Jijini project and improved to 80.1% during the third year of the project’s support. Use of QI teams and root cause analysis to identify and address service delivery gaps, in addition to targeted program interventions and continual performance reviews, can be successful in increasing TB related service delivery uptake at health facilities.

Keywords: isoniazid, quality, health care workers, people leaving with HIV

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Authors: Dustin Schöder

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The potential benefits of the utilization of highly automated and autonomous trucks in logistics operations are the subject of interest to the entire logistics industry. The benefits of the use of these new technologies were scientifically investigated and implemented in roadmaps. So far, reliable data and experiences from real life use cases are still limited. A German research consortium of both academics and industry developed a highly automated (SAE level 4) vehicle for yard operations at railports and container depots. After development and testing, a several month field test at the DUSS Terminal in Ulm-Dornstadt (Germany) and the nearby DB Intermodal Services Container Depot in Ulm-Dornstadt was conducted. The truck was piloted in a shuttle service between both sites. In a holistic automation approach, the vehicle was integrated into a digital communication platform so that the truck could move autonomously without a driver and his manual interactions with a wide variety of stakeholders. The main goal is to investigate the effects of highly automated trucks in the key processes of container loading, unloading and container relocation on holistic railport yard operation. The field test data were used to investigate changes in process efficiency of key processes of railport and container yard operations. Moreover, effects on the capacity utilization and potentials for smothering peak workloads were analyzed. The results state that process efficiency in the piloted use case was significantly higher. The reason for that could be found in the digitalized data exchange and automated dispatch. However, the field test has shown that the effect is greatly varying depending on the ratio of highly automated and manual trucks in the yard as well as on the congestion level in the loading area. Furthermore, the data confirmed that under the right conditions, the capacity utilization of highly automated trucks could be increased. In regard to the potential for smothering peak workloads, no significant findings could be made based on the limited requirements and regulations of railway operation in Germany. In addition, an empirical survey among railport managers, operational supervisors, innovation managers and strategists (n=15) within the logistics industry in Germany was conducted. The goal was to identify key characteristics of future railports and terminals as well as requirements that railports will have to meet in the future. Furthermore, the railport processes where automation and autonomization make the greatest impact, as well as hurdles and challenges in the introduction of new technologies, have been surveyed. Hence, further potential use cases of highly automated and autonomous applications could be identified, and expectations have been mapped. As a result, a highly detailed and practice-based roadmap towards a ‘terminal 4.0’ was developed.

Keywords: highly automated driving, autonomous driving, SAE level 4, railport operations, container depot, intermodal logistics, potentials of autonomization

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Authors: Hyuk-Jin Lee

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Even though 23 years have passed in the 21st century, nation-state and nationality-centered cultural identities are still the sentiments and ideologies that dominate the world. Nevertheless, as seen in many cases in Europe, a new perspective is needed to recognize mutual exchanges and influences and to view them as natural cultural exchanges between countries. The situation in East Asia is completely different from Europe. This is presumed to be from the long tradition of having an ethnocentric state concept for at least hundreds of years, quite different from Europe, where the concept of a nation-state was established relatively recently. In other words, unlike Europe, where active exchanges took place, the problem stems from the unique characteristics of East Asia, which has a strong tradition of finding its identity in 'difference'. Thus, it would not be hard to find cultural studies or news of the three East Asian countries emphasizing differences among one another. This applies to all cultural areas, including traditional architecture. For example, in the Korean traditional architecture field, buildings with effects from neighboring countries tend to be ignored, even if they are traditional Korean architecture. In addition to this, in the case of Korea, there seems to be one more cultural harmful aftereffect caused by the 36 years of Japanese colonial rule in the early 20th century; the obsessive filtering concept of 'it must be different from Japan'. In other words, the implicit ideological coercion that the definition of 'Korean cultural heritage' should not be influenced by exchanges with Japan may be found throughout Korean studies. The architectural and cultural aspects of the vast period of time, from the Three Kingdoms era to the beginning of Joseon, which was a period in which cultural influence exchanges with neighboring countries were relatively strong compared to the late Joseon Dynasty, also reflect the 'distorted filtering' caused by finding a repulsive identity against the Japanese colonial period. It is important to look the cultural heritage and traditions as they are inductively, not deductively. If not, we may often ignore or limit our own precious cultural heritage. Conversely, If Baekje, the ancient Korean Kingdom, helped Japan in construction and craftsmen played a big role in building the ancient temple, it would be a healthier perspective to view it as a cultural exchange rather than proudly seeing it as a cultural owner's perspective because this point of view is a proper reconstruction of our ancient and medieval Asian culture (strictly speaking, the color common to East Asia at the time). In particular, this study will examine this topic by giving specific examples from each field of Korean cultural studies. In the search for cultural identity, it would be more helpful for healthy relations between countries and collaborative research in the sensitive part of the interpretation of historical facts as well as cultural circles to minimize excessive meanings on originality and difference.

Keywords: cultural heritage identity, cultural ideology, East Asia, Korea

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Authors: Moh'd Anwer Al-Shboul

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Jordan Customs (JC) has been established to achieve objectives that must be consistent with the guidance of the wise leadership and its aspirations toward tomorrow. Therefore, it has developed several needed tools to provide a distinguished service to simplify work procedures and used modern technologies. A supply chain (SC) consists of all parties that are involved directly or indirectly in order to fulfill a customer request, which includes manufacturers, suppliers, shippers, retailers and even customer brokers. Within each firm, the SC includes all functions involved in receiving a filling a customers’ requests; one of the main functions include customer service. JC and global SCs are evolving into dynamic environment, which requires flexibility, effective communication, and team management. Thus, human resources (HRs) insight in these areas are critical for the effective development of global process network. The importance of HRs has increased significantly due to the role of employees depends on their knowledge, competencies, abilities, skills, and motivations. Strategic planning in JC began at the end of the 1990’s including operational strategy for Human Resource Management and Development (HRM&D). However, a huge transformation in human resources happened at the end of 2006; new employees’ regulation for customs were prepared, approved and applied at the end of 2007. Therefore, many employees lost their positions, while others were selected based on professorial recruitment and selection process (enter new blood). One of several policies that were applied by human resources in JC department is job rotation. From the researcher’s point of view, it was not based on scientific basis to achieve its goals and objectives, which at the end leads to having a significant negative impact on the Organizational Performance (OP) and weak job rotation approach. The purpose of this study is to call attention to re-review the applying process and procedure of job rotation that HRM directorate is currently applied at JC. Furthermore, it presents an overview of managing the HRs in the SC network that affects their success. The research methodology employed in this study was described as qualitative by conducting few interviews with managers, internal employee, external clients and reviewing the related literature to collect some qualitative data from secondary sources. Thus, conducting frequently and unstructured job rotation policy (i.e. monthly) will have a significant negative impact on JC performance as a whole. The results of this study show that the main impacts will affect on three main elements in JC: (1) internal employees' performance; (2) external clients, who are dealing with customs services; and finally, JC performance as a whole. In order to implement a successful and perfect job rotation technique at JC in a scientific way and to achieve its goals and objectives; JCs should be taken into consideration the proposed solutions and recommendations that will be presented in this study.

Keywords: efficiency, supply chain, human resources, job rotation, organizational performance, Jordan customs

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Authors: Maryam Tabrizi, Shahrzad Aarup

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Objectives- Understanding the close association between oral health and overall health for older adults at the right time and right place, a person, focus treatment through Project ECHO telementoring. Methodology- Data from monthly ECHO telementoring sessions were provided for three years. Sessions including case presentations, overall health conditions, considering medications, organ functions limitations, including the level of cognition. Contributions- Providing the specialist level of providing care to all elderly regardless of their location and other health conditions and decreasing oral health inequity by increasing workforce via Project ECHO telementoring program worldwide. By 2030, the number of adults in the USA over the age of 65 will increase more than 60% (approx.46 million) and over 22 million (30%) of 74 million older Americans will need specialized geriatrician care. In 2025, a national shortage of medical geriatricians will be close to 27,000. Most individuals 65 and older do not receive oral health care due to lack of access, availability, or affordability. One of the main reasons is a significant shortage of Oral Health (OH) education and resources for the elderly, particularly in rural areas. Poor OH is a social stigma, a thread to quality and safety of overall health of the elderly with physical and cognitive decline. Poor OH conditions may be costly and sometimes life-threatening. Non-traumatic dental-related emergency department use in Texas alone was over $250 M in 2016. Most elderly over the age of 65 present with at least one or multiple chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) are at higher risk to develop gum (periodontal) disease, yet they are less likely to get dental care. In addition, most older adults take both prescription and over-the-counter drugs; according to scientific studies, many of these medications cause dry mouth. Reduced saliva flow due to aging and medications may increase the risk of cavities and other oral conditions. Most dental schools have already increased geriatrics OH in their educational curriculums, but the aging population growth worldwide is faster than growing geriatrics dentists. However, without the use of advanced technology and creating a network between specialists and primary care providers, it is impossible to increase the workforce, provide equitable oral health to the elderly. Project ECHO is a guided practice model that revolutionizes health education and increases the workforce to provide best-practice specialty care and reduce health disparities. Training oral health providers for utilizing the Project ECHO model is a logical response to the shortage and increases oral health access to the elderly. Project ECHO trains general dentists & hygienists to provide specialty care services. This means more elderly can get the care they need, in the right place, at the right time, with better treatment outcomes and reduces costs.

Keywords: geriatric, oral health, project echo, chronic disease, oral health

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Authors: Hai L. Tran

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Previous research on agenda setting effects has often focused on the top-down influence of the media at the aggregate level, while overlooking the capacity of audience members to select media and content to fit their individual dispositions. The decentralized characteristics of online communication and digital news create more choices and greater user control, thereby enabling each audience member to seek out a unique blend of media sources, issues, and elements of messages and to mix them into a coherent individual picture of the world. This study examines how audiences use media differently depending on their prior dispositions, thereby making sense of the world in ways that are congruent with their preferences and cognitions. The current undertaking is informed by theoretical frameworks from two distinct lines of scholarship. According to the ideological migration hypothesis, individuals choose to live in communities with ideologies like their own to satisfy their need to belong. One tends to move away from Zip codes that are incongruent and toward those that are more aligned with one’s ideological orientation. This geographical division along ideological lines has been documented in social psychology research. As an extension of agenda setting, the agendamelding hypothesis argues that audiences seek out information in attractive media and blend them into a coherent narrative that fits with a common agenda shared by others, who think as they do and communicate with them about issues of public. In other words, individuals, through their media use, identify themselves with a group/community that they want to join. Accordingly, the present study hypothesizes that because ideology plays a role in pushing people toward a physical community that fits their need to belong, it also leads individuals to receive an idiosyncratic blend of media and be influenced by such selective exposure in deciding what issues are more relevant. Consequently, the individualized focus of media choices impacts how audiences perceive political news coverage and what they know about political issues. The research project utilizes recent data from The American Trends Panel survey conducted by Pew Research Center to explore the nuanced nature of agenda setting at the individual level and amid heightened polarization. Hypothesis testing is performed with both nonparametric and parametric procedures, including regression and path analysis. This research attempts to explore the media-public relationship from a bottom-up approach, considering the ability of active audience members to select among media in a larger process that entails agenda setting. It helps encourage agenda-setting scholars to further examine effects at the individual, rather than aggregate, level. In addition to theoretical contributions, the study’s findings are useful for media professionals in building and maintaining relationships with the audience considering changes in market share due to the spread of digital and social media.

Keywords: agenda setting, agendamelding, audience fragmentation, ideological migration, partisanship, polarization

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Authors: Fabio L. Vieira, Micaelle F. C. Lemos, Luciano C. Lemos, Rafaela S. Oliveira, Ian A. Cunha

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Brazil has some challenges ahead related to population oral health, most of them associated with the need of expanding into the local level its promotion and prevention activities, offer equal access to services and promote changes in the lifestyle of the population. The program implemented an oral health initiative in public schools in the city of Salvador, Bahia. The mission was to improve oral health among students on primary and secondary education, from 2 to 15 years old, using the school as a pathway to increase access to healthcare. The main actions consisted of a team's visit to the schools with educational sessions for dental cavity prevention and individual assessment. The program incorporated a clinical surveillance component through a dental evaluation of every student searching for dental disease and caries, standardization of the dentists’ team to reach uniform classification on the assessments, and the use of an online platform to register data directly from the schools. Sequentially, the students with caries were referred for free clinical treatment on the program’s Health Centre. The primary purpose of this study was to analyze the effects and outcomes of this school-based oral health program. The study sample was composed by data of a period of 3 years - 2015 to 2017 - from 13 public schools on the suburb of the city of Salvador with a total number of assessments of 9,278 on this period. From the data collected the prevalence of children with decay on permanent teeth was chosen as the most reliable indicator. The prevalence was calculated for each one of the 13 schools using the number of children with 1 or more dental caries on permanent teeth divided by the total number of students assessed for school each year. Then the percentage change per year was calculated for each school. Some schools presented a higher variation on the total number of assessments in one of the three years, so for these, the percentage change calculation was done using the two years with less variation. The results show that 10 of the 13 schools presented significative improvements for the indicator of caries in permanent teeth. The mean for the number of students with caries percentage reduction on the 13 schools was 26.8%, and the median was 32.2% caries in permanent teeth institution. The highest percentage of improvement reached a decrease of 65.6% on the indicator. Three schools presented a rise in caries prevalence (8.9, 18.9 and 37.2% increase) that, on an initial analysis, seems to be explained with the students’ cohort rotation among other schools, as well as absenteeism on the treatment. In conclusion, the program shows a relevant impact on the reduction of caries in permanent teeth among students and the need for the continuity and expansion of this integrated healthcare approach. It has also been evident the significative of the articulation between health and educational systems representing a fundamental approach to improve healthcare access for children especially in scenarios such as presented in Brazil.

Keywords: primary care, public health, oral health, school-based oral health, data management

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Authors: Mauro Callejas-Cuervo, Andrea C. Alarcon-Aldana, Andres F. Ruiz-Olaya, Juan C. Alvarez

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Motion capture (MC) is the construction of a precise and accurate digital representation of a real motion. Systems have been used in the last years in a wide range of applications, from films special effects and animation, interactive entertainment, medicine, to high competitive sport where a maximum performance and low injury risk during training and competition is seeking. This paper presents an inertial and magnetic sensor based technological platform, intended for particular amplitude monitoring and telerehabilitation processes considering an efficient cost/technical considerations compromise. Our platform particularities offer high social impact possibilities by making telerehabilitation accessible to large population sectors in marginal socio-economic sector, especially in underdeveloped countries that in opposition to developed countries specialist are scarce, and high technology is not available or inexistent. This platform integrates high-resolution low-cost inertial and magnetic sensors with adequate user interfaces and communication protocols to perform a web or other communication networks available diagnosis service. The amplitude information is generated by sensors then transferred to a computing device with adequate interfaces to make it accessible to inexperienced personnel, providing a high social value. Amplitude measurements of the platform virtual system presented a good fit to its respective reference system. Analyzing the robotic arm results (estimation error RMSE 1=2.12° and estimation error RMSE 2=2.28°), it can be observed that during arm motion in any sense, the estimation error is negligible; in fact, error appears only during sense inversion what can easily be explained by the nature of inertial sensors and its relation to acceleration. Inertial sensors present a time constant delay which acts as a first order filter attenuating signals at large acceleration values as is the case for a change of sense in motion. It can be seen a damped response of platform virtual in other images where error analysis show that at maximum amplitude an underestimation of amplitude is present whereas at minimum amplitude estimations an overestimation of amplitude is observed. This work presents and describes the platform virtual as a motion capture system suitable for telerehabilitation with the cost - quality and precision - accessibility relations optimized. These particular characteristics achieved by efficiently using the state of the art of accessible generic technology in sensors and hardware, and adequate software for capture, transmission analysis and visualization, provides the capacity to offer good telerehabilitation services, reaching large more or less marginal populations where technologies and specialists are not available but accessible with basic communication networks.

Keywords: inertial sensors, joint amplitude measurement, MEMS, telerehabilitation

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Authors: Rasmita Mishra, Chander Shekher

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Background: Population ageing is an inevitable outcome of demographic transition. Due to increased life expectancy, the old age population in India and worldwide has increased, and it will continue to grow more alarmingly in the near future. There are redundant austerity that has been bestowed upon the widows, thus, the life of widows is never been easy in India. The loss of spouse along with other disadvantaged socioeconomic intermediaries like illiteracy and poverty often make the life of widows more difficult to live. Methodology: Ethical statement: The study used secondary data available in the public domain for its wider use in social research. Thus, there was no requirement of ethical consent in the present study. Data source: Building a Knowledge Base on Population Aging in India (BKPAI), 2011 dataset is used to fulfill the objectives of this study. It was carried out in seven states – Himachal Pradesh, Kerala, Maharashtra, Odisha, Punjab, Tamil Nadu, and West Bengal – having a higher percentage of the population in the age group 60 years and above compared to the national average. Statistical analysis: Descriptive and inferential statistics were used to understand the level of elderly widows and incidence of abuse against them in India and selected states. Bivariate and Trivariate analysis were carried out to check the pattern of abuse by selected covariates. Chi-Square test is used to verify the significance of the association. Further, Discriminant Analysis (DA) is carried out to understand which factor can separate out group of neglect and non-neglect elderly. Result: With the addition of 27 million from 2001 to 2011, the total elderly population in India is more than 100 million. Elderly females aged 60+ were more widows than their counterpart elderly males. This pattern was observed across selected states and at national level. At national level, more than one tenth (12 percent) of elderly experienced abuse in their lifetime. Incidence of abuse against elderly widows within family was considerably higher than the outside the family. This pattern was observed across the selected place and abuse in the study. In discriminant analysis, the significant difference between neglected and non-neglected elderly on each of the independent variables was examined using group mean and ANOVA. Discussion: The study is the first of its kind to assess the incidence of abuse against elderly widows using large-scale survey data. Another novelty of this study is that it has assessed for those states in India whereby the proportion of elderly is higher than the national average. Place and perpetrators involved in the abuse against elderly widows certainly envisaged the safeness in the present living arrangement of elderly widows. Conclusion: Due to the increasing life expectancy it is expected that the number of elderly will increase much faster than before. As biologically women live longer than men, there will be more women elderly than men. With respect to the living arrangement, after the demise of the spouse, elderly widows are more likely to live with their children who emerged as the main perpetrator of abuse.

Keywords: elderly abuse, emotional abuse physical abuse, material abuse, psychological abuse, quality of life

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Authors: Lee Boudreau, Ash Kumar Khaitu, Laura A. S. MacDonald

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In April 2015, a magnitude 7.8 earthquake struck Nepal, killing, injuring, and displacing thousands of people. The earthquake also damaged water and sanitation service networks, leading to a high risk of diarrheal disease and the associated negative health impacts. In response to the disaster, the Environment and Public Health Organization (ENPHO), a Kathmandu-based non-governmental organization, worked with the Centre for Affordable Water and Sanitation Technology (CAWST), a Canadian education, training and consulting organization, to develop two training programs to educate volunteers on water, sanitation, and hygiene (WASH) needs. The first training program was intended for acute response, with the second focusing on longer term recovery. A key focus was to equip the volunteers with the knowledge and skills to formulate useful WASH advice in the unanticipated circumstances they would encounter when working in affected areas. Within the first two weeks of the disaster, a two-day acute response training was developed, which focused on enabling volunteers to educate those affected by the disaster about local WASH issues, their link to health, and their increased importance immediately following emergency situations. Between March and October 2015, a total of 19 training events took place, with over 470 volunteers trained. The trained volunteers distributed hygiene kits and liquid chlorine for household water treatment. They also facilitated health messaging and WASH awareness activities in affected communities. A three-day recovery phase training was also developed and has been delivered to volunteers in Nepal since October 2015. This training focused on WASH issues during the recovery and reconstruction phases. The interventions and recommendations in the recovery phase training focus on long-term WASH solutions, and so form a link between emergency relief strategies and long-term development goals. ENPHO has trained 226 volunteers during the recovery phase, with training ongoing as of April 2016. In the aftermath of the earthquake, ENPHO found that its existing pool of volunteers were more than willing to help those in their communities who were more in need. By training these and new volunteers, ENPHO was able to reach many more communities in the immediate aftermath of the disaster; together they reached 11 of the 14 earthquake-affected districts. The collaboration between ENPHO and CAWST in developing the training materials was a highly collaborative and iterative process, which enabled the training materials to be developed within a short response time. By training volunteers on basic WASH topics during both the immediate response and the recovery phase, ENPHO and CAWST have been able to link immediate emergency relief to long-term developmental goals. While the recovery phase training continues in Nepal, CAWST is planning to decontextualize the training used in both phases so that it can be applied to other emergency situations in the future. The training materials will become part of the open content materials available on CAWST’s WASH Resources website.

Keywords: water and sanitation, emergency response, education and training, building resilience

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Authors: Haya Salah, Srinivas Sharan

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Healthcare facilities use appointment systems to schedule their appointments and to manage access to their medical services. With the growing demand for outpatient care, it is now imperative to manage physician's time effectively. However, high variation in consultation duration affects the clinical scheduler's ability to estimate the appointment duration and allocate provider time appropriately. Underestimating consultation times can lead to physician's burnout, misdiagnosis, and patient dissatisfaction. On the other hand, appointment durations that are longer than required lead to doctor idle time and fewer patient visits. Therefore, a good estimation of consultation duration has the potential to improve timely access to care, resource utilization, quality of care, and patient satisfaction. Although the literature on factors influencing consultation length abound, little work has done to predict it using based data-driven approaches. Therefore, this study aims to predict consultation duration using supervised machine learning algorithms (ML), which predicts an outcome variable (e.g., consultation) based on potential features that influence the outcome. In particular, ML algorithms learn from a historical dataset without explicitly being programmed and uncover the relationship between the features and outcome variable. A subset of the data used in this study has been obtained from the electronic medical records (EMR) of four different outpatient clinics located in central Pennsylvania, USA. Also, publicly available information on doctor's characteristics such as gender and experience has been extracted from online sources. This research develops three popular ML algorithms (deep learning, random forest, gradient boosting machine) to predict the treatment time required for a patient and conducts a comparative analysis of these algorithms with respect to predictive performance. The findings of this study indicate that ML algorithms have the potential to predict the provider service time with superior accuracy. While the current approach of experience-based appointment duration estimation adopted by the clinic resulted in a mean absolute percentage error of 25.8%, the Deep learning algorithm developed in this study yielded the best performance with a MAPE of 12.24%, followed by gradient boosting machine (13.26%) and random forests (14.71%). Besides, this research also identified the critical variables affecting consultation duration to be patient type (new vs. established), doctor's experience, zip code, appointment day, and doctor's specialty. Moreover, several practical insights are obtained based on the comparative analysis of the ML algorithms. The machine learning approach presented in this study can serve as a decision support tool and could be integrated into the appointment system for effectively managing patient scheduling.

Keywords: clinical decision support system, machine learning algorithms, patient scheduling, prediction models, provider service time

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Authors: Monica Jong, Antonios Banos, Tom Scott, Chris Webster, David Fletcher

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Hydrogen, as a clean alternative to methane, is relatively easy to make, either from water using electrolysis or from methane using steam reformation. However, hydrogen is much trickier to store than methane, and without effective storage, it simply won’t pass muster as a suitable methane substitute. Physical storage of hydrogen is quite inefficient. Storing hydrogen as a compressed gas at pressures up to 900 times atmospheric is volumetrically inefficient and carries safety implications, whilst storing it as a liquid requires costly and constant cryogenic cooling to minus 253°C. This is where DU steps in as a possible solution. Across the periodic table, there are many different metallic elements that will react with hydrogen to form a chemical compound known as a hydride (or metal hydride). From a chemical perspective, the ‘king’ of the hydride forming metals is palladium because it offers the highest hydrogen storage volumetric capacity. However, this material is simply too expensive and scarce to be used in a scaled-up bulk hydrogen storage solution. Depleted Uranium is the second most volumetrically efficient hydride-forming metal after palladium. The UK has accrued a significant amount of DU because of manufacturing nuclear fuel for many decades, and that is currently without real commercial use. Uranium trihydride (UH3) contains three hydrogen atoms for every uranium atom and can chemically store hydrogen at ambient pressure and temperature at more than twice the density of pure liquid hydrogen for the same volume. To release the hydrogen from the hydride, all you do is heat it up. At temperatures above 250°C, the hydride starts to thermally decompose, releasing hydrogen as a gas and leaving the Uranium as a metal again. The reversible nature of this reaction allows the hydride to be formed and unformed again and again, enabling its use as a high-density hydrogen storage material which is already available in large quantities because of its stockpiling as a ‘waste’ by-product. Whilst the tritium storage credentials of Uranium have been rigorously proven at the laboratory scale and at the fusion demonstrator JET for over 30 years, there is a need to prove the concept for depleted uranium hydrogen storage (HyDUS) at scales towards that which is needed to flexibly supply our national power grid with energy. This is exactly the purpose of the HyDUS project, a collaborative venture involving EDF as the interested energy vendor, Urenco as the owner of the waste DU, and the University of Bristol with the UKAEA as the architects of the technology. The team will embark on building and proving the world’s first pilot scale demonstrator of bulk chemical hydrogen storage using depleted Uranium. Within 24 months, the team will attempt to prove both the technical and commercial viability of this technology as a longer duration energy storage solution for the UK. The HyDUS project seeks to enable a true by-product to wonder material story for depleted Uranium, demonstrating that we can think sustainably about unlocking the potential value trapped inside nuclear waste materials.

Keywords: hydrogen, long duration storage, storage, depleted uranium, HyDUS

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Authors: Halina Veloso e Zarate, Manuela Triggianese

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The urban challenges posed by rapid population growth, climate adaptation, and sustainable living have compelled Dutch cities to reimagine their built environment and transportation systems. As a pivotal contributor to CO₂ emissions, the transportation sector in the Netherlands demands innovative solutions for transitioning to low-carbon mobility. This study investigates the potential of transit oriented development (TOD) as a strategy for achieving carbon reduction and sustainable urban transformation. Focusing on the Lombardijen station area in Rotterdam, which is targeted for significant densification, this paper presents a design-oriented exploration of a low-carbon transport node. By employing a research-by-design methodology, this study delves into multifaceted factors and scales, aiming to propose future scenarios for Lombardijen. Drawing from a synthesis of existing literature, applied research, and practical insights, a robust design framework emerges. To inform this framework, governmental data concerning the built environment and material embodied carbon are harnessed. However, the restricted access to crucial datasets, such as property ownership information from the cadastre and embodied carbon data from De Nationale Milieudatabase, underscores the need for improved data accessibility, especially during the concept design phase. The findings of this research contribute fundamental insights not only to the Lombardijen case but also to TOD studies across Rotterdam's 13 nodes and similar global contexts. Spatial data related to property ownership facilitated the identification of potential densification sites, underscoring its importance for informed urban design decisions. Additionally, the paper highlights the disparity between the essential role of embodied carbon data in environmental assessments for building permits and its limited accessibility due to proprietary barriers. Although this study lays the groundwork for sustainable urbanization through TOD-based design, it acknowledges an area of future research worthy of exploration: the socio-economic dimension. Given the complex socio-economic challenges inherent in the Lombardijen area, extending beyond spatial constraints, a comprehensive approach demands integration of mobility infrastructure expansion, land-use diversification, programmatic enhancements, and climate adaptation. While the paper adopts a TOD lens, it refrains from an in-depth examination of issues concerning equity and inclusivity, opening doors for subsequent research to address these aspects crucial for holistic urban development.

Keywords: Rotterdam zuid, transport oriented development, carbon emissions, low-carbon design, cross-scale design, data-supported design

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Authors: Ali Mirtaghavi, Andy Baldwin, Rajendarn Muthuraj, Jack Luo

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Recent advances in biomaterials have led to utilizing biopolymers to develop 3D scaffolds in tissue regeneration. One of the major challenges of designing biomaterials for 3D scaffolds is to mimic the building blocks similar to the extracellular matrix (ECM) of the native tissues. Biopolymer based aerogels obtained by freeze-drying have shown to provide structural similarities to the ECM owing to their 3D format and a highly porous structure with interconnected pores, similar to the ECM. Gelatin (GEL) is known to be a promising biomaterial with inherent regenerative characteristics owing to its chemical similarities to the ECM in native tissue, biocompatibility abundance, cost-effectiveness and accessible functional groups, which makes it facile for chemical modifications with other biomaterials to form biocomposites. Despite such advantages, gelatin offers poor mechanical properties, sensitive enzymatic degradation and high viscosity at room temperature which limits its application and encourages its use to develop biocomposites. Hydrophilic biomass-based cellulose nanofibrous (CNF) has been explored to use as suspension for biocomposite aerogels for the development of 3D porous structures with excellent mechanical properties, biocompatibility and slow enzymatic degradation. In this work, CNF biocomposite aerogels with various ratios of CNF:GEL) (90:10, 70:30 and 50:50) were prepared by freeze-drying technique, and their properties were investigated in terms of physicochemical, mechanical and biological characteristics. Epichlorohydrin (EPH) was used to investigate the effect of chemical crosslinking on the molecular interaction of CNF: GEL, and its effects on physicochemical, mechanical and biological properties of the biocomposite aerogels. Ultimately, chemical crosslinking helped to improve the mechanical resilience of the resulting aerogels. Amongst all the CNF-GEL composites, the crosslinked CNF: GEL (70:30) biocomposite was found to be favourable for cell attachment and viability. It possessed highly porous structure (porosity of ~93%) with pore sizes ranging from 16-110 µm, adequate mechanical properties (compression modulus of ~47 kPa) and optimal biocompatibility both in-vitro and in-vivo, as well as controlled enzymatic biodegradation, high water penetration, which could be considered a suitable option for wound healing application. In-vivo experiments showed improvement on inflammation and foreign giant body cell reaction for the crosslinked CNF: GEL (70:30) compared to the other samples. This could be due to the superior interaction of CNF with gelatin through chemical crosslinking, resulting in more optimal in-vivo improvement. In-vitro cell culture investigation on human dermal fibroblasts showed satisfactory 3D cell attachment over time. Overall, it has been observed that the developed CNF: GEL aerogel can be considered as a potential scaffold for soft tissue regeneration application.

Keywords: 3D scaffolds, aerogels, Biocomposites , tissue engineering

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Authors: Jeffrey A. Humenik

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Environmental, Limited Liability Corporation (EMR) provided civil construction services to the U.S. Army Corps of Engineers, Kansas City District, for the placement of a protective riprap blanket on the west bank of the Smoky Hill River, construction of 2 shore abutments and the construction of a 140 foot long sill wall spanning the Smoky Hill River in Salina, Kansas. The purpose of the project was to protect the riverbank from erosion and hold back water to a specified elevation, creating a pool to ensure adequate water intake for the municipal water supply. Geotextile matting and riprap were installed for streambank erosion protection. An inflatable bladder (AquaDam®) was designed to the specific river dimension and installed to divert the river and allow for dewatering during the construction of the sill walls and cofferdam. AquaDam® consists of water filled polyethylene tubes to create aqua barriers and divert water flow or prevent flooding. A challenge of the project was the fact that 100% of the sill wall was constructed within an active river channel. The threat of flooding of the work area, damage to the aqua dam by debris, and potential difficulty of water removal presented a unique set of challenges to the construction team. Upon completion of the West Sill Wall, floating debris punctured the AquaDam®. The manufacturing and delivery of a new AquaDam® would delay project completion by at least 6 weeks. To keep the project ahead of schedule, the decision was made to construct an earthen cofferdam reinforced with rip rap for the construction of the East Abutment and East Sill Wall section. During construction of the west sill wall section, a deep scour hole was encountered in the wall alignment that prevented EMR from using the natural rock formation as a concrete form for the lower section of the sill wall. A formwork system was constructed, that allowed the west sill wall section to be placed in two horizontal lifts of concrete poured on separate occasions. The first sectional lift was poured to fill in the scour hole and act as a footing for the second sectional lift. Concrete wall forms were set on the first lift and anchored to the surrounding riverbed in a manner that the second lift was poured in a similar fashion as a basement wall. EMR’s timely decision to keep the project moving toward completion in the face of changing conditions enabled project completion two (2) months ahead of schedule. The use of inflatable bladders is an effective and cost-efficient technology to divert river flow during construction. However, a secondary plan should be part of project design in the event debris transported by river punctures or damages the bladders.

Keywords: abutment, AquaDam®, riverbed, scour

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Authors: Rohini Sharma, Chandan Kumar Sahoo, Rama Krishna Gupta Potnuru

Abstract:

Strong competitive forces and requirements to achieve efficiency are forcing the organizations to realize the necessity and inevitability of change. What's more, the trend does not appear to be abating. Researchers have estimated that about two thirds of change project fails. Empirical evidences further shows that organizations invest significantly in the planned change but people side is accounted for in a token or instrumental way, which is identified as one of the important reason, why change endeavours fail. However, whatever be the reason for change, organizational change readiness must be gauged prior to the institutionalization of organizational change. Hence, in this study the influence of employee voice and employee involvement on organizational change readiness via commitment-to-change is examined, as it is an area yet to be extensively studied. Also, though a recent study has investigated the interrelationship between leadership, organizational change readiness and commitment to change, our study further examined these constructs in relation with employee voice and employee involvement that plays a consequential role for organizational change readiness. Further, integrated conceptual model weaving varied concepts relating to organizational readiness with focus on commitment to change as mediator was found to be an area, which required more theorizing and empirical validation, and this study rooted in an Indian public sector organization is a step in this direction. Data for the study were collected through a survey among employees of Rourkela Steel Plant (RSP), a unit of Steel Authority of India Limited (SAIL); the first integrated Steel Plant in the public sector in India, for which stratified random sampling method was adopted. The schedule was distributed to around 700 employees, out of which 516 complete responses were obtained. The pre-validated scales were used for the study. All the variables in the study were measured on a five-point Likert scale ranging from “strongly disagree (1)” to “strongly agree (5)”. Structural equation modeling (SEM) using AMOS 22 was used to examine the hypothesized model, which offers a simultaneous test of an entire system of variables in a model. The study results shows that inter-relationship between employee voice and commitment-to-change, employee involvement and commitment-to-change and commitment-to-change and organizational change readiness were significant. To test the mediation hypotheses, Baron and Kenny’s technique was used. Examination of direct and mediated effect of mediators confirmed that commitment-to-change partially mediated the relation between employee involvement and organizational change readiness. Furthermore, study results also affirmed that commitment-to-change does not mediate the relation between employee involvement and organizational change readiness. The empirical exploration therefore establishes that it is important to harness employee’s valuable suggestions regarding change for building organizational change readiness. Regarding employee involvement, it was found that sharing information and involving people in decision-making, leads to a creation of participative climate, which educes employee commitment during change and commitment-to-change further, fosters organizational change readiness.

Keywords: commitment-to-change, change management, employee voice, employee involvement, organizational change readiness

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Authors: Aleksander Ejsmont, Stefan Wuttke, Joanna Goscianska

Abstract:

Gaining control over particle shape, size and crystallinity is an ongoing challenge for many materials. Especially metalorganic frameworks (MOFs) are recently widely studied. Besides their remarkable porosity and interesting topologies, morphology has proven to be a significant feature. It can affect the further material application. Thus seeking new approaches that enable MOF morphology modulation is important. MOFs are reticular structures, where building blocks are made up of organic linkers and metallic nodes. The most common strategy of ensuring metal source is using salts, which usually exhibit high solubility and hinder morphology control. However, there has been a growing interest in using metal oxides as structure-directing agents towards MOFs due to their very low solubility and shape preservation. Metal oxides can be treated as a metal reservoir during MOF synthesis. Up to now, reports in which receiving MOFs from metal oxides mostly present ZnO conversion to ZIF-8. However, there are other oxides, for instance, Co₃O₄, which often is overlooked due to their structural stability and insolubility in aqueous solutions. Cobalt-based materials are famed for catalytic activity. Therefore the development of their efficient synthesis is worth attention. In the presented work, an optimized Co₃O₄transition to Co-MOFviaa solvothermal approach was proposed. The starting point of the research was the synthesis of Co₃O₄ flower petals and needles under hydrothermal conditions using different cobalt salts (e.g., cobalt(II) chloride and cobalt(II) nitrate), in the presence of urea, and hexadecyltrimethylammonium bromide (CTAB) surfactant as a capping agent. After receiving cobalt hydroxide, the calcination process was performed at various temperatures (300–500 °C). Then cobalt oxides as a source of cobalt cations were subjected to reaction with trimesic acid in solvothermal environment and temperature of 120 °C leading to Co-MOF fabrication. The solution maintained in the system was a mixture of water, dimethylformamide, and ethanol, with the addition of strong acids (HF and HNO₃). To establish how solvents affect metal oxide conversion, several different solvent ratios were also applied. The materials received were characterized with analytical techniques, including X-ray powder diffraction, energy dispersive spectroscopy,low-temperature nitrogen adsorption/desorption, scanning, and transmission electron microscopy. It was confirmed that the synthetic routes have led to the formation of Co₃O₄ and Co-based MOF varied in shape and size of particles. The diffractograms showed receiving crystalline phase for Co₃O₄, and also for Co-MOF. The Co₃O₄ obtained from nitrates and with using low-temperature calcination resulted in smaller particles. The study indicated that cobalt oxide particles of different size influence the efficiency of conversion and morphology of Co-MOF. The highest conversion was achieved using metal oxides with small crystallites.

Keywords: Co-MOF, solvothermal synthesis, morphology control, core-shell

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Authors: Varsha Puri, Sharon Hudson, Ian Kim

Abstract:

Background: Incest-related childhood sexual abuse (IRCSA) is challenging to study due to the shame and secrecy experienced by its survivors. Ramifications of IRCSA worsen when it is unidentified, and interventions are not made. IRCSA perspectives are essential for future prevention and intervention strategies. However, there is limited understanding of this population’s experiences, perspectives, and long-term struggles. To date, research for IRCSA has utilized data from treatment programs and qualitative research with cohorts of 10-20 people, much of the data is from 10-40 years prior. Methods. In June 2018, an anonymous online survey was posted to multiple social media sites (e.g., Facebook IRCSA groups) and sexual abuse resource sites. Survey responses were collected for a year. The survey collected non-identifying demographics, IRCSA experiences, and outcomes data. Results: We obtained 1310 completed surveys. Demographics of all ages, racial backgrounds, financial backgrounds, and genders were obtained; the majority identified as white (81%) and female (76%). Childhood sexual abuse (CSA) started before the age of 6 in 49% and was endured for more than one year in 84% of respondents, and 39% reported ten or more years of abuse. CSA by multiple perpetrators occurred in 58%, while 8% had ten or more perpetrators. CSA by perpetrators under 21 years old was reported by 46%. Female perpetrators were reported by 28% of respondents. Fathers were the highest reported sexual abusers at 60%, and mothers were reported at 17%. Only 16% reported that at least one of their perpetrators was prosecuted for sexual abuse of a minor. Respondents confirmed that 54% of the time, they informed an adult of the abuse; only 2% agreed that “an intervention was made by the family that protected me.” A majority reported that IRCSA has negatively impacted their intimate/sexual relationships (96%) and mental health (96%). A majority reported negative impacts on biological family relationships (88%), physical health (73%), finances (59%), educational achievement (57%), and employment (56%). When asked about suffering from addiction, 85% of respondents answered yes. Prevention strategies selected most by respondents include early school education around CSA prevention (67%), removing the statute of limitations for reporting CSA (69%), and improved laws protecting IRCSA survivors (63%). Conclusion: The data document that IRCSA can be pervasive, and the dearth of intervention and support for survivors have major lasting impacts. Survivors have a unique and valuable perspective on what interventions are needed to prevent IRCSA and support survivors; their voice has long been unheard in crafting prevention and intervention policies and services. These results thus provide an important call to action from these critical stakeholders. Pediatricians should recognize that perpetrators can be pediatric patients, women, and parents. Pediatricians can advocate for more early CSA prevention education and policy changes that remove the statute of limitations for reporting CSA.

Keywords: incest, childhood sexual abuse, incest-related childhood sexual abuse, incest survivor

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Authors: Lucie Speyer, Vincent Lecocq, Séverine Humbert, Antoine Hugon

Abstract:

Mesoporous alumina is commonly used as a catalyst support for the hydrotreating of heavy petroleum cuts. The process of fabrication usually involves: the synthesis of the boehmite AlOOH precursor, a kneading-extrusion step, and a calcination in order to obtain the final alumina extrudates. Alumina is described as a complex porous medium, generally agglomerates constituted of aggregated nanocrystallites. Its porous texture directly influences the active phase deposition and mass transfer, and the catalytic properties. Then, it is easy to figure out that each step of the fabrication of the supports has a role on the building of their porous network, and has to be well understood to optimize the process. The synthesis of boehmite by precipitation of aluminum salts was extensively studied in the literature and the effect of various parameters, such as temperature or pH, are known to influence the size and shape of the crystallites and the specific surface area of the support. The calcination step, through the topotactic transition from boehmite to alumina, determines the final properties of the support and can tune the surface area, pore volume and pore diameters from those of boehmite. However, the kneading extrusion step has been subject to a very few studies. It generally consists in two steps: an acid, then a basic kneading, where the boehmite powder is introduced in a mixer and successively added with an acid and a base solution to form an extrudable paste. During the acid kneading, the induced positive charges on the hydroxyl surface groups of boehmite create an electrostatic repulsion which tends to separate the aggregates and even, following the conditions, the crystallites. The basic kneading, by reducing the surface charges, leads to a flocculation phenomenon and can control the reforming of the overall structure. The separation and reassembling of the particles constituting the boehmite paste have a quite obvious influence on the textural properties of the material. In this work, we are focused on the influence of the kneading step on the alumina catalysts supports. Starting from an industrial boehmite, extrudates are prepared using various kneading conditions. The samples are studied by nitrogen physisorption in order to analyze the evolution of the textural properties, and by synchrotron small-angle X-ray scattering (SAXS), a more original method which brings information about agglomeration and aggregation of the samples. The coupling of physisorption and SAXS enables a precise description of the samples, as same as an accurate monitoring of their evolution as a function of the kneading conditions. These ones are found to have a strong influence of the pore volume and pore size distribution of the supports. A mechanism of evolution of the texture during the kneading step is proposed and could be attractive in order to optimize the texture of the supports and then, their catalytic performances.

Keywords: alumina catalyst support, kneading, nitrogen physisorption, small-angle X-ray scattering

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