Search results for: cost of care

Authors: Ammar Asma, Bouafia Nabiha, Dhahri Meriem, Ben Cheikh Asma, Ezzi Olfa, Chafai Rim, Njah Mansour

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Despite recent advances in treatment of the lung cancer patients, the prognosis remains poor. Information is limited regarding health related quality of life (QOL) status of advanced lung cancer patients. The purposes of this study were: to assess patient reported symptom burden, to measure their QOL, and to identify determinant factors associated with QOL. Materials/Methods: A cross sectional study of 60 patients was carried out from over the period of 03 months from February 1st to 30 April 2016. Patients were recruited in two department of health care: Pneumology department in a university hospital in Sousse and an oncology unit in a University Hospital in Kairouan. Patients with advanced stage (III and IV) of lung cancer who were hospitalized or admitted in the day hospital were recruited by convenience sampling. We used a questionnaire administrated and completed by a trained interviewer. This questionnaire is composed of three parts: demographic, clinical and therapeutic information’s, QOL measurements: based on the SF-36 questionnaire, Symptom’s burden measurement using the Lung Cancer Symptom Scale (LCSS). To assess Correlation between symptoms burden and QOL, we compared the scores of two scales two by two using the Pearson correlation. To identify factors influencing QOL in Lung cancer, a univariate statistical analysis then, a stepwise backward approach, wherein the variables with p< 0.2, were carried out to determine the association between SF-36 scores and different variables. Results: During the study period, 60 patients consented to complete symptom and quality of life questionnaires at a single point time (72% were recruited from day hospital). The majority of patients were male (88%), age ranged from 21 to 79 years with a mean of 60.5 years. Among patients, 48 (80%) were diagnosed as having non-small cell lung carcinoma (NSCLC). Approximately, 60 % (n=36) of patients were in stage IV, 25 % in stage IIIa and 15 % in stage IIIb. For symptom burden, the symptom burden index was 43.07 (Standard Deviation, 21.45). Loss of appetite and fatigue were rated as the most severe symptoms with mean scores (SD): 49.6 (25.7) and 58.2 (15.5). The average overall score of SF36 was 39.3 (SD, 15.4). The physical and emotional limitations had the lowest scores. Univariate analysis showed that factors which influence negatively QOL were: married status (p<0.03), smoking cessation after diagnosis (p<0.024), LCSS total score (p<0.001), LCSS symptom burden index (p<0.001), fatigue (p<0.001), loss of appetite (p<0.001), dyspnea (p<0.001), pain (p<0.002), and metastatic stage (p<0.01). In multivariate analysis, unemployment (p<0.014), smoking cessation after diagnosis (p<0.013), consumption of analgesic (p<0.002) and the indication of an analgesic radiotherapy (p<0.001) are revealed as independent determinants of QOL. The result of the correlation analyses between total LCSS scores and the total and individual domain SF36 scores was significant (p<0.001); the higher total LCSS score is, the poorer QOL is. Conclusion: A built in support of lung cancer patients would better control the symptoms and promote the QOL of these patients.

Keywords: quality of life, lung cancer, metastasis, symptoms burden

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Authors: Ahmad Mohammad Sharqi, Mohamed Hechmi El Ouni, Saleh Alsulamy

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Due to the emerging technologies revolution worldwide, the need to exploit and employ innovative technologies for other functions and purposes in different aspects has become a remarkable matter. Saudi Arabia is considered one of the most powerful economic countries in the world, where the construction sector participates effectively in its economy. Thus, the construction sector in KSA should convoy the rapid digital revolution and transformation and implement smart devices on sites. A Smart Construction Site (SCS) includes smart devices, artificial intelligence, the internet of things, augmented reality, building information modeling, geographical information systems, and cloud information. This paper aims to study the level of implementation of SCS in KSA, analyze the obstacles and challenges of adopting SCS and find out critical success factors for its implementation. A survey of close-ended questions (scale and multi-choices) has been conducted on professionals in the construction sector of Saudi Arabia. A total number of twenty-nine questions has been prepared for respondents. Twenty-four scale questions were established, and those questions were categorized into several themes: quality, scheduling, cost, occupational safety and health, technologies and applications, and general perception. Consequently, the 5-point Likert scale tool (very low to very high) was adopted for this survey. In addition, five close-ended questions with multi-choice types have also been prepared; these questions have been derived from a previous study implemented in the United Kingdom (UK) and the Dominic Republic (DR), these questions have been rearranged and organized to fit the structured survey in order to place the Kingdom of Saudi Arabia in comparison with the United Kingdom (UK) as well as the Dominican Republic (DR). A total number of one hundred respondents have participated in this survey from all regions of the Kingdom of Saudi Arabia: southern, central, western, eastern, and northern regions. The drivers, obstacles, and success factors for implementing smart devices and technologies in KSA’s construction sector have been investigated and analyzed. Besides, it has been concluded that KSA is on the right path toward adopting smart construction sites with attractive results comparable to and even better than the UK in some factors.

Keywords: artificial intelligence, construction projects management, internet of things, smart construction sites, smart devices

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Authors: Tanya Greathosue, Adrianna Taylor, Lori Darnel, Eileen Starr, Susie Ryder, Julie Clockston, Dawn Matera Bassett, Jess Retrum

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The United States has an identified need to improve the social work mental and behavioral health workforce shortage with a focus on culturally diverse and responsive mental and behavioral health practitioners to adequately serve its rapidly growing multicultural communities. The U.S. is experiencing rapid demographic changes. Ensuring that mental and behavioral health services are effective and accessible for diverse communities is essential for improving overall health outcomes. In response to this need, we developed a training program focused on interdisciplinary collaboration, evidence-based practices, and culturally responsive services. The success of the training program, funded by the Health Resource Service Administration (HRSA) Behavioral Health Workforce Education and Training (BHWET), has provided the foundation for stage two of our programming. In addition to HRSA/BHWET, we are receiving funding from Colorado Access, a state workforce development initiative, and Kaiser Permanente, a healthcare provider network in the United States. We have moved beyond improved learner outcomes to increasing recruitment of historically excluded, disproportionately mistreated learners, mentorship of students to improve retention, and successful, culturally responsive, diverse workforce development. These authors will utilize a pretest-posttest comparison group design and trend analysis to evaluate the success of the training program. Comparison groups will be matched based on age, gender identification, race, income, as well as prior experience in the field, and time in the degree program. This article describes our culturally responsive training program. Our goals are to increase the recruitment and retention of historically excluded, disproportionately mistreated learners. We achieve this by integrating cultural humility and sensitivity training into educational curricula for our scholars who participate in cohort classroom and seminar learning. Additionally, we provide our community partners who serve as internship sites with ongoing continuing education on how to promote and develop inclusive and supportive work environments for our learners. This work will be of value to mental and behavioral health care practitioners who serve historically excluded and mistreated populations. Participants will learn about culturally informed best practices to increase recruitment and retention of culturally diverse learners. Additionally, participants will hear how to create a culturally responsive training program that encourages an inclusive community for their learners through cohort learning, mentoring, community networking, and critical accountability.

Keywords: culturally diverse mental health practitioners, recruitment, mentorship, workforce development, underserved clinics, professional development

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Authors: Samuel Sii, David Homewood, Brendan Dittmer, Tony Nzembela, Jonathan O’Brien, Niall Corcoran, Dinesh Agarwal

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Introduction: Innovation is key to the advancement of medicine and improvement in patient care. This is particularly true in surgery, where pioneering techniques have transformed operative management from a historically highly risky peri-morbid and disfiguring to the contemporary low-risk, sterile and minimally invasive treatment modality. There is a delicate balance between enabling innovation and minimizing patient harm. Publication and discussion of novel surgical techniques allow for independent expert review. Recent journals have increasingly stringent requirements for publications and often require larger case volumes for novel techniques to be published. This potentially impairs the initial publication of novel techniques and slows innovation. The historical perspective provides a better understanding of how requirements for the publication of new techniques have evolved over time. This is essential in overcoming challenges in developing novel techniques. Aims and Objectives: We explore how novel techniques in Urology have been published over the past 200 years. Our objective is to describe the trend and publication requirements of novel urological techniques, both historical and present. Methods: We assessed all major urological operations using multipronged historical analysis. An initial literature search was carried out through PubMed and Google Scholar for original literature descriptions, followed by reference tracing. The first publication of each pioneering urological procedure was recorded. Data collected includes the year of publication, description of the procedure, number of cases and outcomes. Results: 65 papers describing pioneering techniques in Urology were identified. These comprised of 2 experimental studies, 17 case reports and 46 case series. These papers described various pioneering urological techniques in urological oncology, reconstructive urology and endourology. We found that, historically, techniques were published with smaller case numbers. Often, the surgical technique itself was a greater focus of the publication than patient outcome data. These techniques were often adopted prior to larger publications. In contrast, the risks and benefits of recent novel techniques are often well-defined prior to adoption. This historical perspective is important as recent journals have requirements for larger case series and data outcomes. This potentially impairs the initial publication of novel techniques and slows innovation. Conclusion: A better understanding of historical publications and their effect on the adoption of urological techniques into common practice could assist the current generation of Urologists in formulating a safe, efficacious process in promoting surgical innovation and the development of novel surgical techniques. We propose the reassessment of requirements for the publication of novel operative techniques by splitting technical perspectives and data-orientated case series. Existing frameworks such as IDEAL and ASERNIP-S should be integrated into current processes when investigating and developing new surgical techniques to ensure efficacious and safe innovation within surgery is encouraged.

Keywords: urology, surgical innovation, novel surgical techniques, publications

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Authors: Dereje Regasa

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The global food system is at a crossroads, which requires prompt action to minimize the effects of the crises. Agroecology is gaining prominence due to its contributions to sustainable food systems. To support efforts in mitigating the crises, the Food and Agriculture Organization (FAO) established alternative approaches for sustainable agri-food systems. Agroecological elements and principles were developed to guide and support measures that countries need to achieve the Sustainable Development Goals (SDGs). The SDGs require the systemic integration of practices for a smart intensification or adaptation of traditional or industrial agriculture. As one of the countries working towards SDGs, the agricultural practices in Ethiopia need to be guided by these agroecological elements and principles. Aiming at the identification of challenging aspects of a sustainable agri-food system and the characterization of an enabling environment for agroecology, as well as exploring to what extent the existing policies and strategies support the agroecological transition process, five policy and strategy documents were reviewed. These documents are the Rural Development Policy and Strategy, the Environment Policy, the Biodiversity Policy, and the Soil Strategy of the Ministry of Agriculture (MoA). Using the Agroecology Criteria Tool (ACT), the contents were reviewed, focusing on agroecological requirements and the inclusion of sustainable practices. ACT is designed to support a self-assessment of elements supporting agroecology. For each element, binary values were assigned based on the inclusion of the minimum requirements index and then validated through discussion with the document owners. The results showed that the documents were well below the requirements for an agroecological transition of the agri-food system. The Rural Development Policy and Strategy only suffice to 83% in Human and Social Value. It does not support the transition concerning the other elements. The Biodiversity Policy and Soil Strategy suffice regarding the inclusion of Co-creation and Sharing of knowledge (100%), while the remaining elements were not considered sufficiently. In contrast, the Environment Policy supports the transition with three elements accounting for 100%. These are Resilience, Recycling, and Human and Social Care. However, when the four documents were combined, elements such as Synergies, Diversity, Efficiency, Human and Social value, Responsible governance, and Co-creation and Sharing of knowledge were identified as fully supportive (100%). This showed that the policies and strategies complemented one another to a certain extent. However, the evaluation results call for improvements concerning elements like Culture and food traditions, Circular and solidarity economy, Resilience, Recycling, and Regulation and balance since the majority of the elements were not sufficiently observed. Consequently, guidance for the smart intensification of local practices is needed, as well as traditional knowledge enriched with advanced technologies. Ethiopian agricultural and environmental policies and strategies should provide sufficient support and guidance for the intensification of sustainable practices and should provide a framework for an agroecological transition towards a sustainable agri-food system.

Keywords: agroecology, diversity, recycling, sustainable food system, transition

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Authors: Panwad Wongthong, Thanan Apivantanaporn, Sutthiwan Amattayakul

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Nature-based tourism is one of the fastest growing industries that can bring in economic benefits, improve quality of life and promote conservation of biodiversity and habitats. As tourism develops, substantial socio-economic and environmental costs become more explicit. Particularly in island destinations, the dynamic system and geographical limitations makes the intensity of tourism development and severity of the negative environmental impacts greater. The current contribution of the tourism sector to global climate change is established at approximately 5% of global anthropogenic CO2 emissions. In all scenarios, tourism is anticipated to grow substantially and to account for an increasingly large share of global greenhouse gas emissions. This has prompted an urgent call for more sustainable alternatives. This study selected a small island of Koh Mak in Thailand as a case study because of its reputation of being laid back, family oriented and rich in biodiversity. Importantly, it is a test platform for low carbon tourism development project supported by the Designated Areas for Sustainable Tourism Administration (DASTA) in collaboration with the Institute for Small and Medium Enterprises Development (ISMED). The study explores strategies for low carbon tourism management and assesses challenges and opportunities for Koh Mak to become a low carbon tourism destination. The goal is to identify suitable management approaches applicable for Koh Mak which may then be adapted to other small islands in Thailand and the region. Interventions/initiatives to increase energy efficiency in hotels and resorts; cut carbon emissions; reduce impacts on the environment; and promote conservation will be analyzed. Ways toward long-term sustainability of climate-friendly tourism will be recommended. Recognizing the importance of multi-stakeholder involvement in the tourism sector, findings from this study can reward Koh Mak tourism industry with a triple-win: cost savings and compliance with higher standards/markets; less waste, air emissions and effluents; and better capabilities of change, motivation of business owners, staff, tourists as well as residents. The consideration of climate change issues in the planning and implementation of tourism development is of great significance to protect the tourism sector from negative impacts.

Keywords: climate change, CO2 emissions, low carbon tourism, sustainable tourism management

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Authors: F. Al-Fahad, J. Chakkamalayath, A. Al-Aibani

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Conventional methods of determination of concrete strength under controlled laboratory conditions will not accurately represent the actual strength of concrete developed under site curing conditions. This difference in strength measurement will be more in the extreme environment in Kuwait as it is characterized by hot marine environment with normal temperature in summer exceeding 50°C accompanied by dry wind in desert areas and salt laden wind on marine and on shore areas. Therefore, it is required to have test methods to measure the in-place properties of concrete for quality assurance and for the development of durable concrete structures. The maturity method, which defines the strength of a given concrete mix as a function of its age and temperature history, is an approach for quality control for the production of sustainable and durable concrete structures. The unique harsh environmental conditions in Kuwait make it impractical to adopt experiences and empirical equations developed from the maturity methods in other countries. Concrete curing, especially in the early age plays an important role in developing and improving the strength of the structure. This paper investigates the use of maturity method to assess the effectiveness of three different types of curing methods on the compressive and flexural strength development of one high strength concrete mix of 60 MPa produced with silica fume. This maturity approach was used to predict accurately, the concrete compressive and flexural strength at later ages under different curing conditions. Maturity curves were developed for compressive and flexure strengths for a commonly used concrete mix in Kuwait, which was cured using three different curing conditions, including water curing, external spray coating and the use of internal curing compound during concrete mixing. It was observed that the maturity curve developed for the same mix depends on the type of curing conditions. It can be used to predict the concrete strength under different exposure and curing conditions. This study showed that concrete curing with external spray curing method cannot be recommended to use as it failed to aid concrete in reaching accepted values of strength, especially for flexural strength. Using internal curing compound lead to accepted levels of strength when compared with water cuing. Utilization of the developed maturity curves will help contactors and engineers to determine the in-place concrete strength at any time, and under different curing conditions. This will help in deciding the appropriate time to remove the formwork. The reduction in construction time and cost has positive impacts towards sustainable construction.

Keywords: curing, durability, maturity, strength

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Authors: Langhit Kurar, Loren Charles

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Introduction: In light of recent BOAST 12 (August 2016) published guidance on management of ankle fractures, the project aimed to highlight key discrepancies throughout the care trajectory from admission to point of discharge at a district general hospital. Wide breadth of data covering three key domains: accident and emergency, radiology, and orthopaedic surgery were subsequently stratified and recommendations on note documentation, and outpatient follow up were made. Methods: A retrospective twelve month audit was conducted reviewing results of ankle fracture management in 37 patients. Inclusion criterion involved all patients seen at Darent Valley Hospital (DVH) emergency department with radiographic evidence of an ankle fracture. Exclusion criterion involved all patients managed solely by nursing staff or having sustained purely ligamentous injury. Medical notes, including discharge summaries and the PACS online radiographic tool were used for data extraction. Results: Cross-examination of the A & E domain revealed limited awareness of the BOAST 12 recent publication including requirements to document skin integrity and neurovascular assessment. This had direct implications as this would have changed the surgical plan for acutely compromised patients. The majority of results obtained from the radiographic domain were satisfactory with appropriate X-rays taken in over 95% of cases. However, due to time pressures within A & E, patients were often left without a post manipulation XRAY in a backslab. Poorly reduced fractures were subsequently left for a long period resulting in swollen ankles and a time-dependent lag to surgical intervention. This had knocked on implications for prolonged inpatient stay resulting in hospital-acquired co-morbidity including pressure sores. Discussion: The audit has highlighted several areas of improvement throughout the disease trajectory from review in the emergency department to follow up as an outpatient. This has prompted the creation of an algorithm to ensure patients with significant fractures presenting to the emergency department are seen promptly and treatment expedited as per recent guidance. This includes timing for X-rays taken in A & E. Re-audit has shown significant improvement in both documentation at time of presentation and appropriate follow-up strategies. Within the orthopedic domain, we are in the process of creating an ankle fracture pathway to ensure imaging and weight bearing status are made clear to the consulting clinicians in an outpatient setting. Significance/Clinical Relevance: As a result of the ankle fracture algorithm we have adapted the BOAST 12 guidance to shape an intrinsic pathway to not only improve patient management within the emergency department but also create a standardised format for follow up.

Keywords: ankle, fracture, BOAST, radiology

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Authors: Maciej Zasuwa, Grzegorz Ptasinski, Antoni Kopyt

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Nowadays flight simulators offer tremendous possibilities for safe and cost-effective pilot training, by utilization of powerful, computational tools. Due to technology outpacing methodology, vast majority of training related work is done by human instructors. It makes assessment not efficient, and vulnerable to instructors’ subjectivity. The research presents an Objective Assessment Tool (gOAT) developed at the Warsaw University of Technology, and tested on SW-4 helicopter flight simulator. The tool uses database of the predefined manoeuvres, defined and integrated to the virtual environment. These were implemented, basing on Aeronautical Design Standard Performance Specification Handling Qualities Requirements for Military Rotorcraft (ADS-33), with predefined Mission-Task-Elements (MTEs). The core element of the gOAT enhanced algorithm that provides instructor a new set of information. In details, a set of objective flight parameters fused with report about psychophysical state of the pilot. While the pilot performs the task, the gOAT system automatically calculates performance using the embedded algorithms, data registered by the simulator software (position, orientation, velocity, etc.), as well as measurements of physiological changes of pilot’s psychophysiological state (temperature, sweating, heart rate). Complete set of measurements is presented on-line to instructor’s station and shown in dedicated graphical interface. The presented tool is based on open source solutions, and flexible for editing. Additional manoeuvres can be easily added using guide developed by authors, and MTEs can be changed by instructor even during an exercise. Algorithm and measurements used allow not only to implement basic stress level measurements, but also to reduce instructor’s workload significantly. Tool developed can be used for training purpose, as well as periodical checks of the aircrew. Flexibility and ease of modifications allow the further development to be wide ranged, and the tool to be customized. Depending on simulation purpose, gOAT can be adjusted to support simulator of aircraft, helicopter, or unmanned aerial vehicle (UAV).

Keywords: automated assessment, flight simulator, human factors, pilot training

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Authors: Yen-Fen Shen, Meng-Fan Li

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The study aims to investigate the effect of full-body vertical rhythmic training on fatigue, physical activity, and quality of life among middle-aged and elderly hemodialysis patients. The study adopted a quasi-experimental research method and recruited 43 long-term hemodialysis patients from a medical center in northern Taiwan, with 23 and 20 participants in the experimental and control groups, respectively. The experimental group received full-body vertical rhythmic training as an intervention, while the control group received standard hemodialysis care without any intervention. Both groups completed the measurements by using "Fatigue Scale", "Physical Activity Scale" and "Chinese version of the Kidney Disease Quality of Life Questionnaire" before and after the study. The experimental group underwent a 10-minute full-body vertical rhythmic training three times per week, which lasted for eight weeks before receiving regular hemodialysis treatment. The data were analyzed by SPSS 25 software, including descriptive statistics such as frequency distribution, percentages, means, and standard deviations, as well as inferential statistics, including chi-square, independent samples t-test, and paired samples t-test. The study results are summarized as follows: 1. There were no significant differences in demographic variables, fatigue, physical activity, and quality of life between the experimental and control groups in the pre-test. 2. After the intervention of the “full-body vertical rhythmic training,” the experimental group showed significantly better results in the category of "feeling tired and fatigued in the lower back", "physical functioning role limitation", "bodily pain", "social functioning", "mental health", and "impact of kidney disease on life quality." 3. The paired samples t-test results revealed that the control group experienced significant differences between the pre-test and post-test in the categories of feeling tired and fatigued in the lower back, bodily pain, social functioning mental health, and impact of kidney disease on life quality, with scores indicating a decline in life quality. Conversely, the experimental group only showed a significant worsening in bodily pain" and the impact of kidney disease on life quality, with lower change values compared to the control group. Additionally, there was an improvement in the condition of "feeling tired and fatigued in the lower back" for the experimental group. Conclusion: The intervention of the “full-body vertical rhythmic training” had a certain positive effect on the quality of life of the experimental group. While it may not entirely enhance patients' quality of life, it can mitigate the negative impact of kidney disease on certain aspects of the body. The study provides clinical practice, nursing education, and research recommendations based on the results and discusses the limitations of the research.

Keywords: hemodialysis, full-body vertical rhythmic training, fatigue, physical activity, quality of life

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Authors: Ishani Maheshika

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The intermediary role performed by freight forwarders in exportation has become significant in fulfilling businesses’ supply chain needs in this dynamic world. Since the success of exporter’s business is at present, highly reliant on supply chain optimization, cost efficiency, profitability, consistent service and responsiveness, the decision of selecting the most beneficial freight forwarder has become crucial for exporters. Although there are similar foreign researches, prior researches covering Sri Lankan setting are not in existence. Moreover, results vary with time, nature of industry and business environment factors. Therefore, a study from the perspective of Sri Lankan exporters was identified as a requisite to be researched. In order to identify and prioritize key factors which have affected the exporter’s decision in selecting freight forwarders in Sri Lankan context, Sri Lankan export industry was stratified into 22 sectors based on commodity using stratified sampling technique. One exporter from each sector was then selected using judgmental sampling to have a sample of 22. Factors which were identified through a pilot survey, was organized under 6 main criteria. A questionnaire was basically developed as pairwise comparisons using 9-point semantic differential scale and comparisons were done within main criteria and subcriteria. After a pre-testing, interviews and e-mail questionnaire survey were conducted. Data were analyzed using Analytic Hierarchy Process to determine priority vectors of criteria. Customer service was found to be the most important main criterion for Sri Lankan exporters. It was followed by reliability and operational efficiency respectively. The criterion of the least importance is company background and reputation. Whereas small sized exporters pay more attention to rate, reliability is the major concern among medium and large scale exporters. Irrespective of seniority of the exporter, reliability is given the prominence. Responsiveness is the most important sub criterion among Sri Lankan exporters. Consistency of judgments with respect to main criteria was verified through consistency ratio, which was less than 10%. Being more competitive, freight forwarders should come up with customized marketing strategies based on each target group’s requirements and expectations in offering services to retain existing exporters and attract new exporters.

Keywords: analytic hierarchy process, freight forwarders, main criteria, Sri Lankan exporters, subcriteria

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Authors: Md. Kausar Alam, Ramin Motamed

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The damaging effects of liquefaction-induced ground movements have been frequently observed in past earthquakes, such as the 2010-2011 Canterbury Earthquake Sequence (CES) in New Zealand and the 2011 Tohoku earthquake in Japan. To reduce the consequences of soil liquefaction at shallow depths, various ground improvement techniques have been utilized in engineering practice, among which this research is focused on experimentally evaluating the press-in sheet piling technique. The press-in sheet pile technique eliminates the vibration, hammering, and noise pollution associated with dynamic sheet pile installation methods. Unfortunately, there are limited experimental studies on the press-in sheet piling technique for liquefaction mitigation using 1g shake table tests in which all the controlling mechanisms of liquefaction-induced foundation settlement, including sand ejecta, can be realistically reproduced. In this study, a series of moderate scale 1g shake table experiments were conducted at the University of Nevada, Reno, to evaluate the performance of this technique in liquefiable soil layers. First, a 1/5 size model was developed based on a recent UC San Diego shaking table experiment. The scaled model has a density of 50% for the top crust, 40% for the intermediate liquefiable layer, and 85% for the bottom dense layer. Second, a shallow foundation is seated atop an unsaturated sandy soil crust. Third, in a series of tests, a sheet pile with variable embedment depth is inserted into the liquefiable soil using the press-in technique surrounding the shallow foundations. The scaled models are subjected to harmonic input motions with amplitude and dominant frequency properly scaled based on the large-scale shake table test. This study assesses the performance of the press-in sheet piling technique in terms of reductions in the foundation movements (settlement and tilt) and generated excess pore water pressures. In addition, this paper discusses the cost-effectiveness and carbon footprint features of the studied mitigation measures.

Keywords: excess pore water pressure, foundation settlement, press-in sheet pile, soil liquefaction

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Authors: Yena Lee, Vassilis M. Charitopoulos, Karthik Thyagarajan, Ian Morris, Jose M. Pinto, Lazaros G. Papageorgiou

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With globalisation, the need to have better coordination of production and distribution decisions has become increasingly important for industrial gas companies in order to remain competitive in the marketplace. In this work, we investigate a problem that integrates production, inventory, and routing decisions in a liquid oxygen supply chain. The oxygen supply chain consists of production facilities, external third-party suppliers, and multiple customers, including hospitals and industrial customers. The product produced by the plants or sourced from the competitors, i.e., third-party suppliers, is distributed by a fleet of heterogenous vehicles to satisfy customer demands. The objective is to minimise the total operating cost involving production, third-party, and transportation costs. The key decisions for production include production and inventory levels and product amount from third-party suppliers. In contrast, the distribution decisions involve customer allocation, delivery timing, delivery amount, and vehicle routing. The optimisation of the coordinated production, inventory, and routing decisions is a challenging problem, especially when dealing with large-size problems. Thus, we present a two-stage procedure to solve the integrated problem efficiently. First, the problem is formulated as a mixed-integer linear programming (MILP) model by simplifying the routing component. The solution from the first-stage MILP model yields the optimal customer allocation, production and inventory levels, and delivery timing and amount. Then, we fix the previous decisions and solve a detailed routing. In the second stage, we propose a column generation scheme to address the computational complexity of the resulting detailed routing problem. A case study considering a real-life oxygen supply chain in the UK is presented to illustrate the capability of the proposed models and solution method. Furthermore, a comparison of the solutions from the proposed approach with the corresponding solutions provided by existing metaheuristic techniques (e.g., guided local search and tabu search algorithms) is presented to evaluate the efficiency.

Keywords: production planning, inventory routing, column generation, mixed-integer linear programming

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Authors: R. Farhoud, G. Hermand, S. Delepine-lesoille

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Future underground facility of French radioactive waste disposal, named Cigeo, is designed to store intermediate and high level - long-lived French radioactive waste. Intermediate level waste cells are tunnel-like, about 400m length and 65 m² section, equipped with several concrete layers, which can be grouted in situ or composed of tunnel elements pre-grouted. The operating space into cells, to allow putting or removing waste containers, should be monitored for several decades without any maintenance. To provide the required information, design was performed and tested in situ in Andra’s underground laboratory (URL) at 500m under the surface. Based on distributed optic fiber sensors (OFS) and backscattered Brillouin for strain and Raman for temperature interrogation technics, the design consists of 2 loops of OFS, at 2 different radiuses, around the monitored section (Orthoradiale strains) and longitudinally. Strains measured by distributed OFS cables were compared to classical vibrating wire extensometers (VWE) and platinum probes (Pt). The OFS cables were composed of 2 cables sensitive to strains and temperatures and one only for temperatures. All cables were connected, between sensitive part and instruments, to hybrid cables to reduce cost. The connection has been made according to 2 technics: splicing fibers in situ after installation or preparing each fiber with a connector and only plugging them together in situ. Another challenge was installing OFS cables along a tunnel mad in several parts, without interruption along several parts. First success consists of the survival rate of sensors after installation and quality of measurements. Indeed, 100% of OFS cables, intended for long-term monitoring, survived installation. Few new configurations were tested with relative success. Measurements obtained were very promising. Indeed, after 3 years of data, no difference was observed between cables and connection methods of OFS and strains fit well with VWE and Pt placed at the same location. Data, from Brillouin instrument sensitive to strains and temperatures, were compensated with data provided by Raman instrument only sensitive to temperature and into a separated fiber. These results provide confidence in the next steps of the qualification processes which consists of testing several data treatment approach for direct analyses.

Keywords: monitoring, fiber optic, sensor, data treatment

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Authors: Zane Brough, Claudio Paoloni

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Modern low earth orbit (LEO) satellites that require multi-mission flexibility are highly likely to be repositioned between different operational orbits. While executing this process the satellite may experience high levels of vibration and environmental hazards, exposing the deployed solar panel to dangerous stress levels, fatigue and space debris, hence it is desirable to retract the solar array before satellite repositioning to avoid damage or failure. Furthermore, to accommodate for today's technological world, the power demand of a modern LEO satellite is rapidly increasing, which consequently provides pressure upon the design of the satellites solar array system to conform to the strict volume and mass limitations. A novel concept of deployable/retractable hybrid solar array system, aimed to provide a greater power to volume ratio while dramatically reducing the disadvantages of system mass and cost is proposed. Taking advantage of the new lightweight technology in solar panels, a mechanical system composed of both rigid and flexible solar panels arranged within a petal formation is proposed to yield a stowed to deployment area ratio up to at least 1:7, which improves the power density dramatically. The system consists of five subsystems, the outer ones based on a novel eight-petal configuration that provides a large surface and supports the flexible solar panels. A single cable and spool based hinge mechanism were designed to synchronously deploy/retract the panels in a safe, simple and efficient manner while the mass compared to the previous systems is considerably reduced. The relevant challenge to assure a smooth movement is resolved by a proper minimization of the gearing system and the use of a micro-controller system. A prototype was designed by 3D simulators and successfully constructed and tested. Further design works are in progress to implement an epicyclical gear hinge mechanism, which will further reduce the volume, mass and complexity of the system significantly. The proposed system due to an effective and reliable mechanism provides a large active surface, whilst being very compact. It could be extremely advantageous for use as ground portable solar panel system.

Keywords: mechatronic engineering, satellite, solar panel, deployable/retractable mechanism

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Authors: Rui Lin, Jimmy Xiangji Huang, Gary Spraakman

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This forthcoming systematic review will underscore the imperative of leveraging technology to mitigate social isolation in older adults, particularly in the context of unprecedented global challenges such as the COVID-19 pandemic. With the continual evolution of technology, it becomes crucial to scrutinize the efficacy of interventions and discern how they can alleviate social isolation and augment social well-being among the elderly. This review will strive to clarify the best methods for older adults to utilize cost-effective and user-friendly technology and will investigate how the adaptation and execution of such interventions can be fine-tuned to maximize their positive outcomes. The study will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to filter pertinent studies. We foresee conducting an analysis of articles and executing a narrative analysis to discover themes and indicators related to quality of life and, technology use and well-being. The review will examine how involving older adults at the community level, applying top practices from community-based participatory research, can establish efficient strategies to implement technology-based interventions designed to diminish social isolation and boost digital use self-efficacy. Applications based on mobile technology and virtual platforms are set to assume a crucial role not only in enhancing connections within families but also in connecting older adults to vital healthcare resources, fostering both physical and mental well-being. The review will investigate how technological devices and platforms can address the cognitive, visual, and auditory requirements of older adults, thus strengthening their confidence and proficiency in digital use—a crucial factor during enforced social distancing or self-isolation periods during pandemics. This review will endeavor to provide insights into the multifaceted benefits of technology for older adults, focusing on how tailored technological interventions can be a beacon of social and mental wellness in times of social restrictions. It will contribute to the growing body of knowledge on the intersection of technology and elderly well-being, offering nuanced understandings and practical implications for developing user-centric, effective, and inclusive technological solutions for older populations.

Keywords: older adults, health service delivery, digital health, social isolation, social well-being

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Authors: Merih Welay Welesilassie

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This research investigated the factors influencing digital inclusion for young students with disabilities in Ethiopian schools. In this context, socio-economic, infrastructural, and cultural challenges amplify educational disparities. In the era of digital technology's pivotal role in education, it is crucial to ensure equitable access for students with disabilities. Nevertheless, obstacles like inadequate infrastructure, insufficient teacher training, and economic constraints impede the incorporation of digital tools in educational environments, especially for marginalised groups. This study employed an explanatory sequential mixed-methods approach involving data collection through a survey administered to 300 students. Subsequently, in-depth interviews were conducted with 30 participants to provide comprehensive insights into their experiences. The quantitative analysis uncovered that students with disabilities have limited support for digital readiness, find digital technologies less accessible, and perceive digital tools as less easy to use. The study revealed that economic barriers, such as the high cost of devices and limited internet access, prevent students from fully utilising digital resources. Furthermore, infrastructural challenges, such as unreliable electricity and poor internet connectivity, exacerbate the issue. The qualitative data provided a more profound understanding by emphasising social and attitudinal obstacles, including a lack of empathy from both peers and educators, exclusion from participatory digital tasks, and enduring negative stereotypes regarding disabilities. The research highlights the importance of implementing interventions to enhance digital accessibility for students with disabilities. Essential suggestions encompass refining teacher training programs to effectively facilitate inclusive education, improving digital infrastructure, and offering financial assistance to procure digital tools. Furthermore, implementing policy reforms and public awareness campaigns is crucial to cultivate a cultural shift and nurture a more inclusive societal atmosphere. This study yields valuable perspectives on the digital inclusion scenario in Ethiopia, laying the groundwork for prospective research endeavours to narrow the digital gap for students with disabilities.

Keywords: digital inclussion, students with disabilities, ethiopian education, barries and access

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Authors: Nayara Torres B. Acioli, José Fernando T. Jucá

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The uncontrolled emission of gases in urban residues' embankment located near urban areas is a social and environmental problem, common in Brazilian cities. Several environmental impacts in the local and global scope may be generated by atmospheric air contamination by the biogas resulted from the decomposition of solid urban materials. In Brazil, the cities of small size figure mostly with 90% of all cities, with the population smaller than 50,000 inhabitants, according to the 2011 IBGE' census, most of the landfill covering layer is composed of clayey, pure soil. The embankments undertaken with pure soil may reach up to 60% of retention of methane, for the other 40% it may be dispersed into the atmosphere. In face of this figures the oxidative covering layer is granted some space of study, envisaging to reduce this perceptual available in the atmosphere, releasing, in spite of methane, carbonic gas which is almost 20 times as less polluting than Methane. This paper exposes the results of studies on the characteristics of the soil used for the oxidative coverage layer of the experimental embankment of Solid Urban Residues (SUR), built in Muribeca-PE, Brazil, supported of the Group of Solid Residues (GSR), located at Federal University of Pernambuco, through laboratory vacuum experiments (determining the characteristics curve), granularity, and permeability, that in soil with saturation over 85% offers dramatic drops in the test of permeability to the air, by little increments of water, based in the existing Brazilian norm for this procedure. The suction was studied, as in the other tests, from the division of prospection of an oxidative coverage layer of 60cm, in the upper half (0.1 m to 0.3 m) and lower half (0.4 m to 0.6 m). Therefore, the consequences to be presented from the lixiviation of the fine materials after 5 years of finalization of the embankment, what made its permeability increase. Concerning its humidity, it is most retained in the upper part, that comprises the compound, with a difference in the order of 8 percent the superior half to inferior half, retaining the least suction from the surface. These results reveal the efficiency of the oxidative coverage layer in retaining the rain water, it has a lower cost when compared to the other types of layer, offering larger availability of this layer as an alternative for a solution for the appropriate disposal of residues.

Keywords: oxidative coverage layer, permeability, suction, saturation

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Authors: Ayse Gul Bilen

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Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed antidepressants that are used clinically for the treatment of anxiety disorders, obsessive-compulsive disorder (OCD), panic disorders and eating disorders. The first SSRI, fluoxetine (sold under the brand names Prozac and Sarafem among others), had an adverse effect profile better than any other available antidepressant when it was introduced because of its selectivity for serotonin receptors. They have been considered almost free of side effects and have become widely prescribed, however questions about the safety and tolerability of SSRIs have emerged with their continued use. Most SSRI side effects are dose-related and can be attributed to serotonergic effects such as nausea. Continuous use might trigger adverse effects such as hyponatremia, tremor, nausea, weight gain, sleep disturbance and sexual dysfunction. Moderate toxicity can be safely observed in the hospital for 24 hours, and mild cases can be safely discharged (if asymptomatic) from the emergency department once cleared by Psychiatry in cases of intentional overdose and after 6 to 8 hours of observation. Although fluoxetine is relatively safe in terms of overdose, it might still be cardiotoxic and inhibit platelet secretion, aggregation, and plug formation. There have been reported clinical cases of seizures, cardiac conduction abnormalities, and even fatalities associated with fluoxetine ingestions. While the medical literature strongly suggests that most fluoxetine overdoses are benign, emergency physicians need to remain cognizant that intentional, high-dose fluoxetine ingestions may induce seizures and can even be fatal due to cardiac arrhythmia. Our case is a 35-year old female patient who was sent to ER with symptoms of confusion, amnesia and loss of orientation for time and location after being found wandering in the streets unconsciously by police forces that informed 112. Upon laboratory examination, no pathological symptom was found except sinus tachycardia in the EKG and high levels of aspartate transaminase (AST) and alanine transaminase (ALT). Diffusion MRI and computed tomography (CT) of the brain all looked normal. Upon physical and sexual examination, no signs of abuse or trauma were found. Test results for narcotics, stimulants and alcohol were negative as well. There was a presence of dysrhythmia which required admission to the intensive care unit (ICU). The patient gained back her conscience after 24 hours. It was discovered from her story afterward that she had been using fluoxetine due to post-traumatic stress disorder (PTSD) for 6 months and that she had attempted suicide after taking 3 boxes of fluoxetine due to the loss of a parent. She was then transferred to the psychiatric clinic. Our study aims to highlight the need to consider toxicologic drug use, in particular, the abuse of selective serotonin reuptake inhibitors (SSRIs), which have been widely prescribed due to presumed safety and tolerability, for diagnosis of patients applying to the emergency room (ER).

Keywords: abuse, amnesia, fluoxetine, intoxication, SSRI

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Authors: Martin Kleynhans, Margot Soler, Gavin Quibell

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Malawi is one of the world’s poorest nations and consequently, the design of flood risk management infrastructure comes with a different set of challenges. There is a lack of good quality hydromet data, both in spatial terms and in the quality thereof and the challenge in the design of flood risk management infrastructure is compounded by the fact that maintenance is almost completely non-existent and that solutions have to be simple to be effective. Solutions should not require any further resources to remain functional after completion, and they should be resilient. They also have to be cost effective. The Lower Shire Valley of Malawi suffers from frequent flood events. Various flood risk management interventions have been designed across the valley during the course of the Shire River Basin Management Project – Phase I, and due to the data poor environment, indigenous knowledge was relied upon to a great extent for hydrological and hydraulic model calibration and verification. However, indigenous knowledge comes with the caveat that it is ‘fuzzy’ and that it can be manipulated for political reasons. The experience in the Lower Shire valley suggests that indigenous knowledge is unlikely to invent a problem where none exists, but that flood depths and extents may be exaggerated to secure prioritization of the intervention. Indigenous knowledge relies on the memory of a community and cannot foresee events that exceed past experience, that could occur differently to those that have occurred in the past, or where flood management interventions change the flow regime. This complicates communication of planned interventions to local inhabitants. Indigenous knowledge is, for the most part, intuitive, but flooding can sometimes be counter intuitive, and the rural poor may have a lower trust of technology. Due to a near complete lack of maintenance of infrastructure, infrastructure has to be designed with no moving parts and no requirement for energy inputs. This precludes pumps, valves, flap gates and sophisticated warning systems. Designs of dykes during this project included ‘flood warning spillways’, that double up as pedestrian and animal crossing points, which provide warning of impending dangerous water levels behind dykes to residents before water levels that could cause a possible dyke failure are reached. Locally available materials and erosion protection using vegetation were used wherever possible to keep costs down.

Keywords: design of dykes in low-income countries, flood warning spillways, indigenous knowledge, Malawi

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Authors: Mireille Canal-Raffin, Nadege Lepage, Antoine Villa

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Context: Most antineoplastic drugs (AD) have a potential carcinogenic, mutagenic and/or reprotoxic effect and are classified as 'hazardous to handle' by National Institute for Occupational Safety and Health Their handling increases with the increase of cancer incidence. AD contamination from workers who handle AD and/or care for treated patients is, therefore, a major concern for occupational physicians. As part of the process of evaluation and prevention of chemical risks for professionals exposed to AD, Biological Monitoring of Occupational Exposure (BMOE) is the tool of choice. BMOE allows identification of at-risk groups, monitoring of exposures, assessment of poorly controlled exposures and the effectiveness and/or wearing of protective equipment, and documenting occupational exposure incidents to AD. This work aims to make proposals for the practical implementation of the BMOE for AD. The proposed strategy is based on the French good practice recommendations for BMOE, issued in 2016 by 3 French learned societies. These recommendations have been adapted to occupational exposure to AD. Results: AD contamination of professionals is a sensitive topic, and the BMOE requires the establishment of a working group and information meetings within the concerned health establishment to explain the approach, objectives, and purpose of monitoring. Occupational exposure to AD is often discontinuous and 2 steps are essential upstream: a study of the nature and frequency of AD used to select the Biological Exposure Indice(s) (BEI) most representative of the activity; a study of AD path in the institution to target exposed professionals and to adapt medico-professional information sheet (MPIS). The MPIS is essential to gather the necessary elements for results interpretation. Currently, 28 urinary specific BEIs of AD exposure have been identified, and corresponding analytical methods have been published: 11 BEIs were AD metabolites, and 17 were AD. Results interpretation is performed by groups of homogeneous exposure (GHE). There is no threshold biological limit value of interpretation. Contamination is established when an AD is detected in trace concentration or in a urine concentration equal or greater than the limit of quantification (LOQ) of the analytical method. Results can only be compared to LOQs of these methods, which must be as low as possible. For 8 of the 17 AD BEIs, the LOQ is very low with values between 0.01 to 0.05µg/l. For the other BEIs, the LOQ values were higher between 0.1 to 30µg/l. Results restitution by occupational physicians to workers should be individual and collective. Faced with AD dangerousness, in cases of workers contamination, it is necessary to put in place corrective measures. In addition, the implementation of prevention and awareness measures for those exposed to this risk is a priority. Conclusion: This work is a help for occupational physicians engaging in a process of prevention of occupational risks related to AD exposure. With the current analytical tools, effective and available, the (BMOE) to the AD should now be possible to develop in routine occupational physician practice. The BMOE may be complemented by surface sampling to determine workers' contamination modalities.

Keywords: antineoplastic drugs, urine, occupational exposure, biological monitoring of occupational exposure, biological exposure indice

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Authors: Massimiliano Condotta, Paolo Ruggeri, Chiara Scanagatta, Giovanni Borga

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Architects and urban planners, when designing and renewing cities, have to face a complex set of problems, including the issues of noise and air pollution which are considered as hot topics (i.e., the Clean Air Act of London and the Soundscape definition). It is usually taken for granted that these problems go by together because the noise pollution present in cities is often linked to traffic and industries, and these produce air pollutants as well. Traffic congestion can create both noise pollution and air pollution, because NO₂ is mostly created from the oxidation of NO, and these two are notoriously produced by processes of combustion at high temperatures (i.e., car engines or thermal power stations). We can see the same process for industrial plants as well. What have to be investigated – and is the topic of this paper – is whether or not there really is a correlation between noise pollution and air pollution (taking into account NO₂) in urban areas. To evaluate if there is a correlation, some low-cost methodologies will be used. For noise measurements, the OpeNoise App will be installed on an Android phone. The smartphone will be positioned inside a waterproof box, to stay outdoor, with an external battery to allow it to collect data continuously. The box will have a small hole to install an external microphone, connected to the smartphone, which will be calibrated to collect the most accurate data. For air, pollution measurements will be used the AirMonitor device, an Arduino board to which the sensors, and all the other components, are plugged. After assembling the sensors, they will be coupled (one noise and one air sensor) and placed in different critical locations in the area of Mestre (Venice) to map the existing situation. The sensors will collect data for a fixed period of time to have an input for both week and weekend days, in this way it will be possible to see the changes of the situation during the week. The novelty is that data will be compared to check if there is a correlation between the two pollutants using graphs that should show the percentage of pollution instead of the values obtained with the sensors. To do so, the data will be converted to fit on a scale that goes up to 100% and will be shown thru a mapping of the measurement using GIS methods. Another relevant aspect is that this comparison can help to choose which are the right mitigation solutions to be applied in the area of the analysis because it will make it possible to solve both the noise and the air pollution problem making only one intervention. The mitigation solutions must consider not only the health aspect but also how to create a more livable space for citizens. The paper will describe in detail the methodology and the technical solution adopted for the realization of the sensors, the data collection, noise and pollution mapping and analysis.

Keywords: air quality, data analysis, data collection, NO₂, noise mapping, noise pollution, particulate matter

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Authors: Namasivayam Navaranjan, Eric Dimla

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The world needs more quality food, shelter and transportation to meet the demands of growing population and improving living standard of those who currently live below the poverty line. Materials are essential commodities for various applications including food and pharmaceutical packaging, building and automobile. Petroleum based plastics are widely used materials amongst others for these applications and their demand is expected to increase. Use of plastics has environment related issues because considerable amount of plastic used worldwide is disposed in landfills, where its resources are wasted, the material takes up valuable space and blights communities. Some countries have been implementing regulations and/or legislations to increase reuse, recycle, renew and remanufacture materials as well as to minimise the use of non-environmentally friendly materials such as petroleum plastics. However, issue of material waste is still a concern in the countries who have low environmental regulations. Development of materials, mostly bioplastics from renewable biomass resources has become popular in the last decade. It is widely believed that the potential for up to 90% substitution of total plastics consumption by bioplastics is technically possible. The global demand for bioplastics is estimated to be approximately six times larger than in 2010. Recently, standard polymers like polyethylene (PE), polypropylene (PP), Polyvinyl Chloride (PVC) or Polyethylene terephthalate (PET), but also high-performance polymers such as polyamides or polyesters have been totally or partially substituted by their renewable equivalents. An example is Polylactide (PLA) being used as a substitute in films and injection moulded products made of petroleum plastics, e.g. PET. The starting raw materials for bio-based materials are usually sugars or starches that are mostly derived from food resources, partially also recycled materials from food or wood processing. The risk in lower food availability by increasing price of basic grains as a result of competition with biomass-based product sectors for feedstock also needs to be considered for the future bioplastic production. Manufacturing of bioplastic materials is often still reliant upon petroleum as an energy and materials source. Life Cycle Assessment (LCA) of bioplastic products has being conducted to determine the sustainability of a production route. However, the accuracy of LCA depends on several factors and needs improvement. Low oil price and high production cost may also limit the technically possible growth of these plastics in the coming years.

Keywords: bioplastics, plastics, renewable resources, biomass

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Authors: M. A. N. Rasanjalee Perera

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The world is facing several problems due to increasing elderly population. In Sri Lanka, along with the complexity of the modern society and structural and functional changes of the family, “caring for elders” seems as an emerging social problem. This situation may intensify as the county is moving into a middle income society. Seeking higher education and related career opportunities, and urban living in modern housing are new trends, through which several problems are generated. Among many issues related with elders, “lack of accessible and appropriate facilities in their houses as well as public buildings” can be identified as a major problem. This study argues that welfare facilities provided for the elderly people, particularly in the home environment, in the country are not adequate. Modern housing features such as bathrooms, pantries, lobbies, and leisure areas etc. are questionable as to whether they match with elders’ physical and mental needs. Consequently, elders have to face domestic accidents and many other difficulties within their living environments. Records of hospitals in the country also proved this fact. Therefore, this study tries to identify how far modern houses are suited with elders’ needs. The study further questioned whether “aging” is a considerable matter when people are buying, planning and renovating houses. A randomly selected sample of 50 houses were observed and 50 persons were interviewed around the Maharagama urban area in Colombo district to obtain primary data, while relevant secondary data and information were used to have a depth analysis. The study clearly found that none of the houses included to the sample are considering elders’ needs in planning, renovating, or arranging the home. Instead, most of the families were giving priority to the rich and elegant appearance and modern facilities of the houses. Particularly, to the bathrooms, pantry, large setting areas, balcony, parking slots for two vehicles, ad parapet walls with roller-gates are the main concerns. A significant factor found here is that even though, many children of the aged are in middle age and reaching their older years at present, they do not plan their future living within a safe and comfortable home, despite that they are hoping to spent the latter part of their lives in the their current homes. This fact highlights that not only the other responsible parts of the society, but also those who are reaching their older ages are ignoring the problems of the aged. At the same time, it was found that more than 80% of old parents do not like to stay at their children’s homes as the living environments in such modern homes are not familiar or convenient for them. Due to this context, the aged in Sri Lanka may have to be alone in their own homes due to current trend of society of migrating to urban living in modern houses. At the same time, current urban families who live in modern houses may have to face adding accessible facilities in their home environment, as current modern housing facilities may not be appropriate them for a better life in their latter part of life.

Keywords: aging population, elderly care, home environment, housing facilities

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Authors: Sakinah Idris, Gabrine Jagersma, Bjorn Jaime Van Pelt, Kirstin Greaves-Lord

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Background: The PEERS (Program for the Education and Enrichment of Relational Skills) intervention can be considered a well-established, evidence-based intervention in the USA. However, testing the efficacy of cultural adaptations of PEERS is still ongoing. More and more, the involvement of all stakeholders in the development and evaluation of interventions is acknowledged as crucial for the longer term implementation of interventions across settings. Therefore, in the current project, teens with ASD (Autism Spectrum Disorder), their neurotypical peers, parents, teachers, as well as clinicians were involved in the development and evaluation of the Dutch version of PEERS. Objectives: The current presentation covers (1) the formative phase and (2) the preliminary adaptation test phase of the cultural adaptation of evidence-based interventions. In the formative phase, we aim to describe the process of adaptation of the PEERS program to the Dutch culture and care system. In the preliminary adaptation phase, we will present results from the preliminary adaptation test among 32 adolescents with ASD. Methods: In phase 1, a group discussion on common vocabulary was conducted among 70 teenagers (and their teachers) from special and regular education aged 12-18 years old. This inventory concerned 14 key constructs from PEERS, e.g., areas of interests, locations for making friends, common peer groups and crowds inside and outside of school, activities with friends, commonly used ways for electronic communication, ways for handling disagreements, and common teasing comebacks. Also, 15 clinicians were involved in the translation and cultural adaptation process. The translation and cultural adaptation process were guided by the research team, and who included input and feedback from all stakeholders through an iterative feedback incorporation procedure. In phase 2, The parent-reported Social Responsiveness Scale (SRS), the Test of Adolescent Social Skills Knowledge (TASSK), and the Quality of Socialization Questionnaire (QSQ) were assessed pre- and post-intervention to evaluate potential treatment outcome. Results: The most striking cultural adaptation - reflecting the standpoints of all stakeholders - concerned the strategies for handling rumors and gossip, which were suggested to be taught using a similar approach as the teasing comebacks, more in line with ‘down-to-earth’ Dutch standards. The preliminary testing of this adapted version indicated that the adolescents with ASD significantly improved their social knowledge (TASSK; t₃₁ = -10.9, p < .01), social experience (QSQ-Parent; t₃₁ = -4.2, p < .01 and QSQ-Adolescent; t₃₂ = -3.8, p < .01), and in parent-reported social responsiveness (SRS; t₃₃ = 3.9, p < .01). In addition, subjective evaluations of teens with ASD, their parents and clinicians were positive. Conclusions: In order to further scrutinize the effectiveness of the Dutch version of the PEERS intervention, we recommended performing a larger scale randomized control trial (RCT) design, for which we provide several methodological considerations.

Keywords: cultural adaptation, PEERS, preliminary testing, translation

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Authors: Kirolos Gerges Yakoub Gerges

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Self-sustaining agricultural machines act in stochastic surroundings and therefore, should be capable of perceive the surroundings in real time. This notion can be done using image sensors blended with superior device learning, mainly Deep mastering. Deep convolutional neural networks excel in labeling and perceiving colour pix and since the fee of RGB-cameras is low, the hardware cost of accurate notion relies upon heavily on memory and computation power. This paper investigates the opportunity of designing lightweight convolutional neural networks for semantic segmentation (pixel clever class) with reduced hardware requirements, to allow for embedded usage in self-reliant agricultural machines. The usage of compression techniques, a lightweight convolutional neural community is designed to carry out actual-time semantic segmentation on an embedded platform. The community is skilled on two big datasets, ImageNet and Pascal Context, to apprehend as much as four hundred man or woman instructions. The 400 training are remapped into agricultural superclasses (e.g. human, animal, sky, road, area, shelterbelt and impediment) and the capacity to provide correct actual-time perception of agricultural environment is studied. The network is carried out to the case of self-sufficient grass mowing the usage of the NVIDIA Tegra X1 embedded platform. Feeding case-unique pics to the community consequences in a fully segmented map of the superclasses within the picture. As the network remains being designed and optimized, handiest a qualitative analysis of the technique is entire on the abstract submission deadline. intending this cut-off date, the finalized layout is quantitatively evaluated on 20 annotated grass mowing pictures. Light-weight convolutional neural networks for semantic segmentation can be implemented on an embedded platform and show aggressive performance on the subject of accuracy and speed. It’s miles viable to offer value-efficient perceptive capabilities related to semantic segmentation for autonomous agricultural machines.

Keywords: centrifuge pump, hydraulic energy, agricultural applications, irrigationaxial flux machines, axial flux applications, coreless machines, PM machinesautonomous agricultural machines, deep learning, safety, visual perception

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Authors: Ndibarefinia Tobin

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The UK construction industry has been under pressure for many years to produce economical buildings which offer value for money, not only during the construction phase, but more importantly, during the full life of the building. Whole life costing is considered as an economic analysis tool that takes into account the total investment cost in and ownership, operation and subsequent disposal of a product or system to which the whole life costing method is being applied. In spite of its importance, the practice is still crippled by the lack of tangible evidence, ‘know-how’ skills and knowledge of the practice i.e. the lack of professionals with the knowledge and training on the use of the practice in construction project, this situation is compounded by the absence of available data on whole life costing from relevant projects, lack of data collection mechanisms and so on. The aforementioned problems has forced many construction organisations to adopt project enhancement initiatives to boost their performance on the use of whole life costing techniques so as to produce economical buildings which offer value for money during the construction stage also the whole life of the building/asset. The management of knowledge in whole life costing is considered as one of the many project enhancement initiative and it is becoming imperative in the performance and sustainability of an organisation. Procuring building projects using whole life costing technique is heavily reliant on the knowledge, experience, ideas and skills of workers, which comes from many sources including other individuals, electronic media and documents. Due to the diversity of knowledge, capabilities and skills of employees that vary across an organisation, it is significant that they are directed and coordinated efficiently so as to capture, retrieve and share knowledge in order to improve the performance of the organisation. The implementation of knowledge management concept has different levels in each organisation. Measuring the maturity level of knowledge management in whole life costing practice will paint a comprehensible picture of how knowledge is managed in construction organisations. Purpose: The purpose of this study is to identify knowledge management maturity in UK construction organisations adopting whole life costing in construction project. Design/methodology/approach: This study adopted a survey method and conducted by distributing questionnaires to large construction companies that implement knowledge management activities in whole life costing practice in construction project. Four level of knowledge management maturity was proposed on this study. Findings: From the results obtained in the study shows that 34 contractors at the practiced level, 26 contractors at managed level and 12 contractors at continuously improved level.

Keywords: knowledge management, whole life costing, construction industry, knowledge

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Authors: Sharad Kumar Kulshreshtha

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India is a great land of cultural and traditional diversity. Its spectrums create a unique ambiance in all over the country. Specially, fairs and festivals are ancient phenomena in Indian culture. In India, there are thousands of such religious, spiritual, cultural fairs organized on auspicious occasions. These fairs reflect the effective and efficient role of social governance and responsibility of Indian society. In this context a mega event known as ‘Kumbha Mela’ literally mean ‘Kumbha Fair’ which is organize after every twelve years at (Prayaag) Allahabad an ancient city of India, now is in the state of Uttar Pradesh. Kumbh Mela is one of the largest human congregations on the Earth. The Kumbha Mela that is held here is considered to be the largest and holiest city among the four cities where Kubha fair organize. According to the Hindu religious scripture a dip for possessing the holy confluence, known as Triveni Sangam, which is a meeting point of the three sacred rivers of India i.e., –Ganges, Yamuna and Saraswati (mythical). During the Kumbha fair the River Ganges is believed to turn to nectar, bringing great blessing to everyone who bathes in it. Other activities include religious discussions, devotional singings and mass feedings pilgrims and poor. The venue for Kumbh Mela (fair) depends on the position Sun, Moon, and Jupiter which holds in that period in different zodiac signs. More than 120 Millions (12 Crore) people visited in the Kumbha Fair-2013 in Allahabad. A temporary tented city was set up for the pilgrims over an area of 2 hectares of the land along the river of Ganges. As many as 5 power substations, temporary police stations, hospitals, bus terminals, stalls were set up for providing various facilities to the visitors and thousands of volunteers participated for assistance of this event. All efforts made by fair administration to provide facility to visitors, such security and sanitation, medical care and frequent water and power supply. The efficient and timely arrangement at the Kumbha Mela attracted the attention of many government and institutions. The Harvard University of USA conducted research to find out how it was made possible. This paper will focuses on effective and efficient planning and preparation of Kumbha Fair which includes facilitation process, role of various coordinating agencies. risk management crisis management strategies Prevention, Preparedness, Response, and Recovery (PPRR Approach), emergency response plan (ERP), safety and security issues, various environmental aspects along with health hazards and hygiene crowd management, evacuation, monitoring, control and evaluation.

Keywords: event planning and facility arrangement, risk management, crowd management, India

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Authors: Ammar Y. Alqahtani

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In order to minimize the negative impact on the environment, it is essential to manage the waste that generated from the premature disposal of end-of-life (EOL) products properly. Consequently, government and international organizations introduced new policies and regulations to minimize the amount of waste being sent to landfills. Moreover, the consumers’ awareness regards environment has forced original equipment manufacturers to consider being more environmentally conscious. Therefore, manufacturers have thought of different ways to deal with waste generated from EOL products viz., remanufacturing, reusing, recycling, or disposing of EOL products. The rate of depletion of virgin natural resources and their dependency on the natural resources can be reduced by manufacturers when EOL products are treated as remanufactured, reused, or recycled, as well as this will cut on the amount of harmful waste sent to landfills. However, disposal of EOL products contributes to the problem and therefore is used as a last option. Number of EOL need to be estimated in order to fulfill the components demand. Then, disassembly process needs to be performed to extract individual components and subassemblies. Smart products, built with sensors embedded and network connectivity to enable the collection and exchange of data, utilize sensors that are implanted into products during production. These sensors are used for remanufacturers to predict an optimal warranty policy and time period that should be offered to customers who purchase remanufactured components and products. Sensor-provided data can help to evaluate the overall condition of a product, as well as the remaining lives of product components, prior to perform a disassembly process. In this paper, a multi-period disassembly-to-order (DTO) model is developed that takes into consideration the different system uncertainties. The DTO model is solved using Nonlinear Programming (NLP) in multiple periods. A DTO system is considered where a variety of EOL products are purchased for disassembly. The model’s main objective is to determine the best combination of EOL products to be purchased from every supplier in each period which maximized the total profit of the system while satisfying the demand. This paper also addressed the impact of sensor embedded products on the cost of warranties. Lastly, this paper presented and analyzed a case study involving various simulation conditions to illustrate the applicability of the model.

Keywords: closed-loop supply chains, environmentally conscious manufacturing, product recovery, reverse logistics

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Authors: Saad Mohamed Elsaid Onaizah

Abstract:

One of the reasons for the intensive use of pesticides is to protect agricultural crops and orchards from pests or agricultural worms. The period of time that pesticides stay inside the soil is estimated at about (2) to (12) weeks. Perhaps the most important reason that led to groundwater pollution is the easy leakage of these harmful pesticides from the soil into the aquifers. This research aims to find the best ways to use trated activated charcoal with gold nitrate solution; For the purpose of removing the deadly pesticides from the aqueous solution by adsorption phenomenon. The most used pesticides in Egypt were selected, such as Malathion, Methomyl Abamectin and, Thiamethoxam. Activated charcoal doped with gold ions was prepared by applying chemical and thermal treatments to activated charcoal using gold nitrate solution. Adsorption of studied pesticide onto activated carbon /Au was mainly by chemical adsorption forming complex with the gold metal immobilised on activated carbon surfaces. Also, gold atom was considered as a catalyst to cracking the pesticide molecule. Gold activated charcoal is a low cost material due to the use of very low concentrations of gold nitrate solution. its notice the great ability of activated charcoal in removing selected pesticides due to the presence of the positive charge of the gold ion, in addition to other active groups such as functional oxygen and lignin cellulose. The presence of pores of different sizes on the surface of activated charcoal is the driving force for the good adsorption efficiency for the removal of the pesticides under study The surface area of the prepared char as well as the active groups were determined using infrared spectroscopy and scanning electron microscopy. Some factors affecting the ability of activated charcoal were applied in order to reach the highest adsorption capacity of activated charcoal, such as the weight of the charcoal, the concentration of the pesticide solution, the time of the experiment, and the pH. Experiments showed that the maximum limit revealed by the batch adsorption study for the adsorption of selected insecticides was in contact time (80) minutes at pH (7.70). These promising results were confirmed, and by establishing the practical application of the developed system, the effect of various operating factors with equilibrium, kinetic and thermodynamic studies is evident, using the Langmuir application on the effectiveness of the absorbent material with absorption capacities higher than most other adsorbents.

Keywords: waste water, pesticides pollution, adsorption, activated carbon

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