Search results for: health service access

Authors: Bailey Houghtaling, Elena Serrano, Vivica Kraak, Samantha Harden, George Davis, Sarah Misyak

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United States (U.S.) Department of Agriculture Supplemental Nutrition Assistance Program (SNAP) participants are low-income Americans receiving federal dollars for supplemental food and beverage purchases. Participants use a variety of (traditional/non-traditional) SNAP-authorized stores for household dietary purchases - also representing food access points for all Americans. Importantly consumers' food and beverage purchases from non-traditional store formats tend to be higher in saturated fats, added sugars, and sodium when compared to purchases from traditional (e.g., grocery/supermarket) formats. Overconsumption of energy-dense and low-nutrient food and beverage products contribute to high obesity rates and adverse health outcomes that differ in severity among urban/rural U.S. locations and high/low-income populations. Little is known about the SNAP-authorized food store format landscape nationally, regionally, or by urban-rural status, as traditional formats are currently used as the gold standard in food access research. This research utilized publicly available U.S. databases to fill this large literature gap and to provide insight into modes of food access for vulnerable U.S. populations: (1) SNAP Retailer Locator which provides a list of all authorized food stores in the U.S., and; (2) Rural-Urban Continuum Codes (RUCC) that categorize U.S. counties as urban (RUCC 1-3) or rural (RUCC 4-9). Frequencies were determined for the highest occurring food store formats nationally and within two regionally diverse U.S. states – Virginia in the east and California in the west. Store format codes were assigned (e.g., grocery, drug, convenience, mass merchandiser, supercenter, dollar, club, or other). RUCC was applied to investigate state-level differences in urbanity-rurality regarding prevalent food store formats and Chi Square test of independence was used to determine if food store format distributions significantly (p < 0.05) differed by region or rurality. The resulting research sample that represented highly prevalent SNAP-authorized food stores nationally included 41.25% of all SNAP stores in the U.S. (N=257,839), comprised primarily of convenience formats (31.94%) followed by dollar (25.58%), drug (19.24%), traditional (10.87%), supercenter (6.85%), mass merchandiser (1.62%), non-food store or restaurant (1.81%), and club formats (1.09%). Results also indicated that the distribution of prevalent SNAP-authorized formats significantly differed by state. California had a lower proportion of traditional (9.96%) and a higher proportion of drug (28.92%) formats than Virginia- 11.55% and 19.97%, respectively (p < 0.001). Virginia also had a higher proportion of dollar formats (26.11%) when compared to California (10.64%) (p < 0.001). Significant differences were also observed for rurality variables (p < 0.001). Prominently, rural Virginia had a significantly higher proportion of dollar formats (41.71%) when compared to urban Virginia (21.78%) and rural California (21.21%). Non-traditional SNAP-authorized formats are highly prevalent and significantly differ in distribution by U.S. region and rurality. The largest proportional difference was observed for dollar formats where the least nutritious consumer purchases are documented in the literature. Researchers/practitioners should investigate non-traditional food stores at the local level using these research findings and similar applied methodologies to determine how access to various store formats impact obesity prevalence. For example, dollar stores may be prime targets for interventions to enhance nutritious consumer purchases in rural Virginia while targeting drug formats in California may be more appropriate.

Keywords: food access, food store format, nutrition interventions, SNAP consumers

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Authors: Hashim Ali, Sheheryar Khan

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Security for applications is always been a keen issue of concern. In general, security is to allow access of grant to legal user or to deny non-authorized access to the system. Shoulder surfing is an observation technique to hack an account or to enter into a system. When a malicious observer is capturing or recording the fingers of a user while he is entering sensitive inputs (PIN, Passwords etc.) and may be able to observe user’s password credential. It is very rigorous for a novice user to prevent himself from shoulder surfing or unaided observer in a public place while accessing his account. In order to secure the user account, there are five factors of authentication; they are: “(i) something you have, (ii) something you are, (iii) something you know, (iv) somebody you know, (v) something you process”. A technique has been developed of fifth-factor authentication “something you process” to provide novel approach to the user. In this paper, we have applied position based operational code authentication in such a way to more easy and user friendly to the user.

Keywords: shoulder surfing, malicious observer, sensitive inputs, authentication

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Authors: Sherif K. El Dyasti, Esam A. Hagras, Adel E. El-Hennawy

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This paper addresses the performance of antenna array beam-forming on Chip-Interleaved Code Division Multiple Access (CI_CDMA) system based on Minimum Mean Square Error (MMSE) detector in aeronautical mobile radio channel. Multipath fading, Doppler shifts caused by the speed of the aircraft, and Multiple Access Interference (MAI) are the most important reasons that affect and reduce the performance of aeronautical system. In this paper, we suggested the CI-CDMA with antenna array to combat this fading and improve the bit error rate (BER) performance. We further evaluate the performance of the proposed system in the four standard scenarios in aeronautical mobile radio channel.

Keywords: aeronautical channel, CI-CDMA, beamforming, communication, information

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Authors: Kristen Emory, Jerry Flores

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Purpose: We explore the unique and underrepresented experiences of Indigenous women living in Toronto, Canada, during the first year of the COVID-19 pandemic. The purpose of this study is to better document the impacts of COVID-19 on the mental health and well-being of Indigenous women in Toronto, Canada, in order to better understand unmet needs, as well as lay the groundwork for more targeted research and potential interventions based on these needs. Background: It has been fairly well documented that the COVID-19 pandemic has increased mental health concerns among various populations globally. There have also been numerous studies indicating increases in substance use and abuse in response to the stress of the pandemic. There is also evidence that the COVID-19 pandemic has disproportionately impacted a variety of historically marginalized populations in Canada, the US, and globally, including Indigenous populations. While these studies provide some insight into how the COVID-19 pandemic is impacting the global population, much less is known about the lived experiences of Indigenous populations during the time of COVID-19. Better understanding these experiences will allow public health professionals, governments, and non-governmental organizations better combat health inequities related to the pandemic. Methods: In-depth qualitative semi-structured virtual (due to COVID-19) interviews with 13 Indigenous women were conducted during the first year of the COVID-19 pandemic (2020). Interviews were recorded, transcribed, and analyzed by team members using Dedoose qualitative analysis software. Findings: COVID-19 negatively affected Indigenous females identifying participants’ mental health and corresponding reported increases in substance use. In addition to the daily stress of the unpredictability of life in the time of the COVID-19 pandemic, participants cited job loss, economic concerns, homeschooling, and lack of access to medical resources as primary factors in increasing their stress and decreasing mental health and wellbeing. In response to these stressors, a majority of participants cited coping mechanisms such as increased substance use to help deal with the uncertainty. In particular, alcohol and tobacco emerged as coping mechanisms to help participants cope with stress related to the pandemic (as well as its social and economic toll on respondents' lives). We will present qualitative data to be presented, including participant direct quotes, explaining their experiences with COVID-19, mental health, and increased substance use, as well as analysis and synthesis with the existing scientific evidence base. Conclusion: This research is among the good studies to our knowledge that scientifically explore the impact of COVID-19 on mental health and well-being and corresponding increases in reported substance use.

Keywords: mental health, covid-19, indigenous, inequity, anxiety, depression, stress

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Authors: Liwen Wang, Yuting Chen, Tong Wu, Shaolei Hu

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In order to enhance the security of critical financial infrastructure, this study carries out a transformation of the architecture of a financial trading terminal to a zero trust architecture (ZTA), constructs an active defense system for cybersecurity, improves the security level of trading services in the Internet environment, enhances the ability to prevent network attacks and unknown risks, and reduces the industry and security risks brought about by cybersecurity risks. This study introduces the SDP technology of ZTA, adapts and applies it to a financial trading terminal to achieve security optimization and fine-grained business grading control. The upgraded architecture of the trading terminal moves security protection forward to the user access layer, replaces VPN to optimize remote access, and significantly improves the security protection capability of Internet transactions. The study achieves 1. deep integration with the access control architecture of the transaction system; 2. no impact on the performance of terminals and gateways, and no perception of application system upgrades; 3. customized checklist and policy configuration; 4. introduction of industry-leading security technology such as single-packet authorization (SPA) and secondary authentication. This study carries out a successful application of ZTA in the field of financial trading and provides transformation ideas for other similar systems while improving the security level of financial transaction services in the Internet environment.

Keywords: zero trust, trading terminal, architecture, network security, cybersecurity

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Authors: Jang-hyun Oh, Kyoung-ho Choi, Jea-sun Lee

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The outbreak of the COVID-19 pandemic brought reconsiderations and doubts about urban density as compact cities became epidemic hot spots. Density, though, provides an upside in that medical services required to protect citizens against the spread of disease are concentrated within compact cities, which helps reduce the mortality rate. Sociodemographic characteristics are also a crucial factor in determining the vulnerability of the population, and the purpose of this study is to empirically discover how these three urban factors affect the severity of the epidemic impacts. The study aimed to investigate the influential relationships between urban factors and epidemic impacts and provide answers to whether superb medical service in compact cities can scale down the impacts of COVID-19. SEM (Structural Equation Modeling) was applied as a suitable research method for verifying interrelationships between factors based on theoretical grounds. The study accounted for 144 municipalities in South Korea during periods from the first emergence of COVID-19 to December 31st, 2022. The study collected data related to infection and mortality cases from each municipality, and it holds significance as primary research that enlightens the aspects of epidemic impact concerning urban settings and investigates for the first time the mediated effects of medical service. The result of the evaluation shows that compact cities are most likely to have lower sociodemographic vulnerability and better quality of medical service, while cities with low density contain a higher portion of vulnerable populations and poorer medical services. However, the quality of medical service had no significant influence in reducing neither the infection rate nor the mortality rate. Instead, density acted as the major influencing factor in the infection rate, while sociodemographic vulnerability was the major determinant of the mortality rate. Thus, the findings strongly paraphrase that compact cities, although with high infection rates, tend to have lower mortality rates due to less vulnerability in sociodemographics, Whereas death was more frequent in less dense cities due to higher portions of vulnerable populations such as the elderly and low-income classes. Findings suggest an important lesson for post-pandemic urban planning-intrinsic characteristics of urban settings, such as density and population, must be taken into account to effectively counteract future epidemics and minimize the severity of their impacts. Moreover, the study is expected to contribute as a primary reference material for follow-up studies that further investigate related subjects, including urban medical services during the pandemic.

Keywords: urban planning, sociodemographic vulnerability, medical service, COVID-19, pandemic

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Authors: Liang Zhao, Guangwen Wang, Guichang Liu

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Constant potometer is an important component of pipeline anti-corrosion systems in the chemical industry. Based on Internet of Things (IoT) technology, Programmable Logic Controller (PLC) technology and database technology, this paper developed a set of a constant potometer remote monitoring management system. The remote monitoring and remote adjustment of the working status of the constant potometer are realized. The system has real-time data display, historical data query, alarm push management, user permission management, and supporting Web access and mobile client application (APP) access. The actual engineering project test results show the stability of the system, which can be widely used in cathodic protection systems.

Keywords: internet of things, pipe corrosion protection, potentiostat, remote monitoring

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Authors: Hrishikesh Purandare, Ashwini Pethe

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Research from developed countries has demonstrated that the built environment can have a significant effect on children’s cognitive and socio-emotional development. A majority of the studies on the relationship between the built environment and the well-being of children have been conducted in North America and Western Europe, though most of the world’s children live in the global South. Millions of children living in urban slums in India confront issues associated with poor living conditions and lack of access to basic services. It is a well-known fact that slums are places of extreme poverty, substandard housing, overcrowding, and poor sanitation. These challenges faced by children living in slums can have a significant impact on their physical, psychological, and social development. Despite the magnitude of the problem, the area of research, particularly on the impact of the built environment of slums on children and adolescent well-being, has been understudied in India. Only a few studies in the global South have investigated the impact of the built environment on children’s well-being. Apart from issues of the limited access to health and education of these children, the perception of children regarding the built environment which they inhabit is rarely addressed. A sample of 120 children living in the slums of Pune city between the ages 7 and 16 participated in this study, which employed a concurrent embedded approach of mixed method research. Questionnaires were administered to obtain quantitative data that included attributes of crowding, noise, privacy, territoriality and housing quality in the built environment. The qualitative analysis of children’s sketches highlighted aspects of the built environment with which they associated themselves the most. The study sought to examine the perception of the deprived children living in the urban slums in the city of Pune (India) towards their built environment.

Keywords: physical environment, poverty, underprivileged children, urban Indian slums

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Authors: Bahareh Arghand

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The establishment of rules and regulations for more effective energy-environment interactions are essential to achieving sustainable development. Sustainable development requires mechanisms that can promote compliance in energy-environment conventions. There are many binding agreements and non-binding instruments at regional and international levels on energy and the environment. These conventions try to decrease conflicts of interest between energy, environment and economic by legal principles and practical mechanisms. The major core of conventions is their implementations because the poor implementation and enforcement power affect their success. In this regard, the main goal of this study is proposing the effective implementation mechanisms. Energy service companies' (ESCOs) activities can improve energy efficiency and decrease the environmental degradations. Therefore, it can be proposed and assessed the merit mechanism of ESCO performance as a facilitator to implement energy-environment conventions. An assessment of ESCO performance, including its potentials, problems, and limitations, as a facilitator for effective implementation of the energy-environment convention, is included. This study is oriented towards effective development and application of laws and the function of ESCOs as appropriate economic instruments and facilitator for implementation of energy-environment conventions. The resulting system of close cooperation between the energy-environment conventions and ESCOs is geared toward advancing environmental protection and economic factors by the transfer of environmentally-sound technologies that meet sustainable development objectives.

Keywords: energy-environment conventions, energy service company, facilitator mechanism, sustainable development

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Authors: Ernestina Ohenewaah Denchie, Kevin Lo

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Access to clean water is a key element of sustainable development, yet many nations cannot provide reliable water supply to their inhabitants, particularly in rural areas. In Ghana, public smart taps with pre-paid tokens for public standpipe management have been introduced to enhance access to clean water in small towns and rural communities. This research article highlights the impact of pre-paid token systems on water accessibility in small towns and rural Ghana, focusing on their alignment with Sustainable Development Goal 6. We utilize the Technology Acceptance Model (TAM) with data obtained from both quantitative and qualitative responses to demonstrate the user’s acceptance and overall effectiveness of the pre-paid token system in improving access to clean water. We find that among the characteristics of the pre-paid token system, convenience of use, user satisfaction, proximity and accessibility impact smart tap usage positively. Further analyses reveal that providing token loading points at vantage points within communities would improve smart tap usage by about 96%. Finally, our thematic analyses reveal that the problems of the smart tap system can be improved through regular maintenance and technical support, system improvement such as developing an online app for credit loading, restoring lost or unused credits, and better tracking of lost tokens.

Keywords: smart tap, pre-paid, technology acceptance model, water supply

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Authors: Wen Li, Zhengyu Bai, Qi Zhang

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The demand for smart scheduling platform in agriculture, particularly in the scheduling process of machinery equipment, is high. With the continuous development of agricultural machinery equipment technology, a large number of agricultural machinery equipment and agricultural machinery cooperative service organizations continue to appear in China. The large area of cultivated land and a large number of agricultural activities in the central and western regions of China have made the demand for smart and efficient agricultural machinery equipment scheduling platforms more intense. In this study, we design and implement a platform for agricultural machinery equipment scheduling to allocate agricultural machinery equipment resources reasonably. With agricultural machinery equipment scheduling platform taken as the research object, we discuss its research significance and value, use the service blueprint technology to analyze and characterize the agricultural machinery equipment schedule workflow, the network analytic method to obtain the demand platform function requirements, and divide the platform functions through the platform function division diagram. Simultaneously, based on the case-based reasoning (CBR) algorithm, the equipment scheduling module of the agricultural machinery equipment scheduling platform is realized; finally, a design scheme of the agricultural machinery equipment scheduling platform architecture is provided, and the visualization interface of the platform is established via VB programming language. It provides design ideas and theoretical support for the construction of a modern agricultural equipment information scheduling platform.

Keywords: case-based reasoning, service blueprint, system design, ANP, VB programming language

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Authors: Jennifer Zelmer

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The debate regarding the morality, and therefore legality, of abortion has many social, political, and medical ramifications worldwide. In a developing country like Bolivia, carrying a pregnancy to delivery is incredibly risky. Given the very high maternal mortality rate in Bolivia, greater consideration has been given to the (de)criminalization of abortion – a contributing cause of maternal death. In the spring of 2017, the Bolivian government proposed to loosen restrictions on women’s access to receiving a safe abortion, which was met with harsh criticism from 'pro-vida' (pro-life) factions. Although the current Bolivian government Movimiento al Socialismo (Movement Toward Socialism) portrays an agenda of decolonization, or to seek a 'traditionally-modern' society, nevertheless, Bolivia still has one of the highest maternal mortality rates in the Americas, because of centuries of colonial and patriarchal order. Applying a feminist critique and using the abortion debate as the central point, this paper argues that the 'traditionally-modern' society Bolivia strives towards is a paradox, and in fact only contributes to the reciprocal process of the death of 'mother tongues' and the unnecessary death of women. This claim is supported by a critical analysis of historical texts about Spanish Colonialism in Bolivia; the linguistic reality of reproductive educational strategies, and the philosophical framework which the Bolivian government and its citizens implement. This analysis is demonstrated in the current state of women’s access to reproductive healthcare in Cochabamba, Bolivia based on recent fieldwork which included audits of clinics and hospitals, interviews, and participant observation. This paper has two major findings: 1) the language used by opponents of abortion in Bolivia is not consistent with the claim of being 'pro-life' but more accurately with being 'pro-potential'; 2) when the topic of reproductive health appears in Cochabamba, Bolivia, it is often found written in the Spanish language, and does not cater to the many indigenous communities that inhabit or visit this city. Finally, this paper considers the crucial role of public health documentation to better inform the abortion debate, as well as the necessity of expanding reproductive health information to more than text-based materials in Cochabamba. This may include more culturally appropriate messages and mediums that cater to the oral tradition of the indigenous communities, who historically and currently have some of the highest fertility rates. If the objective of one who opposes abortion is to save human lives, then preventing the death of women should equally be of paramount importance. But rather, the 'pro-life' movement in Bolivia is willing to risk the lives of to-be mothers, by judicial punishment or death, for the chance of a potential baby. Until abortion is fully legal, safe, and accessible, there will always be the vestiges of colonial and patriarchal order in Bolivia which only perpetuates the needless death of women.

Keywords: abortion, feminist theory, Quechua, reproductive health education

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Authors: Lazlo Fauth, Andreas Ligocki

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For cost-effective use of harvesters, expensive repairs and unplanned downtimes must be reduced as far as possible. The predictive detection of failing systems and the calculation of intelligent service intervals, necessary to avoid these factors, require in-depth knowledge of the machines' behavior. Such know-how needs permanent monitoring of the machine state from different technical perspectives. In this paper, three approaches will be presented as they are currently pursued in the publicly funded project PreForst at Ostfalia University of Applied Sciences. These include the intelligent linking of workshop and service data, sensors on the harvester, and a special online hydraulic oil condition monitoring system. Furthermore the paper shows potentials as well as challenges for the use of these data in the conception of a predictive maintenance system.

Keywords: predictive maintenance, condition monitoring, forest harvesting, forest engineering, oil data, hydraulic data

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Authors: Kailas Bhandarkar, Talib Dar, Laura Karia, Manasvi Upadhyaya

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Introduction: Frenotomy for tongue tie is commonly performed in breastfed infants who experience difficulty in latching after failed conservative management for tongue tie. However, there is no consensus for the routine use of massage following frenotomy. Our aim was to assess the efficacy of massage in preventing recurrence following frenotomy. Methods: The tongue tie service in our tertiary referral hospital consists of 5 consultants and a breastfeeding (BF) midwife. 3 consultants routinely advice massage post procedure. Babies are assessed by the midwife after the procedure and a follow-up consultation after a week. After due ethical approval, data were collected by two staff members who were independent of TT service on a standardized questionnaire to avoid bias. Fischer exact test was employed (p < 0.05 considered significant). Results: Six hundred and thirty-two babies attended the clinic from January 2018 to December 2018. Thirty-three of these were excluded as the procedure was not needed. Parents were contacted at a median of six months post-procedure (range 2-10 months). 282/599 were advised massage. 92/282 could be contacted. 40/ 92 adhered to massage regimen. None of these had a recurrence. 52/92 (54%), although advised, did not perform massage. Reasons cited for lack of adherence to massage included difficulty in performing massaging and conflicting advice given by other health care professionals involved in patient care like paediatricians and group practice and lack of information on the internet). Overall, 4/599 (0.66%) had recurrences, and this difference was not statistically significant. Conclusion: In our experience, the rate of recurrence after frenotomy is low enough for us to conclude that there is no significant benefit of massage after frenotomy for tongue tie. We could also conclude that among parents who were advised massage more than half failed to adhere to the advice.

Keywords: tongue tie, frenotomy, massage, recurrence

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Authors: Manfred F. Maute, Olga Naumenko, Raymond T. Kong

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Using data from a nationally representative financial panel of Canadian households, this study develops a psychographic segmentation of the customers of a value-expressive credit card service and tests for effects on relational response differences. The variety of segments elicited by agglomerative and k means clustering and the familiar profiles of individual clusters suggest that the face validity of the psychographic segmentation was quite high. Segmentation had a significant effect on customer satisfaction and relationship depth. However, when socio-demographic characteristics like household size and income were accounted for in the psychographic segmentation, the effect on relational response differences was magnified threefold. Implications for the segmentation of financial services markets are considered.

Keywords: customer satisfaction, financial services, psychographics, response differences, segmentation

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Authors: N. Y. H. Konagano

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Riverside population of Brazilian amazon suffers drinking water scarcity, seeking alternative water resources such as well and rivers, ordinary polluted. Although Amazon Region holds high annual river inflow and enough available of underground water, human activities have compromised the conservation of water resources. In addition, decentralized rural households make difficult to access of potable water. Main objective is to analyze quantitatively the potential of rainwater harvesting to human consumption at Marupaúba community, located in northeast of Amazon region, Brazil. Methods such as historical rainfall data series of municipality of Tomé-Açu at Pará state were obtained from Hydrological Information System of National Water Agency (ANA). Besides, Rippl method was used to calculate, mainly, volume of the reservoir based on difference of water demand and volume available through rainwater using as references two houses (CA I and CA II) as model of rainwater catchment and supply. Results presented that, from years 1984 to 2017, average annual precipitation was 2.607 mm, average maximum precipitation peak was 474 mm on March and average minimum peak on September was 44 mm. All months, of a year, surplus volume of water have presented in relation to demand, considering catchment area (CA) I = 134.4m² and demand volume =0.72 m³/month; and, CA II = 81.84 m² and demand volume = 0.48 m³/month. Based on results, it is concluded that it is feasible to use rainwater for the supply of the rural community Marupaúba, since the access of drinking water is a human right and the lack of this resource compromises health and daily life of human beings.

Keywords: Amazon Region, rainwater harvesting, rainwater resource, rural community

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Authors: S. Girish, N. Ajay

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Permeation properties have been widely used to quantify durability characteristics of concrete for assessing long term performance and sustainability. The processes of deterioration in concrete are mediated largely by water. There is a strong interest in finding a better way of assessing the material properties of concrete in terms of durability. Water sorptivity is a useful single material property which can be one of the measures of durability useful in service life planning and prediction, especially in severe environmental conditions. This paper presents the results of the comparative study of sorptivity of Self-Compacting Concrete (SCC) with conventionally vibrated concrete. SCC is a new, special type of concrete mixture, characterized by high resistance to segregation that can flow through intricate geometrical configuration in the presence of reinforcement, under its own mass, without vibration and compaction. SCC mixes were developed for the paste contents of 0.38, 0.41 and 0.43 with fly ash as the filler for different cement contents ranging from 300 to 450 kg/m3. The study shows better performance by SCC in terms of capillary absorption. The sorptivity value decreased as the volume of paste increased. The use of higher paste content in SCC can make the concrete robust with better densification of the micro-structure, improving the durability and making the concrete more sustainable with improved long term performance. The sorptivity based on secondary absorption can be effectively used as a durability index to predict the time duration required for the ingress of water to penetrate the concrete, which has practical significance.

Keywords: self-compacting concrete, service life prediction, sorptivity, volume of paste

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Authors: R. Malisa, E. Schwella, K. I. Theletsane

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Due to climate change, population growth and rapid urbanization, the demand for water in South Africa is inevitably surpassing supply. To address similar challenges globally, there has been a paradigm shift from conventional urban waste water management “government” to a “governance” paradigm. From the governance paradigm, Integrated Urban Water Management (IUWM) principle emerged. This principle emphasizes efficient urban waste water treatment and production of high-quality recyclable effluent. In so doing mimicking natural water systems, in their processes of recycling water efficiently, and averting depletion of natural water resources.  The objective of this study was to investigate drivers of shifting the current urban waste water management approach from a “government” paradigm towards “governance”. The study was conducted through Interactive Management soft systems research methodology which follows a qualitative research design. A case study methodology was employed, guided by realism research philosophy. Qualitative data gathered were analyzed through interpretative structural modelling using Concept Star for Professionals Decision-Making tools (CSPDM) version 3.64.  The constructed model deduced that the main drivers in shifting the Stellenbosch municipal urban waste water management towards IUWM “governance” principles are mainly social elements characterized by overambitious expectations of the public on municipal water service delivery, mis-interpretation of the constitution on access to adequate clean water and sanitation as a human right and perceptions on recycling water by different communities. Inadequate public participation also emerged as a strong driver. However, disruptive events such as draught may play a positive role in raising an awareness on the value of water, resulting in a shift on the perceptions on recycled water. Once the social elements are addressed, the alignment of governance and administration elements towards IUWM are achievable. Hence, the point of departure for the desired paradigm shift is the change of water service authorities and serviced communities’ perceptions and behaviors towards shifting urban waste water management approaches from “government” to “governance” paradigm.

Keywords: integrated urban water management, urban water system, wastewater governance, wastewater treatment works

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Authors: N. Al Khashan, H. Al Shammari, W. Al Bahli

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Patients who are eligible to receive treatment at the National Guard Health Affairs (NGHA), Saudi Arabia will typically have four medical record numbers (MRN), one in each of the geographical areas. More hospitals and primary healthcare facilities in other geographical areas will launch soon which means more MRNs. When patients own four MRNs, this will cause major drawbacks in patients’ quality of care such as creating new medical files in different regions for relocated patients and using referral system among regions. Consequently, the access to a patient’s medical record from other regions and the interoperability of health information between the four hospitals’ information system would be challenging. Thus, there is a need to unify medical records among these five facilities. As part of the effort to increase the quality of care, a new Hospital Information Systems (HIS) was implemented in all NGHA facilities by the end of 2016. NGHA’s plan is put to be aligned with the Saudi Arabian national transformation program 2020; whereby 70% citizens and residents of Saudi Arabia would have a unified medical record number that enables transactions between multiple Electronic Medical Records (EMRs) vendors. The aim of the study is to explore the plan, the challenges and barriers of unifying the 4 MRNs into one Enterprise Patient Identifier (EPI) in NGHA hospitals by December 2018. A descriptive study methodology was used. A journey map and a project plan are created to be followed by the project team to ensure a smooth implementation of the EPI. It includes the following: 1) Approved project charter, 2) Project management plan, 3) Change management plan, 4) Project milestone dates. Currently, the HIS is using the regional MRN. Therefore, the HIS and all integrated health care systems in all regions will need modification to move from MRN to EPI without interfering with patient care. For now, the NGHA have successfully implemented an EPI connected with the 4 MRNs that work in the back end in the systems’ database.

Keywords: consumer health, health informatics, hospital information system, universal medical record number

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Authors: M. Macchiaroli, V. Pellecchia, L. Dolores

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Within any European and world model of management of the integrated water service (in Italy only since 2012 is regulated by a national Authority, that is ARERA), a significant part is covered by the development of assets in terms of hydraulic networks and wastewater collection networks, including all their relative building works. The process of selecting the investments to be made starts from the preventive analysis of critical issues (water losses, unserved areas, low service standards, etc.) who occur in the managed territory of the Operator. Through the Program of Interventions (Provision by ARERA n. 580/2019/R/idr), the Operator provides to program the projects that can meet the emerged needs to determine the improvement of the water service levels. This phase (analyzed and solved by the author with a work published in 2019) involves the use of evaluation techniques (cost-benefit analysis, multi-criteria, and multi-objective techniques, neural networks, etc.) useful in selecting the most appropriate design answers to the different criticalities. However, at this point, the problem of establishing the time priorities between the various works deemed necessary remains open. That is, it is necessary to hierarchize the investments. In this decision-making moment, the interests of the private Operator are often opposed, which favors investments capable of generating high profitability, compared to those of the public controller (ARERA), which favors investments in greater social impact. In support of the concertation between these two actors, the protocol set out in the research has been developed, based on the AHP and capable of borrowing from the programmatic documents an orientation path for the settlement of the conflict. The protocol is applied to a case study of the Campania Region in Italy and has been professionally applied in the shared decision process between the manager and the local Authority.

Keywords: analytic hierarchy process, decision making, economic evaluation of projects, integrated water service

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Authors: Felermino D. M. A. Ali, S. C. Ng

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E-learning is an evolutionary form of distance learning and has become better over time as new technologies emerged. Today, efforts are still being made to embrace E-learning systems with emerging technologies in order to make them better. Among these advancements, Educational Data Mining (EDM) is one that is gaining a huge and increasing popularity due to its wide application for improving the teaching-learning process in online practices. However, even though EDM promises to bring many benefits to educational industry in general and E-learning environments in particular, its principal drawback is the lack of easy to use tools. The current EDM tools usually require users to have some additional technical expertise to effectively perform EDM tasks. Thus, in response to these limitations, this study intends to design and implement an EDM application framework which aims at automating and simplify the development of EDM in E-learning environment. The application framework introduces a Service-Oriented Architecture (SOA) that hides the complexity of technical details and enables users to perform EDM in an automated fashion. The framework was designed based on abstraction, extensibility, and interoperability principles. The framework implementation was made up of three major modules. The first module provides an abstraction for data gathering, which was done by extending Moodle LMS (Learning Management System) source code. The second module provides data mining methods and techniques as services; it was done by converting Weka API into a set of Web services. The third module acts as an intermediary between the first two modules, it contains a user-friendly interface that allows dynamically locating data provider services, and running knowledge discovery tasks on data mining services. An experiment was conducted to evaluate the overhead of the proposed framework through a combination of simulation and implementation. The experiments have shown that the overhead introduced by the SOA mechanism is relatively small, therefore, it has been concluded that a service-oriented architecture can be effectively used to facilitate educational data mining in E-learning environments.

Keywords: educational data mining, e-learning, distributed data mining, moodle, service-oriented architecture, Weka

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Authors: Amal Ezzidani, Abdelghani Ben Tahar, Mohamed Hanini

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A sequence of finite tandem queue is considered for this study. Each one has a single server, which operates under the egalitarian processor sharing discipline. External customers arrive at each queue according to a renewal input process and having a general service times distribution. Upon completing service, customers leave the current queue and enter to the next. Under mild assumptions, including critical data, we prove the existence and the uniqueness of the fluid solution. For asymptotic behavior, we provide necessary and sufficient conditions for the invariant state and the convergence to this invariant state. In the end, we establish the convergence of a correctly normalized state process to a fluid limit characterized by a system of algebraic and integral equations.

Keywords: fluid limit, fluid model, measure valued process, processor sharing, tandem queue

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Authors: Sumaya Ismail, Aijaz Ahmad Reshi

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The advances in sensor and embedded technologies have led to rapid developments in Wireless Sensor Networks (WSNs). Presently researchers focus on the integration of WSNs to the Internet for their pervasive availability to access these network resources as the interoperable subsystems. The recent computing technologies like cloud computing has made resource sharing as a converged infrastructure with required service interfaces for the shared resources over the Internet. This paper presents application architecture for wireless Sensor and Actuator Networks (WSANS) following web of things, which allows easy integration of each node to the Internet in order to provide them with web accessibility. The architecture enables the sensors and actuator nodes accessed and controlled using cloud interface on WWW. The application architecture was implemented using existing web and its emerging technologies. In particular, the Representational State Transfer protocol (REST) was extended for the specific requirements of the application. The Cloud computing environment has been used as a development platform for the application to assess the possibility of integrating the WSAN nodes to Cloud services. The mushroom farm environment monitoring and control using WSANs has been taken as a research use case.

Keywords: WSAN, REST, web of things, ZigBee, cloud interface, PaaS, sensor gateway

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Authors: Parastoo Kazemiyan

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Over the past 80 years, in compliance with the advent of modernity in Iran and Turkey, the presence of women in economic and social arenas has creates serious challenges in the capacity of urban spaces to respond to their presence and transport because urban spaces up until then were based on masculine criteria and therefore, women could use such spaces in the company of their fathers or husbands. However, as modernity expanded by Reza Shah and Ataturk, women found the opportunity to work and be present in urban spaces alongside men and their presence in economic and social domains resulted in their presence in these spaces in the early and late hours of the day. Therefore, the city had to be transformed in structural, social, and environmental terms to accommodate women's activities and presence in various urban arenas, which was a huge step in transition from a masculine man-based culture to an all-inclusive human-based culture in these two countries. However, the optimization of urban space was subject to political changes in the two countries, leading to significant differences in designing urban spaces in Tehran and Istanbul. What shows the importance and novelty of the present study lie in the differences in urban planning and optimization in the two capital cities, which gave rise to different outcomes in desirability and quality of living in these two capital cities. Due to the importance of the topic, one of the most significant factors in desirability and acceptability of urban space for women was examined using a descriptive-analytic method based on qualitative methodology in Tehran and Istanbul. The results showed that the infrastructural factors in Istanbul, including safety of access, variety, and number of public transport modes, transparency, and supervision over public spaces have provided women with a safer and more constant presence compared to Tehran. It seems that challenges involved in providing access to urban spaces in Tehran in terms of infrastructure and function have made Tehran unable to respond to the most basic needs of its female citizens.

Keywords: gender differences, urban space security, access to transportation systems, women's challenges

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Authors: Giada Feletti, Daniela Tedesco, Paolo Trucco

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The present study aims to develop a dashboard of Key Performance Indicators (KPI) to enhance information and predictive capabilities in Emergency Medical Services (EMS) systems, supporting both operational and strategic decisions of different actors. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning the indicators currently used for the performance measurement of EMS systems. From this literature analysis, it emerged that current studies focus on two distinct perspectives: the ambulance service, a fundamental component of pre-hospital health treatment, and the patient care in the Emergency Department (ED). The perspective proposed by this study is to consider an integrated view of the ambulance service process and the ED process, both essential to ensure high quality of care and patient safety. Thus, the proposal focuses on the entire healthcare service process and, as such, allows considering the interconnection between the two EMS processes, the pre-hospital and hospital ones, connected by the assignment of the patient to a specific ED. In this way, it is possible to optimize the entire patient management. Therefore, attention is paid to the dependency of decisions that in current EMS management models tend to be neglected or underestimated. In particular, the integration of the two processes enables the evaluation of the advantage of an ED selection decision having visibility on EDs’ saturation status and therefore considering the distance, the available resources and the expected waiting times. Starting from a critical review of the KPIs proposed in the extant literature, the design of the dashboard was carried out: the high number of analyzed KPIs was reduced by eliminating the ones firstly not in line with the aim of the study and then the ones supporting a similar functionality. The KPIs finally selected were tested on a realistic dataset, which draws us to exclude additional indicators due to the unavailability of data required for their computation. The final dashboard, which was discussed and validated by experts in the field, includes a variety of KPIs able to support operational and planning decisions, early warning, and citizens’ awareness of EDs accessibility in real-time. By associating each KPI to the EMS phase it refers to, it was also possible to design a well-balanced dashboard covering both efficiency and effective performance of the entire EMS process. Indeed, just the initial phases related to the interconnection between ambulance service and patient’s care are covered by traditional KPIs compared to the subsequent phases taking place in the hospital ED. This could be taken into consideration for the potential future development of the dashboard. Moreover, the research could proceed by building a multi-layer dashboard composed of the first level with a minimal set of KPIs to measure the basic performance of the EMS system at an aggregate level and further levels with KPIs that can bring additional and more detailed information.

Keywords: dashboard, decision support, emergency medical services, key performance indicators

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Authors: Devyani Shete, Sudeep Rai

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Background: The COVID-19 pandemic has caused one of the highest disruptions to the NHS (National Health Service), especially to the fundamental cervical cancer screening service. To prioritize screening response effectively, it is vital to understand the underlying disease risks amongst groups of women who are less likely to resume their screening/follow up at General Practices. The current government target is to have>=80% of women have an adequate test within the previous 3.5 years (ages 25-49) or 5.5 years (ages 50-64). Aims/Objectives: To increase the number of eligible people aged 25-49 attending cervical screening by 5% at Lakeside Healthcare (a General Practice in Corby). Methods: An online survey was posted on the Lakeside Healthcare website to find out what the barriers towards cervical screening were. It was apparent that patients needed more information catered to their responses. 6 informational videos and a “Cervical Screening Guide” were created for Lakeside patients about cervical screening, which were posted on the Healthcare website. Lakeside also started sending reminder texts to those eligible, with a link to a booking form. Results: On 18th January 2022, 69.7% of patients aged 25-49 years (7207) had an adequate cervical screening test in the last 3.5 years. There were 80 total responders to the online survey. In response to “which of the following are reasons why you have not attended screening”, 30% ticked “I kept putting it off/did not get around to it,” and 13% ticked “I was worried it would be painful or daunting.” In response to “which of the following would make you more likely to book an appointment”, 23% ticked “More detailed explanations of what the risks are if I don’t have screening,” and 20% ticked “I would like more information about the test and what the smear entails.” 10% of responders had previous trauma, whilst 28% of responders said the pandemic had impacted them getting a smear. Survey results were used to carry out interventions to increase smear uptake. On 23rdMarch 2022 (after a 2-month period), 75%of patients aged 25-49 (7119) attended the screening, which was a 5.3% increase from January. Discussion/Conclusion: The survey was vital in carrying out the exact interventions that were required for patients to increase screening uptake, as it is important to know what the populations’ needs are in order to create personalized invitations. This helps to optimise response during a pandemic. A HPV self-sample kit at home could be a popular method of dealing with further outbreaks.

Keywords: gynaecology, cervical screening, public health, COVID-19

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Authors: Nulu Nanono

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Background: The Ugandan national health policy and the national population policy all recognize the need to increase access to quality, affordable, acceptable and sustainable contraceptive services for all people but provision and utilization of quality services remains low. Two contraceptive methods are categorized as long-acting temporary methods: intrauterine contraceptive devices (IUCDs) and implants. Copper-containing IUCDs, generally available in Ministry of Health (MoH) family planning programs and is effective for at least 12 years while Implants, depending on the type, last for up to three to seven years. Uganda’s current policy and political environment are favorable towards achieving national access to quality and safe contraceptives for all people as evidenced by increasing government commitments and innovative family planning programs. Despite the increase of modern contraception use from 14% to 26%, long acting reversible contraceptive (LARC) utilization has relatively remained low with less than 5% using IUDs & Implants which in a way explains Uganda’s persistent high fertility rates. Main question/hypothesis: The purpose of the study was to examine relationship between the demographic, socio-economic characteristics of women, health facility factors and long acting reversible contraception utilization. Methodology: LARC utilization was investigated comprising of the two questions namely are you or your partner currently doing something or using any method to delay or avoid getting pregnant? And which method or methods are you using? Data for the study was sourced from the 2016 Uganda Performance Monitoring and Accountability 2020 Survey comprising of 3816 female respondents aged 15 to 49 years. The analysis was done using the Chi-squared tests and the probit regression at bivariate and multivariate levels respectively. The model was further tested for validity and normality of the residuals using the Sharipo wilks test and test for kurtosis and skewness. Results: The results showed the model the age, parity, marital status, region, knowledge of LARCs, availability of LARCs to be significantly associated with long acting contraceptive utilization with p value of less than 0.05. At the multivariate analysis level, women who had higher parities (0.000) tertiary education (0.013), no knowledge about LARCs (0.006) increases their probability of using LARCs. Furthermore while women age 45-49, those who live in the eastern region reduces their probability of using LARCs. Knowledge contribution: The findings of this study join the debate of prior research in this field and add to the body of knowledge related to long acting reversible contraception. An outstanding and queer finding from the study is the non-utilization of LARCs by women who are aware and have knowledge about them, this may be an opportunity for further research to investigate the attribution to this.

Keywords: contraception, long acting, utilization, women (15-49)

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Authors: Bhavishya Ramchandani

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A little electronic device that is worn on the finger is called a smart ring. It incorporates mobile technology and has features that make it simple to use the device. These gadgets, which resemble conventional rings and are usually made to fit on the finger, are outfitted with features including access management, gesture control, mobile payment processing, and activity tracking. A poor sleep pattern, an irregular schedule, and bad eating habits are all part of the problems with health that a lot of people today are facing. Diets lacking fruits, vegetables, legumes, nuts, and whole grains are common. Individuals in India also experience metabolic issues. In the medical field, smart rings will help patients with problems relating to stomach illnesses and the incapacity to consume meals that are tailored to their bodies' needs. The smart ring tracks all bodily functions, including blood sugar and glucose levels, and presents the information instantly. Based on this data, the ring generates what the body will find to be perfect insights and a workable site layout. In addition, we conducted focus groups and individual interviews as part of our core approach and discussed the difficulties they're having maintaining the right diet, as well as whether or not the smart ring will be beneficial to them. However, everyone was very enthusiastic about and supportive of the concept of using smart rings in healthcare, and they believed that these rings may assist them in maintaining their health and having a well-balanced diet plan. This response came from the primary data, and also working on the Emerging Technology Canvas Analysis of smart rings in healthcare has led to a significant improvement in our understanding of the technology's application in the medical field. It is believed that there will be a growing demand for smart health care as people become more conscious of their health. The majority of individuals will finally utilize this ring after three to four years when demand for it will have increased. Their daily lives will be significantly impacted by it.

Keywords: smart ring, healthcare, electronic wearable, emerging technology

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Authors: Derlis Gregor, Kevin Cikel, Mario Arzamendia, Raúl Gregor

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This paper presents a self-sustaining mobile system for counting and classification of vehicles through processing video. It proposes a counting and classification algorithm divided in four steps that can be executed multiple times in parallel in a SBC (Single Board Computer), like the Raspberry Pi 2, in such a way that it can be implemented in real time. The first step of the proposed algorithm limits the zone of the image that it will be processed. The second step performs the detection of the mobile objects using a BGS (Background Subtraction) algorithm based on the GMM (Gaussian Mixture Model), as well as a shadow removal algorithm using physical-based features, followed by morphological operations. In the first step the vehicle detection will be performed by using edge detection algorithms and the vehicle following through Kalman filters. The last step of the proposed algorithm registers the vehicle passing and performs their classification according to their areas. An auto-sustainable system is proposed, powered by batteries and photovoltaic solar panels, and the data transmission is done through GPRS (General Packet Radio Service)eliminating the need of using external cable, which will facilitate it deployment and translation to any location where it could operate. The self-sustaining trailer will allow the counting and classification of vehicles in specific zones with difficult access.

Keywords: intelligent transportation system, object detection, vehicle couting, vehicle classification, video processing

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Authors: Gurjit Kaur, Neena Gupta

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In this paper, we have analyzed and compared the performance of various coding schemes. The basic ID prime sequence codes are unique in only dimension, i.e. time slots, whereas 2D coding techniques are not unique by their time slots but with their wavelengths also. In this research, we have evaluated and compared the performance of 1D and 2D coding techniques constructed using prime sequence coding pattern for Optical Code Division Multiple Access (OCDMA) system on a single platform. Analysis shows that 2D prime code supports lesser number of active users than 1D codes, but they are having large code family and are the most secure codes compared to other codes. The performance of all these codes is analyzed on basis of number of active users supported at a Bit Error Rate (BER) of 10-9.

Keywords: CDMA, OCDMA, BER, OOC, PC, EPC, MPC, 2-D PC/PC, λc, λa

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