Search results for: healthcare costs

Authors: Shiming Li, Qingwang Liu, Honggan Wu, Jianbing Zhang

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Plantation forests are useful for timber production, recreation, environmental protection and social development. Stands height is an important parameter for the estimation of forest volume and carbon stocks. Although lidar is suitable technology for the vertical parameters extraction of forests, but high costs make it not suitable for operational inventory. With the development of computer vision and photogrammetry, aerial photos from unmanned aerial system can be used as an alternative solution for height mapping. Structure-from-motion (SfM) photogrammetry technique can be used to extract DSM and DEM information. Canopy height model (CHM) can be achieved by subtraction DEM from DSM. Our result shows that overlapping aerial photos is a potential solution for plantation forests height mapping.

Keywords: forest height mapping, plantation forests, structure-from-motion photogrammetry, UAS

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Authors: Jaroslav Masek, Juraj Camaj, Eva Nedeliakova

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The aim of optimization of store management is not only designing the situation of store management itself including its equipment, technology and operation. In optimization of store management we need to consider also synchronizing of technological, transport, store and service operations throughout the whole process of logistic chain in such a way that a natural flow of material from provider to consumer will be achieved the shortest possible way, in the shortest possible time in requested quality and quantity and with minimum costs. The paper deals with the application of the queuing theory for optimization of warehouse processes. The first part refers to common information about the problematic of warehousing and using mathematical methods for logistics chains optimization. The second part refers to preparing a model of a warehouse within queuing theory. The conclusion of the paper includes two examples of using queuing theory in praxis.

Keywords: queuing theory, logistics system, mathematical methods, warehouse optimization

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Authors: Ingrid Snustad, Asmund Ervik, Anders Austegard, Amy Brunsvold, Jianying He, Zhiliang Zhang

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CO₂ capture, transport and storage (CCS) is essential to mitigate global anthropogenic CO₂ emissions. To make CCS a widely implemented technology in, e.g. the power sector, the reduction of costs is crucial. For a large cost reduction, every part of the CCS chain must contribute. By increasing the heat transfer efficiency during liquefaction of CO₂, which is a necessary step, e.g. ship transportation, the costs associated with the process are reduced. Heat transfer rates during dropwise condensation are up to one order of magnitude higher than during filmwise condensation. Dropwise condensation usually occurs on a non-wetting surface (Superlyophobic surface). The vapour condenses in discrete droplets, and the non-wetting nature of the surface reduces the adhesion forces and results in shedding of condensed droplets. This, again, results in fresh nucleation sites for further droplet condensation, effectively increasing the liquefaction efficiency. In addition, the droplets in themselves have a smaller heat transfer resistance than a liquid film, resulting in increased heat transfer rates from vapour to solid. Surface tension is a crucial parameter for dropwise condensation, due to its impact on the solid-liquid contact angle. A low surface tension usually results in a low contact angle, and again to spreading of the condensed liquid on the surface. CO₂ has very low surface tension compared to water. However, at relevant temperatures and pressures for CO₂ condensation, the surface tension is comparable to organic compounds such as pentane, a dropwise condensation of CO₂ is a completely new field of research. Therefore, knowledge of several important parameters such as contact angle and drop size distribution must be gained in order to understand the nature of the condensation. A new setup has been built to measure these relevant parameters. The main parts of the experimental setup is a pressure chamber in which the condensation occurs, and a high- speed camera. The process of CO₂ condensation is visually monitored, and one can determine the contact angle, contact angle hysteresis and hence, the surface adhesion of the liquid. CO₂ condensation on different surfaces can be analysed, e.g. copper, aluminium and stainless steel. The experimental setup is built for accurate measurements of the temperature difference between the surface and the condensing vapour and accurate pressure measurements in the vapour. The temperature will be measured directly underneath the condensing surface. The next step of the project will be to fabricate nanostructured surfaces for inducing superlyophobicity. Roughness is a key feature to achieve contact angles above 150° (limit for superlyophobicity) and controlled, and periodical roughness on the nanoscale is beneficial. Surfaces that are non- wetting towards organic non-polar liquids are candidates surface structures for dropwise condensation of CO₂.

Keywords: CCS, dropwise condensation, low surface tension liquid, superlyophobic surfaces

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Authors: Raja Omman Zafar, Yves Rybarczyk, Johan Borg

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This article proposes a conceptual framework for the application of digital twin technology in home care. The main goal is to bridge the gap between advanced digital twin concepts and their practical implementation in home care. This study uses a literature review and thematic analysis approach to synthesize existing knowledge and proposes a structured framework suitable for homecare applications. The proposed framework integrates key components such as IoT sensors, data-driven models, cloud computing, and user interface design, highlighting the importance of personalized and predictive homecare solutions. This framework can significantly improve the efficiency, accuracy, and reliability of homecare services. It paves the way for the implementation of digital twins in home care, promoting real-time monitoring, early intervention, and better outcomes.

Keywords: digital twin, homecare, older adults, healthcare, IoT, artificial intelligence

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Authors: Pawan Hinge, Priya Gupta

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Due to cutting edge competitions between organizations and war for talent, the workforce as an asset is gaining significance. The employees are considered as the brand ambassadors of an organization, and their interactions with the clients and customers might impact directly or indirectly on the overall value of the organization. Especially, organizations in the healthcare industry the value of an organization in the perception of their employees can be one of the revenue generating and talent retention strategy. In such context, it is essential to understand that the brand awareness among employees can effect on employer brand image and brand value since the brand ambassadors are the interface between organization and customers and clients. In this exploratory study, we have adopted both quantitative and qualitative approaches for data analysis. Our study shows existing variation among nurses working in different business units of the same organization in terms of their customer interface or interactions and brand awareness.

Keywords: brand awareness, brand image, brand value, customer interface

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Authors: Danylo Brindak, Viktor Liashko, Olexander Chepurniy

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Despite considerable experience in implementation of the best international approaches and services within response to epidemy of multi-drug resistant tuberculosis, the results of situation analysis indicate the presence of faults in this area. In 2014, Ukraine (for the first time) was included in the world’s five countries with the highest level of drug-resistant tuberculosis. The effectiveness of its treatment constitutes only 35% in the country. In this context, the increase in allocation of funds to control the epidemic of multidrug-resistant tuberculosis does not produce perceptible positive results. During 2001-2016, only the Global Fund to fight AIDS, Tuberculosis, and Malaria allocated to Ukraine more than USD 521,3 million for programs of tuberculosis and HIV/AIDS control. However, current conditions in post-Semashko system create little motivation for rational use of resources or cost control at inpatient TB facilities. There is no motivation to reduce overdue hospitalization and to target resources to priority sectors of modern tuberculosis control, including a model of care focused on the patient. In the presence of a line-item budget at medical institutions, based on the input factors as the ratios of beds and staff, there is a passive disposal of budgetary funds by health care institutions and their employees who have no motivation to improve quality and efficiency of service provision. Outpatient treatment of tuberculosis is being implemented in Ukraine since 2011 and has many risks, namely creation of parallel systems, low consistency through dependence on funding for the project, reduced the role of the family doctor, the fragmentation of financing, etc. In terms of reforming approaches to health system financing, which began in Ukraine in late 2016, NGO Infection Control in Ukraine conducted piloting of a new, motivating method of remuneration of employees in primary health care. The innovative aspect of this funding mechanism is cost according to results of treatment. The existing method of payment on the basis of the standard per inhabitant (per capita ratio) was added with motivating costs according to results of work. The effectiveness of such treatment of TB patients at the outpatient stage is 90%, while in whole on the basis of a current system the effectiveness of treatment of newly diagnosed pulmonary TB with positive swab is around 60% in the country. Even though Ukraine has 5.24 TB beds per 10 000 citizens. Implemented pilot model of ambulatory treatment will be used for the creation of costs system according to results of activities, the integration of TB and primary health and social services and their focus on achieving results, the reduction of inpatient treatment of tuberculosis.

Keywords: health care reform, multi-drug resistant tuberculosis, outpatient treatment efficiency, tuberculosis

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Authors: Asad Abbas, Muhammad Fezan Afzal, Muhammad Latif Anjum, Muhammad Azmat

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The Internet of Things (IoT) is used to link up real objects that use the internet to interact. IoT applications allow handling and operating the equipment in accordance with environmental needs, such as transportation and healthcare. IoT devices are linked together via a number of agents that act as a middleman for communications. The operation of a heat sensor differs indoors and outside because agent applications work with environmental variables. In this article, we suggest using Software Product Line (SPL) to model IoT agents and applications' features on an XML-based basis. The contextual diversity within the same domain of application can be handled, and the reusability of features is increased by XML-based feature modelling. For the purpose of managing contextual variability, we have embraced XML for modelling IoT applications, agents, and internet-connected devices.

Keywords: IoT agents, IoT applications, software product line, feature model, XML

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Authors: Maha Atout, Pippa Hemingway, Jane Seymour

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A preliminary systematic review shows that health professionals experience a tension when communicating with the parents and family members of children with life-threatening and life-limiting conditions. On the one hand, they want to promote open and honest communication, while on the other, they are apprehensive about fostering an unrealistic sense of hope. Defining the boundaries between information that might offer reasonable hope versus that which results in false reassurance is challenging. Some healthcare providers worry that instilling a false sense of hope could motivate parents to seek continued aggressive treatment for their child, which in turn might cause the patient further unnecessary suffering. To date, there has been a lack of research in the Middle East regarding how healthcare providers do or should communicate bad news; in particular, the issue of hope in the field of paediatric palliative care has not been researched thoroughly. This study aims to explore, from the perspective of patients’ mothers, physicians, and nurses, the experience of communicating and receiving bad news in the care of children with palliative care needs. Data were collected using a collective qualitative case study approach across three paediatric units in a Jordanian hospital. Two data collection methods were employed: participant observation and semi-structured interviews. The overall number of cases was 15, with a total of 56 interviews with mothers (n=24), physicians (n=12), and nurses (n=20) completed, as well as 197 observational hours logged. The findings demonstrate that mothers wanted their doctors to provide them with hopeful information about the future progression of their child’s illness. Although some mothers asked their doctors to provide them with honest information regarding the condition of their child, they still considered a sense of hope to be essential for coping with caring for their child. According to mothers, hope was critical to treatment as it helped them to stay committed to the treatment and protected them to some extent from the extreme emotional suffering that would occur if they lost hope. The health professionals agreed with the mothers on the importance of hope, so long as it was congruent with the stage and severity of each patient’s disease. The findings of this study conclude that while parents typically insist on knowing all relevant information when their child is diagnosed with a severe illness, they considered hope to be an essential part of life, and they found it very difficult to handle suffering without any glimmer of it. This study finds that using negative terms has extremely adverse effects on the parents’ emotions. Hence, although the mothers asked the doctors to be as honest as they could, they still wanted the physicians to provide them with a positive message by communicating this information in a sensitive manner including hope.

Keywords: health professionals, children, communication, hope, information, mothers, palliative care

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Authors: Oscar Vega Camacho, Andrea Vargas Guevara, Ellery Rowina Ariza

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This paper presents the application of finite dynamic programming, specifically the "Markov Chain" model, as part of the decision making process of a company in the cosmetics sector located in the vicinity of Bogota DC. The objective of this process was to decide whether the company should completely reconstruct its wastewater treatment plant or instead optimize the plant through the addition of equipment. The goal of both of these options was to make the required improvements in order to comply with parameters established by national legislation regarding the treatment of waste before it is released into the environment. This technique will allow the company to select the best option and implement a solution for the processing of waste to minimize environmental damage and the acquisition and implementation costs.

Keywords: decision making, Markov chain, optimization, wastewater

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Authors: L. Ramirez, E. Guillén, J. Sánchez

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Some of the main goals about telecare such as monitoring, treatment, telediagnostic are deployed with the integration of applications with specific appliances. In order to achieve a coherent model to integrate software, hardware, and healthcare systems, different telehealth models with Internet of Things (IoT), cloud computing, artificial intelligence, etc. have been implemented, and their advantages are still under analysis. In this paper, we propose an integrated model based on IoT architecture and cloud computing telehealth center. Analytics module is presented as a solution to control an ideal diagnostic about some diseases. Specific features are then compared with the recently deployed conventional models in telemedicine. The main advantage of this model is the availability of controlling the security and privacy about patient information and the optimization on processing and acquiring clinical parameters according to technical characteristics.

Keywords: analytics, telemedicine, internet of things, cloud computing

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Authors: Mandayachepa C. Nyando, Lauren Suchman, Innocencia Mtalimanja, Address Malata, Tamanda Jumbe, Martha Kamanga, Peter Waiswa

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Background: Subcutaneous depot medroxyprogesterone acetate (DMPA-SC) is a new innovation in contraceptive methods that allow users to inject themselves with a hormonal contraceptive in their own homes. Self-injection (SI) of DMPA-SC has the potential to improve the accessibility of family planning to women who want it and who are capable of injecting themselves. Malawi started implementing this new innovation in 2018. SI was incorporated into the DMPA-SC delivery strategy from its outset. Methodology: This study involved two districts in Malawi where DMPA-SC SI was rolled out: Mulanje and Ntchisi. We used a qualitative cross-sectional study design where 60 in-depth interviews were conducted with women of reproductive age group stratified as 15-45 age band. These included women who were SI users, non-users, and any woman who was on any contraceptive methods. The women participants were tape-recorded, and data were transcribed and then analysed using Dedoose software, where themes were categorised into mother and child themes. Results: Women perceived DMPA SC SI as uniquely private, convenient, and less painful when self-injected. In terms of privacy, women in Mulanje and Ntchisi especially appreciated that self-injecting allowed them to use covertly from partners. Some men do not allow their spouses to use modern contraceptive methods; hence women prefer to use them covertly. “… but I first reach out to men because the strongest power is answered by men (MJ015).” In addition, women reported that SI offers privacy from family/community and less contact with healthcare providers. These aspects of privacy were especially valued in areas where there is a high degree of mistrust around family planning and among those who feel judged or antagonized purchasing contraception, such as young unmarried women. Women also valued the convenience SI provided in terms of their ability to save time by injecting themselves at home rather than visiting a healthcare provider and having more reliable access to contraception, particularly in the face of stockouts. SI allows for stocking up on doses to accommodate shifting work schedules in case of future stockouts or hard times, such as the period of COVID-19, where there was a limitation in the movement of the people. Conclusion: Our findings suggest that SI may meet the needs of many women in Malawi as long as the barriers are eliminated. The barriers women mentioned include fear of self-inject and proper storage of the DMPA SC SI, and these barriers can be eliminated by proper training. The findings also set the scene for policy revision and direction at a national level and integrate the approach with national family planning strategies in Malawi. Findings provide insights that may guide future implementation strategies, strengthen non-clinic family planning access programs and stimulate continued research.

Keywords: family planning, Malawi, Sayana press, self-injection

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Authors: Mwafak Shakoor

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The purpose of this study was to reduce patient waiting times, improve system throughput and improve resources utilization in radiology department. A discrete event simulation model was developed using Arena simulation software to investigate different alternatives to improve the overall system delivery based on adding resource scenarios due to the linkage between patient waiting times and resource availability. The study revealed that there is no addition investment need to procure additional scanner but hospital management deploy managerial tactics to enhance machine utilization and reduce the long waiting time in the department.

Keywords: discrete event simulation, radiology department, arena, waiting time, healthcare modeling, computed tomography

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Authors: Louise Ödlund, Danica Djuric Ilic

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Sustainable development includes many challenges related to energy use, such as (1) developing flexibility on the demand side of the electricity systems due to an increased share of intermittent electricity sources (e.g., wind and solar power), (2) overcoming economic challenges related to an increased share of renewable energy in the transport sector, (3) increasing efficiency of the biomass use, (4) increasing utilization of industrial excess heat (e.g., approximately two thirds of the energy currently used in EU is lost in the form of excess and waste heat). The European Commission has been recognized DH technology as of essential importance to reach sustainability. Flexibility in the fuel mix, and possibilities of industrial waste heat utilization, combined heat, and power (CHP) production and energy recovery through waste incineration, are only some of the benefits which characterize DH technology. The aim of this study is to provide an overview of the possible business strategies which would enable DH to have an important role in future sustainable energy systems. The methodology used in this study is a systematic literature review. The study includes a systematic approach where DH is seen as a part of an integrated system that consists of transport , industrial-, and electricity sectors as well. The DH technology can play a decisive role in overcoming the sustainability challenges related to our energy use. The introduction of biofuels in the transport sector can be facilitated by integrating biofuel and DH production in local DH systems. This would enable the development of local biofuel supply chains and reduce biofuel production costs. In this way, DH can also promote the development of biofuel production technologies that are not yet developed. Converting energy for running the industrial processes from fossil fuels and electricity to DH (above all biomass and waste-based DH) and delivering excess heat from industrial processes to the local DH systems would make the industry less dependent on fossil fuels and fossil fuel-based electricity, as well as the increasing energy efficiency of the industrial sector and reduce production costs. The electricity sector would also benefit from these measures. Reducing the electricity use in the industry sector while at the same time increasing the CHP production in the local DH systems would (1) replace fossil-based electricity production with electricity in biomass- or waste-fueled CHP plants and reduce the capacity requirements from the national electricity grid (i.e., it would reduce the pressure on the bottlenecks in the grid). Furthermore, by operating their central controlled heat pumps and CHP plants depending on the intermittent electricity production variation, the DH companies may enable an increased share of intermittent electricity production in the national electricity grid.

Keywords: energy system, district heating, sustainable business strategies, sustainable development

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Authors: Halil Ibrahim Demir, Alper Goksu, Onur Canpolat, Caner Erden, Melek Nur

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Traditionally process planning, scheduling and due date assignment are performed sequentially and separately. High interrelation between these functions makes integration very useful. Although there are numerous works on integrated process planning and scheduling and many works on scheduling with due date assignment, there are only a few works on the integration of these three functions. Here we tested the different integration levels of these three functions and found a fully integrated version as the best. We applied genetic search and random search and genetic search was found better compared to the random search. We penalized all earliness, tardiness and due date related costs. Since all these three terms are all undesired, it is better to penalize all of them.

Keywords: process planning, scheduling, due-date assignment, genetic algorithm, random search

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Authors: Saheed A. Gbadegeshin

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Commercialization method is a means to make inventions available at the market for final consumption. It is described as an important tool for keeping business enterprises sustainable and improving national economic growth. Thus, there are several scholarly publications on it, either presenting or testing different methods for commercialization. However, young entrepreneurs, technologists and scientists would like to know the best method to commercialize their innovations. Then, this question arises: What is the best commercialization method? To answer the question, a systematic literature review was conducted, and practitioners were interviewed. The literary results revealed that there are many methods but new methods are needed to improve commercialization especially during these times of economic crisis and political uncertainty. Similarly, the empirical results showed there are several methods, but the best method is the one that reduces costs, reduces the risks associated with uncertainty, and improves customer participation and acceptability. Therefore, it was concluded that new commercialization method is essential for today's high technologies and a method was presented.

Keywords: commercialization method, technology, knowledge, intellectual property, innovation, invention

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Authors: Francis Gyapong, Denis Yar

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The use of cell phones has become an indispensable tool in the hospital's settings. Cell phones are used in hospitals without restrictions regardless of their unknown microbial load. However, the indiscriminate use of mobile devices, especially at health facilities, can act as a vehicle for transmitting pathogenic bacteria and other microorganisms. These potential pathogens become exogenous sources of infection for the patients and are also a potential health hazard for self and as well as family members. These are a growing problem in many health care institutions. Innovations in mobile communication have led to better patient care in diabetes, asthma, and increased in vaccine uptake via SMS. Notwithstanding, the use of cell phones can be a great potential source for nosocomial infections. Many studies reported heavy microbial contamination of cell phones among healthcare workers and communities. However, limited studies have been reported in our region on bacterial contamination on cell phones among healthcare workers. This study assessed microbial contamination of cell phones of health care workers (HCWs) at the Mampong Municipal Government Hospital (MMGH), Ghana. A cross-sectional design was used to characterize bacterial microflora on cell phones of HCWs at the MMGH. A total of thirty-five (35) swab samples of cell phones of HCWs at the Laboratory, Dental Unit, Children’s Ward, Theater and Male ward were randomly collected for laboratory examinations. A suspension of the swab samples was each streak on blood and MacConkey agar and incubated at 37℃ for 48 hours. Bacterial isolates were identified using appropriate laboratory and biochemical tests. Kirby-Bauer disc diffusion method was used to determine the antimicrobial sensitivity tests of the isolates. Data analysis was performed using SPSS version 16. All mobile phones sampled were contaminated with one or more bacterial isolates. Cell phones from the Male ward, Dental Unit, Laboratory, Theatre and Children’s ward had at least three different bacterial isolates; 85.7%, 71.4%, 57.1% and 28.6% for both Theater and Children’s ward respectively. Bacterial contaminants identified were Staphylococcus epidermidis (37%), Staphylococcus aureus (26%), E. coli (20%), Bacillus spp. (11%) and Klebsiella spp. (6 %). Except for the Children ward, E. coli was isolated at all study sites and predominant (42.9%) at the Dental Unit while Klebsiella spp. (28.6%) was only isolated at the Children’s ward. Antibiotic sensitivity testing of Staphylococcus aureus indicated that they were highly sensitive to cephalexin (89%) tetracycline (80%), gentamycin (75%), lincomycin (70%), ciprofloxacin (67%) and highly resistant to ampicillin (75%). Some of these bacteria isolated are potential pathogens and their presence on cell phones of HCWs could be transmitted to patients and their families. Hence strict hand washing before and after every contact with patient and phone be enforced to reduce the risk of nosocomial infections.

Keywords: mobile phones, bacterial contamination, patients, MMGH

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Authors: Emil Mathew

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Liberalisation policies adopted by a large number of countries, implementation of technological innovations with development in communication networks and continuous reduction in transport costs contributed towards the growth of international transportation of goods over the last 50 to 60 years. The present paper examines the environmental externalities of maritime transportation, that is, externalities associated with the movement of cargoes, as distinct from those emanate from production and consumption of goods. Though shipping is less polluting compared to other modes of transportation, considering the huge volume of goods transported and future growth prospects, it is important to examine environmental externalities of maritime transportation. It focuses on varied types of environmental externalities of maritime transportation and suggests that appropriate policies may be adopted by international agencies to address this issue without adversely affecting the course of international trade and also its possibility to get diverted to alternate modes of transportation.

Keywords: externalities of globalisation, maritime environment, maritime externality, transportation externality

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Authors: Sina Dehghani, Zhikang Rong

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Historically, a variety of approaches have been taken to forecast commodity prices due to the significant implications of these values on the global economy. An accurate forecasting tool for a valuable commodity would significantly benefit investors and governmental agencies. Silver, in particular, has grown significantly as a commodity in recent years due to its use in healthcare and technology. This manuscript aims to utilize the Geometric Brownian Motion predictive model to forecast silver commodity prices over multiple 3-year periods. The results of the study indicate that the model has several limitations, particularly its inability to work effectively over longer periods of time, but still was extremely effective over shorter time frames. This study sets a baseline for silver commodity forecasting with GBM, and the model could be further strengthened with refinement.

Keywords: geometric Brownian motion, commodity, risk management, volatility, stochastic behavior, price forecasting

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Authors: Sagar Hedaoo, Fazle Baki, Ahmed Azab

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In supply chain management, network design for scalable manufacturing facilities is an emerging field of research. Facility location allocation assigns facilities to customers to optimize the overall cost of the supply chain. To further optimize the costs, capacities of these facilities can be changed in accordance with customer demands. A mathematical model is formulated to fully express the problem at hand and to solve small-to-mid range instances. A dedicated constraint has been developed to restrict emissions in line with the Kyoto protocol. This problem is NP-Hard; hence, a simulated annealing metaheuristic has been developed to solve larger instances. A case study on the USA-Canada cross border crossing is used.

Keywords: emission, mixed integer linear programming, metaheuristic, simulated annealing

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Authors: Tunjo Perič, Marin Fatović

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In this paper a new methodology for vendor selection and supply quotas determination (VSSQD) is proposed. The problem of VSSQD is solved by the model that combines revised weighting method for determining the objective function coefficients, and a multiple objective linear programming (MOLP) method based on the cooperative game theory for VSSQD. The criteria used for VSSQD are: (1) purchase costs and (2) product quality supplied by individual vendors. The proposed methodology is tested on the example of flour purchase for a bakery with two decision makers.

Keywords: cooperative game theory, multiple objective linear programming, revised weighting method, vendor selection

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Authors: Robert L. Fine, Zhiyong Yang, Christy Spivey, Bonnie Boardman, Maureen Courtney

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Importance: Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Reengineering ACP by using a web-based, consumer-driven process has recently been suggested. We report early experience with such a process. Objective: Begin to analyze the potential of the creation and use of ACP/ADs as generated by a consumer-friendly, digital process by 1) assessing the likelihood that consumers would create ACP/ADs without structured intervention by medical or legal professionals, and 2) analyzing the responses to determine if the plans can help doctors better understand a person’s goals, preferences, and priorities for their medical treatments and the naming of healthcare agents. Design: The authors chose 900 users of MyDirectives.com, a digital ACP/AD tool, solely based on their state of residence in order to achieve proportional representation of all 50 states by population size and then reviewed their responses, summarizing these through descriptive statistics including treatment preferences, demographics, and revision of preferences. Setting: General United States population. Participants: The 900 participants had an average age of 50.8 years (SD = 16.6); 84.3% of the men and 91% of the women were in self-reported good health when signing their ADs. Main measures: Preferences regarding the use of life-sustaining treatments, where to spend final days, consulting a supportive and palliative care team, attempted cardiopulmonary resuscitation (CPR), autopsy, and organ and tissue donation. Results: Nearly 85% of respondents prefer cessation of life-sustaining treatments during their final days whenever those may be, 76% prefer to spend their final days at home or in a hospice facility, and 94% wanted their future doctors to consult a supportive and palliative care team. 70% would accept attempted CPR in certain limited circumstances. Most respondents would want an autopsy under certain conditions, and 62% would like to donate their organs. Conclusions and relevance: Analysis of early experience with an all-digital web-based ACP/AD platform demonstrates that individuals from a wide range of ages and conditions can engage in an interrogatory process about values, goals, preferences, and priorities for their medical treatments by developing advance directives and easily make changes to the AD created. Online creation, storage, and retrieval of advance directives has the potential to remove barriers to ACP/AD and, thus, to further improve patient-centered end-of-life care.

Keywords: Advance Care Plan, Advance Decisions, Advance Directives, Consumer; Digital, End of Life Care, Goals, Living Wills, Prefences, Universal Advance Directive, Statements

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Authors: Jakub Stelina, Janina Ciechanowicz-McLean

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Fifty years of existence and development of international environmental law brought a deep disappointment with efficiency and effectiveness of traditional command and control mechanisms of environmental regulation. Agenda 21 agreed during the first Earth Summit in Rio de Janeiro 1992 was one of the first international documents, which explicitly underlined the importance of public participation in environmental protection. This participation includes also the initiatives undertaken by business corporations in the form of private environmental standards setting. Twenty years later during the Rio 20+ Earth Summit the private sector obligations undertaken during the negotiations have proven to be at least as important as the ones undertaken by the governments. The private sector has taken the leading role in environmental standard setting. Among the research methods used in the article two are crucial in the analysis. The comparative analysis of law is the instrument used in the article to analyse the practice of states and private business companies in the field of sustainable development. The article uses economic analysis of law to estimate the costs and benefits of Corporate Social Responsibility Projects in the field of environmental protection. The study is based on the four premises. First is the role of social dialogue, which is crucial for both Corporate Social Responsibility and modern environmental protection regulation. The Aarhus Convention creates a procedural environmental human right to participate in administrative procedures of law setting and environmental decisions making. The public participation in environmental impact assessment is nowadays a universal standard. Second argument is about the role of precaution as a principle of modern environmental regulation. This principle can be observed both in governmental regulatory undertakings and also private initiatives within the Corporate Social Responsibility environmental projects. Even in the jurisdictions which are relatively reluctant to use the principle of preventive action in environmental regulation, the companies often use this standard in their own private business standard setting initiatives. This is often due to the fact that soft law standards are used as the basis for private Corporate Social Responsibility regulatory initiatives. Third premise is about the role of ecological education in environmental protection. Many soft law instruments underline the importance of environmental education. Governments use environmental education only to the limited extent due to the costs of such projects and problems with effects assessment. Corporate Social Responsibility uses various means of ecological education as the basis of their actions in the field of environmental protection. Last but not least Sustainable development is a goal of both legal protection of the environment, and economic instruments of companies development. Modern environmental protection law uses to the increasing extent the Corporate Social Responsibility. This may be the consequence of the limits of hard law regulation. Corporate Social Responsibility is nowadays not only adapting to soft law regulation of environmental protection but also creates such standards by itself, showing new direction for development of international environmental law. Corporate Social Responsibility in environmental protection can be good investment in future development of the company.

Keywords: corporate social responsibility, environmental CSR, environmental justice, stakeholders dialogue

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Authors: Luis Javier Serrano Tamayo

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This research on technology makes a first approach to the selection of an amphibious landing ship with strategic capabilities, through the implementation of a multi-criteria model using Analytical Hierarchical Process (AHP), in which a significant group of alternatives of latest technology has been considered. The variables were grouped at different levels to match design and performance characteristics, which affect the lifecycle as well as the acquisition, maintenance and operational costs. The model yielded an overall measure of effectiveness and an overall measure of cost of each kind of ship that was compared each other inside the model and showed in a Pareto chart. The modeling was developed using the Expert Choice software, based on AHP method.

Keywords: analytic hierarchy process, multi-criteria decision-making, Pareto analysis, Colombian Marine Corps, projection operations, expert choice, amphibious landing ship

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Authors: Christian Lauter, Corin Reuter, Shuang Wu, Thomas Troester

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Lightweight construction became more and more important over the last decades in several applications, e.g. in the automotive or aircraft sector. This is the result of economic and ecological constraints on the one hand and increasing safety and comfort requirements on the other hand. In the field of lightweight design, different approaches are used due to specific requirements towards the technical systems. The use of endless carbon fiber reinforced plastics (CFRP) offers the largest weight saving potential of sometimes more than 50% compared to conventional metal-constructions. However, there are very limited industrial applications because of the cost-intensive manufacturing of the fibers and production technologies. Other disadvantages of pure CFRP-structures affect the quality control or the damage resistance. One approach to meet these challenges is hybrid materials. This means CFRP and sheet metal are combined on a material level. Therefore, new opportunities for innovative process routes are realizable. Hybrid lightweight design results in lower costs due to an optimized material utilization and the possibility to integrate the structures in already existing production processes of automobile manufacturers. In recent and current research, the advantages of two-layered hybrid materials have been pointed out, i.e. the possibility to realize structures with tailored mechanical properties or to divide the curing cycle of the epoxy resin into two steps. Current research work at the Chair for Automotive Lightweight Design (LiA) at the Paderborn University focusses on production processes for fiber-metal-laminates. The aim of this work is the development and qualification of a large-scale production process for high-performance fiber-metal-laminates (FML) for industrial applications in the automotive or aircraft sector. Therefore, the prepreg-press-technology is used, in which pre-impregnated carbon fibers and sheet metals are formed and cured in a closed, heated mold. The investigations focus e.g. on the realization of short process chains and cycle times, on the reduction of time-consuming manual process steps, and the reduction of material costs. This paper gives an overview over the considerable steps of the production process in the beginning. Afterwards experimental results are discussed. This part concentrates on the influence of different process parameters on the mechanical properties, the laminate quality and the identification of process limits. Concluding the advantages of this technology compared to conventional FML-production-processes and other lightweight design approaches are carried out.

Keywords: composite material, fiber-metal-laminate, lightweight construction, prepreg-press-technology, large-series production

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Authors: Okunola Oluseye Ademola

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The study investigated various socio-cultural factors influencing adherence to antiretroviral drugs among people living with HIV in a University Teaching Hospital in South-western Nigeria. The objectives are to examine the perception of people living with HIV/AIDS (PLWHA) of antiretroviral therapy (ART) in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, investigate the influence of socio-cultural factors on adherence of PLWHA to treatment regimen in the study area and assess the prevalence of adherence to ART among PLWHA in the study area. It was a cross-sectional where both qualitative and quantitative research methods were adopted. The participants were HIV diagnosed patients attending clinic at the Obafemi Awolowo University Teaching Hospitals Complex in Ile-Ife between the ages of 18 and 60 years. Also three healthcare delivery personnel working in the clinic were interviewed. Out of the 3007 patients receiving treatment, using Fischer’s formula of sampling technique, 336 patients living with HIV/AIDS were selected for the study. These participants had been on antiretroviral drugs for more than six months prior to the study and were selected using simple random sampling technique. Two focus group discussion sessions comprising of 10 male and 10 female living with HIV and currently on ART were conducted. These groups were purposively selected based on their being on ART for more than one year. Also in-depth interviews were conducted among three purposively selected healthcare givers (an experienced nurse, a doctor and a pharmacist) who are working in this clinic. All the participants were interviewed at the clinic on the various clinic days. Data were collected using a structured questionnaire, an interview guide and tape-recorder. The quantitative data were analysed using descriptive and inferential statistics. Content analysis was employed to analyse responses from IDI and FGD sessions. The findings from the study revealed a very positive perception to ART among PLWHA which was about 86.3% while the level of adherence to ART was 89.0% among the respondents. There was a very strong relationship between social and family supports and the degree of adherence to ART in the PLWHA. Nutrition, polygamy, difficulty in financing transportation fare to the clinic, unemployment, drug hawkers, religion, excuse duty from work and waking up very early were highlighted as socio-cultural barriers to adherence to ART. Fear of death, strong family support, religion belief, not seeking alternative treatment, absence of rituals and perceived improved health status were identified as very strong facilitators to adherence. The study concluded that to achieve a very optimal outcome in the management of HIV among PLWHA, various social and cultural contexts should be taken into consideration as this study was able to ascertain the influence of various socio-cultural factors militating and facilitating adherence to ART.

Keywords: ART, HIV, PLWHA, socio-cultural

Procedia PDF Downloads 278

Authors: A.N. Zhilkaidarov, G.K. Iskakova, V.Y. Chernyh

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High-qualified and not-expensive products of daily usage have a big demand on food products’ market. Moreover, it is about independent and irreplaceable product as pasta. Pasta is a product, which represents itself the conserved dough from wheat flour made through special milling process. A wide assortment of the product and its pleasant taste properties allow to use pasta products in very different combinations with other food products. Pasta industry of Kazakhstan has large perspectives of development. There are many premises for it, which includes first an importance of pasta as a social product. Due to for its nutritional and energetically value pasta is the part of must have food. Besides that, the pasta production in Kazakhstan has traditional bases, and nowadays the market of this product develops rapidly as in quantity as well as in quality aspects. Moreover, one of the advantages of this branch is an economical aspect – pasta is the product of secondary processing, and therefore price for sailing is much higher as its own costs.

Keywords: pasta, new wheat sorts, domesic sorts of wheat, macaronic flour

Procedia PDF Downloads 527

Authors: Bashir Abdu Muzakkari, Aisha Umar Sulaiman, Mohamed Afendee Muhamad, Sanah Abdullahi Muaz

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The field of the Internet of Things (IoT) is rapidly expanding and has the potential to completely change how we work, live, and interact with the world. The Internet of Things (IoT) is the term used to describe a network of networked physical objects, including machinery, vehicles, and buildings, which are equipped with electronics, software, sensors, and network connectivity. This review paper aims to provide a comprehensive overview of the current state of IoT, including its definition, key components, development history, and current applications. The paper will also discuss the challenges and opportunities presented by IoT, as well as its potential impact on various industries, such as healthcare, agriculture, and transportation. In addition, this paper will highlight the ethical and security concerns associated with IoT and the need for effective solutions to address these challenges. The paper concludes by highlighting the prospects of IoT and the directions for future research in this field.

Keywords: internet of things, IoT, sensors, network

Procedia PDF Downloads 176

Authors: Dilek Bilgiç

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Configuration Management (CM) is a discipline assuring the consistency between product information the reality all along the product lifecycle. Although the extensive benefits of this discipline, such as the direct impact on increasing return on investment, reducing lifecycle costs, are realized by most organizations. It is worth evaluating that CM functions might be successfully implemented in some organized anarchies. This paper investigates how to manage ambiguity in CM processes as an opportunity within an environment that has different types of complexities and choice arenas. It is not explained how to establish a configuration management organization in a company; more specifically, it is analyzed how to apply configuration management processes when different types of streams exist. From planning to audit, all the CM functions may provide different organization learning opportunities when those applied with the right leadership methods.

Keywords: configuration management, leadership, organizational analysis, organized anarchy, cm process, organizational learning, organizational maturity, configuration status accounting, leading innovation, change management

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Authors: Dirk Briskorn, Michael Dienstknecht

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Cranes are a key element in construction projects as they are the primary lifting equipment and among the most expensive construction equipment. Thus, selecting cranes and locating them on-site is an important factor for a project's profitability. We focus on a site with supply and demand areas that have to be connected by tower cranes. There are several types of tower cranes differing in certain specifications such as costs or operating radius. The objective is to select cranes and determine their locations such that each demand area is connected to its supply area at minimum cost. We detail the problem setting and show how to obtain a discrete set of candidate locations for each crane type without losing optimality. This discretization allows us to reduce our problem to the classic set cover problem. Despite its NP-hardness, we achieve good results employing a standard solver and a greedy heuristic, respectively.

Keywords: positioning, selection, standard solver, tower cranes

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Authors: M. S. Annie Christi

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Transportation Problem (TP) is based on supply and demand of commodities transported from one source to the different destinations. Usual methods for finding solution of TPs are North-West Corner Rule, Least Cost Method Vogel’s Approximation Method etc. The transportation costs tend to vary at each time. We can use fuzzy numbers which would give solution according to this situation. In this study the Best Candidate Method (BCM) is applied. For ranking Centroid Ranking Technique (CRT) and Robust Ranking Technique have been adopted to transform the fuzzy TP and the above methods are applied to EDWARDS Vacuum Company, Crawley, in West Sussex in the United Kingdom. A Comparative study is also given. We see that the transportation cost can be minimized by the application of CRT under BCM.

Keywords: best candidate method, centroid ranking technique, fuzzy transportation problem, robust ranking technique, transportation problem

Procedia PDF Downloads 296