Search results for: long-term care cost

Authors: Salinee Thumronglaohapun

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The proper number and appropriate locations of service centers can save cost, raise revenue and gain more satisfaction from customers. Establishing service centers is high-cost and difficult to relocate. In long-term planning periods, several factors may affect the service. One of the most critical factors is uncertain demand of customers. The opened service centers need to be capable of serving customers and making a profit although the demand in each period is changed. In this work, the capacitated location-allocation problem with stochastic demand is considered. A mathematical model is formulated to determine suitable locations of service centers and their allocation to maximize total profit for multiple planning periods. Two heuristic methods, a local search and genetic algorithm, are used to solve this problem. For the local search, five different chances to choose each type of moves are applied. For the genetic algorithm, three different replacement strategies are considered. The results of applying each method to solve numerical examples are compared. Both methods reach to the same best found solution in most examples but the genetic algorithm provides better solutions in some cases.

Keywords: location-allocation problem, stochastic demand, local search, genetic algorithm

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Authors: Peggy M. Randon, Lisa Randon

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Introduction: The post-COVID-19 era has presented unique challenges for addressing complex mental health issues, particularly due to exacerbated stress, increased social isolation, and disrupted continuity of care. This article outlines relevant health disparities and policy implications within the context of the United States while maintaining international relevance. Methods: A comprehensive literature review (including studies, reports, and policy documents) was conducted to examine concerns related to childhood-onset schizophrenia and the impact on patients and their families. Qualitative and quantitative data were synthesized to provide insights into the complex etiology of schizophrenia, the effects of the pandemic, and the challenges faced by socioeconomically disadvantaged populations. Case studies were employed to illustrate real-world examples and areas requiring policy reform. Results: Early intervention in childhood is crucial for preventing or mitigating the long-term impact of complex psychotic disorders, particularly schizophrenia. A comprehensive understanding of the genetic, environmental, and physiological factors contributing to the development of schizophrenia is essential. The COVID-19 pandemic worsened symptoms and disrupted treatment for many adolescent patients with schizophrenia, emphasizing the need for adaptive interventions and the utilization of virtual platforms. Health disparities, including stigma, financial constraints, and language or cultural barriers, further limit access to care, especially for socioeconomically disadvantaged populations. Policy implications: Current US health policies inadequately support patients with schizophrenia. The limited availability of longitudinal care, insufficient resources for families, and stigmatization represent ongoing policy challenges. Addressing these issues necessitates increased research funding, improved access to affordable treatment plans, and cultural competency training for healthcare providers. Public awareness campaigns are crucial to promote knowledge, awareness, and acceptance of mental health disorders. Conclusion: The unique challenges faced by children and families in the US affected by schizophrenia and other psychotic disorders have yet to be adequately addressed on institutional and systemic levels. The relevance of findings to an international audience is emphasized by examining the complex factors contributing to the onset of psychotic disorders and their global policy implications. The broad impact of the COVID-19 pandemic on mental health underscores the need for adaptive interventions and global responses. Addressing policy challenges, improving access to care, and reducing the stigma associated with mental health disorders are crucial steps toward enhancing the lives of adolescents and young adults with schizophrenia and their family members. The implementation of virtual platforms can help overcome barriers and ensure equitable access to support and resources for all patients, enabling them to lead healthy and fulfilling lives.

Keywords: childhood, schizophrenia, policy, United, States, health, disparities

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Authors: Asharaf Abdul Salam

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Arabian Gulf countries have norms and rules different from others: having an exodus of male immigrant labor contract holders of age 20-60 years as a floating population. Such a demographic scenario camouflages population ageing. However, it is observed on examining vigilantly, not only in the native population but also in the general population. This research on population ageing in the Arabian Gulf examines ageing scenario and concerns through analyses of international databases (US Census Bureau and United Nations) and national level databases (Censuses and Surveys) apart from a review of published research. Transitions in demography and epidemiology lead to gains in life expectancy and thereby reductions in fertility, leading to ageing of the population in the region. Even after bringing adult immigrants, indices and age pyramids show an increasing ageing trend in the total population, demonstrating an ageing workforce. Besides, the exclusive native population analysis reveals a trend of expansive pyramids (pre-transitional stage) turning to constrictive (transition stage) and cylindrical (post-transition stage) shapes. Age-based indices such as the index of ageing, age dependency ratio, and median age confirm this trend. While the feminine nature of ageing is vivid, gains in life expectancy and causes of death in old age, indicating co-morbidity compression, are concerns to ageing. Preparations are in demand to cope with ageing from different dimensions, as explained in the United Nations Plans of Action. A strategy of strengthening informal care with supportive semi-formal and supplementary formal care networks would alleviate this crisis associated with population ageing.

Keywords: total versus native population, indices of ageing, age pyramids, feminine nature, comorbidity compression, strategic interventions

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Authors: Edmund M. Muthigani

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Background: Adequate, decent housing is a universal human right integral component. Resources’ costs and intensified rural-urban migration have increased the demand for affordable housing in urban areas. Modern knowledge-based economy uses innovation. The construction industry uses product and process innovation to provide adequate and decent low-cost housing. Kenya adopted innovation practices in slum upgrading that used cost-effectively locally available building materials. This study objectively looked at the outcomes, social and economic impacts of innovative housing technologies construction in the Mathare valley slums upgrading project. Methods: This post-occupancy study used an exploratory-descriptive research design. Random sampling was used to sample 384 users of low-cost housing projects in Mathare Valley, Nairobi County. Research instruments included semi-structured questionnaires and interview guides. Pilot study, validity and reliability tests ensured the quality of a study. Ethical considerations included university approval and consent. Statistical package for social sciences (SPSS) software version 21 was applied to compute the descriptive and inferential statistics. Findings: Slum-upgrading had a significant-positive outcome on improved houses and community. Social impacts included communal facilities, assurance of security of tenure, and retained frameworks of establishments. Economic impacts included employment; affordable and durable units (p values <0.05). The upgrading process didn’t influence rent fees, was corrupt and led to the displacement of residents. Conclusion: Slum upgrading process impacted positively. Similar projects should consider residents in decision-making.

Keywords: innovation, technologies, slum upgrading, Mathare valley slum, social impact, economic impact

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Authors: A. Sherif, H. Sabry, A. Elzafarany, M. Gadelhak, R. Arafa, M. Aly

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This paper addresses the design of hospital Intensive Care Unit windows for the achievement of visual comfort and energy savings. The aim was to identify the window size and shading system configurations that could fulfill daylighting adequacy, avoid glare and reduce energy consumption. The study focused on addressing the effect of utilizing different shading systems in association with a range of Window-to-Wall Ratios (WWR) in different orientations under the desert clear-sky of Cairo, Egypt. The results of this study demonstrated that solar penetration is a critical concern affecting the design of ICU windows in desert locations, as in Cairo, Egypt. Use of shading systems was found to be essential in providing acceptable daylight performance and energy saving. Careful positioning of the ICU window towards a proper orientation can dramatically improve performance. It was observed that ICU windows facing the north direction enjoyed the widest range of successful window configuration possibilities at different WWRs. ICU windows facing south enjoyed a reasonable number of configuration options as well. By contrast, the ICU windows facing the east orientation had a very limited number of options that provide acceptable performance. These require additional local shading measures at certain times due to glare incidence. Moreover, use of horizontal sun breakers and solar screens to protect the ICU windows proved to be more successful than the other alternatives in a wide range of Window to Wall Ratios. By contrast, the use of light shelves and vertical shading devices seemed questionable.

Keywords: daylighting, desert, energy efficiency, shading

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Authors: Mehrnoosh Abouzari, Shahrokh Sahraei

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Today, with the increase in quantity and quality and variety of crimes, the discussion of crime prevention has faced a serious challenge that human resources alone and with traditional methods will not be effective. One of the developments in the modern world is the presence of artificial intelligence in various fields, including criminal law. In fact, the use of artificial intelligence in criminal investigations and fighting crime is a necessity in today's world. The use of artificial intelligence is far beyond and even separate from other technologies in the struggle against crime. Second, its application in criminal science is different from the discussion of prevention and it comes to the prediction of crime. Crime prevention in terms of the three factors of the offender, the offender and the victim, following a change in the conditions of the three factors, based on the perception of the criminal being wise, and therefore increasing the cost and risk of crime for him in order to desist from delinquency or to make the victim aware of self-care and possibility of exposing him to danger or making it difficult to commit crimes. While the presence of artificial intelligence in the field of combating crime and social damage and dangers, like an all-seeing eye, regardless of time and place, it sees the future and predicts the occurrence of a possible crime, thus prevent the occurrence of crimes. The purpose of this article is to collect and analyze the studies conducted on the use of artificial intelligence in predicting and preventing crime. How capable is this technology in predicting crime and preventing it? The results have shown that the artificial intelligence technologies in use are capable of predicting and preventing crime and can find patterns in the data set. find large ones in a much more efficient way than humans. In crime prediction and prevention, the term artificial intelligence can be used to refer to the increasing use of technologies that apply algorithms to large sets of data to assist or replace police. The use of artificial intelligence in our debate is in predicting and preventing crime, including predicting the time and place of future criminal activities, effective identification of patterns and accurate prediction of future behavior through data mining, machine learning and deep learning, and data analysis, and also the use of neural networks. Because the knowledge of criminologists can provide insight into risk factors for criminal behavior, among other issues, computer scientists can match this knowledge with the datasets that artificial intelligence uses to inform them.

Keywords: artificial intelligence, criminology, crime, prevention, prediction

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Authors: Matt Collins, Bernadette O'Regan, Tom Cosgrove

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To determine the potential of a low cost Irish engineered timber product to replace high cost solid timber for use in bending active structures such as gridshells a single Irish engineered timber product in the form of orientated strand board (OSB) was selected. A comparative study of OSB and solid timber was carried out to determine the optimum properties that make a material suitable for use in gridshells. Three parameters were identified to be relevant in the selection of a material for gridshells. These three parameters are the strength to stiffness ratio, the flexural stiffness of commercially available sections, and the variability of material and section properties. It is shown that when comparing OSB against solid timber, OSB is a more suitable material for use in gridshells that are at the smaller end of the scale and that have tight radii of curvature. Typically, for solid timber materials, stiffness is used as an indicator for strength and engineered timber is no different. Thus, low flexural stiffness would mean low flexural strength. However, when it comes to bending active gridshells, OSB offers a significant advantage. By the addition of multiple layers, an increased section size is created, thus endowing the structure with higher stiffness and higher strength from initial low stiffness and low strength materials while still maintaining tight radii of curvature. This allows OSB to compete with solid timber on large scale gridshells. Additionally, a preliminary sustainability study using a set of sustainability indicators was carried out to determine the relative sustainability of building a large-scale gridshell in Ireland with a primary focus on economic viability but a mention is also given to social and environmental aspects. For this, the Savill garden gridshell in the UK was used as the functional unit with the sustainability of the structural roof skeleton constructed from UK larch solid timber being compared with the same structure using Irish OSB. Albeit that the advantages of using commercially available OSB in a bending active gridshell are marginal and limited to specific gridshell applications, further study into an optimised engineered timber product is merited.

Keywords: bending active gridshells, high end timber structures, low cost material, sustainability

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Authors: Bing Lu, Shuang Li, Hongyuan Zhou

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The steel–concrete hybrid structure has been extensively employed in high–rise buildings and super high–rise buildings. The light gauge steel–concrete hybrid structure, including light gauge steel structure and concrete hybrid structure, is a new–type steel–concrete hybrid structure, which possesses some advantages of light gauge steel structure and concrete hybrid structure. The seismic behavior and loss assessment of three high–rise buildings with three different concrete hybrid structures were investigated through finite element software, respectively. The three concrete hybrid structures are reinforced concrete column–steel beam (RC‒S) hybrid structure, concrete–filled steel tube column–steel beam (CFST‒S) hybrid structure, and tubed concrete column–steel beam (TC‒S) hybrid structure. The nonlinear time-history analysis of three high–rise buildings under 80 earthquakes was carried out. After simulation, it indicated that the seismic performances of three high–rise buildings were superior. Under extremely rare earthquakes, the maximum inter–storey drifts of three high–rise buildings are significantly lower than 1/50. The inter–storey drift and floor acceleration of high–rise building with CFST‒S hybrid structure were bigger than those of high–rise buildings with RC‒S hybrid structure, and smaller than those of high–rise building with TC‒S hybrid structure. Then, based on the time–history analysis results, the post-earthquake repair cost ratio and repair time of three high–rise buildings were predicted through an economic performance analysis method proposed in FEMA‒P58 report. Under frequent earthquakes, basic earthquakes and rare earthquakes, the repair cost ratio and repair time of three high-rise buildings were less than 5% and 15 days, respectively. Under extremely rare earthquakes, the repair cost ratio and repair time of high-rise buildings with TC‒S hybrid structure were the most among three high rise buildings. Due to the advantages of CFST-S hybrid structure, it could be extensively employed in high-rise buildings subjected to earthquake excitations.

Keywords: seismic behavior, loss assessment, light gauge steel–concrete hybrid structure, high–rise building, time–history analysis

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Authors: María Molinos-Senante, Giulia Romano

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This paper aims at investigating the effect of ownership in the efficiency assessment of municipal solid waste management. In doing so, the Data Envelopment Analysis meta-frontier approach integrating unsorted waste as undesirable output was applied. Three different clusters of municipalities have been created on the basis of the ownership type of municipal waste operators. In the second stage of analysis, the paper investigates factors affecting efficiency, in order to provide an outlook of levers to be used by policy and decision makers to improve efficiency, taking into account different management models in force. Results show that public waste management firms have better performance than mixed and private ones since their efficiency scores are significantly larger. Moreover, it has been demonstrated that the efficiency of waste management firms is statistically influenced by the age of population, population served, municipal size, population density and tourism rate. It evidences the importance of economies of scale on the cost efficiency of waste management. This issue is relevant for policymakers to define and implement policies aimed to improve the long-term sustainability of waste management in municipalities.

Keywords: data envelopment analysis, efficiency, municipal solid waste, ownership, undesirable output

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Authors: David Tennison

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In the wake of the Covid-19 pandemic, a new chronic illness emerged onto the global stage: Long Covid. Long Covid presents with several symptoms commonly seen in other poorly-understood illnesses, such as fibromyalgia (FM) and myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS). However, while Long Covid has swiftly become a recognised illness, FM and ME/CFS are still seen as contested, which impacts patient care and healthcare experiences. This study aims to examine what the differences are between Long Covid and FM; and if the Long Covid case can provide guidance for how to address the healthcare challenge of contested illnesses. To address this question, this study performed comprehensive research into the history of FM; our current biomedical understanding of it; and available healthcare interventions (within the context of the UK NHS). Analysis was undertaken of the stigma and stereotypes around FM, and a comparison made between FM and the emerging Long Covid literature, along with the healthcare response to Long Covid. This study finds that healthcare for chronic contested illnesses in the UK is vastly insufficient - in terms of pharmaceutical and holistic interventions, and the provision of secondary care options. Interestingly, for Long Covid, many of the treatment suggestions are pulled directly from those used for contested illnesses. The key difference is in terms of funding and momentum – Long Covid has generated exponentially more interest and research in a short time than there has been in the last few decades of contested illness research. This stands to help people with FM and ME/CFS – for example, research has recently been funded into “brain fog”, a previously elusive and misunderstood symptom. FM is culturally regarded as a “women’s disease” and FM stigma stems from notions of “hysteria”. A key finding is that the idea of FM affecting women disproportionally is not reflected in modern population studies. Emerging data on Long Covid also suggests a slight leaning towards more female patients, however it is less feminised, potentially due to it emerging in the global historical moment of the pandemic. Another key difference is that FM is rated as an extremely low-prestige illness by healthcare professionals, while it was in large part due to the advocacy of affected healthcare professionals that Long Covid was so quickly recognised by science and medicine. In conclusion, Long Covid (and the risk of future pandemics and post-viral illnesses) highlight a crucial need for implementing new, and reinforcing existing, care networks for chronic illnesses. The difference in how contested illnesses like FM, and new ones like Long Covid are treated have a lot to do with the historical moment in which they emerge – but cultural stereotypes, from within and without medicine, need updating. Particularly as they contribute to disease stigma that causes genuine harm to patients. However, widespread understanding and acceptance of Long Covid could help fight contested illness stigma, and the attention, funding and research into Long Covid may actually help raise the profile of contested illnesses and uncover answers about their symptomatology.

Keywords: long COVID, fibromyalgia, myalgic encephalomyelitis, chronic fatigue syndrome, NHS, healthcare, contested illnesses, chronic illnesses, COVID-19 pandemic

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Authors: Manisha Choudhary, Sudarsan Neogi

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Malachite green (MG), an organic basic dye, has been widely used for the dyeing purpose, as well as a fungicide and antiseptic in aquaculture industry to control fish parasites and disease. However, MG has now turned out to be an extremely controversial compound due to its adverse impact on living beings. Due to high toxicity, proper treatment of wastewater containing MG is utmost important. Among different available technologies, adsorption process is one of the most efficient and cost-effective treatment method due to its simplicity of design, ease of operation and regeneration of used materials. Nonetheless, commercial activated carbon is expensive leading the researchers to focus on utilizing natural resources. In the present work, a species of cactus, Opuntia ficus-indica (OFI), was used to develop a highly efficient, low-cost powdered activated carbon by chemical activation using NaOH. The biosorbent was characterized by Fourier-transform infrared spectroscopy, field emission scanning electron microscope, energy-dispersive X-ray spectroscopy, Brunauer–Emmett–Teller (BET) and X-ray diffraction analysis. Batch adsorption studies were performed to remove MG from an aqueous solution as a function of contact time, initial solution pH, initial dye concentration, biosorbent dosages, the presence of salt and temperature. By increasing the initial dye concentration from 100 to 500 mg/l, adsorption capacity increased from 165.45 to 831.58 mg/g. The adsorption kinetics followed the pseudo-second-order model and the chemisorption mechanisms were revealed. The electrostatic attractions and chemical interactions were observed between amino and hydroxyl groups of the biosorbent and amine groups of the dye. The adsorption was solely controlled by film diffusion. Different isotherm models were used to fit the adsorption data. The excellent recovery of adsorption efficiency after the regeneration of biosorbent indicated the high potential of this adsorbent to remove MG from aqueous solution and an excellent cost-effective biosorbent for wide application in wastewater treatment.

Keywords: adsorption, biosorbent, cactus, malachite green

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Authors: Lucie Mrackova, Helena Kisvetrova

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Spirituality is an integral part of human life. In a secular environment, spiritual needs are often overlooked, especially in acute nursing care. Spiritual needs assessment for patients (SNAP), which also exists in the Czech version (SNAP-CZ), can be used for objective evaluation. The aim of this study was to measure the psychometric properties of SNAP-CZ and to find correlations between SNAP-CZ and sociodemographic and clinical variables. A cross-sectional study with tools assessing spiritual needs (SNAP-CZ), anxiety (Beck Anxiety Inventory; BAI), depression (Beck Depression Inventory; BDI), pain (Visual Analogue Scale; VAS), self-sufficiency (Barthel Index; BI); cognitive function (Montreal Cognitive Test; MoCa) and selected socio-demographic data was performed. The psychometric properties of SNAP-CZ were tested using factor analysis, reliability and validity tests, and correlations between the questionnaire and sociodemographic data and clinical variables. Internal consistency was established with Cronbach’s alfa for the overall score, respective domains, and individual items. Reliability was assessed by test-retest by Interclass correlation coefficient (ICC). Data for correlation analysis were processed according to Pearson's correlation coefficient. The study included 172 trauma patients (the mean age = 40.6 ± 12.1 years) who experienced polytrauma or severe monotrauma. There were a total of 106 (61.6%) male subjects, 140 (81.4%) respondents identified themselves as non-believers. The full-scale Cronbach's alpha was 0.907. The test-retest showed the reliability of the individual domains in the range of 0.924 to 0.960 ICC. Factor analysis resulted in a three-factor solution (psychosocial needs (alfa = 0.788), spiritual needs (alfa = 0.886) and religious needs (alfa = 0.841)). Correlation analysis using Pearson's correlation coefficient showed that the domain of psychosocial needs significantly correlated only with gender (r = 0.178, p = 0.020). Males had a statistically significant lower average value in this domain (mean = 12.5) compared to females (mean = 13.8). The domain of spiritual needs significantly correlated with gender (r = 0.199, p = 0.009), social status (r = 0.156, p = 0.043), faith (r = -0.250, p = 0.001), anxiety (r = 0.194, p = 0.011) and depression (r = 0.155, p = 0.044). The domain of religious needs significantly correlated with age (r = 0,208, p = 0,007), education (r = -0,161, p = 0,035), faith (r = -0,575, p < 0,0001) and depression (r = 0,179, p = 0,019). Overall, the whole SNAP scale significantly correlated with gender (r = 0.219, p = 0.004), social status (r = 0.175, p = 0.023), faith (r = -0.334, p <0.0001), anxiety (r = 0.177, p = 0.022) and depression (r = 0.173, p = 0.025). The results of this study corroborate the reliability of the SNAP-CZ and support its future use in the nursing care of trauma patients in a secular society. Acknowledgment: The study was supported by grant nr. IGA_FZV_2020_003.

Keywords: acute nursing care, assessment of spiritual needs, patient, psychometric validation, spirituality

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Authors: Atcharawan Phenwansuk

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The product design is important to the development of SME towards the global, because it made to the quality product to react the needs of consumers and could reduces cost in the production, making it more profitable. As a results, the business are competition advantage for more marketing. It also enhance image of product and firms to build its own brand products to be acceptable. The product was designed should be shape, size, colorful, and direct of target consumers. This is method to add value products to get popular and effective, because the beauty is first satisfaction which come from main shape and color of the design product, but the product was designed need to hold data and law combination of shape and color between artistic theory and satisfaction of consumers together. The design must consider the safety of life and asset of consumers the most important. From to use of designed products should be to consider the cost savings, convenient distance, transportation, routes (land, water or air) of living space on transport (capacity, volume, width, length of the car, truck and container, etc). The packaging must be can to prevent not damage of the products. If products is more large , maybe to design new packaging, which can easily disassembled for make smaller package such as designing the assembly. Products must be packed in the container for size standard for save costs, as well as the buyer can make transport and assembly of products to fit easily on your own.

Keywords: logistics process , pineapple’s leaves product, product design, satisfaction of consumers

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Authors: Rui Brito

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This contribution regards a literature review of inventory management that is a relevant topic for the firms, due to its important use of capital with implications in firm’s profitability within the complexity of a more competitive and globalized world. Firms look for small inventories in order to reduce holding costs, namely opportunity cost, warehousing and handling costs, deterioration and being out of style, but larger inventories are required by some reasons, such as customer service, ordering cost, transportation cost, supplier’s payment to reduce unit costs or to take advantage of price increase in the near future, and equipment setup cost. Thus, management shall address a trade-off between small inventories and larger inventories. This literature review concerns three types of inventory (spare parts, safety stock, and vendor) whose management usually is beyond the scope of logistics. The applied methodology consisted of an online search of databases regarding scientific documents in English, namely Elsevier, Springer, Emerald, Wiley, and Taylor & Francis, but excluding books except if edited, using search engines, such as Google Scholar and B-on. The search was based on three keywords/strings (themes) which had to be included just as in the article title, suggesting themes were very relevant to the researchers. The whole search period was between 2009 and 2018 with the aim of collecting between twenty and forty studies considered relevant within each of the key words/strings specified. Documents were sorted by relevance and to prevent the exclusion of the more recent articles, based on lower quantity of citations partially due to less time to be cited in new research articles, the search period was divided into two sub-periods (2009-2015 and 2016-2018). The number of surveyed articles by theme showed a variation from 40 to 200 and the number of citations of those articles showed a wider variation from 3 to 216. Selected articles from the three themes were analyzed and the first seven of the first sub-period and the first three of the second sub-period with more citations were read in full to make a synopsis of each article. Overall, the findings show that the majority of article types were models, namely mathematical, although with different sub-types for each theme. Almost all articles suggest further studies, with some mentioning it for their own author(s), which widen the diversity of the previous research. Identified research gaps concern the use of surveys to know which are the models more used by firms, the reasons for not using the models with more performance and accuracy, and which are the satisfaction levels with the outcomes of the inventories management and its effect on the improvement of the firm’s overall performance. The review ends with the limitations and contributions of the study.

Keywords: inventory management, safety stock, spare parts inventory, vendor managed inventory

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Authors: Philip Feig, Klaus Gschwendtner, Julian Schatz, Frank Diermeyer

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Projects of accident research analysis are mostly focused on accidents involving personal damage. Property damage only has a high frequency of occurrence combined with high economic impact. This paper describes main influencing parameters for the extent of damage and presents a repair cost model. For a prospective evaluation method of the monetary effect of advanced driver assistance systems (ADAS), it is necessary to be aware of and quantify all influencing parameters. Furthermore, this method allows the evaluation of vehicle concepts in combination with an ADAS at an early point in time of the product development process. In combination with a property damage database and the introduced repair cost model relevant test scenarios for specific vehicle configurations and their individual property damage risk may be determined. Currently, equipment rates of ADAS are low and a purchase incentive for customers would be beneficial. The next ADAS generation will prevent property damage to a large extent or at least reduce damage severity. Both effects may be a purchasing incentive for the customer and furthermore contribute to increased traffic safety.

Keywords: accident research, accident scenarios, ADAS, effectiveness, property damage analysis

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Authors: Stephanie Zuba-Bates

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Purpose: This qualitative research study explored the lived experience of people with functional movement disorder (FMD) including how it impacts their quality of life and participation in life activities. It aims to educate health care professionals about FMD from the perspective of those living with the disorder. Background: Functional movement disorder is characterized by abnormal motor movements including tremors, abnormal gait, paresis, and dystonia with no known underlying pathophysiological cause. Current research estimates that FMD may account for 2-20% of clients seen by neurologists. Getting a diagnosis of FMD is typically long and difficult. In addition, many healthcare professionals are unfamiliar with the disorder which may delay treatment. People living with FMD face great disruption in major areas of life including activities of daily living (ADLs), work, leisure, and community participation. OT practitioners have expertise in working with people with both physical disabilities as well as mental illness and this expertise has the potential to guide treatment and become part of the standard of care. In order for occupational therapists to provide these services, they must be aware of the disorder and must advocate for clients to be referred to OT services. In addition, referring physicians and other health professionals need to understand how having FMD impacts the daily functioning of people living with the disorder and how OT services can intervene to improve their quality of life. This study aimed to answer the following research questions: 1) What is the lived experience of individuals with FMD?; 2) How has FMD impacted their participation in major areas of life?; and, 3) What treatment have they found to be effective in improving their quality of life? Method: A naturalistic approach was used to collect qualitative data through semi-structured telephone interviews of five individuals living with FMD. Subjects were recruited from social media websites and resources for people with FMD. Data was analyzed for common themes among participants. Results: Common themes including the variability of symptoms of the disorder; challenges to receiving a diagnosis; frustrations with and distrust of health care professionals; the impact of FMD on the participant’s ability to perform daily activities; and, strategies for living with the symptoms of FMD. Conclusion: All of the participants in the study had to modify their daily activities, roles and routines as a result of the disorder. This is an area where occupational therapists may intervene to improve the quality of life of these individuals. Additionally, participants reported frustration with the medical community regarding the awareness of the disorder and how they were treated by medical professionals. Much more research and awareness of the disorder is in order.

Keywords: functional movement disorder, occupational therapy, participation, quality of life

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Authors: Devin Doos, Ashley Hughes, Trang Pham, Paul Barach, Rami Ahmed

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Over 115,000 Health Care Workers (HCWs) have died from COVID-19, and millions have been infected while caring for patients. HCWs have filed thousands of safety complaints surrounding safety concerns due to Personal Protective Equipment (PPE) shortages, which included concerns around inadequate and PPE reuse. Protocols for donning and doffing PPE remain ambiguous, lacking an evidence-base, and often result in wide deviations in practice. PPE donning and doffing protocol deviations commonly result in self-contamination but have not been thoroughly addressed. No evidence-driven protocols provide guidance on protecting HCW during periods of PPE reuse. Objective: The aim of this study was to examine safety-related threats and risks to Health Care Workers (HCWs) due to the reuse of PPE among Emergency Department personnel. Method: We conducted a prospective observational study to examine the risks of reusing PPE. First, ED personnel were asked to don and doff PPE in a simulation lab. Each participant was asked to don and doff PPE five times, according to the maximum reuse recommendation set by the Centers for Disease Control and Prevention (CDC). Each participant was videorecorded; video recordings were reviewed and coded independently by at least 2 of the 3trained coders for safety behaviors and riskiness of actions. A third coder was brought in when the agreement between the 2 coders could not be reached. Agreement between coders was high (81.9%), and all disagreements (100%) were resolved via consensus. A bowtie risk assessment chart was constructed analyzing the factors that contribute to increased risks HCW are faced with due to PPE use and reuse. Agreement amongst content experts in the field of Emergency Medicine, Human Factors, and Anesthesiology was used to select aspects of health care that both contribute and mitigate risks associated with PPE reuse. Findings: Twenty-eight clinician participants completed five rounds of donning/doffing PPE, yielding 140 PPE donning/doffing sequences. Two emerging threats were associated with behaviors in donning, doffing, and re-using PPE: (i) direct exposure to contaminant, and (ii) transmission/spread of contaminant. Protective behaviors included: hand hygiene, not touching the patient-facing surface of PPE, and ensuring a proper fit and closure of all PPE materials. 100% of participants (n= 28) deviated from the CDC recommended order, and most participants (92.85%, n=26) self-contaminated at least once during reuse. Other frequent errors included failure to tie all ties on the PPE (92.85%, n=26) and failure to wash hands after a contamination event occurred (39.28%, n=11). Conclusions: There is wide variation and regular errors in how HCW don and doffPPE while including in reusing PPE that led to self-contamination. Some errors were deemed “recoverable”, such as hand washing after touching a patient-facing surface to remove the contaminant. Other errors, such as using a contaminated mask and accidentally spreading to the neck and face, can lead to compound risks that are unique to repeated PPE use. A more comprehensive understanding of the contributing threats to HCW safety and complete approach to mitigating underlying risks, including visualizing with risk management toolsmay, aid future PPE designand workflow and space solutions.

Keywords: bowtie analysis, health care, PPE reuse, risk management

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Authors: Sungmin Park, Gyungmok Nam, Seungpyo Woo, Young Choi, Sangheon Park, Sang-Hee Yoon

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Puncturing human skin with microneedles is critically important for microneedle-mediate drug delivery. Despite of extensive efforts in the past decades, the scale-up fabrication of sharp-tipped and high-aspect-ratio microneedles, especially made of biodegradable polymers, is still a long way off. Here, we present a UV dose insensitive and cost-effective microfabrication method for the biodegradable polymer microneedles with sharp tips and long lengths which can pierce human skin with low insertion force. The biodegradable polymer microneedles are fabricated with the polymer solution casting where a poly(lactic-co-glycolic acid) (PLGA, 50:50) solution is coated onto a SU-8 mold prepared with a reverse, ramped, and rotational (R3) UV exposure. The R3 UV exposure is modified from the multidirectional UV exposure both to suppress UV reflection from the bottom surface without anti-reflection layers and to optimize solvent concentration in the SU-8 photoresist, therefore achieving robust (i.e., highly insensitive to UV dose) and cost-effective fabrication of biodegradable polymer microneedles. An optical model for describing the spatial distribution of UV irradiation dose of the R3 UV exposure is also developed to theoretically predict the microneedle geometry fabricated with the R3 UV exposure and also to demonstrate the insensitiveness of microneedle geometry to UV dose. In the experimental characterization, the microneedles fabricated with the R3 UV exposure are compared with those fabricated with a conventional method (i.e., multidirectional UV exposure). The R3 UV exposure-based microfabrication reduces the end-tip radius by a factor of 5.8 and the deviation from ideal aspect ratio by 74.8%, compared with conventional method-based microfabrication. The PLGA microneedles fabricated with the R3 UV exposure pierce full-thickness porcine skins successfully and are demonstrated to completely dissolve in PBS (phosphate-buffered saline). The findings of this study will lead to an explosive growth of the microneedle-mediated drug delivery market.

Keywords: R³ UV exposure, optical model, UV dose, reflection, solvent concentration, biodegradable polymer microneedle

Procedia PDF Downloads 154

Authors: James Hilton Williams

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Recent tsunami events, including the 2011 Tohoku Tsunami, Japan, and the 2015 Illapel Tsunami, Chile, have highlighted the potential for tsunami impacts on the built environment. International research in the tsunami impacts domain has been largely focused toward impacts on buildings and casualty estimations, while only limited attention has been placed on the impacts on infrastructure which is critical for the recovery of impacted communities. New Zealand, with 75% of the population within 10 km of the coast, has a large amount of coastal infrastructure exposed to local, regional and distant tsunami sources. To effectively manage tsunami risk for New Zealand critical infrastructure, including energy, transportation, and communications, the vulnerability of infrastructure networks and components must first be determined. This research develops infrastructure asset vulnerability, functionality and repair- cost functions based on international post-event tsunami impact assessment data from technologically similar countries, including Japan and Chile, and adapts these to New Zealand. These functions are then utilized within a New Zealand based impact framework, allowing for cost benefit analyses, effective tsunami risk management strategies and mitigation options for exposed critical infrastructure to be determined, which can also be applied internationally.

Keywords: impact assessment, infrastructure, tsunami impacts, vulnerability functions

Procedia PDF Downloads 140

Authors: J. S. P. Barbosa, L. C. Pereira, K. R. Garcia, P. C. P. Bouchardet, S. C. T. Vieira, A. O. Gomes, S. S. Funghetto, M. G. O. Kanikowski

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For this population, height seems to be a good predictor of strength and body composition. This increase in life expectancy of the Brazilian's population is associated with sociodemographic variables, but also to more access to health services in the prevention and better living conditions. With the growth of elderly population, a problem that has been a concern to health's professionals and public health at all is the use of psychoactive substances. The purpose of this study was to identify the sociodemographic profile of the elderly people who was attended at the Center of Psychosocial Care of alcohol and other drugs in the Federal District of Brazil. 408 medical records of people aged 60 years or over were evaluated, and it is possible to know that most of them were males (85.3%), with a mean age of 64 years (DP ± 4.16), 60 and 84 years and a mean age of 64 years (DP ± 4.42); 88.2% have some family ties, are married and have children, with relatives living in masonry housing. The educational level of drug users was considered low with more emphasis on those who had elementary education being the majority retired or unemployed. Regarding the street situation, there was no significance (p = 0.084), and the women (OR = 2.98) had few chances of street situations compared to men (OR = 0.89). As for substance consumption, the highest quantity of drug consumption bids in relation to the number of illicit. It did not present significant statistical value, and there is a greater probability of consumption/abuse of legal and/or illicit drugs for both sexes (OR = 0.96) for men and (OR = 1.32) for women. In relation to the use of multiple drugs, there was no significant difference between the sexes, (OR = 1.1) male sex and (OR = 0.74) female sex. Based on the results found in the present study, it was concluded that alcohol consumption is the main agent that causes vulnerability in the elderly and predisposes the latter to the consumption of other associated drugs.

Keywords: centers of attention psychosocial alcohol and drugs, elderly, mental disorder due to drug use, street situations

Procedia PDF Downloads 194

Authors: B. Schofield, F. Gul, S. McClean, R. Hoskins, R. Terry, U. Rolfe, A. Gibson, S. Voss, J. Benger

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Aim: The aim of this study is to determine whether and how health promotion activities are undertaken by paramedics and emergency department nurses and investigate ways of overcoming potential barriers. Background: Paramedics and emergency department nurses are uniquely placed to reach millions of people and could use these contacts as positive opportunities to help people improve their health by identifying people with risk factors and provide information, brief interventions, and signposting to locally provided services. These interventions can be carried out when the opportunity arises, typically take no more than a few minutes, have a low financial cost and can be a highly efficient method of health promotion. Methodology: Three NHS Emergency Departments and four Ambulance Trusts in England were recruited to the study. A link to an online survey was distributed to paramedics and emergency department nurses at participating sites. Staff were invited to participate in virtual semi-structured interviews. Patients seen, treated, and discharged at the participating sites were invited to virtual semistructured interviews. Findings: A total of 331 survey responses were received, 21 virtual semi-structured staff interviews and 11 patient interviews were completed. Staff reported lack of time to prioritise, lack of knowledge, resources, and confidence as barriers. Receptiveness of patients guided their decision to undertake health promotion activities. They reported a desire to learn how to undertake health promotion conversations. Emergency department nurses felt more supported than paramedics by their organisations to undertake health promotion activities. Patients were not aware of health promotion activities and reported fear and lack of privacy as barriers. Conclusions: These results will guide the development of an intervention to support the provision of health promotion by staff in urgent and emergency care settings. The components of the intervention will be mapped to a framework which will consider the needs of staff working within these settings, patients they treat, and organisational issues and practices related to the implementation of such an intervention.

Keywords: emergency service, hospital, nursing, allied health personnel, emergency medical services, health promotion

Procedia PDF Downloads 37

Authors: Guo Yan

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Clothing recycling bin is a traditional way to collect textile waste in many areas. In the clothing recycling business, the transportation cost normally takes over 50% of total costs. This case gives a good way to reduce transportation cost by reverse logistics system. In this reverse logistics system, there are offline strategic alliance partners, such as transport firms, convenience stores, laundries, and post office which are integrated onto the mobile APP. Offline strategic alliance partners provide the service of textile waste collection, and transportation by their vacant vehicles return journey from convenience stores, laundries and post offices to sorting centers. The results of the case study provide the strategic alliance with a valuable and light - asset business model by using the logistics of offline memberships. The company in this case just focuses on textile waste sorting, reuse, recycling etc. The research method of this paper is a case study of a clothing recycling company in Chengdu by field research and interview; the analysis is based on the theory of the reverse logistics system.

Keywords: closed-loop recycles system, clothing recycling, end-of-life clothing, sharing economy, strategic alliance, reverse logistics.

Procedia PDF Downloads 133

Authors: Sadaf Salek

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Introduction: Cats are susceptible to various health conditions, and one such ailment that can affect their oral health is epulis in their lips. Epulis refers to a benign tumor or growth that can develop in different areas of a cat's mouth, including the lips. While epulis is not life-threatening, it can still cause discomfort and affect a cat's overall quality of life. This essay aims to delve into the causes, symptoms, and treatment options for epulis in cat's lips, shedding light on this lesser-known oral condition. Causes: Epulis in a cat's lips can have several causes. Firstly, genetic predisposition plays a significant role, with certain breeds being more prone to developing these growths. Secondly, chronic irritation to the mouth, such as from dental diseases or foreign objects, can also contribute to the development of epulis. Lastly, hormonal imbalances, specifically an excess of estrogen, have been associated with the occurrence of these tumors in cats. Understanding these causes can help cat owners take preventive measures to reduce the risk of epulis in their feline companions. Symptoms: Identifying the symptoms of epulis in a cat's lips is vital for early intervention and effective treatment. The most common symptoms include swelling, redness, and the presence of a visible growth or lump on the lip. Cats with epulis may also exhibit drooling, difficulty eating, and a reluctance to groom themselves. Any change in eating habits or oral behavior should not be overlooked and prompt a visit to the veterinarian for a thorough examination. Treatment ptions: When it comes to treating epulis in a cat's lips, various options are available, depending on the size, location, and characteristics of the growth. The primary treatment involves surgical removal of the tumor. This procedure should be performed by a qualified veterinarian, ensuring complete excision of the mass while preserving as much healthy tissue as possible. In some cases, radiation therapy may be necessary, especially if the tumor is large or aggressive. Additionally, a veterinarian may recommend oral hygiene care and regular dental cleaning to prevent further growths and maintain the cat's oral health. Prevention and Care: Preventing epulis in a cat's lips is not always possible, especially if genetic factors are involved. However, certain preventive measures can minimize the risk of these growths. Maintaining good oral hygiene through regular brushing and the use of appropriate dental products can help prevent chronic irritation and dental diseases. Routine veterinary check-ups should also include thorough oral examinations to detect any abnormal growths or changes in the mouth at an early stage. Pet owners should be observant and seek veterinary care promptly for any signs of discomfort or changes in eating habits. Conclusion: Epulis in a cat's lips is a condition that requires attention and proper treatment. Understanding the causes, identifying symptoms, and exploring treatment options are of utmost importance to help improve a cat's oral health and overall well-being.

Keywords: fibroma, cat, lip, epulis

Procedia PDF Downloads 34

Authors: Vipul Shiralkar, Rohit Khadilkar, Shekhar Kulkarni, Ismail Mullani, Omkar Malvankar

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The use of water cooler has increased and become an important appliance in the world of global warming. Most of the coolers are electrically operated. In this study an experimental setup of evaporative water cooler using solar energy is designed and developed. It works on the principle of heat transfer using evaporation of water. Water is made to flow through copper tubes arranged in a specific array manner. Cotton plug is wrapped on copper tubes and rubber pipes are arranged in the same way as copper tubes above it. Water percolated from rubber pipes is absorbed by cotton plug. The setup has 40L water carrying capacity with forced cooling arrangement and variable speed fan which uses solar energy stored in 20Ah capacity battery. Fan speed greatly affects the temperature drop. Tests were performed at different fan speed. Maximum temperature drop achieved was 90C at 1440 rpm of fan speed. This temperature drop is very attractive. This water cooler uses solar energy hence it is cost efficient and it is affordable to rural community as well. The cooler is free from any harmful emissions like other refrigerants and hence environmental friendly. Very less maintenance is required as compared to the conventional electrical water cooler.

Keywords: evaporation, cooler, energy, copper, solar, cost

Procedia PDF Downloads 302

Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Traditional medicine refers to a diverse range of therapeutic practices and knowledge systems that have been employed by different cultures over an extended period to uphold and rejuvenate health. These practices can involve herbal remedies, acupuncture, massage, and alternative healing methods that deviate from conventional medical approaches. In Tunisia, we often use unidentified utensils to scratch the oral cavity internally in infants in order to widen the oral cavity for better breathing and swallowing. However, these practices can be risky and may jeopardize the patients' prognosis or even their lives. Aim: This is the case of a nine-month-old infant, admitted to the pediatric department and subsequently to the intensive care unit due to a peritonsillar abscess following the utilization of an unidentifiable tool to scrape the interior of the oral cavity. Case Report: This is a 9-month-old infant with no particular medical history, admitted for high respiratory distress and a fever persisting for 4 days. On clinical examination, he had a respiratory rate of 70 cycles per minute with an oxygen saturation of 97% and subcostal retractions, along with a heart rate of 175 beats per minute. His white blood cell count was 40,960/mm³, and his C-reactive protein was 250 mg/L. Given the severity of the clinical presentation, the infant was transferred to the intensive care unit, intubated, and mechanically ventilated. A cervical-thoracic CT scan was performed, revealing a ruptured 18 mm left peritonsillar abscess in the oropharynx associated with cellulitis of the retropharyngeal space. The oto-rhino-laryngoscopic examination revealed an asymmetry involving the left lateral wall of the oropharynx with the presence of a fistula behind the posterior pillar. Dissection of the collection cavity was performed, allowing the drainage of 2 ml of pus. The culture was negative. The patient received cefotaxime in combination with metronidazole and gentamicin for a duration of 10 days, followed by a switch to amoxicillin-clavulanic acid for 7 days. The patient was extubated after 4 days of treatment, and the clinical and radiological progress was favorable. Conclusions: Traditional medicine remains risky due to the lack of scientific evidence and the potential for injuries and transmission of infectious diseases, especially in children, who constitute a vulnerable population. Therefore, parents should consult healthcare professionals and rely on evidence-based care.

Keywords: children, peritonsillar abscess, traditional medicine, respiratory distress

Procedia PDF Downloads 52

Authors: Haythem H. Abdullah, Hesham Elkady

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With the fast increase in radio frequency identification (RFID) applications such as medical recording, library management, etc., the limitation of active tags stems from its need to external batteries as well as passive or active chips. The chipless RFID tag reduces the cost to a large extent but at the expense of utilizing the spectrum. The reduction of the cost of chipless RFID is due to the absence of the chip itself. The identification is done by utilizing the spectrum in such a way that the frequency response of the tags consists of some resonance frequencies that represent the bits. The system capacity is decided by the number of resonators within the pre-specified band. It is important to find a solution to enhance the spectrum utilization when using chipless RFID. Target identification is a process that results in a decision that a specific target is present or not. Several target identification schemes are present, but one of the most successful techniques in radar target identification in the oscillatory region is the extinction pulse technique (E-Pulse). The E-Pulse technique is used to identify targets via its characteristics (natural) modes. By introducing an innovative solution for chipless RFID reader and tag designs, the spectrum utilization goes to the optimum case. In this paper, a novel capacity enhancement scheme based on the E-pulse technique is introduced to improve the performance of the chipless RFID system.

Keywords: chipless RFID, E-pulse, natural modes, resonators

Procedia PDF Downloads 55

Authors: Taufik Rizkiandi, Teuku Yuri M. Zagloel, Andri Dwi Setiawan

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Distribution and growth in the transportation and warehousing business sector decreased by 15,04%. There was a decrease in Gross Domestic Product (GDP) contribution level from rank 7 of 4,41% in 2019 to 3,81% in rank 8 in 2020. A decline in the transportation and warehousing business sector contributes to GDP, resulting in oil and gas companies implementing an efficient supply chain strategy to ensure the availability of goods, especially lubricants. Fluctuating demand for lubricants and warehouse service time limits are essential things that are taken into account in determining an efficient route. Add depots points as a solution so that demand for lubricants is fulfilled (not stock out). However, adding a depot will increase operating costs and storage costs. Therefore, it is necessary to optimize the addition of depots using the Capacitated Vehicle Routing Problem with Time Windows (CVRPTW). This research case study was conducted at an oil and gas company that produces lubricants from 2019 to 2021. The study results obtained the optimal route and the addition of a depot with a minimum additional cost. The total cost remains efficient with the addition of a depot when compared to one depot from Jakarta.

Keywords: CVRPTW, optimal route, depot, tabu search algorithm

Procedia PDF Downloads 124

Authors: Joseph E. Hummer

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An efficient freeway system will be essential to the development of Africa, and interchanges are a key to that efficiency. Around the world, many interchanges between freeways and surface streets, called service interchanges, are of the diamond configuration, and interchanges using roundabouts or loop ramps are also popular. However, many diamond interchanges have serious operational problems, interchanges with roundabouts fail at high demand levels, and loops use lots of expensive land. Newer service interchange designs provide other options. The most popular new interchange design in the US at the moment is the double crossover diamond (DCD), also known as the diverging diamond. The DCD has enormous potential, but also has several significant limitations. The objectives of this paper are to review new service interchange options and to highlight some of the main features of those alternatives. The paper tests four conventional and seven unconventional designs using seven measures related to efficiency, cost, and safety. The results show that there is no superior design in all measures investigated. The DCD is better than most designs tested on most measures examined. However, the DCD was only superior to all other designs for bridge width. The DCD performed relatively poorly for capacity and for serving pedestrians. Based on the results, African freeway designers are encouraged to investigate the full range of alternatives that could work at the spot of interest. Diamonds and DCDs have their niches, but some of the other designs investigated could be optimum at some spots.

Keywords: interchange, diamond, diverging diamond, capacity, safety, cost

Procedia PDF Downloads 234

Authors: Margaret Denise P. Del Rosario, Geraldine Alcantara

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Background: The declaration of the COVID-19 pandemic has impacted hospital visits of child abuse cases with less consults but more severe injuries. Objective: The study aims to identify the clinical profiles of patients seen in the hospital ng Makati Women and Children Protection Unit before and during the pandemic. Design: A cross-sectional analytic study design through review of records that underwent quantitative analysis. Results: 264 cases pre-pandemic and 208 cases during the pandemic were reviewed. Most reported cases were neglect comprising of 47% of the pre-pandemic cases and 68% of cases during the pandemic. Supervisory neglect was most commonly reported. An equal distribution between males and females were seen among victims and alleged perpetrators. The age group of both victims and alleged perpetrators during the pandemic was significantly younger compared to the pre-pandemic period. Children belonging to larger family groups were commonly encountered with most of them being the eldest amongst siblings. Alleged perpetrators were mostly secondary graduates for both time periods. A significant increase of cases during the pandemic occurred at home. More patients required hospitalization during the pandemic period with 37% compared to the 23% of admissions prior to the pandemic. Furthermore, a three-fold increase of injuries sustained during the pandemic required intensive care. Conclusion: The study reflects increased severity of injuries related to abuse during the pandemic compared to pre-pandemic times. A significant increase in injuries requiring intensive care were also seen despite less reported cases.

Keywords: child abuse, COVID-19, violence against children, WCPU, neglect

Procedia PDF Downloads 35

Authors: Priya Kedia, Kiranmoy Das

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There is a rich literature on variable selection in regression setting. However, most of these methods assume normality for the response variable under consideration for implementing the methodology and establishing the statistical properties of the estimates. In many real applications, the distribution for the response variable may be non-Gaussian, and one might be interested in finding the best subset of covariates at some predetermined quantile level. We develop dynamic Bayesian approach for variable selection in quantile regression framework. We use a zero-inflated mixture prior for the regression coefficients, and consider the asymmetric Laplace distribution for the response variable for modeling different quantiles of its distribution. An efficient Gibbs sampler is developed for our computation. Our proposed approach is assessed through extensive simulation studies, and real application of the proposed approach is also illustrated. We consider the data from health and retirement study conducted by the University of Michigan, and select the important predictors when the outcome of interest is out-of-pocket medical cost, which is considered as an important measure for financial risk. Our analysis finds important predictors at different quantiles of the outcome, and thus enhance our understanding on the effects of different predictors on the out-of-pocket medical cost.

Keywords: variable selection, quantile regression, Gibbs sampler, asymmetric Laplace distribution

Procedia PDF Downloads 146