Search results for: significant risk factors in megaprojects
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 26876

Search results for: significant risk factors in megaprojects

17186 Scheduling of Repetitive Activities for Height-Rise Buildings: Optimisation by Genetic Algorithms

Authors: Mohammed Aljoma

Abstract:

In this paper, a developed prototype for the scheduling of repetitive activities in height-rise buildings was presented. The activities that describe the behavior of the most of activities in multi-storey buildings are scheduled using the developed approach. The prototype combines three methods to attain the optimized planning. The methods include Critical Path Method (CPM), Gantt and Line of Balance (LOB). The developed prototype; POTER is used to schedule repetitive and non-repetitive activities with respect to all constraints that can be automatically generated using a generic database. The prototype uses the method of genetic algorithms for optimizing the planning process. As a result, this approach enables contracting organizations to evaluate various planning solutions that are calculated, tested and classified by POTER to attain an optimal time-cost equilibrium according to their own criteria of time or coast.

Keywords: planning scheduling, genetic algorithms, repetitive activity, construction management, planning, scheduling, risk management, project duration

Procedia PDF Downloads 295
17185 Harnessing Renewable Energy as a Strategy to Combating Climate Change in Sub Saharan Africa

Authors: Gideon Nyuimbe Gasu

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Sub Saharan Africa is at a critical point, experiencing rapid population growth, particularly in urban areas and young growing force. At the same time, the growing risk of catastrophic global climate change threatens to weaken food production system, increase intensity and frequency of drought, flood, and fires and undermine gains on development and poverty reduction. Although the region has the lowest per capital greenhouse gas emission level in the world, it will need to join global efforts to address climate change, including action to avoid significant increases and to encourage a green economy. Thus, there is a need for the concept of 'greening the economy' as was prescribed at Rio Summit of 1992. Renewable energy is one of the criterions to achieve this laudable goal of maintaining a green economy. There is need to address climate change while facilitating continued economic growth and social progress as energy today is critical to economic growth. Fossil fuels remain the major contributor of greenhouse gas emission. Thus, cleaner technologies such as carbon capture storage, renewable energy have emerged to be commercially competitive. This paper sets out to examine how to achieve a low carbon economy with minimal emission of carbon dioxide and other greenhouse gases which is one of the outcomes of implementing a green economy. Also, the paper examines the different renewable energy sources such as nuclear, wind, hydro, biofuel, and solar voltaic as a panacea to the looming climate change menace. Finally, the paper assesses the different renewable energy and energy efficiency as a propeller to generating new sources of income and jobs and in turn reduces carbon emission. The research shall engage qualitative, evaluative and comparative methods. The research will employ both primary and secondary sources of information. The primary sources of information shall be drawn from the sub Saharan African region and the global environmental organizations, energy legislation, policies and related industries and the judicial processes. The secondary sources will be made up of some books, journal articles, commentaries, discussions, observations, explanations, expositions, suggestions, prescriptions and other material sourced from the internet on renewable energy as a panacea to climate change. All information obtained from these sources will be subject to content analysis. The research result will show that the entire planet is warming as a result of the activities of mankind which is clear evidence that the current development is fundamentally unsustainable. Equally, the study will reveal that a low carbon development pathway in the sub Saharan African region should be embraced to minimize emission of greenhouse gases such as using renewable energy rather than coal, oil, and gas. The study concludes that until adequate strategies are devised towards the use of renewable energy the region will continue to add and worsen the current climate change menace and other adverse environmental conditions.

Keywords: carbon dioxide, climate change, legislation/law, renewable energy

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17184 Comparing Media-Based Strategies of Identity Formation in Chicanos and Cuban-Americans

Authors: Kwang Yeon Kim

Abstract:

This paper will explore the directly proportional relationship between the influence of Hispanophone media in U.S. markets and Hispanic population growth. Though this growth has origins across south and central America, in U.S. media markets Mexican and Cuban immigrants, have traditionally been considered the most influential. Having endured significant historical discrimination, disparagement, and ethnic framing from conventional Anglophone media, such groups have sought to form their own identities as media consuming and producing Americans of Latin American origin. Although immigrants to the U.S. have traditionally faced obstacles in access to education, children of Mexican-Americans (Chicanos) and Cuban-Americans have made significant progress in overcoming these obstacles, partly explaining their media dominance. This is particularly true in the case of Cuban-Americans, for whom such media presence is not predicted by share of population. By conducting comparative studies of Chicano media and Cuban-Americans media, common ground was found in strategies of reliance on media-driven identity formation. In contrast to the mainstream media portrayal of Latino/as with limiting, negative stereotypes, Spanish-language media’s goal is to form the identity of being Latino for those living in the United States. Providing both news from countries of origin and local news within the United States, Chicano and Cuban-American media performs rituals of recollection while rooting such populations in more proximate media paradigms.

Keywords: Chicano identity, Cuban-Americans, Hispanophone media, Latino/a community

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17183 Stability Indicating RP – HPLC Method Development, Validation and Kinetic Study for Amiloride Hydrochloride and Furosemide in Pharmaceutical Dosage Form

Authors: Jignasha Derasari, Patel Krishna M, Modi Jignasa G.

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Chemical stability of pharmaceutical molecules is a matter of great concern as it affects the safety and efficacy of the drug product.Stability testing data provides the basis to understand how the quality of a drug substance and drug product changes with time under the influence of various environmental factors. Besides this, it also helps in selecting proper formulation and package as well as providing proper storage conditions and shelf life, which is essential for regulatory documentation. The ICH guideline states that stress testing is intended to identify the likely degradation products which further help in determination of the intrinsic stability of the molecule and establishing degradation pathways, and to validate the stability indicating procedures. A simple, accurate and precise stability indicating RP- HPLC method was developed and validated for simultaneous estimation of Amiloride Hydrochloride and Furosemide in tablet dosage form. Separation was achieved on an Phenomenexluna ODS C18 (250 mm × 4.6 mm i.d., 5 µm particle size) by using a mobile phase consisting of Ortho phosphoric acid: Acetonitrile (50:50 %v/v) at a flow rate of 1.0 ml/min (pH 3.5 adjusted with 0.1 % TEA in Water) isocratic pump mode, Injection volume 20 µl and wavelength of detection was kept at 283 nm. Retention time for Amiloride Hydrochloride and Furosemide was 1.810 min and 4.269 min respectively. Linearity of the proposed method was obtained in the range of 40-60 µg/ml and 320-480 µg/ml and Correlation coefficient was 0.999 and 0.998 for Amiloride hydrochloride and Furosemide, respectively. Forced degradation study was carried out on combined dosage form with various stress conditions like hydrolysis (acid and base hydrolysis), oxidative and thermal conditions as per ICH guideline Q2 (R1). The RP- HPLC method has shown an adequate separation for Amiloride hydrochloride and Furosemide from its degradation products. Proposed method was validated as per ICH guidelines for specificity, linearity, accuracy; precision and robustness for estimation of Amiloride hydrochloride and Furosemide in commercially available tablet dosage form and results were found to be satisfactory and significant. The developed and validated stability indicating RP-HPLC method can be used successfully for marketed formulations. Forced degradation studies help in generating degradants in much shorter span of time, mostly a few weeks can be used to develop the stability indicating method which can be applied later for the analysis of samples generated from accelerated and long term stability studies. Further, kinetic study was also performed for different forced degradation parameters of the same combination, which help in determining order of reaction.

Keywords: amiloride hydrochloride, furosemide, kinetic study, stability indicating RP-HPLC method validation

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17182 Study of Oxidative Processes in Blood Serum in Patients with Arterial Hypertension

Authors: Laura M. Hovsepyan, Gayane S. Ghazaryan, Hasmik V. Zanginyan

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Hypertension (HD) is the most common cardiovascular pathology that causes disability and mortality in the working population. Most often, heart failure (HF), which is based on myocardial remodeling, leads to death in hypertension. Recently, endothelial dysfunction (EDF) or a violation of the functional state of the vascular endothelium has been assigned a significant role in the structural changes in the myocardium and the occurrence of heart failure in patients with hypertension. It has now been established that tissues affected by inflammation form increased amounts of superoxide radical and NO, which play a significant role in the development and pathogenesis of various pathologies. They mediate inflammation, modify proteins and damage nucleic acids. The aim of this work was to study the processes of oxidative modification of proteins (OMP) and the production of nitric oxide in hypertension. In the experimental work, the blood of 30 donors and 33 patients with hypertension was used. For the quantitative determination of OMP products, the based on the reaction of the interaction of oxidized amino acid residues of proteins and 2,4-dinitrophenylhydrazine (DNPH) with the formation of 2,4-dinitrophenylhydrazones, the amount of which was determined spectrophotometrically. The optical density of the formed carbonyl derivatives of dinitrophenylhydrazones was recorded at different wavelengths: 356 nm - aliphatic ketone dinitrophenylhydrazones (KDNPH) of neutral character; 370 nm - aliphatic aldehyde dinirophenylhydrazones (ADNPH) of neutral character; 430 nm - aliphatic KDNFG of the main character; 530 nm - basic aliphatic ADNPH. Nitric oxide was determined by photometry using Grace's solution. Adsorption was measured on a Thermo Scientific Evolution 201 SF at a wavelength of 546 nm. Thus, the results of the studies showed that in patients with arterial hypertension, an increased level of nitric oxide in the blood serum is observed, and there is also a tendency to an increase in the intensity of oxidative modification of proteins at a wavelength of 270 nm and 363 nm, which indicates a statistically significant increase in aliphatic aldehyde and ketone dinitrophenylhydrazones. The increase in the intensity of oxidative modification of blood plasma proteins in the studied patients, revealed by us, actually reflects the general direction of free radical processes and, in particular, the oxidation of proteins throughout the body. A decrease in the activity of the antioxidant system also leads to a violation of protein metabolism. The most important consequence of the oxidative modification of proteins is the inactivation of enzymes.

Keywords: hypertension (HD), oxidative modification of proteins (OMP), nitric oxide (NO), oxidative stress

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17181 Warfield Spying Robot Using LoRa

Authors: Madhavi T., Sireesha Sakhamuri, Hema Sri A., Harika K.

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Today as technological advancements are taking place, these advancements are being used by the armed forces to reduce the risk of their losses and to defeat their enemies. The development of sophisticated technology relies mostly on the use of high- tech weapons or machinery. Robotics is one of the hot spheres of the modern age in which nations concentrate on the state of war and peace for military purposes. They have been in use for demining and rescue operations for some time now but are being propelled by using them for combat and spy missions. This project focuses on creating a LoRa-based spying robot with a wireless IP camera attached to it that can rising the human target. This robot transmits the signal via an IP camera to the base station. One of this project’s major applications can be analyzed using a PC that can be used to control the robot’s movement. The robot sends the signal through the LoRa transceiver at the base station to the LoRa transceiver mounted on the robot. With this function, the, robot can relay videos in real- time along with anti-collision capabilities and the enemies in the war zone cannot recognize them. More importantly, this project focuses on increasing communication using LoRa.

Keywords: lora, IP cam, metal detector, laser shoot

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17180 Comparative Analysis of Residual Shear Depiction and Grain Distribution Characteristics of Slide Soil Profile Sections

Authors: Ephrem Getahun, Shengwen Qi, Songfeng Guo, Yu Zou, Melesse Alemayehu

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Residual shear characteristics of slide soil profile sections (SSPS) were examined using ring shear tests to know the relative residual shear behaviors among the sections of slide soil. The multistage-multiphase shearing techniques were employed to perform the experiment for each soil specimen continuously towards large displacements. The grain distribution analysis of SSPS samples was characterized by coarsening upward from bottom slip to the top sections; however, the slip surface was considered as a sheared zone that endorses their low shear resistance for failure. There is an average range of 1-2.5 mm axial displacement on each stage of loadings and phases of shearing that depicts the significant effect of dilation and compression of soil specimen. The middle section has the largest consolidation percentage (10-29%), and vertical displacement compared to other sections and showed high shear strengthening behavior having maximum shear stress of 189kPa at 240kPa loading compared to basal and top sections. It is found that the middle section of SSPS has relatively high shear resistance behavior for large displacement shearing. The residual shear assessment indicates that there is a significant influence of large displacement and rate on the friction coefficient behaviors; it resulted in shear weakening effect to attain their residual condition.

Keywords: comparison, displacements, residual shear stress, shear behavior, slide soils

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17179 Examining Audiology Students: Clinical Reasoning Skills When Using Virtual Audiology Cases Aided With no Collaboration, Live Collaboration, and Virtual Collaboration

Authors: Ramy Shaaban

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The purpose of this study was to examine the difference in clinical reasoning skills of students when using virtual audiology cases with and without collaborative assistance from major learning approaches important to clinical reasoning skills and computer-based learning models: Situated Learning Theory, Social Development Theory, Scaffolding, and Collaborative Learning. A quasi-experimental design was conducted at two United States universities to examine whether there is a significant difference in clinical reasoning skills between three treatment groups using IUP Audiosim software. Two computer-based audiology case simulations were developed, and participants were randomly placed into the three groups: no collaboration, virtual collaboration, and live collaboration. The clinical reasoning data were analyzed using One-Way ANOVA and Tukey posthoc analyses. The results show that there was a significant difference in clinical reasoning skills between the three treatment groups. The score obtained by the no collaboration group was significantly less than the scores obtained by the virtual and live collaboration groups. Collaboration, whether virtual or in person, has a positive effect on students’ clinical reasoning. These results with audiology students indicate that combining collaboration models with scaffolding and embedding situated learning and social development theories into the design of future virtual patients has the potential to improve students’ clinical reasoning skills.

Keywords: clinical reasoning, virtual patients, collaborative learning, scaffolding

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17178 Preservation and Packaging Techniques for Extending the Shelf Life of Cucumbers: A Review of Methods and Factors Affecting Quality

Authors: Abdul Umaro Tholley

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The preservation and packaging of cucumbers are essential to maintain their shelf life and quality. Cucumbers are a perishable food item that is highly susceptible to spoilage due to their high-water content and delicate nature. Therefore, proper preservation and packaging techniques are crucial to extend their shelf life and prevent economic loss. There are several methods of preserving cucumbers, including refrigeration, canning, pickling, and dehydration. Refrigeration is the most used preservation method, as it slows down the rate of deterioration and maintains the freshness and quality of the cucumbers. Canning and pickling are also popular preservation methods that use heat treatment and acidic solutions, respectively, to prevent microbial growth and increase shelf life. Dehydration involves removing the water content from cucumbers to increase their shelf life, but it may affect their texture and taste. Packaging also plays a vital role in preserving cucumbers. The packaging materials should be selected based on their ability to maintain the quality and freshness of the cucumbers. The most used packaging materials for cucumbers are polyethylene bags, which prevent moisture loss and protect the cucumbers from physical damage. Other packaging materials, such as corrugated boxes and wooden crates, may also be used, but they offer less protection against moisture loss and damage. The quality of cucumbers is affected by several factors, including storage temperature, humidity, and exposure to light. Cucumbers should be stored at temperatures between 7 and 10 °C, with a relative humidity of 90-95%, to maintain their freshness and quality. Exposure to light should also be minimized to prevent the formation of yellowing and decay. In conclusion, the preservation and packaging of cucumbers are essential to maintain their quality and extend their shelf life. Refrigeration, canning, pickling, and dehydration are common preservation methods that can be used to preserve cucumbers. The packaging materials used should be carefully selected to prevent moisture loss and physical damage. Proper storage conditions, such as temperature, humidity, and light exposure, should also be maintained to ensure the quality and freshness of cucumbers. Overall, proper preservation and packaging techniques can help reduce economic loss and provide consumers with high-quality cucumbers.

Keywords: cucumbers, preservation, packaging, shelf life

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17177 Genotoxic Effect of Tricyclic Antidepressant Drug “Clomipramine Hydrochloride’ on Somatic and Germ Cells of Male Mice

Authors: Samia A. El-Fiky, Fouad A. Abou-Zaid, Ibrahim M. Farag, Naira M. El-Fiky

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Clomipramine hydrochloride is one of the most used tricyclic antidepressant drug in Egypt. This drug contains in its chemical structure on two benzene rings. Benzene is considered to be toxic and clastogenic agent. So, the present study was designed to assess the genotoxic effect of Clomipramine hydrochloride on somatic and germ cells in mice. Three dose levels 0.195 (Low), 0.26 (Medium), and 0.65 (High) mg/kg.b.wt. were used. Seven groups of male mice were utilized in this work. The first group was employed as a control. In the remaining six groups, each of the above doses was orally administrated for two groups, one of them was treated for 5 days and the other group was given the same dose for 30 days. At the end of experiments, the animals were sacrificed for cytogenetic and sperm examination as well as histopathological investigations by using hematoxylin and eosin stains (H and E stains) and electron microscope. Concerning the sperm studies, these studies were confined to 5 days treatment with different dose levels. Moreover, the ultrastructural investigation by electron microscope was restricted to 30 days treatment with drug doses. The results of the dose dependent effect of Clomipramine showed that the treatment with three different doses induced increases of frequencies of chromosome aberrations in bone marrow and spermatocyte cells as compared to control. In addition, mitotic and meiotic activities of somatic and germ cells were declined. The treatments with medium or high doses were more effective for inducing significant increases of chromosome aberrations and significant decreases of cell divisions than treatment with low dose. The effect of high dose was more pronounced for causing such genetic deleterious in respect to effect of medium dose. Moreover, the results of the time dependent effect of Clomipramine observed that the treatment with different dose levels for 30 days led to significant increases of genetic aberrations than treatment for 5 days. Sperm examinations revealed that the treatment with Clomipramine at different dose levels caused significant increase of sperm shape abnormalities and significant decrease in sperm count as compared to control. The adverse effects on sperm shape and count were more obviousness by using the treatments with medium or high doses than those found in treatment with low dose. The group of mice treated with high dose had the highest rate of sperm shape abnormalities and the lowest proportion of sperm count as compared to mice received medium dose. In histopathological investigation, hematoxylin and eosin stains showed that, the using of low dose of Clomipramine for 5 or 30 days caused a little pathological changes in liver tissue. However, using medium and high doses for 5 or 30 days induced severe damages than that observed in mice treated with low dose. The treatment with high dose for 30 days gave the worst results of pathological changes in hepatic cells. Moreover, ultrastructure examination revealed, the mice treated with low dose of Clomipramine had little differences in liver histological architecture as compared to control group. These differences were confined to cytoplasmic inclusions. Whereas, prominent pathological changes in nuclei as well as dilated of rough Endoplasmic Reticulum (rER) were observed in mice treated with medium or high doses of Clomipramine drug. In conclusion, the present study adds evidence that treatments with medium or high doses of Clomipramine have genotoxic effects on somatic and germ cells of mice, as unwanted side effects. However, the using of low dose (especially for short time, 5 days) can be utilized as a therapeutic dose, where it caused relatively similar proportions of genetic, sperm, and histopathological changes as those found in normal control.

Keywords: chromosome aberrations, clomipramine, mice, histopathology, sperm abnormalities

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17176 How to Use E-Learning to Increase Job Satisfaction in Large Commercial Bank in Bangkok

Authors: Teerada Apibunyopas, Nithinant Thammakoranonta

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Many organizations bring e-Learning to use as a tool in their training and human development department. It is getting more popular because it is easy to access to get knowledge all the time and also it provides a rich content, which can develop the employees skill efficiently. This study focused on the factors that affect using e-Learning efficiently, so it will make job satisfaction increased. The questionnaires were sent to employees in large commercial banks, which use e-Learning located in Bangkok, the results from multiple linear regression analysis showed that employee’s characteristics, characteristics of e-Learning, learning and growth have influence on job satisfaction.

Keywords: e-Learning, job satisfaction, learning and growth, Bangkok

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17175 Laser Shock Peening of Additively Manufactured Nickel-Based Superalloys

Authors: Michael Munther, Keivan Davami

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One significant roadblock for additively manufactured (AM) parts is the buildup of residual tensile stresses during the fabrication process. These residual stresses are formed due to the intense localized thermal gradients and high cooling rates that cause non-uniform material expansion/contraction and mismatched strain profiles during powder-bed fusion techniques, such as direct metal laser sintering (DMLS). The residual stresses adversely affect the fatigue life of the AM parts. Moreover, if the residual stresses become higher than the material’s yield strength, they will lead to acute geometric distortion. These are limiting the applications and acceptance of AM components for safety-critical applications. Herein, we discuss laser shock peening method as an advanced technique for the manipulation of the residual stresses in AM parts. An X-ray diffraction technique is used for the measurements of the residual stresses before and after the laser shock peening process. Also, the hardness of the structures is measured using a nanoindentation technique. Maps of nanohardness and modulus are obtained from the nanoindentation, and a correlation is made between the residual stresses and the mechanical properties. The results indicate that laser shock peening is able to induce compressive residual stresses in the structure that mitigate the tensile residual stresses and increase the hardness of AM IN718, a superalloy, almost 20%. No significant changes were observed in the modulus after laser shock peening. The results strongly suggest that laser shock peening can be used as an advanced post-processing technique to optimize the service lives of critical components for various applications.

Keywords: additive manufacturing, Inconel 718, laser shock peening, residual stresses

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17174 Water Ingress into Underground Mine Voids in the Central Rand Goldfields Area, South Africa-Fluid Induced Seismicity

Authors: Artur Cichowicz

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The last active mine in the Central Rand Goldfields area (50 km x 15 km) ceased operations in 2008. This resulted in the closure of the pumping stations, which previously maintained the underground water level in the mining voids. As a direct consequence of the water being allowed to flood the mine voids, seismic activity has increased directly beneath the populated area of Johannesburg. Monitoring of seismicity in the area has been on-going for over five years using the network of 17 strong ground motion sensors. The objective of the project is to improve strategies for mine closure. The evolution of the seismicity pattern was investigated in detail. Special attention was given to seismic source parameters such as magnitude, scalar seismic moment and static stress drop. Most events are located within historical mine boundaries. The seismicity pattern shows a strong relationship between the presence of the mining void and high levels of seismicity; no seismicity migration patterns were observed outside the areas of old mining. Seven years after the pumping stopped, the evolution of the seismicity has indicated that the area is not yet in equilibrium. The level of seismicity in the area appears to not be decreasing over time since the number of strong events, with Mw magnitudes above 2, is still as high as it was when monitoring began over five years ago. The average rate of seismic deformation is 1.6x1013 Nm/year. Constant seismic deformation was not observed over the last 5 years. The deviation from the average is in the order of 6x10^13 Nm/year, which is a significant deviation. The variation of cumulative seismic moment indicates that a constant deformation rate model is not suitable. Over the most recent five year period, the total cumulative seismic moment released in the Central Rand Basin was 9.0x10^14 Nm. This is equivalent to one earthquake of magnitude 3.9. This is significantly less than what was experienced during the mining operation. Characterization of seismicity triggered by a rising water level in the area can be achieved through the estimation of source parameters. Static stress drop heavily influences ground motion amplitude, which plays an important role in risk assessments of potential seismic hazards in inhabited areas. The observed static stress drop in this study varied from 0.05 MPa to 10 MPa. It was found that large static stress drops could be associated with both small and large events. The temporal evolution of the inter-event time provides an understanding of the physical mechanisms of earthquake interaction. Changes in the characteristics of the inter-event time are produced when a stress change is applied to a group of faults in the region. Results from this study indicate that the fluid-induced source has a shorter inter-event time in comparison to a random distribution. This behaviour corresponds to a clustering of events, in which short recurrence times tend to be close to each other, forming clusters of events.

Keywords: inter-event time, fluid induced seismicity, mine closure, spectral parameters of seismic source

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17173 Local Gambling Attitudes, Corporate R&D Investment and Long-Term Financial Performance

Authors: Hong Fan, Lifang Gao, Feng Zhan

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This paper examines the influence of local gambling attitudes on a firm's long-term financial performance. Firms located in gambling-prone regions may be more willing to take risks, thus spending more on innovative projects. However, firms in such regions may also be likely to choose projects impulsively and allocate resources inefficiently. By studying Chinese publicly listed firms from 2010 to 2017, we find that firms in more gambling-prone regions invest more in R&D. Both local gambling attitudes and firms’ R&D spending are positively associated with firms’ long-term financial performance. More importantly, our study reveals that the positive impact of R&D spending on firms’ long-term financial performance is weakened by gambling-friendly attitudes, probably because firms in gambling-prone regions are more likely to overinvest in risky projects. This effect is stronger for larger firms, state-owned enterprises (SOEs), firms with more government subsidies, and firms with weaker internal control.

Keywords: regional gambling attitudes, long-term financial performance, R&D, risk, local bias

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17172 Assessing Sustainability of Bike Sharing Projects Using Envision™ Rating System

Authors: Tamar Trop

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Bike sharing systems can be important elements of smart cities as they have the potential for impact on multiple levels. These systems can add a significant alternative to other modes of mass transit in cities that are continuously looking for measures to become more livable and maintain their attractiveness for citizens, businesses and tourism. Bike-sharing began in Europe in 1965, and a viable format emerged in the mid-2000s thanks to the introduction of information technology. The rate of growth in bike-sharing schemes and fleets has been very rapid since 2008 and has probably outstripped growth in every other form of urban transport. Today, public bike-sharing systems are available on five continents, including over 700 cities, operating more than 800,000 bicycles at approximately 40,000 docking stations. Since modern bike sharing systems have become prevalent only in the last decade, the existing literature analyzing these systems and their sustainability is relatively new. The purpose of the presented study is to assess the sustainability of these newly emerging transportation systems, by using the Envision™ rating system as a methodological framework and the Israeli 'Tel -O-Fun' – bike sharing project as a case study. The assessment was conducted by project team members. Envision™ is a new guidance and rating system used to assess and improve the sustainability of all types and sizes of infrastructure projects. This tool provides a holistic framework for evaluating and rating the community, environmental, and economic benefits of infrastructure projects over the course of their life cycle. This evaluation method has 60 sustainability criteria divided into five categories: Quality of life, leadership, resource allocation, natural world, and climate and risk. 'Tel -O-Fun' project was launched in Tel Aviv-Yafo on 2011 and today provides about 1,800 bikes for rent, at 180 rental stations across the city. The system is based on a complex computer terminal that is located in the docking stations. The highest-rated sustainable features that the project scored include: (a) Improving quality of life by: offering a low cost and efficient form of public transit, improving community mobility and access, enabling the flexibility of travel within a multimodal transportation system, saving commuters time and money, enhancing public health and reducing air and noise pollution; (b) improving resource allocation by: offering inexpensive and flexible last-mile connectivity, reducing space, materials and energy consumption, reducing wear and tear on public roads, and maximizing the utility of existing infrastructure, and (c) reducing of greenhouse gas emissions from transportation. Overall, 'Tel -O-Fun' project was highly scored as an environmentally sustainable and socially equitable infrastructure. The use of this practical framework for evaluation also yielded various interesting insights on the shortcoming of the system and the characteristics of good solutions. This can contribute to the improvement of the project and may assist planners and operators of bike sharing systems to develop a sustainable, efficient and reliable transportation infrastructure within smart cities.

Keywords: bike sharing, Envision™, sustainability rating system, sustainable infrastructure

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17171 Reliability of Slender Reinforced Concrete Columns: Part 1

Authors: Metwally Abdel Aziz Ahmed, Ahmed Shaban Abdel Hay Gabr, Inas Mohamed Saleh

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The main objective of structural design is to ensure safety and functional performance requirements of a structural system for its target reliability levels. In this study, the reliability index for the reinforcement concrete slender columns with rectangular cross section is studied. The variable parameters studied include the loads, the concrete compressive strength, the steel yield strength, the dimensions of concrete cross-section, the reinforcement ratio, and the location of steel placement. Risk analysis program was used to perform the analytical study. The effect of load eccentricity on the reliability index of reinforced concrete slender column was studied and presented. The results of this study indicate that the good quality control improve the performance of slender reinforced columns through increasing the reliability index β.

Keywords: reliability, reinforced concrete, safety, slender column

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17170 Screening of Congenital Heart Diseases with Fetal Phonocardiography

Authors: F. Kovács, K. Kádár, G. Hosszú, Á. T. Balogh, T. Zsedrovits, N. Kersner, A. Nagy, Gy. Jeney

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The paper presents a novel screening method to indicate congenital heart diseases (CHD), which otherwise could remain undetected because of their low level. Therefore, not belonging to the high-risk population, the pregnancies are not subject to the regular fetal monitoring with ultrasound echocardiography. Based on the fact that CHD is a morphological defect of the heart causing turbulent blood flow, the turbulence appears as a murmur, which can be detected by fetal phonocardiography (fPCG). The proposed method applies measurements on the maternal abdomen and from the recorded sound signal a sophisticated processing determines the fetal heart murmur. The paper describes the problems and the additional advantages of the fPCG method including the possibility of measurements at home and its combination with the prescribed regular cardiotocographic (CTG) monitoring. The proposed screening process implemented on a telemedicine system provides an enhanced safety against hidden cardiac diseases.

Keywords: cardiac murmurs, fetal phonocardiography, screening of CHDs, telemedicine system

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17169 Interaction Design In Home Appliance: An Integrated Approach InKanseiAnd Hedonomic “Cases: Rice Cooker, Juicer, Mixer”

Authors: Sara Mostowfi, Hassan Sadeghinaeini, Sana Behnamasl, Leila Ensaniat, Maryam Mostafaee

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Nowadays, most of product producers, e.g. home appliance, electronic machines and vehicles focus on quality and comfort, and promise consumers ease of use and pleasurable experiences during product using. Consumers make their purchase decisions according to two needs: functional and emotional needs. Functional needs are fulfilled by product functionality, besides emotional needs are related to psychologists’ aspects of production. Emotions are distinctive elements which should be added to products and services to lead them up. In this case, the authors’ survey conducted pleasurable and hedonomic aspects in products of a home appliance company in Iran. In this regard, three samples of home appliance were selected: mixer, rice cooker, iron. Fifteen women (20-60) participated in this study. Every user evaluated each product by questionnaire based on 7 point semantic differential scale. After analyzing the results with statistical methods, results showed that 90% of users aren’t satisfied with hedonic and pleasurable criteria in interaction with these products. They notified that regarding hedonomics and pleasurable criteria’s they will have better ease of use and functionality. Our findings show a significant association between products’ features and user satisfaction. It seems that industrial design has a significant impression on the company’s products and with regard the pleasurable criteria the company sales will be more successful.

Keywords: home appliance, interaction, pleasure, hedonomy, ergonomy

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17168 Affectivity of Smoked Edible Sachet in Preventing Oxidation of Natural Condiment Stored in Ambient Temperature

Authors: Feny Mentang, Roike Iwan Montolalu, Henny Adeleida Dien, Kristhina P. Rahael, Tomy Moga, Ayub Meko, Siegfried Berhimpon

Abstract:

Smoked fish is one of the famous fish products in North Sulawesi, Indonesia. Research in producing smoked fish using smoke liquid, and the use of that product as main taste for a new “natural condiment” have been done, including a series of researches to find materials for sachet. Research aims are to determine the effectiveness of smoked edible sachets, in preventing oxidation of natural condiment, stored in ambient temperature. Two kinds of natural condiment flavors were used, i.e. smoked Skipjack flavor, and Sea Food flavor. Three variables of edible sachets were used for the natural condiments, i.e. non-sachet, edible sachet without smoke liquid, and edible sachet with smoke liquid. The natural condiments were then stored in ambient temperature, for 0, 10, 20, and 30 days. To determine the effectiveness of edible sachets in preventing oxidation, analysis of TBA, water content, and pH were conducted. The results shown that natural condiment with smoked seafood taste had TBA values higher than that of smoked Skipjack. Edible sachet gave a highly significant effect (P > 0.01) on TBA. Natural condiment in smoked edible sachet has a lower TBA than natural condiment non-sachet, and with sachet without smoke liquid. The longer storing time, the higher TBA, especially for non-sachet and with sachet without smoke liquid. There were no significant effect (P > 0.05) of edible sachet on water content and pH.

Keywords: edible sachet, smoke liquid, natural condiment, oxidation

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17167 Modification of Date Palm Leaflets Fibers Used as Thermoplastic Reinforcement

Authors: K. Almi, S.Lakel, A. Benchabane, A. Kriker

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The fiber–matrix compatibility can be improved if suitable enforcements are chosen. Whenever the reinforcements have more thermal stability, they can resist to the main processes for wood–thermoplastic composites. This paper is an investigation of effect of different treatment process on the mechanical proprieties and on the thermal stability of date palm leaflets fibers with a view to improve the date palm fiber proprieties used as reinforcement of thermoplastic materials which main processes require extrusion, hot press. To compare the effect of alkali and acid treatment on the date palm leaflets fiber properties, different treatment were used such as Sodium hydroxide NaOH solution, aluminium chloride AlCl3 and acid treatment with HCL solution. All treatments were performed at 70°C for 4h and 48 h. The mechanical performance (tensile strength and elongation) is affected by immersion time in alkaline and acid solutions. The reduction of the tensile strength and elongation of fibers at 48h was higher in acid treatment than in alkali treatment at high concentration. No significant differences were observed in mechanical and thermal proprieties of raw fibers and fibers submerged in AlCl3 at low concentration 1% for 48h. Fibers treated by NaOH at 6% for 4h showed significant increase in the mechanical proprieties and thermal stability of date palm leaflets fibers. Hence, soda treatment is necessary to improve the fibers proprieties and consequently optimize the composite performance.

Keywords: date palm fibers, surface treatments, thermoplastic composites, thermal analysis

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17166 A Refined Nonlocal Strain Gradient Theory for Assessing Scaling-Dependent Vibration Behavior of Microbeams

Authors: Xiaobai Li, Li Li, Yujin Hu, Weiming Deng, Zhe Ding

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A size-dependent Euler–Bernoulli beam model, which accounts for nonlocal stress field, strain gradient field and higher order inertia force field, is derived based on the nonlocal strain gradient theory considering velocity gradient effect. The governing equations and boundary conditions are derived both in dimensional and dimensionless form by employed the Hamilton principle. The analytical solutions based on different continuum theories are compared. The effect of higher order inertia terms is extremely significant in high frequency range. It is found that there exists an asymptotic frequency for the proposed beam model, while for the nonlocal strain gradient theory the solutions diverge. The effect of strain gradient field in thickness direction is significant in low frequencies domain and it cannot be neglected when the material strain length scale parameter is considerable with beam thickness. The influence of each of three size effect parameters on the natural frequencies are investigated. The natural frequencies increase with the increasing material strain gradient length scale parameter or decreasing velocity gradient length scale parameter and nonlocal parameter.

Keywords: Euler-Bernoulli Beams, free vibration, higher order inertia, Nonlocal Strain Gradient Theory, velocity gradient

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17165 Investing the Employees Higher Quitting Intention at the Call Centers of Pakistan: A Reality or a Myth: A Case Study of Pakistan Telecommunication Sector

Authors: Naheed Malik, Marisa Smith

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This study has been undertaken as an attempt to explore the underlying reasons that cause higher employee turnover rates at the call centers of Pakistan. This research also aimed to examine the relationship among the job related variables such as job satisfaction, organizational commitment, supervisor support, self-esteem, organizational stressors (work overload, role ambiguity and work family conflict) and quitting inclination. A total of 340 call centers respondents filled the survey questionnaire. The data was analyzed through SPSS 19.0. Results reveal the significant relationship among the study variables and stress level contributing more towards employee penchant to leave the job. A significant amount of call centers employee have proclivity to quit from their jobs as soon as they would be able to find some other jobs with attractive compensation. The majority of the respondents were found to be unhappy and dissatisfied due to hectic schedule and imbalance between family and work. This research also highlighted the specific areas in which call centre management needs to emphasize deliberately that affect more sharply on employee leaving aptitude. This study also suggests some useful strategies for the well being of employees that can minimize their tendency of quitting and retention in the long run.

Keywords: call centers, stress, job satisfaction, organizational commitment, supervisor’s support, self esteem, employee turnover, employees’ intention to quit, customer service representative (CSRs)

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17164 Unveiling the Chaura Thrust: Insights into a Blind Out-of-Sequence Thrust in Himachal Pradesh, India

Authors: Rajkumar Ghosh

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The Chaura Thrust, located in Himachal Pradesh, India, is a prominent geological feature that exhibits characteristics of an out-of-sequence thrust fault. This paper explores the geological setting of Himachal Pradesh, focusing on the Chaura Thrust's unique characteristics, its classification as an out-of-sequence thrust, and the implications of its presence in the region. The introduction provides background information on thrust faults and out-of-sequence thrusts, emphasizing their significance in understanding the tectonic history and deformation patterns of an area. It also outlines the objectives of the paper, which include examining the Chaura Thrust's geological features, discussing its classification as an out-of-sequence thrust, and assessing its implications for the region. The paper delves into the geological setting of Himachal Pradesh, describing the tectonic framework and providing insights into the formation of thrust faults in the region. Special attention is given to the Chaura Thrust, including its location, extent, and geometry, along with an overview of the associated rock formations and structural characteristics. The concept of out-of-sequence thrusts is introduced, defining their distinctive behavior and highlighting their importance in the understanding of geological processes. The Chaura Thrust is then analyzed in the context of an out-of-sequence thrust, examining the evidence and characteristics that support this classification. Factors contributing to the out-of-sequence behavior of the Chaura Thrust, such as stress interactions and fault interactions, are discussed. The geological implications and significance of the Chaura Thrust are explored, addressing its impact on the regional geology, tectonic evolution, and seismic hazard assessment. The paper also discusses the potential geological hazards associated with the Chaura Thrust and the need for effective mitigation strategies in the region. Future research directions and recommendations are provided, highlighting areas that warrant further investigation, such as detailed structural analyses, geodetic measurements, and geophysical surveys. The importance of continued research in understanding and managing geological hazards related to the Chaura Thrust is emphasized. In conclusion, the Chaura Thrust in Himachal Pradesh represents an out-of-sequence thrust fault that has significant implications for the region's geology and tectonic evolution. By studying the unique characteristics and behavior of the Chaura Thrust, researchers can gain valuable insights into the geological processes occurring in Himachal Pradesh and contribute to a better understanding and mitigation of seismic hazards in the area.

Keywords: chaura thrust, out-of-sequence thrust, himachal pradesh, geological setting, tectonic framework, rock formations, structural characteristics, stress interactions, fault interactions, geological implications, seismic hazard assessment, geological hazards, future research, mitigation strategies.

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17163 Economic Efficiency of Cassava Production in Nimba County, Liberia: An Output-Oriented Approach

Authors: Kollie B. Dogba, Willis Oluoch-Kosura, Chepchumba Chumo

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In Liberia, many of the agricultural households cultivate cassava for either sustenance purposes, or to generate farm income. Many of the concentrated cassava farmers reside in Nimba, a north-eastern County that borders two other economies: the Republics of Cote D’Ivoire and Guinea. With a high demand for cassava output and products in emerging Asian markets coupled with an objective of the Liberia agriculture policies to increase the competitiveness of valued agriculture crops; there is a need to examine the level of resource-use efficiency for many agriculture crops. However, there is a scarcity of information on the efficiency of many agriculture crops, including cassava. Hence the study applying an output-oriented method seeks to assess the economic efficiency of cassava farmers in Nimba County, Liberia. A multi-stage sampling technique was employed to generate a sample for the study. From 216 cassava farmers, data related to on-farm attributes, socio-economic and institutional factors were collected. The stochastic frontier models, using the Translog functional forms, of production and revenue, were used to determine the level of revenue efficiency and its determinants. The result showed that most of the cassava farmers are male (60%). Many of the farmers are either married, engaged or living together with a spouse (83%), with a mean household size of nine persons. Farmland is prevalently obtained by inheritance (95%), average farm size is 1.34 hectares, and most cassava farmers did not access agriculture credits (76%) and extension services (91%). The mean cassava output per hectare is 1,506.02 kg, which estimates average revenue of L$23,551.16 (Liberian dollars). Empirical results showed that the revenue efficiency of cassava farmers varies from 0.1% to 73.5%; with the mean revenue efficiency of 12.9%. This indicates that on average, there is a vast potential of 87.1% to increase the economic efficiency of cassava farmers in Nimba by improving technical and allocative efficiencies. For the significant determinants of revenue efficiency, age and group membership had negative effects on revenue efficiency of cassava production; while farming experience, access to extension, formal education, and average wage rate have positive effects. The study recommends the setting-up and incentivizing of farmer field schools for cassava farmers to primarily share their farming experiences with others and to learn robust cultivation techniques of sustainable agriculture. Also, farm managers and farmers should consider a fix wage rate in labor contracts for all stages of cassava farming.

Keywords: economic efficiency, frontier production and revenue functions, Nimba County, Liberia, output-oriented approach, revenue efficiency, sustainable agriculture

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17162 Inflammatory Markers in the Blood and Chronic Periodontitis

Authors: Saimir Heta, Ilma Robo, Nevila Alliu, Tea Meta

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Background: Plasma levels of inflammatory markers are the expression of the infectious wastes of existing periodontitis, as well as of existing inflammation everywhere in the body. Materials and Methods: The study consists of the clinical part of the measurement of inflammatory markers of 23 patients diagnosed with chronic periodontitis and the recording of parental periodontal parameters of patient periodontal status: hemorrhage index and probe values, before and 7-10 days after non-surgical periodontal treatment. Results: The level of fibrinogen drops according to the categorization of disease progression, active and passive, with the biggest % (18%-30%) at the fluctuation 10-20 mg/d. Fluctuations in fibrinogen level according to the age of patients in the range 0-10 mg/dL under 40 years and over 40 years was 13%-26%, in the range 10-20 mg/dL was 26%-22%, in the 20-40 mg/dL was 9%-4%. Conclusions: Non-surgical periodontal treatment significantly reduces the level of non-inflammatory markers in the blood. Oral health significantly reduces the potential source for periodontal bacteria, with the potential of promoting thromboembolism, through interaction between thrombocytes.

Keywords: chronic periodontitis, atherosclerosis, risk factor, inflammatory markers

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17161 The Impact of Life Satisfaction on Substance Abuse: Delinquency as a Mediator

Authors: Mahadzirah Mohamad, Morliyati Mohammad, Nor Azman Mat Ali, Zainudin Awang

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Globally, youth substance abuse has been identified as the problem that causes substantial damage not only to individuals, but also to families and communities. In addition, substance abuse youths have become unproductive resources that would play lesser roles in the nation’s development. The increasing trend of substance abuse among youths has raised a lot of concern among various quarters in Malaysia. It has also been reported that Malay youths are the majority group involved in substance abuse. However, it was noted that life satisfaction had been found to be an important mitigating factor that addressed substance abuse. The objectives of the study were twofold: firstly, to ascertain the effect of life satisfaction on substance abuse among Malay youth. Secondly, to identify the role of delinquency on the relationship between life satisfaction and substance abuse. This study adopted a cross-sectional research design. Self-administered questionnaires were distributed to 500 Malay youths at the youth programmes using a two-step sampling technique: area sampling and systematic sampling. The research hypotheses were tested using Structural Equation Modelling. The findings of the study revealed that there is no significance relationship between life satisfaction and substance abuse. There is a significant inverse relationship between life satisfaction and delinquency. Moreover, delinquency has a positive significant influence on substance abuse. The use of Bootstrapping analysis proved that delinquency plays a full mediating role in the relationship between life satisfaction and substance abuse. This study suggested that life satisfaction has no effect on youth substance abuse. In order to reduce substance abuse, efforts should be undertaken to reduce delinquency behaviour by increasing youth life satisfaction.

Keywords: delinquency, life satisfaction, substance abuse, youth

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17160 Investigation of the Possible Correlation of Earthquakes with a Red Tide Occurrence in the Persian Gulf and Oman Sea

Authors: Hadis Hosseinzadehnaseri

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The red tide is a kind of algae blooming, caused different problems at different sizes for the human life and the environment, so it has become one of the serious global concerns in the field of Oceanography in few recent decades. This phenomenon has affected on Iran's water, especially the Persian Gulf's since last few years. Collecting data associated with this phenomenon and comparison in different parts of the world is significant as a practical way to study this phenomenon and controlling it. Effective factors to occur this phenomenon lead to the increase of the required nutrients of the algae or provide a good environment for blooming. In this study, we examined the probability of relation between the earthquake and the harmful algae blooming in the Persian Gulf's water through comparing the earthquake data and the recorded Red tides. On the one hand, earthquakes can cause changes in seawater temperature that is effective in creating a suitable environment and the other hand, it increases the possibility of water nutrients, and its transportation in the seabed, so it can play a principal role in the development of red tide occurrence. Comparing the distribution spatial-temporal maps of the earthquakes and deadly red tides in the Persian Gulf and Oman Sea, confirms the hypothesis, why there is a meaningful relation between these two distributions. Comparing the number of earthquakes around the world as well as the number of the red tides in many parts of the world indicates the correlation between these two issues. This subject due to numerous earthquakes, especially in recent years and in the southern part of the country should be considered as a warning to the possibility of re-occurrence of a critical state of red tide in a large scale, why in the year 2008, the number of recorded earthquakes have been more than near years. In this year, the distribution value of the red tide phenomenon in the Persian Gulf got measured about 140,000 square kilometers and entire Oman Sea, with 10 months Survival in the area, which is considered as a record among the occurred algae blooming in the world. In this paper, we could obtain a logical and reasonable relation between the earthquake frequency and this phenomenon occurrence, through compilation of statistics relating to the earthquakes in the southern Iran, from 2000 to the end of the first half of 2013 and also collecting statistics on the occurrence of red tide in the region as well as examination of similar data in different parts of the world. As shown in Figure 1, according to a survey conducted on the earthquake data, the most earthquakes in the southern Iran ranks first in the fourth Gregorian calendar month In April, coincided with Ordibehesht and Khordad in Persian calendar and then in the tenth Gregorian calendar month In October, coincided in Aban and Azar in Persian calendar.

Keywords: red tide, earth quake, persian gulf, harmful algae bloom

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17159 Allelopathic Effect of Foliar Extracts of Leucaena leucocephala on Germination and Growth Behavior of Zea mays L.

Authors: Guru Prasad Satsangi, Shiv Shankar Gautam

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Allelopathy is a potential area of research for sustainable agriculture. It is environmentally safe, can conserve the available resources, and also may mitigate the problems raised by synthetic chemicals. The allelo-chemicals are secondary metabolites produced by plants, which are the byproducts of the primary metabolic process. These allelo-chemicals may be stimulatory, inhibitory, or may have no effect on the growth of the other plants. It has been observed in the present study that foliar extracts of Leucaena leucocephala showed an inhibitory effect on the germination of the test crop maize. The results revealed that at different concentrations of Leucaena leucocephala foliar extract, caused a significant inhibition in germination and growth behavior of Zea mays L. seedlings. Minimum germination and growth occurred in 100 % concentration, and an increase in extract concentrations result in a decrease in the germination. Bioassay also depicted that this inhibitory effect was proportional to the concentration of the extract as the higher concentration having a lesser stimulatory effect or vice versa. The phytochemical analysis of the secondary metabolites from foliar extracts of Leucaena leucocephala L. showed the presence of tannins, saponins, phenols, alkaloids, and flavanoids. Among various extracts, the presence of methanol extract was found in a significant amount of phytochemicals, followed by the aqueous and ethanol extracts. Leaves showed a significantly higher amount of the allelochemicals.

Keywords: allelopathic effect, germination /growth behavior , foliar extracts, Leucaena leucceophala , Zea mays L.

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17158 Family Cohesion, Interpersonal Difficulties and Mental Health Problems in University Students

Authors: Narmeen Ali, Muhammad Arshad

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Cohesion has an exact association with family functioning and enmeshment (togetherness) on one side and disengagement (separateness) on the other. Family cohesion can apprehend as a concerned association that family members have with each other and an affirmation of association inside the family. Family cohesion, assigned as the level of congruity or sympathetic or emotional attachment that relatives have toward each other, and it was seen to be associated with relational well-being and feeling of comfort in the young generation. The cross-sectional research design was used by the researcher to answer the research questions. A stratified sampling technique was used to collect the data from the participants. The data was collected equally from the males and females of different universities and different departments of Lahore, Pakistan. A self-report questionnaire was developed of given literature and which were found to be associated with family cohesion, interpersonal difficulties and mental health problems of university students. The demographic information included age, gender, university’s name, class, family system, parent’s education, parent’s profession, number of siblings and birth order. Correlation shows the negative relation between balanced cohesion and interpersonal difficulties, while interpersonal difficulties have a highly positive relationship with mental health problems. Mental health problems also have a negative correlation with the balanced family cohesion. Gender, family system, depression and anxiety are the significant predictors of interpersonal difficulties scale in university students. And gender showed a significant difference regarding family cohesion and interpersonal difficulty scale, as women reported more interpersonal difficulties than men.

Keywords: family cohesion, interpersonal difficulties, mental health problems, university students

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17157 Improving the Quality of Discussion and Documentation of Advance Care Directives in a Community-Based Resident Primary Care Clinic

Authors: Jason Ceavers, Travis Thompson, Juan Torres, Ramanakumar Anam, Alan Wong, Andrei Carvalho, Shane Quo, Shawn Alonso, Moises Cintron, Ricardo C. Carrero, German Lopez, Vamsi Garimella, German Giese

Abstract:

Introduction: Advance directives (AD) are essential for patients to communicate their wishes when they are not able to. Ideally, these discussions should not occur for the first time when a patient is hospitalized with an acute life-threatening illness. There is a large number of patients who do not have clearly documented ADs, resulting in the misutilization of resources and additional patient harm. This is a nationwide issue, and the Joint Commission has it as one of its national quality metrics. Presented here is a proposed protocol to increase the number of documented AD discussions in a community-based, internal medicine residency primary care clinic in South Florida. Methods: The SMART Aim for this quality improvement project is to increase documentation of AD discussions in the outpatient setting by 25% within three months in medicare patients. A survey was sent to stakeholders (clinic attendings, residents, medical assistants, front desk staff, and clinic managers), asking them for three factors they believed contributed most to the low documentation rate of AD discussions. The two most important factors were time constraints and systems issues (such as lack of a standard method to document ADs and ADs not being uploaded to the chart) which were brought up by 25% and 21.2% of the 32 survey responders, respectively. Pre-intervention data from clinic patients in 2020-2021 revealed 17.05% of patients had clear, actionable ADs documented. To address these issues, an AD pocket card was created to give to patients. One side of the card has a brief explanation of what ADs are. The other side has a column of interventions (cardiopulmonary resuscitation, mechanical ventilation, dialysis, tracheostomy, feeding tube) with boxes patients check off if they want the intervention done, do not want the intervention, do not want to discuss the topic, or need more information. These cards are to be filled out and scanned into their electronic chart to be reviewed by the resident before their appointment. The interventions that patients want more information on will be discussed by the provider. If any changes are made, the card will be re-scanned into their chart. After three months, we will chart review the patients seen in the clinic to determine how many medicare patients have a pocket card uploaded and how many have advance directives discussions documented in a progress note or annual wellness note. If there is not enough time for an AD discussion, a follow-up appointment can be scheduled for that discussion. Discussion: ADs are a crucial part of patient care, and failure to understand a patient’s wishes leads to improper utilization of resources, avoidable litigation, and patient harm. Time constraints and systems issues were identified as two major factors contributing to the lack of advance directive discussion in our community-based resident primary care clinic. Our project aims at increasing the documentation rate for ADs through a simple pocket card intervention. These are self-explanatory, easy to read and allow the patients to clearly express what interventions they desire or what they want to discuss further with their physician.

Keywords: advance directives, community-based, pocket card, primary care clinic

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