Search results for: construction project assessment risk factor

Authors: A. N. Ghafar, O. A. Chaudhari, W. Oettel, P. Fontana

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This study is a part of the EU project GEOCOND-Advanced materials and processes to improve performance and cost-efficiency of shallow geothermal systems and underground thermal storage. In heat exchange boreholes, to improve the heat transfer between the pipes and the surrounding ground, the space between the pipes and the borehole wall is normally filled with geothermal grout. Traditionally, bentonite has been a crucial component in most commercially available geothermal grouts to assure the required stability and impermeability. The investigations conducted in the early stage of this project during the benchmarking tests on some commercial grouts showed considerable sensitivity of the rheological properties of the tested grouts to the mixing parameters, i.e., mixing time and velocity. Further studies on this matter showed that bentonite, which has been one of the important constituents in most grout mixes, was probably responsible for such behavior. Apparently, proper amount of shear should be applied during the mixing process to sufficiently activate the bentonite. The higher the amount of applied shear the more the activation of bentonite, resulting in change in the grout rheology. This explains why, occasionally in the field applications, the flow properties of the commercially available geothermal grouts using different mixing conditions (mixer type, mixing time, mixing velocity) are completely different than expected. A series of tests were conducted on the grout mixes, with and without bentonite, using different mixing protocols. The aim was to eliminate/reduce the sensitivity of the rheological properties of the geothermal grouts to the mixing parameters by replacing bentonite with polymeric (non-clay) stabilizers. The results showed that by replacing bentonite with a proper polymeric stabilizer, the sensitivity of the grout mix on mixing time and velocity was to a great extent diminished. This can be considered as an alternative for the developers/producers of geothermal grouts to provide enhanced materials with less uncertainty in obtained results in the field applications.

Keywords: flow properties, geothermal grout, mixing time, mixing velocity, rheological properties

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Authors: Johannes Van Der Sandt

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This quantitative study investigates different approaches of community singing, in building social capital in South Tyrol, Italy, and South Africa. The impact of the various approaches of community singing is examined by investigating the main components of social capital, namely, social norms and obligations, social networks and associations and trust, and how these components are manifested in two different societies. The research is based on the premise that community singing is an important agent for the development of social capital. It seeks to establish in what form community singing can best enhance the social capital of communities in South Tyrol that are undergoing significant changes in the ways in which social capital is generally being generated on account of demographic, economic, technological and cultural changes. South Tyrol and South Africa share some similarities in the management of their multi-cultural composition. By comparing the different approaches to community singing in two multi-cultural societies, it is hoped to gain insight, and an understanding of the connections between culture, social cohesion, identity and therefore to be able to add to the understanding of the building of social capital through community singing. Participation in music contributes to the growth of social capital in communities, this is amongst others the finding of an ever increasing amount of research. In sociological discourses on social capital generation, the dimension of community music making is recognized as an important factor. Trust and mutual cooperation are products when people listen to each other, when they work or play together, and when they care about each other. This is how social capital develops as an important shared resource. Scholars of Community Music still do not agree on a short and concise definition for Community Music. For the purpose of this research, the author concurs with the definition of Community Music of the Community Music Activity commission of the International Society of Music Education as having the following characteristics: decentralization, accessibility, equal opportunity, and active participation in music-making. These principles are social and political ones, and there can be no doubt that community music activity is more than a purely musical one. Trust, shared norms and values civic and community involvement, networks, knowledge resources, contact with families and friends, and fellowship are key components in fostering group cohesion and social capital development in a community. The research will show that there is no better place for these factors to flourish than in a community singing group. Through this comparative study, it is the aim to identify, analyze and explain similarities and differences in approaches to community across societies that find themselves in a rapid transition from traditional cultural to global cultural habits characterized by a plurality of orientation points, with the aim to gain a better understanding of the various directions South Tyrolean singing culture can take.

Keywords: community music, multicultural, singing, social capital

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Authors: Satu Lautamäki

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This paper presents findings from a multidisciplinary course (bachelor level) implemented at Seinäjoki University of Applied Sciences, Finland. The course aims to develop innovative thinking of students, by having projects given by companies, using design thinking methods as a tool for creativity and by integrating students into multidisciplinary teams working on the given projects. The course is obligatory for all first year bachelor students across four faculties (business and culture, food and agriculture, health care and social work, and technology). The course involves around 800 students and 30 pedagogical coaches, and it is implemented as an intensive one-week course each year. The paper discusses the pedagogy, structure and coordination of the course. Also, reflections on methods for the development of creative skills are given. Experts in contemporary, global context often work in teams, which consist of people who have different areas of expertise and represent various professional backgrounds. That is why there is a strong need for new training methods where multidisciplinary approach is at the heart of learning. Creative learning takes place when different parties bring information to the discussion and learn from each other. When students in different fields are looking for professional growth for themselves and take responsibility for the professional growth of other learners, they form a mutual learning relationship with each other. Multidisciplinary team members make decisions both individually and collectively, which helps them to understand and appreciate other disciplines. Our results show that creative and multidisciplinary project learning can develop diversity of knowledge and competences, for instance, students’ cultural knowledge, teamwork and innovation competences, time management and presentation skills as well as support a student’s personal development as an expert. It is highly recommended that higher education curricula should include various studies for students from different study fields to work in multidisciplinary teams.

Keywords: multidisciplinary learning, creative skills, innovative thinking, project-based learning

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Authors: Rajesh Ranjan, Marimuthu Palaniswami, A. A. Hashmi

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With the changing lifestyle and environment around us, the prevalence of the critical and incurable disease has proliferated. One such condition is the neurological disorder which is rampant among the old age population and is increasing at an unstoppable rate. Most of the neurological disorder patients suffer from some movement disorder affecting the movement of their body parts. Tremor is the most common movement disorder which is prevalent in such patients that infect the upper or lower limbs or both extremities. The tremor symptoms are commonly visible in Parkinson’s disease patient, and it can also be a pure tremor (essential tremor). The patients suffering from tremor face enormous trouble in performing the daily activity, and they always need a caretaker for assistance. In the clinics, the assessment of tremor is done through a manual clinical rating task such as Unified Parkinson’s disease rating scale which is time taking and cumbersome. Neurologists have also affirmed a challenge in differentiating a Parkinsonian tremor with the pure tremor which is essential in providing an accurate diagnosis. Therefore, there is a need to develop a monitoring and assistive tool for the tremor patient that keep on checking their health condition by coordinating them with the clinicians and caretakers for early diagnosis and assistance in performing the daily activity. In our research, we focus on developing a system for automatic classification of tremor which can accurately differentiate the pure tremor from the Parkinsonian tremor using a wearable accelerometer-based device, so that adequate diagnosis can be provided to the correct patient. In this research, a study was conducted in the neuro-clinic to assess the upper wrist movement of the patient suffering from Pure (Essential) tremor and Parkinsonian tremor using a wearable accelerometer-based device. Four tasks were designed in accordance with Unified Parkinson’s disease motor rating scale which is used to assess the rest, postural, intentional and action tremor in such patient. Various features such as time-frequency domain, wavelet-based and fast-Fourier transform based cross-correlation were extracted from the tri-axial signal which was used as input feature vector space for the different supervised and unsupervised learning tools for quantification of severity of tremor. A minimum covariance maximum correlation energy comparison index was also developed which was used as the input feature for various classification tools for distinguishing the PT and ET tremor types. An automatic system for efficient classification of tremor was developed using feature extraction methods, and superior performance was achieved using K-nearest neighbors and Support Vector Machine classifiers respectively.

Keywords: machine learning approach for neurological disorder assessment, automatic classification of tremor types, feature extraction method for tremor classification, neurological movement disorder, parkinsonian tremor, essential tremor

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Authors: Edgar Santoyo, Daniel Perez-Zarate, Agustin Acevedo, Lorena Diaz-Gonzalez, Mirna Guevara

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Four new gas geothermometers have been derived from a multivariate geo chemometric analysis of a geothermal fluid chemistry database, two of which use the natural logarithm of CO₂ and H2S concentrations (mmol/mol), respectively, and the other two use the natural logarithm of the H₂S/H₂ and CO₂/H₂ ratios. As a strict compilation criterion, the database was created with gas-phase composition of fluids and bottomhole temperatures (BHTM) measured in producing wells. The calibration of the geothermometers was based on the geochemical relationship existing between the gas-phase composition of well discharges and the equilibrium temperatures measured at bottomhole conditions. Multivariate statistical analysis together with the use of artificial neural networks (ANN) was successfully applied for correlating the gas-phase compositions and the BHTM. The predicted or simulated bottomhole temperatures (BHTANN), defined as output neurons or simulation targets, were statistically compared with measured temperatures (BHTM). The coefficients of the new geothermometers were obtained from an optimized self-adjusting training algorithm applied to approximately 2,080 ANN architectures with 15,000 simulation iterations each one. The self-adjusting training algorithm used the well-known Levenberg-Marquardt model, which was used to calculate: (i) the number of neurons of the hidden layer; (ii) the training factor and the training patterns of the ANN; (iii) the linear correlation coefficient, R; (iv) the synaptic weighting coefficients; and (v) the statistical parameter, Root Mean Squared Error (RMSE) to evaluate the prediction performance between the BHTM and the simulated BHTANN. The prediction performance of the new gas geothermometers together with those predictions inferred from sixteen well-known gas geothermometers (previously developed) was statistically evaluated by using an external database for avoiding a bias problem. Statistical evaluation was performed through the analysis of the lowest RMSE values computed among the predictions of all the gas geothermometers. The new gas geothermometers developed in this work have been successfully used for predicting subsurface temperatures in high-temperature geothermal systems of Mexico (e.g., Los Azufres, Mich., Los Humeros, Pue., and Cerro Prieto, B.C.) as well as in a blind geothermal system (known as Acoculco, Puebla). The last results of the gas geothermometers (inferred from gas-phase compositions of soil-gas bubble emissions) compare well with the temperature measured in two wells of the blind geothermal system of Acoculco, Puebla (México). Details of this new development are outlined in the present research work. Acknowledgements: The authors acknowledge the funding received from CeMIE-Geo P09 project (SENER-CONACyT).

Keywords: artificial intelligence, gas geochemistry, geochemometrics, geothermal energy

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Authors: Jae-Neung Lee, Myung-Won Lee, Jung-Su Han, Keun-Chang Kwak

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The paper established DB on the basis of five sailing essentials in the real yachting environment. It obtained the yacht condition (tilt, speed and course), surrounding circumstances (wind direction and speed) and user motion. Gopro camera for image processing was used to recognize the user motion and tilt sensor was employed to see the yacht balance. In addition, GPS for course, wind speed and direction sensor and marked suit were employed.

Keywords: DB consturuction, yacht, five essentials of sailing, marker, Gps

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Authors: Mamani Acurio Alex, Aguilar Alonso Igor

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The lack of interest and the lack of motivation are related. The lack of both in school generates serious problems such as school dropout or a low level of learning. Augmented reality has been very useful in different areas, and in this research, it was implemented in the area of education. Information necessary for the correct development of this mobile application with augmented reality was searched using six different research repositories. It was concluded that the application must be immersive, attractive, and fun for students, and the necessary technologies for its construction were defined.

Keywords: augmented reality, Vuforia, school interest, learning

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Authors: Keyvan Ramin

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The geometric nonlinearity of Off-Diagonal Bracing System (ODBS) could be a complementary system to covering and extending the nonlinearity of reinforced concrete material. Finite element modeling is performed for flexural frame, x-braced frame and the ODBS braced frame system at the initial phase. Then the different models are investigated along various analyses. According to the experimental results of flexural and x-braced frame, the verification is done. Analytical assessments are performed in according to three-dimensional finite element modeling. Non-linear static analysis is considered to obtain performance level and seismic behavior, and then the response modification factors calculated from each model’s pushover curve. In the next phase, the evaluation of cracks observed in the finite element models, especially for RC members of all three systems is performed. The finite element assessment is performed on engendered cracks in ODBS braced frame for various time steps. The nonlinear dynamic time history analysis accomplished in different stories models for three records of Elcentro, Naghan, and Tabas earthquake accelerograms. Dynamic analysis is performed after scaling accelerogram on each type of flexural frame, x-braced frame and ODBS braced frame one by one. The base-point on RC frame is considered to investigate proportional displacement under each record. Hysteresis curves are assessed along continuing this study. The equivalent viscous damping for ODBS system is estimated in according to references. Results in each section show the ODBS system has an acceptable seismic behavior and their conclusions have been converged when the ODBS system is utilized in reinforced concrete frame.

Keywords: FEM, seismic behaviour, pushover analysis, geometric nonlinearity, time history analysis, equivalent viscous damping, passive control, crack investigation, hysteresis curve

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Authors: Shih-Tsung Chen, Yenchin Hsiao

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Evergreen Lily is a newly-built school after Morakot Typhoon took place. The school is located on Majia farm, which is surrounded by mountains. The fund in the construction of the school is solely sponsored by Chang Yung-Fa Foundation. There are 483 permanent houses near the school belonging to three tribes, Dashe, Majia, and Haocha. Due to the most ancient heritages of Paiwan and Rukai in these three tribes, the school is full of cultural atmosphere. From modern and traditional perspectives, Evergreen Lily strives to establish and develop a long-lasting educational model to meet the expectation of the tribes, parents, and the public. This study is a case study of how to develop indigenous education in newly established schools after the Morakot Hurricane disaster to meet the concept of environmental education. The systematic curriculum construction of education and cultural integration and the systematic practice of curriculum practice will be discussed, and the concept and practice of tribal education curriculum and sustainable environmental education will be understood. This study found that this school integrates the spirit of natural philosophy, democratic education, ethnic and experimental education, and constructs a knowledge system that includes three levels of spiritual culture, institutional culture, and material culture, as well as six dimensions of life philosophy, natural ecology, organizational system, tribal literature and history, song and dance, and technical and artistic methods. Adhering to the concept of harmonious education and the sustainable common good, the development of school-based tribal academic courses accounts for about one-third of the total number of teaching sessions, and there are different cultural themes in grades one to six, and there are clear teaching modules to effectively enhance students' potential inspiration. The complete curriculum implementation model can be described as a model for the development of indigenous schools to sustainable environmental education.

Keywords: environmental education, indigenous education, sustainable development, school-based curriculum

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Authors: Naz Najma, Grace T. M. Dal Sasso, Maria de Lourdes de Souza

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The development of information and communication technologies and the accessibility of mobile devices has increased the possibilities of the teaching and learning process anywhere and anytime. Mobile and web application allows the production of constructive teaching and learning models in various educational settings, showing the potential for active learning in nursing. The objective of this study was to present the development of an educational technology (Savinglife®, an app) for learning cardiopulmonary resuscitation and advanced cardiovascular life support training. Savinglife® is a technological production, based on the concept of virtual learning and problem-based learning approach. The study was developed from January 2016 to November 2016, using five phases (analyze, design, develop, implement, evaluate) of the instructional systems development process. The technology presented 10 scenarios and 12 simulations, covering different aspects of basic and advanced cardiac life support. The contents can be accessed in a non-linear way leaving the students free to build their knowledge based on their previous experience. Each scenario is presented through interactive tools such as scenario description, assessment, diagnose, intervention and reevaluation. Animated ECG rhythms, text documents, images and videos are provided to support procedural and active learning considering real life situation. Accessible equally on small to large devices with or without an internet connection, Savinglife® offers a dynamic, interactive and flexible tool, placing students at the center of the learning process. Savinglife® can contribute to the student’s learning in the assessment and management of basic and advanced cardiac life support in a safe and ethical way.

Keywords: problem-based learning, cardiopulmonary resuscitation, nursing education, advanced cardiac life support, educational technology

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Authors: Lahaina U. Dilangalen

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Using descriptive-experimental research methods, this study aimed to identify the main resources of water, assessed the water quality, sanitation and hygiene practices, and extent of implementation. Complete enumeration was done in 28 elementary public schools of Datu Odin Sinsuat Municipality. Questionnaires were given to the school advisers. Water samples were obtained from the same schools and were submitted to the Department of Science and Technology (DOST) Region XII for microbial analysis, specifically the presence of fecal coliform bacteria. Four water resources such as hand pump, faucet, deep well and spring were found being used in the 28 schools. Of water resources, the only treated was from the faucet. Most of the schools used the water for drinking and washing. Two schools strongly agreed, nine schools agreed and seventeen schools disagreed that they implemented DepEd Order no.56 s. 2009. In addition, two schools strongly agreed and twenty six agreed that they implemented DepEd Order No. 65 s. 2009. Five schools had water supply that were safe to drink while sixteen schools had water supply that were not safe to drink due to high fecal coliform count and did not undergo chemical treatment. The only safe for drinking were water resources that came from faucet because they were chemically treated. Seven out of 28 schools did not have water supply due to their location in mountainous areas. More than half of the schools did not comply with the DepEd Order No. 56 s. 2009 due to the lack of funds and support from the PTA and LGU. It is recommended that the Department of Education must have an urgent assessment of implementing both DepEd Orders No.56 and 65, to assure that the schoolchildren be protected from water and sanitation related ailments. Also, all water resources that are not treated must be used for washing only. Ideally, all the water resources must be treated to assure the safety of all school constituents. Moreover, the school administrators and teachers in the municipality must be provided copies of the results of this study for reference in implementing the said programs.

Keywords: assessment, drinking water, fecal coliform, groundwater

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Authors: Donglan Zha, Jiansong Si

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Because of its flexibility, CES attracts much interest in economic growth and programming models, and the macroeconomics or micro-macro models. This paper focuses on the development, estimating methods of CES production function considering energy as an input. We leave for future research work of relaxing the assumption of constant returns to scale, the introduction of potential input factors, and the generalization method of the optimal nested form of multi-factor production functions.

Keywords: bias of technical change, CES production function, elasticity of substitution, energy input

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Authors: Lorena Coelho, David Ramada, Catarina Nobre, Joaquim Gaião, Juliana Duarte

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The development of processes that allows the valorization of waste and by-products generated by industries is crucial to promote symbiotic relationships between different sectors and is mandatory to “close the loop” in the circular economy paradigm. In recent years, by-products and waste from agro-food and forestry sector have attracted attention due to their potential application and technical characteristics. The extraction of bio-based active compounds to be reused is in line with the circular bioeconomy concept trends, combining the use of renewable resources with the process’s circularity, aiming the waste reduction and encouraging reuse and recycling. Among different types of bio-based materials, which are being explored and can be extracted, proteins fractions are becoming an attractive new raw material. Within this context, BioTrace4Leather project, a collaboration between two Technological Centres – CeNTI and CTIC, and a company of Tanning and Finishing of Leather – Curtumes Aveneda, aims to develop innovative and biologically sustainable solutions for leather industry and accomplish the market circularity trends. Specifically, it aims to the valorisation of waste and by-products from the tannery industry through proteins extraction and the development of an innovative and biologically sustainable materials. The achieved results show that keratin, gelatine, and collagen fractions can be successfully extracted from hair and leather bovine waste. These products could be reintegrated into the industrial manufacturing process to attain innovative and functional textile and leather substrates. ACKNOWLEDGEMENT This work has been developed under BioTrace4Leather scope, a project co-funded by Operational Program for Competitiveness and Internationalization (COMPETE) of PORTUGAL2020, through the European Regional Development Fund (ERDF), under grant agreement Nº POCI-01-0247-FEDER-039867.

Keywords: leather by-products, circular economy, sustainability, protein fractions

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Authors: Aanh Eduardo Dimate-Garcia, Diana Carolina Rodriguez-Romero, Edna Yuliana Gonzalez Rincon, Diana Marcela Pardo Lopez, Yessica Garibello Cubillos

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Musculoskeletal disorders (MD) are the new epidemic of chronic diseases, are multifactorial and affect the different productive sectors. Although there are multiple instruments to evaluate the static and dynamic load, the method of repetitive occupational action (OCRA) seems to be an attractive option. Objective: It is aimed to analyze the use of the OCRA method and the prevalence of MD in workers of various productive sectors according to the literature (2007-2018). Materials and Methods: A literature review (following the PRISMA statement) of studies aimed at assessing the level of biomechanical risk (OCRA) and the prevalence of MD in the databases Scielo, Science Direct, Scopus, ProQuest, Gale, PubMed, Lilacs and Ebsco was realized; 7 studies met the selection criteria; the majority are quantitative (cross section). Results: it was evidenced (gardening and flower-growers) in this review that 79% of the conditions related to the task require physical requirements and involve repetitive movements. In addition, of the high appearance of DM in the high-low back, upper and lower extremities that are produced by the frequency of the activities carried out (footwear production). Likewise, there was evidence of 'very high risks' of developing MD (salmon industry) and a medium index (OCRA) for repetitive movements that require special care (U-Assembly line). Conclusions: the review showed the limited use of the OCRA method for the detection of MD in workers from different sectors, and this method can be used for the detection of biomechanical risk and the appearance of MD.

Keywords: checklist, cumulative trauma disorders, musculoskeletal diseases, repetitive movements

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Authors: Jill Hanass-Hancock, Bradley Carpenter, Samantha Willan, Kristin Dunkle

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Access to quality health care for persons with disabilities is the litmus test in our strive toward universal health coverage. Persons with disabilities experience a variety of health disparities related to increased health risks, greater socioeconomic challenges, and persistent ableism in the provision of health care. In low- and middle-income countries, the support needed to address the diverse needs of persons with disabilities and close the gaps in inclusive and accessible health care can appear overwhelming to staff with little knowledge and tools available. An action-orientated disability inclusion toolkit for health facilities was developed through consensus-building consultations and field testing in South Africa. The co-creation of the toolkit followed a bottom-up approach with healthcare staff and persons with disabilities in two developmental cycles. In cycle one, a disability facility assessment tool was developed to increase awareness of disability accessibility and service delivery gaps in primary healthcare services in a simple and action-orientated way. In cycle two, an intervention menu was created, enabling staff to respond to identified gaps and improve accessibility and inclusion. Each cycle followed five distinct steps of development: a review of needs and existing tools, design of the draft tool, consensus discussion to adapt the tool, pilot-testing and adaptation of the tool, and identification of the next steps. The continued consultations, adaptations, and field-testing allowed the team to discuss and test several adaptations while co-creating a meaningful and feasible toolkit with healthcare staff and persons with disabilities. This approach led to a simplified tool design with ‘key elements’ needed to achieve universal health coverage: universal design of health facilities, reasonable accommodation, health care worker training, and care pathway linkages. The toolkit was adapted for paper or digital data entry, produces automated, instant facility reports, and has easy-to-use training guides and online modules. The cyclic approach enabled the team to respond to emerging needs. The pilot testing of the facility assessment tool revealed that healthcare workers took significant actions to change their facilities after an assessment. However, staff needed information on how to improve disability accessibility and inclusion, where to acquire accredited training, and how to improve disability data collection, referrals, and follow-up. Hence, intervention options were needed for each ‘key element’. In consultation with representatives from the health and disability sectors, tangible and feasible solutions/interventions were identified. This process included the development of immediate/low-cost and long-term solutions. The approach gained buy-in from both sectors, who called for including the toolkit in the standard quality assessments for South Africa’s health care services. Furthermore, the process identified tangible solutions for each ‘key element’ and highlighted where research and development are urgently needed. The cyclic and consultative approach enabled the development of a feasible facility assessment tool and a complementary intervention menu, moving facilities toward universal health coverage for and persons with disabilities in low- or better-resourced contexts while identifying gaps in the availability of interventions.

Keywords: public health, disability, accessibility, inclusive health care, universal health coverage

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Authors: Oliver Chunho Ma, Tszying Chang

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Background: Traditional Chinese Medicine (TCM) has been widely used in the treatment of eczema. However, there is currently a lack of comprehensive research on the overall effectiveness of TCM in treating eczema, particularly using the Eczema Area and Severity Index (EASI) score as an evaluation tool. Meta-analysis can integrate the results of multiple studies to provide more convincing evidence. Objective: To conduct a systematic review and meta-analysis based on the EASI score to evaluate the overall effectiveness of TCM in the treatment of eczema. Specifically, the study will review and analyze published clinical studies that investigate TCM treatments for eczema and use the EASI score as an outcome measure, comparing the differences in improving the severity of eczema between TCM and other treatment modalities, such as conventional Western medicine treatments. Methods: Relevant studies, including randomized controlled trials (RCTs) and non-randomized controlled trials, that involve TCM treatment for eczema and use the EASI score as an outcome measure will be searched in medical literature databases such as PubMed, CNKI, etc. Relevant data will be extracted from the selected studies, including study design, sample size, treatment methods, improvement in EASI score, etc. The methodological quality and risk of bias of the included studies will be assessed using appropriate evaluation tools (such as the Cochrane Handbook). The results of the selected studies will be statistically analyzed, including pooling effect sizes (such as standardized mean differences, relative risks, etc.), subgroup analysis (e.g., different TCM syndromes, different treatment modalities), and sensitivity analysis (e.g., excluding low-quality studies). Based on the results of the statistical analysis and quality assessment, the overall effectiveness of TCM in improving the severity of eczema will be interpreted. Expected outcomes: By integrating the results of multiple studies, we expect to provide more convincing evidence regarding the specific effects of TCM in improving the severity of eczema. Additionally, subgroup analysis and sensitivity analysis can further elucidate whether the effectiveness of TCM treatment is influenced by different factors. Besides, we will compare the results of the meta-analysis with the clinical data from our clinic. For both the clinical data and the meta-analysis results, we will perform descriptive statistics such as means, standard deviations, percentages, etc. and compare the differences between the two using statistical tests such as independent samples t-test or non-parametric tests to assess the statistical differences between them.

Keywords: Eczema, traditional Chinese medicine, EASI, systematic review, meta-analysis

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Authors: Sandrieli Afornali, Adriano Keijiro Maeda, Renato Fedatto Beraldo, Carlos Alberto Mattozo, Ricardo Nascimento Brito

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BACKGROUND: The most used variety in hydrocephalus treatment is the ventriculoperitoneal shunt (VPS). However, it may fails in 20 to 70% of cases. It makes necessary to have alternative cavities for the implantation of the distal catheter. Ventriculo-atrial shunting (VAS) is described as the second option. To our knowledge, there are 121 reported cases of VGB shunt in children until 2020 and a highly variable success rate, from 25 to 100%, with an average of 63% of patients presenting good long-term results. Our goal is to evaluate the epidemiological profile of patients submitted to ventriculo-gallbladder (VGB) shunt and, through a review of literature, to compare our results with others series. METHODS: a retrospective cross-sectional observational study of a case series of nine patients. The medical records of all patients were reviewed, who underwent VGB shunt at the Hospital Pequeno Príncipe from Curitiba, Paraná, Brazil, from January 2014 to October 2022. The inclusion criteria were: patients under 17 years of age with hydrocephalus of any etiology, currently using or prior to VGB shunt. RESULTS: There were 6 (66,7%) male and 3 (33,3%) female. The average age of 73.6 months or 6.1 years at the time of surgery. They were submitted on average 5.1 VPS reviews previous to VGB shunt. Five (55,5%) had complications of VGB shunt: infection (11.1%), atony (11.1%), hypodrainage due to kinking the distal catheter in the solution (11.1%) and ventriculoenteric fistula (22.2%); all these patients were cured at surgical reapproach, and in 2 of them the VGB shunt was reimplanted. Two patients died (22.2%), and five (55,5%) patients maintained the use of VGB shunt in the follow-up period; and in 4 (44.4%) there was never need for review. CONCLUSION: VGB shunt tends to be underestimated because it is still unconventional and little publicized in literature. Our article shows a lower risk of death and similar risk of complications when compared to others altenatives shunts. We emphasize VGB shunt as a safe procedure to be the second option when VPS fails or has contraindications.

Keywords: hydrocephalus, ventricular-gallbladder shunt, VGB shunt, VPS, ventriculoperitoneal shunt, ventriculoatrial shunt

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Authors: Dilek Saritas Atalar, Cansu Alsancak Akbulut, İrem Metin Orta, Feyza Yön, Zeynep Yenen, Joan Grusec

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Objective: The aim of this study was to develop semi-structured Domains of Socialization Interview and its coding manual and to test their psychometric properties. Domains of Socialization Interview was designed to assess maternal awareness regarding effective parenting in five socialization domains (protection, mutual reciprocity, control, guided learning, and group participation) within the framework of the domains-of-socialization approach. Method: A series of two studies were conducted to develop and validate the interview and its coding manual. The pilot study, sampled 13 mothers of preschool-aged children, was conducted to develop the assessment tools and to test their function and clarity. Participants of the main study were 82 Turkish mothers (Xage = 34.25, SD = 3.53) who have children aged between 35-76 months (Xage = 50.75, SD = 11.24). Mothers filled in a questionnaire package including Coping with Children’s Negative Emotions Questionnaire, Social Competence and Behavior Evaluation-30, Child Rearing Questionnaire, and Two Dimensional Social Desirability Questionnaire. Afterward, interviews were conducted online by a single interviewer. Interviews were rated independently by two graduate students based on the coding manual. Results: The relationships of the awareness of effective parenting scores to the other measures demonstrate convergent, discriminant, and predictive validity of the coding manual. Intra-class correlation coefficient estimates were ranged between 0.82 and 0.90, showing high interrater reliability of the coding manual. Conclusion: Taken as a whole, the results of these studies demonstrate the validity and reliability of a new and useful interview to measure maternal awareness regarding effective parenting within the framework of the domains-of-socialization approach.

Keywords: domains of socialization, parenting, interview, assessment

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Authors: Daniela Magalhaes, Jorge Pedro, Pedro Souteiro, Joao S. Neves, Sofia Castro-Oliveira, Vanessa Guerreiro, Rita Bettencourt- Silva, Maria M. Costa, Ana Varela, Joana Queiros, Paula Freitas, Davide Carvalho

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Introduction: Obesity is an independent risk factor for renal dysfunction. Our aims were: (1) evaluate the impact of bariatric surgery (BS) on renal function; (2) clarify the factors determining the postoperative evolution of the glomerular filtration rate (GFR); (3) access the occurrence of oxalate-mediated renal complications. Methods: We investigated a cohort of 1448 obese patients who underwent bariatric surgery. Those with basal GFR (GFR0) < 30mL/min or without information about the GFR 2-year post-surgery (GFR2) were excluded. Results: We included 725 patients, of whom 647 (89.2%) women, with 41 (IQR 34-51) years, a median weight of 112.4 (IQR 103.0-125.0) kg and a median BMI of 43.4 (IQR 40.6-46.9) kg/m2. Of these, 459 (63.3%) performed gastric bypass (RYGB), 144 (19.9%) placed an adjustable gastric band (AGB) and 122 (16.8%) underwent vertical gastrectomy (VG). At 2-year post-surgery, excess weight loss (EWL) was 60.1 (IQR 43.7-72.4) %. There was a significant improve of metabolic and inflammatory status, as well as a significant decrease in the proportion of patients with diabetes, arterial hypertension and dyslipidemia (p < 0.0001). At baseline, 38 (5.2%) of subjects had hyperfiltration with a GFR0 ≥ 125mL/min/1.73m2, 492 (67.9%) had a GFR0 90-124 mL/min/1.73m2, 178 (24.6%) had a GFR0 60-89 mL/min/1.73m2, and 17 (2.3%) had a GFR0 < 60 mL/min/1.73m2. GFR decreased in 63.2% of patients with hyperfiltration (ΔGFR=-2.5±7.6), and increased in 96.6% (ΔGFR=22.2±12.0) and 82.4% (ΔGFR=24.3±30.0) of the subjects with GFR0 60-89 and < 60 mL/min/1.73m2, respectively ( p < 0.0001). This trend was maintained when adjustment was made for the type of surgery performed. Of 321 patients, 10 (3.3%) had a urinary albumin excretion (UAE) > 300 mg/dL (A3), 44 (14.6%) had a UAE 30-300 mg/dL (A2) and 247 (82.1%) has a UAE < 30 mg/dL (A1). Albuminuria decreased after surgery and at 2-year follow-up only 1 (0.3%) patient had A3, 17 (5.6%) had A2 and 283 (94%) had A1 (p < 0,0001). In multivariate analysis, the variables independently associated with ΔGFR were BMI (positively) and fasting plasma glucose (negatively). During the 2-year follow-up, only 57 of the 725 patients had transient urinary excretion of calcium oxalate crystals. None has records of oxalate-mediated renal complications at our center. Conclusions: The evolution of GFR after BS seems to depend on the initial renal function, as it decreases in subjects with hyperfiltration, but tends to increase in those with renal dysfunction. Our results suggest that BS is associated with improvement of renal outcomes, without significant increase of renal complications. So, apart the clear benefits in metabolic and inflammatory status, maybe obese adults with nondialysis-dependent CKD should be referred for bariatric surgery evaluation.

Keywords: albuminuria, bariatric surgery, glomerular filtration rate, renal function

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Authors: Anietie J. Atangwho, Udeme E. Asibong, Item J. Atangwho, Ndifreke E. Udonwa

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Diabesity, a syndrome where diabetes and obesity occur simultaneously in a single patient, has emerged as a recent challenge to the medical world and is already at epidemic proportion in some countries. Therefore, this study aimed to determine the prevalence of diabesity among adult patients attending the General Outpatient clinic of three healthcare facilities in Calabar in a bid to improve healthcare delivery to patients at risk. A cross-sectional descriptive study design was employed using a mixed method approach that comprised quantitative and qualitative components i.e., Focused Group Discussion (FGD) and Key Informant Interview (KII). One hundred and ninety (190) participants aged 18 to 72 years and body mass index (BMI) ≥ 30kg/m2 were recruited as the study population for the quantitative study using systematic random sampling technique and analysed using SPSS version 25. The qualitative component performed 4 FGDs and 3 KIIs. Results of sociodemographic variables showed respondents aged 35 – 44 as highest in number (37.3%). Of this number, 83.7% were females, 76.8% married, and 3.7% earned USD1,110.00 monthly. Whereas majority of the participants (65.8 %) were within class 1 obesity, only 38% considered themselves obese. Diabesity occurrence was found to be 12.6% (i.e. BMI ≥ 30 to 45.2kg/m2 vs FBS ≥ 7.0 – 14.8mmo/l), with 38% of them being previously undiagnosed. About 48.4 % of the respondents ate two meals only per day; with 90.5% eating between meals. Snacking was predominant, mostly pastries (67.9%), with 58.9% taking cola drinks alongside. Sixty-one percent participated in one form of exercise or the other, with walking/trekking as the most common; 34.4 % had no regular exercise schedule. Only about 39.5% of the participants spent less than an hour on devices like phone, television, and laptops. Additionally, previously known and newly diagnosed hypertensive patients were 27.9% and 7.2%, respectively. Qualitative assessment with KII and FGDs showed eating unhealthy diets and lack of exercise as major factors responsible for diabesity. The bivariate analysis revealed significant association between diabesity with marital status and hypertension (p = 0.007 and p = 0.005, respectively). Also, positive association with diabesity were eating snacking (p = 0.017) and number of times a respondent snacks per day (p = 0.035). Overall, the study has revealed the occurrence of diabesity in Calabar at 12.6 % of the study population, with 38 % of them previously undiagnosed; it identified unhealthy diets and lack of exercise as causative factors as well as hypertension as snacking associatory indicators of diabesity.

Keywords: diabesity, obesity, diabetes, unhealthy diet

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Authors: Emna Hlel, Salma Jamousi, Abdelmajid Ben Hamadou

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Every model for knowledge representation to model real-world applications must be able to cope with the effects of uncertain phenomena. One of main defects of classical ontology is its inability to represent and reason with uncertainty. To remedy this defect, we try to propose a method to construct probabilistic ontology for integrating uncertain information in an ontology modeling a set of basic publications DBLP (Digital Bibliography & Library Project) using a probabilistic model.

Keywords: classical ontology, probabilistic ontology, uncertainty, Bayesian network

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Authors: T. Sahbani, M. Bouteraa, R. Wamkeue

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Wind Turbine are considered to be one of the more efficient system of energy production nowadays, a reason that leads the main industrial companies in wind turbine construction and researchers in over the world to look for better performance and one of the ways for that is the use of the synchronous permanent magnet generator. In this context, this work is about developing an analytical model that could simulate different situation in which the synchronous generator may go through, and of course this model match perfectly with the numerical and experimental model.

Keywords: MATLAB, synchronous permanent magnet generator, wind turbine, analytical model

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Authors: Sylvain Perrin, Thomas Saillour

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The Grande-Motte port and seafront development project on the French Mediterranean coastline entailed evaluating wave impact loads (pressures and forces) on the new beach seawall and comparing the resulting scour potential at the base of the existing and new seawall. A physical model was built at ARTELIA’s hydraulics laboratory in Grenoble (France) to provide insight into the evolution of scouring overtime at the front of the wall, quasi-static and impulsive wave force intensity and distribution on the wall, and water and sand overtopping discharges over the wall. The beach was constituted of fine sand and approximately 50 m wide above mean sea level (MSL). Seabed slopes were in the range of 0.5% offshore to 1.5% closer to the beach. A smooth concrete structure will replace the existing concrete seawall with an elevated curved crown wall. Prior the start of breaking (at -7 m MSL contour), storm-driven maximum spectral significant wave heights of 2.8 m and 3.2 m were estimated for the benchmark historical storm event dated of 1997 and the 50-year return period storms respectively, resulting in 1 m high waves at the beach. For the wave load assessment, a tensor scale measured wave forces and moments and five piezo / piezo-resistive pressure sensors were placed on the wall. Light-weight sediment physical model and pressure and force measurements were performed with scale 1:18. The polyvinyl chloride light-weight particles used to model the prototype silty sand had a density of approximately 1 400 kg/m3 and a median diameter (d50) of 0.3 mm. Quantitative assessments of the seabed evolution were made using a measuring rod and also a laser scan survey. Testing demonstrated the occurrence of numerous impulsive wave impacts on the reflector (22%), induced not by direct wave breaking but mostly by wave run-up slamming on the top curved part of the wall. Wave forces of up to 264 kilonewtons and impulsive pressure spikes of up to 127 kilonewtons were measured. Maximum scour of -0.9 m was measured for the new seawall versus -0.6 m for the existing seawall, which is imputable to increased wave reflection (coefficient was 25.7 - 30.4% vs 23.4 - 28.6%). This paper presents a methodology for the setup and operation of a physical model in order to assess the hydrodynamic and morphodynamic processes at a beach seawall during storms events. It discusses the pros and cons of such methodology versus others, notably regarding structures peculiarities and model effects.

Keywords: beach, impacts, scour, seawall, waves

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Authors: Michelle Blewitt, Scott P. Wilson, Heidi Tait, Juniper Riordan

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Rubber crumb is a physical and chemical pollutant of concern for the environment and human health, warranting immediate investigations into its pathways to the environment and potential impacts. This emerging microplastic is created by shredding end-of-life tyres into ‘rubber crumb’ particles between 1-5mm used on synthetic turf fields and soft-fall playgrounds as a solution to intensifying tyre waste worldwide. Despite having known toxic and carcinogenic properties, studies into the transportation pathways and movement patterns of rubber crumbs from these surfaces remain in their infancy. To address this deficit, AUSMAP, the Australian Microplastic Assessment Project, in partnership with the Tangaroa Blue Foundation, conducted a study to quantify crumb loss from soft-fall surfaces. To our best knowledge, this is the first of its kind, with funding for the audits being provided by the Australian Government’s Reef Trust. Sampling occurred at 12 soft-fall playgrounds within the Great Barrier Reef Catchment Area on Australia’s North-East coast, in close proximity to the United Nations World Heritage Listed Reef. Samples were collected over a 12-month period using randomized sediment cores at 0, 2 and 4 meters away from the playground edge along a 20-meter transect. This approach facilitated two objectives pertaining to particle movement: to establish that crumb loss is occurring and that it decreases with distance from the soft-fall surface. Rubber crumb abundance was expressed as a total value and used to determine an expected average of rubber crumb loss per m2. An Analysis of Variance (ANOVA) was used to compare the differences in crumb abundance at each interval from the playground. Site characteristics, including surrounding sediment type, playground age, degree of ultra-violet exposure and amount of foot traffic, were additionally recorded for the comparison. Preliminary findings indicate that crumb is being lost at considerable rates from soft-fall playgrounds in the region, emphasizing an urgent need to further examine it as a potential source of aquatic pollution, soil contamination and threat to individuals who regularly utilize these surfaces. Additional implications for the future of rubber crumbs as a fit-for-purpose recycling initiative will be discussed with regard to industry, governments and the economic burden of surface maintenance and/ or replacement.

Keywords: microplastics, toxic rubber crumb, litter pathways, marine environment

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Authors: Marita Pigłowska, Beata Kurc, Paweł Daszkiewicz

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Railway vehicles are divided into two groups: traction (powered) vehicles and wagons. The traction vehicles include locomotives (line and shunting), railcars (sometimes referred to as railbuses), and multiple units (electric and diesel), consisting of several or a dozen carriages. In vehicles with diesel traction, fuel energy (petrol, diesel, or compressed gas) is converted into mechanical energy directly in the internal combustion engine or via electricity. In the latter case, the combustion engine generator produces electricity that is then used to drive the vehicle (diesel-electric drive or electric transmission). In Poland, such a solution dominates both in heavy linear and shunting locomotives. The classic diesel drive is available for the lightest shunting locomotives, railcars, and passenger diesel multiple units. Vehicles with electric traction do not have their own source of energy -they use pantographs to obtain electricity from the traction network. To determine the competitiveness of the hydrogen propulsion system, it is essential to understand how it works. The basic elements of the construction of a railway vehicle drive system that uses hydrogen as a source of traction force are fuel cells, batteries, fuel tanks, traction motors as well as main and auxiliary converters. The compressed hydrogen is stored in tanks usually located on the roof of the vehicle. This resource is supplemented with the use of specialized infrastructure while the vehicle is stationary. Hydrogen is supplied to the fuel cell, where it oxidizes. The effect of this chemical reaction is electricity and water (in two forms -liquid and water vapor). Electricity is stored in batteries (so far, lithium-ion batteries are used). Electricity stored in this way is used to drive traction motors and supply onboard equipment. The current generated by the fuel cell passes through the main converter, whose task is to adjust it to the values required by the consumers, i.e., batteries and the traction motor. The work will attempt to construct a fuel cell with unique electrodes. This research is a trend that connects industry with science. The first goal will be to obtain hydrogen on a large scale in tube furnaces, to thoroughly analyze the obtained structures (IR), and to apply the method in fuel cells. The second goal is to create low-energy energy storage and distribution station for hydrogen and electric vehicles. The scope of the research includes obtaining a carbon variety and obtaining oxide systems on a large scale using a tubular furnace and then supplying vehicles. Acknowledgments: This work is supported by the Polish Ministry of Science and Education, project "The best of the best! 4.0", number 0911/MNSW/4968 – M.P. and grant 0911/SBAD/2102—B.K.

Keywords: railway, hydrogen, fuel cells, hybrid vehicles

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Authors: Syed Kamran Sami, Saqib Siddiqui

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In recent times, flexible supercapacitors retaining high electrochemical performance and steadiness along with mechanical endurance has developed as a spring of attraction due to the exponential progress and innovations in energy storage devices. To meet the rampant increasing demand of energy storage device with the small form factor, a unique, low cost and high-performance supercapacitor with considerably higher capacitance and mechanical robustness is required to recognize their real-life applications. Here in this report, synthesis route of electrode materials with low rigidity and high charge storage performance is reported using 1D-1D hybrid structure of zinc oxide (ZnO) nanorods, and conductive polymer smeared polyvinylidene fluoride–trifluoroethylene (P(VDF–TrFE)) electrospun nanofibers. The ZnO nanorods were uniformly grown on poly (3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT: PSS) coated P(VDF-TrFE) nanofibers using hydrothermal growth to manufacture light weight, permeable electrodes for supercapacitor. The PEDOT: PSS coated P(VDF-TrFE) porous web of nanofibers act as framework with high surface area. The incorporation of ZnO nanorods further boost the specific capacitance by 59%. The symmetric device using the fabricated 1D-1D hybrid electrodes reveals fairly high areal capacitance of 1.22mF/cm² at a current density of 0.1 mA/cm² with a power density of more than 1600 W/Kg. Moreover, the fabricated electrodes show exceptional flexibility and high endurance with 90% and 76% specific capacitance retention after 1000 and 5000 cycles respectively signifying the astonishing mechanical durability and long-term stability. All the properties exhibited by the fabricated electrode make it convenient for making flexible energy storage devices with the low form factor.

Keywords: ZnO nanorods, electrospinning, mechanical endurance, flexible supercapacitor

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Authors: Yung Yau

Abstract:

'Little people' are those who have extremely short stature as they suffer from rare bone diseases. They are commonly known as 'dwarves' or 'people with dwarfism'. Dwarfism is generally regarded as a type of rare disease for its extremely small odds (~1 in 15,000). On account of its rarity, dwarfism, unlike other types of disability, has attracted relatively little attention from the general public and in various academic fields (e.g. architecture, psychology and sociology) except medical science. In view of the extant research gaps, this study aims to investigate the physical barriers facing the little people in the built environment in Hong Kong. Between November 2017 and July 2018, ten little people or their family members participated in in-depth interviews. Responses of the interviewees were transcribed (i.e., speech being converted to text word for word). Interview data were then analyzed using the interpretative phenomenological analysis methodology developed by J. Smith and others in 2009. The findings of the project reveal that although Hong Kong's built environment has been designed barrier-free pursuant to the prevailing building standards, those standards do not cater to the special anthropometric characteristics of little people. As a result, little people face a lot of challenges when using built facilities. For example, most water closets, urinals, and wash hand basins are not fit for little people's use. As indicated by the project findings, we are still far away from providing a discrimination-free and barrier-free living environment for the little people in Hong Kong. To make Hong Kong society more inclusive to the little people, there is a need for further tailored building design. A set of building design principles for better inclusion of the little people in our society are highlighted. These principles include 'the building design should accommodate individuals with different heights' and 'the building design should allow individuals to use comfortably and efficiently with a minimum of fatigue'. At the end of the paper, the author also calls for an agenda for further studies. For instance, we need an anthropometric study on little people for developing practical building design guidelines.

Keywords: dwarfism, little people, inclusive buildings, people with disabilities, social sustainability

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Authors: Hellen L. De Castro e Silva, Ana A. Robles Aguilar, Erik Meers

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Digestates are residual by-products, rich in nutrients and trace elements, which can be used as organic fertilisers on soils. However, due to the non-digestibility of these elements and reduced dry matter during the anaerobic digestion process, metal concentrations are higher in digestates than in feedstocks, which might hamper their use as fertilisers according to the threshold values of some country policies. Furthermore, there is uncertainty regarding the required assimilated amount of these elements by some crops, which might result in their bioaccumulation. Therefore, further processing of the digestate to obtain safe fertilizing products has been recommended. This research aims to analyze the effect of applying the hydrothermal carbonization process to manure-derived digestates as a thermal treatment to reduce the bioavailability of heavy metals in mono and co-digestates derived from pig manure and maize from contaminated land in France. This study examined pig manure collected from a novel stable system (VeDoWs, province of East Flanders, Belgium) that separates the collection of pig urine and feces, resulting in a solid fraction of manure with high up-concentration of heavy metals and nutrients. Mono-digestion and co-digestion processes were conducted in semi-continuous reactors for 45 days at mesophilic conditions, in which the digestates were dried at 105 °C for 24 hours. Then, hydrothermal carbonization was applied to a 1:10 solid/water ratio to guarantee controlled experimental conditions in different temperatures (180, 200, and 220 °C) and residence times (2 h and 4 h). During the process, the pressure was generated autogenously, and the reactor was cooled down after completing the treatments. The solid and liquid phases were separated through vacuum filtration, in which the solid phase of each treatment -hydrochar- was dried and ground for chemical characterization. Different fractions (exchangeable / adsorbed fraction - F1, carbonates-bound fraction - F2, organic matter-bound fraction - F3, and residual fraction – F4) of some heavy metals (Cd, Cr, Ni, and Cr) have been determined in digestates and derived hydrochars using the modified Community Bureau of Reference (BCR) sequential extraction procedure. The main results indicated a difference in the heavy metals fractionation between digestates and their derived hydrochars; however, the hydrothermal carbonization operating conditions didn’t have remarkable effects on heavy metals partitioning between the hydrochars of the proposed treatments. Based on the estimated potential ecological risk assessment, there was one level decrease (considerate to moderate) when comparing the HMs partitioning in digestates and derived hydrochars.

Keywords: heavy metals, bioavailability, hydrothermal treatment, bio-based fertilisers, agriculture

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Authors: Zeleke Ayalew Alemu

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This study aims to investigate tax administration constraints in Addis Ababa with a focus on small and medium-sized enterprises by identifying issues and constraints in tax administration and assessment. The study identifies problems associated with taxpayers and tax-collecting authorities in the city. The research used qualitative and quantitative research designs and employed questionnaires, focus group discussion and key informant interviews for primary data collection and also used secondary data from different sources. The study identified many constraints that taxpayers are facing. Among others, tax administration offices’ inefficiency, reluctance to respond to taxpayers’ questions, limited tax assessment and administration knowledge and skills, and corruption and unethical practices are the major ones. Besides, the tax laws and regulations are complex and not enforced equally and fully on all taxpayers, causing a prevalence of business entities not paying taxes. This apparently results in an uneven playing field. Consequently, the tax system at present is neither fair nor transparent and increases compliance costs. In case of dispute, the appeal process is excessively long and the tax authority’s decision is irreversible. The Value Added Tax (VAT) administration and compliance system is not well designed, and VAT has created economic distortion among VAT-registered and non-registered taxpayers. Cash registration machine administration and the reporting system are big headaches for taxpayers. With regard to taxpayers, there is a lack of awareness of tax laws and documentation. Based on the above and other findings, the study forwarded recommendations, such as, ensuring fairness and transparency in tax collection and administration, enhancing the efficiency of tax authorities by use of modern technologies and upgrading human resources, conducting extensive awareness creation programs, and enforcing tax laws in a fair and equitable manner. The objective of this study is to assess problems, weaknesses and limitations of small and medium-sized enterprise taxpayers, tax authority administrations, and laws as sources of inefficiency and dissatisfaction to forward recommendations that bring about efficient, fair and transparent tax administration. The entire study has been conducted in a participatory and process-oriented manner by involving all partners and stakeholders at all levels. Accordingly, the researcher used participatory assessment methods in generating both secondary and primary data as well as both qualitative and quantitative data on the field. The research team held FGDs with 21 people from Addis Ababa City Administration tax offices and selected medium and small taxpayers. The study team also interviewed 10 KIIs selected from the various segments of stakeholders. The lead, along with research assistants, handled the KIIs using a predesigned semi-structured questionnaire.

Keywords: taxation, tax system, tax administration, small and medium enterprises

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Authors: Irene Kretchy, Frances Owusu-Daaku, Samuel Danquah

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Hypertension is the leading risk factor for cardiovascular diseases, and a major cause of death and disability worldwide. This study examined whether psychosocial variables influenced patients’ perception and experience of side effects of their medicines, how they coped with these experiences and the impact on mental health and medication adherence to conventional hypertension therapies. Methods: A hospital-based mixed methods study, using quantitative and qualitative approaches was conducted on hypertensive patients. Participants were asked about side effects, medication adherence, common psychological symptoms, and coping mechanisms with the aid of standard questionnaires. Information from the quantitative phase was analyzed with the Statistical Package for Social Sciences (SPSS) version 20. The interviews from the qualitative study were audio-taped with a digital audio recorder, manually transcribed and analyzed using thematic content analysis. The themes originated from participant interviews a posteriori. Results: The experiences of side effects – such as palpitations, frequent urination, recurrent bouts of hunger, erectile dysfunction, dizziness, cough, physical exhaustion - were categorized as no/low (39.75%), moderate (53.0%) and high (7.25%). Significant relationships between depression (x 2 = 24.21, P < 0.0001), anxiety (x 2 = 42.33, P < 0.0001), stress (x 2 = 39.73, P < 0.0001) and side effects were observed. A logistic regression model using the adjusted results for this association are reported – depression [OR = 1.9 (1.03 – 3.57), p = 0.04], anxiety [OR = 1.5 (1.22 – 1.77), p = < 0.001], and stress [OR = 1.3 (1.02 – 1.71), p = 0.04]. Side effects significantly increased the probability of individuals to be non-adherent [OR = 4.84 (95% CI 1.07 – 1.85), p = 0.04] with social factors, media influences and attitudes of primary caregivers further explaining this relationship. The personal adoption of medication modifying strategies, espousing the use of complementary and alternative treatments, and interventions made by clinicians were the main forms of coping with side effects. Conclusions: Results from this study show that contrary to a biomedical approach, the experience of side effects has biological, social and psychological interrelations. The result offers more support for the need for a multi-disciplinary approach to healthcare where all forms of expertise are incorporated into health provision and patient care. Additionally, medication side effects should be considered as a possible cause of non-adherence among hypertensive patients, thus addressing this problem from a Biopsychosocial perspective in any intervention may improve adherence and invariably control blood pressure.

Keywords: biopsychosocial, hypertension, medication adherence, psychological disorders

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