Search results for: insurance cycle
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2337

Search results for: insurance cycle

2127 Beliefs, Attitudes, and Understanding of Childhood Cancer Among White and Latino Parents in the Phoenix Metropolitan Area: A Comparative Study

Authors: Florence Awde

Abstract:

In 2023, it was expected 350 parents in Arizona would have a child receive a cancer diagnosis (Welcome Arizona Cancer Foundation For Children, n.d.). The news of a child’s diagnosis with cancer can be overwhelming and confusing, especially for those lucky enough to lack a personal tie to the disease that takes approximately 1800 children’s lives each year in the United States (Deegan et al., n.d.). A parent’s beliefs, attitudes, and understandings surrounding cancer are vital for medical staff to provide adequate and culturally competent care for each patient, especially across cultural and ethnic lines in regions housing multicultural populations. Arizona's cultural/linguistic mosaic houses many White and Latino populations and English and Spanish speakers. Variations in insurance coverage, from those insured through public insurance programs (e.g., Medicaid) or private insurance plans (e.g., employee-sponsored insurance) versus those uninsured, also factor into health-seeking attitudes and behaviors. To further understand parental attitudes, understandings, and beliefs towards childhood cancer, 22 parents (11 of Latino ethnicity, 11 of White ethnicity) were interviewed on these facets of childhood cancer, despite 21 of the 22 never having a child receive a cancer diagnosis. The exploration of these perceptions across ethnic lines revealed a higher report of fear-orientated beliefs amongst Latino parents--hypothesized to be rooted in the starkly contrasting lack of belief in the possibility of recovering for children with cancer, compared to their white counterparts who displayed more optimism in the recovery process. Further, this study’s results lay the foundation for future scholarship to explore avenues of information dispersal to Latino parents that correct misconceptions of health outcomes and enable earlier intervention to be possible, ultimately correlating to better health and treatment outcomes by increasing parental health literacy rates for childhood cancer in the Phoenix Metropolitan.

Keywords: Childhood Cancer, Parental Beliefs, Parental Attitudes, Parental Understandings, Phoenix Metropolitan, Culturally Competent Care, Health Disparities, Health Inequities

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2126 Constructing a Bayesian Network for Solar Energy in Egypt Using Life Cycle Analysis and Machine Learning Algorithms

Authors: Rawaa H. El-Bidweihy, Hisham M. Abdelsalam, Ihab A. El-Khodary

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In an era where machines run and shape our world, the need for a stable, non-ending source of energy emerges. In this study, the focus was on the solar energy in Egypt as a renewable source, the most important factors that could affect the solar energy’s market share throughout its life cycle production were analyzed and filtered, the relationships between them were derived before structuring a Bayesian network. Also, forecasted models were built for multiple factors to predict the states in Egypt by 2035, based on historical data and patterns, to be used as the nodes’ states in the network. 37 factors were found to might have an impact on the use of solar energy and then were deducted to 12 factors that were chosen to be the most effective to the solar energy’s life cycle in Egypt, based on surveying experts and data analysis, some of the factors were found to be recurring in multiple stages. The presented Bayesian network could be used later for scenario and decision analysis of using solar energy in Egypt, as a stable renewable source for generating any type of energy needed.

Keywords: ARIMA, auto correlation, Bayesian network, forecasting models, life cycle, partial correlation, renewable energy, SARIMA, solar energy

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2125 Assessing the Prevalence of Accidental Iatrogenic Paracetamol Overdose in Adult Hospital Patients Weighing <50kg: A Quality Improvement Project

Authors: Elisavet Arsenaki

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Paracetamol overdose is associated with significant and possibly permanent consequences including hepatotoxicity, acute and chronic liver failure, and death. This quality improvement project explores the prevalence of accidental iatrogenic paracetamol overdose in hospital patients with a low body weight, defined as <50kg and assesses the impact of educational posters in trying to reduce it. The study included all adult inpatients on the admissions ward, a short stay ward for patients requiring 12-72 hour treatment, and consisted of three cycles. Each cycle consisted of 3 days of data collection in a given month (data collection for cycle 1 occurred in January 2022, February 2022 for cycle 2 and March 2022 for cycle 3). All patients given paracetamol had their prescribed dose checked against their charted weight to identify the percentage of adult inpatients <50kg who were prescribed 1g of paracetamol instead of 500mg. In the first cycle of the audit, data were collected from 83 patients who were prescribed paracetamol on the admissions ward. Subsequently, four A4 educational posters were displayed across the ward, on two separate occasions and with a one-month interval in between each poster display. The aim of this was to remind prescribing doctors of their responsibility to check patient body weight prior to prescribing paracetamol. Data were collected again one week after each round of poster display, from 72 and 70 patients respectively. Over the 3 cycles with a cumulative 225 patients, 15 weighed <50kg (6.67%) and of those, 5 were incorrectly prescribed 1g of paracetamol, yielding a 33.3% prevalence of accidental iatrogenic paracetamol overdose in adult inpatients. In cycle 1 of the project, 3 out of 6 adult patients weighing <50kg were overdosed on paracetamol, meaning that 50% of low weight patients were prescribed the wrong dose of paracetamol for their weight. In the second data collection cycle, 1 out of 5 <50kg patients were overdosed (20%) and in the third cycle, 1 out of 4 (25%). The use of educational posters resulted in a lower prevalence of accidental iatrogenic paracetamol overdose in low body weight adult inpatients. However, the differences observed were statistically insignificant (p value 0.993 and 0.995 respectively). Educational posters did not induce a significant decrease in the prevalence of accidental iatrogenic paracetamol overdose. More robust strategies need to be employed to further decrease paracetamol overdose in patients weighing <50kg.

Keywords: iatrogenic, overdose, paracetamol, patient, safety

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2124 Development of Pre-Mitigation Measures and Its Impact on Life-Cycle Cost of Facilities: Indian Scenario

Authors: Mahima Shrivastava, Soumya Kar, B. Swetha Malika, Lalu Saheb, M. Muthu Kumar, P. V. Ponambala Moorthi

Abstract:

Natural hazards and manmade destruction causes both economic and societal losses. Generalized pre-mitigation strategies introduced and adopted for prevention of disaster all over the world are capable of augmenting the resiliency and optimizing the life-cycle cost of facilities. In countries like India where varied topographical feature exists requires location specific mitigation measures and strategies to be followed for better enhancement by event-driven and code-driven approaches. Present state of vindication measures followed and adopted, lags dominance in accomplishing the required development. In addition, serious concern and debate over climate change plays a vital role in enhancing the need and requirement for the development of time bound adaptive mitigation measures. For the development of long-term sustainable policies incorporation of future climatic variation is inevitable. This will further assist in assessing the impact brought about by the climate change on life-cycle cost of facilities. This paper develops more definite region specific and time bound pre-mitigation measures, by reviewing the present state of mitigation measures in India and all over the world for improving life-cycle cost of facilities. For the development of region specific adoptive measures, Indian regions were divided based on multiple-calamity prone regions and geo-referencing tools were used to incorporate the effect of climate changes on life-cycle cost assessment. This study puts forward significant effort in establishing sustainable policies and helps decision makers in planning for pre-mitigation measures for different regions. It will further contribute towards evaluating the life cycle cost of facilities by adopting the developed measures.

Keywords: climate change, geo-referencing tools, life-cycle cost, multiple-calamity prone regions, pre-mitigation strategies, sustainable policies

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2123 Application of Life Cycle Assessment “LCA” Approach for a Sustainable Building Design under Specific Climate Conditions

Authors: Djeffal Asma, Zemmouri Noureddine

Abstract:

In order for building designer to be able to balance environmental concerns with other performance requirements, they need clear and concise information. For certain decisions during the design process, qualitative guidance, such as design checklists or guidelines information may not be sufficient for evaluating the environmental benefits between different building materials, products and designs. In this case, quantitative information, such as that generated through a life cycle assessment, provides the most value. LCA provides a systematic approach to evaluating the environmental impacts of a product or system over its entire life. In the case of buildings life cycle includes the extraction of raw materials, manufacturing, transporting and installing building components or products, operating and maintaining the building. By integrating LCA into building design process, designers can evaluate the life cycle impacts of building design, materials, components and systems and choose the combinations that reduce the building life cycle environmental impact. This article attempts to give an overview of the integration of LCA methodology in the context of building design, and focuses on the use of this methodology for environmental considerations concerning process design and optimization. A multiple case study was conducted in order to assess the benefits of the LCA as a decision making aid tool during the first stages of the building design under specific climate conditions of the North East region of Algeria. It is clear that the LCA methodology can help to assess and reduce the impact of a building design and components on the environment even if the process implementation is rather long and complicated and lacks of global approach including human factors. It is also demonstrated that using LCA as a multi objective optimization of building process will certainly facilitates the improvement in design and decision making for both new design and retrofit projects.

Keywords: life cycle assessment, buildings, sustainability, elementary schools, environmental impacts

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2122 Optimal Mitigation of Slopes by Probabilistic Methods

Authors: D. De-León-Escobedo, D. J. Delgado-Hernández, S. Pérez

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A probabilistic formulation to assess the slopes safety under the hazard of strong storms is presented and illustrated through a slope in Mexico. The formulation is based on the classical safety factor (SF) used in practice to appraise the slope stability, but it is introduced the treatment of uncertainties, and the slope failure probability is calculated as the probability that SF<1. As the main hazard is the rainfall on the area, statistics of rainfall intensity and duration are considered and modeled with an exponential distribution. The expected life-cycle cost is assessed by considering a monetary value on the slope failure consequences. Alternative mitigation measures are simulated, and the formulation is used to get the measures driving to the optimal one (minimum life-cycle costs). For the example, the optimal mitigation measure is the reduction on the slope inclination angle.

Keywords: expected life-cycle cost, failure probability, slopes failure, storms

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2121 Simulation Research of City Bus Fuel Consumption during the CUEDC Australian Driving Cycle

Authors: P. Kacejko, M. Wendeker

Abstract:

The fuel consumption of city buses depends on a number of factors that characterize the technical properties of the bus and driver, as well as traffic conditions. This parameter related to greenhouse gas emissions is regulated by law in many countries. This applies to both fuel consumption and exhaust emissions. Simulation studies are a way to reduce the costs of optimization studies. The paper describes simulation research of fuel consumption city bus driving. Parameters of the developed model are based on experimental results obtained on chassis dynamometer test stand and road tests. The object of the study was a city bus equipped with a compression-ignition engine. The verified model was applied to simulate the behavior of a bus during the CUEDC Australian Driving Cycle. The results of the calculations showed a direct influence of driving dynamics on fuel consumption.

Keywords: Australian Driving Cycle, city bus, diesel engine, fuel consumption

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2120 Innovations and Agricultural Development Potential in Georgia

Authors: Tamar Lazariashvili

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Introduction: The growth and development of the economy in the country depend on many factors, the most important of which is the use of innovation. The article analyzes the innovations and the potential of agricultural development in Georgia, presents the problems in the field, justifies the need to introduce innovations, shows the policy of innovation development, evaluates the positive and negative factors of the use of innovations in agriculture. Methodology: The article uses general and specific research methods, namely, analysis, synthesis, induction, deduction, comparison and statistical ones: selection, grouping, observation, trend. All these methods used together in the article reveal the main problems and challenges and their development trends. Main Findings: The introduction of innovations for the country has an impact if there is established state support system for business development and the State creates an effective environment for innovation development. As a result, the appropriate establishment gives incentives to increase budget revenues, create new jobs, increase export turnover and improve the overall economic situation in the country. Georgia has sufficient resource potential to create and develop new businesses in agriculture by introducing innovations and contribute to the further socio-economic development of the country. Political and economic stability, the existing legislation in the country, infrastructure, the proper functioning of financial institutions and the qualification of the workforce are crucial for the development of innovations. These criteria determine the political and economic ratings of all countries of the world, which are of great importance to foreign investors in the implementation of innovations. Conclusion: Enactment of agro-insurance will increase the interest and confidence of financial institutions in the farming sector, financial resources will be accessible to the farmers that will facilitate the stable development of the sector in the country. The size of the agro-insurance market in the country should be increased and the new territories should be covered. The State must have an obligation to ensure the risk of farmers and subsidize insurance companies. Based on an analysis of the insurance market the conclusions on agro-insurance issues and the relevant recommendations are proposed. The introduction of innovations in agriculture will have a great impact on the Georgian economy: it will improve the technological base, establish enterprises equipped with modern equipment and methodologies, retrain existing enterprises, promote to improve skills of workers and improve management systems. Based on the analysis, conclusions are made about the prospects for the development of innovation in agriculture and relevant recommendations are proposed.

Keywords: agriculture, development potential, innovation, optimal environment

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2119 Thermodynamics Analysis of Transcritical HTHP Cycles Using Eco-Friendly Refrigerant and low-Grade Waste Heat Recovery: A Theoretical Evaluation

Authors: Adam Y. Sulaiman, Donal F. Cotter, Ming J. Huang, Neil J. Hewitt

Abstract:

Decarbonization of the industrial sector in developed countries has become indispensable for addressing climate change. Industrial processes including drying, distillation, and injection molding require a process heat exceeding 180°C, rendering the subcriticalHigh-Temperature heat pump(HTHP) technique unsuitable. A transcritical HTHP utilizing ecologically friendly working fluids is a highly recommended system that incorporates the features of high-energy efficiency, extended operational range, and decarbonizing the industrial sector. This paper delves into the possibility and feasibility of leveraging the HTTP system to provide up to 200°C of heat using R1233zd(E) as a working fluid. Using a steady-state model, various transcritical HTHP cycle configurations aretheoretically compared,analyzed, and evaluatedin this study. The heat transfer characteristics for the evaporator and gas cooler are investigated, as well as the cycle's energy, exergetic, and environmental performance. Using the LMTD method, the gas cooler's heat transfer coefficient, overall length, and heat transfer area were calculated. The findings indicate that the heat sink pressure level, as well as the waste heat temperature provided to the evaporator, have a significant impact on overall cycle performance. The investigation revealed the potential challenges and barriers, including the length of the gas cooler and the lubrication of the compression process. The basic transcritical HTTP cycle with additional IHX was demonstrated to be the most efficient cycle across a variety of heat source temperatures ranging from 70 to 90 °C based on theoretical energetic and exergetic performance.

Keywords: high-temperature heat pump, transcritical cycle, refrigerants, gas cooler, energy, exergy

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2118 A Prenylflavanoid, HME5 with Antiproliferative Activity in Human Ovarian Cancer Cells

Authors: Mashitoh Abd Rahman, Najihah Mohd Hashim, Faiqah Ramli, Syam Mohan, Noraziah Nordin, Hamed Karimian, Hapipah Mohd Ali

Abstract:

Ovarian cancer is the most lethal gynecological malignancies. HME5, a prenylflavanoid has been isolated from local medicinal plant. This compound has been reported to possess a broad spectrum of biological activities including anticancer property. However, the potential of HME5 as an antiproliferative and cytotoxic agent on an ovarian cancer cells has not yet been investigated. In this present study, we examined the antiproliferative and cytotoxic effect of HME5 on Caov-3 (Human Ovarian Adenocarcinoma) cell line by using 3-[4,5-dimethylthizol-2-y]-2,5-diphenyltetrazolium bromide (MTT) assay, Acridine orange and propidium Iodide (AOPi) and cell cycle analysis study. HME5 has shown to inhibit Caov-3 in a time-dependent manner with the IC50 values of 5µg/ml, 2µg/ml and 1µg/ml after 24h, 48h and 72h treatment, respectively. Morphological study from AOPi analysis showed that HME5 induced apoptosis after 24 and 48h post-treatment. Nevertheless, HME5 exhibited cell cycle arrest at G1 phase as indicated in flow cytometry cell cycle profiling. In conclusion, HME5 inhibited proliferation of Caov-3 through induction of apoptosis and cell cycle arrest at G1 phase.

Keywords: apoptosis, prenylflavanoid, ovarian cancer, HME5

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2117 Performance Analysis and Multi-Objective Optimization of a Kalina Cycle for Low-Temperature Applications

Authors: Sadegh Sadeghi, Negar Shabani

Abstract:

From a thermal point of view, zeotropic mixtures are likely to be more efficient than azeotropic fluids in low-temperature thermodynamic cycles due to their suitable boiling characteristics. In this study, performance of a low-temperature Kalina cycle with R717/water working fluid used in different existing power plants is mathematically investigated. To analyze the behavior of the cycle, mass conservation, energy conservation, and exergy balance equations are presented. With regard to the similarity in molar mass of R717 (17.03 gr/mol) and water (18.01 gr/mol), there is no need to alter the size of Kalina system components such as turbine and pump. To optimize the cycle energy and exergy efficiencies simultaneously, a constrained multi-objective optimization is carried out applying an Artificial Bee Colony algorithm. The main motivation behind using this algorithm lies on its robustness, reliability, remarkable precision and high–speed convergence rate in dealing with complicated constrained multi-objective problems. Convergence rates of the algorithm for calculating the optimal energy and exergy efficiencies are presented. Subsequently, due to the importance of exergy concept in Kalina cycles, exergy destructions occurring in the components are computed. Finally, the impacts of pressure, temperature, mass fraction and mass flow rate on the energy and exergy efficiencies are elaborately studied.

Keywords: artificial bee colony algorithm, binary zeotropic mixture, constrained multi-objective optimization, energy efficiency, exergy efficiency, Kalina cycle

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2116 Digital Individual Benefit Statement: The Use of a Triangulation Methodology to Design a Digital Platform for Switzerland

Authors: Catherine Equey Balzli

Abstract:

Old age retirement pensions are an important concern among the Swiss but estimating one’s income after retirement is difficult due to the Swiss insurance system’s complexity. This project’s aim is to prepare for developing a digital platform that will allow individuals to plan for retirement in a simplified manner. The main objective of the platform will be to give individuals the tools to check that their savings and retirement benefits will allow them to continue the lifestyle to which they are accustomed once they are retired. The research results from qualitative (focus group) and quantitative (survey) methodologies, recommend the scope and functionalities for a digital platform to be developed. A main outcome is the need to limit the platform’s scope to old-age pension only (excluding survivors’ or disability pensions, for instance). Furthermore, an outcome regarding the functionalities is the proposition of scenarios such as early retirement, changes to income, or modifications to personal status. The development of the digital platform will be a subsequent project.

Keywords: benefit statement, digital platform, retirement financial planning, social insurance

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2115 Damage to LCP by the Ratcheting Phenomenon Under Cyclic Motion in Oligocyclic Fatigue

Authors: Aboussalih Amira, Zarza Tahar, Fedaoui Kamel, Baroura Lazhar, Hammoudi Salah

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316 L steel is a stainless steel frequently used in orthopedic surgery; in the design of implants (hip, knee, shoulder, ankle, etc.), in dental surgery, cardiology, ophthalmology. Before any use, it is essential to predict the macroscopic phenomenological behavior of the material, and to analyze its response. The behavior of 316 L steel in low cycle fatigue, under uniaxial cyclic loading of tension/compression, producing significant plastic deformations leading to material damage. This investigation allowed us to characterize the behavior of the 316L steel employed in the locking of the compression plates (LCP), of which they are generally used in orthopedics to stabilize the fractured bone parts. And to perceive the phenomenon of Ratcheting leading to the damage of LCP by an excess of plastic deformation under nonsymmetrical alternated imposed constraint in low cycle fatigue.

Keywords: 316L SS, locking compression plate, low cycle fatigue, ratcheting

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2114 Agent-Based Modeling to Simulate the Dynamics of Health Insurance Markets

Authors: Haripriya Chakraborty

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The healthcare system in the United States is considered to be one of the most inefficient and expensive systems when compared to other developed countries. Consequently, there are persistent concerns regarding the overall functioning of this system. For instance, the large number of uninsured individuals and high premiums are pressing issues that are shown to have a negative effect on health outcomes with possible life-threatening consequences. The Affordable Care Act (ACA), which was signed into law in 2010, was aimed at improving some of these inefficiencies. This paper aims at providing a computational mechanism to examine some of these inefficiencies and the effects that policy proposals may have on reducing these inefficiencies. Agent-based modeling is an invaluable tool that provides a flexible framework to model complex systems. It can provide an important perspective into the nature of some interactions that occur and how the benefits of these interactions are allocated. In this paper, we propose a novel and versatile agent-based model with realistic assumptions to simulate the dynamics of a health insurance marketplace that contains a mixture of private and public insurers and individuals. We use this model to analyze the characteristics, motivations, payoffs, and strategies of these agents. In addition, we examine the effects of certain policies, including some of the provisions of the ACA, aimed at reducing the uninsured rate and the cost of premiums to move closer to a system that is more equitable and improves health outcomes for the general population. Our test results confirm the usefulness of our agent-based model in studying this complicated issue and suggest some implications for public policies aimed at healthcare reform.

Keywords: agent-based modeling, healthcare reform, insurance markets, public policy

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2113 Life Cycle Assessment in Road Pavements: A Literature Review and the Potential Use in Brazil

Authors: B. V. Santos, M. T. M. Carvalho, J. H. S. Rêgo

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The article presents a literature review on recent advances related to studies of the environmental impact of road pavements, with reference to the concepts of Life Cycle Assessment (LCA). An introduction with the main motivations for the development of the research is presented, with a current overview of the Brazilian transport infrastructure and the projections for the road mode for the coming years, and the possibility of using the referred methodology by the road sector in Brazil. The article explores the origin of LCA in road pavements and the details linked to its implementation from the perspective of the four main phases of the study (goal and scope definition, inventory analysis, impact assessment, and interpretation). Finally, the main advances and deficiencies observed in the selected studies are gathered, with the proposition of research fields that can be explored in future national or international studies of LCA of road pavements.

Keywords: Brazil, life cycle assessment, road pavements, sustainable

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2112 The Effects of Menstrual Phase on Upper and Lower Body Anaerobic Performance in College-Aged Women

Authors: Kelsey Scanlon

Abstract:

Introduction: With the rate of female collegiate and professional athletes on the rise in recent decades, fluctuations in physical performance in relation to the menstrual cycle is an important area of study. PURPOSE: The purpose of this research was to compare differences in upper and lower body maximal anaerobic capacities across a single menstrual cycle. Methode: Participants (n=11) met a total of four times; once for familiarization and again on day 1 of menses (follicular phase), day 14 (ovulation), and day 21 (luteal phase) respectively. Upper body power was assessed using a bench press weight of ~50% of the participant’s predetermined 1-repetition maximum (1-RM) on a ballistic measurement system and variables included peak force (N), mean force (N), peak power (W), mean power (W), and peak velocity (m/s). Lower body power output was collected using a standard Wingate test. The variables of interest were anaerobic capacity (w/kg), peak power (W), mean power (W), fatigue index (W/s), and total work (J). Result: Statistical significance was not observed (p > 0.05) in any of the aforementioned variables after completing multiple one ways of analyses of variances (ANOVAs) with repeated measures on time. Conclusion: Within the parameters of this research, neither female upper nor lower body power output differed across the menstrual cycle when analyzed using 50% of one repetition (1RM) maximal bench press and the 30-second maximal effort cycle ergometer Wingate test. Therefore, researchers should not alter their subject populations due to the incorrect assumption that power output may be influenced by the menstrual cycle.

Keywords: anaerobic, athlete, female, power

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2111 Next Generation UK Storm Surge Model for the Insurance Market: The London Case

Authors: Iacopo Carnacina, Mohammad Keshtpoor, Richard Yablonsky

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Non-structural protection measures against flooding are becoming increasingly popular flood risk mitigation strategies. In particular, coastal flood insurance impacts not only private citizens but also insurance and reinsurance companies, who may require it to retain solvency and better understand the risks they face from a catastrophic coastal flood event. In this context, a framework is presented here to assess the risk for coastal flooding across the UK. The area has a long history of catastrophic flood events, including the Great Flood of 1953 and the 2013 Cyclone Xaver storm, both of which led to significant loss of life and property. The current framework will leverage a technology based on a hydrodynamic model (Delft3D Flexible Mesh). This flexible mesh technology, coupled with a calibration technique, allows for better utilisation of computational resources, leading to higher resolution and more detailed results. The generation of a stochastic set of extra tropical cyclone (ETC) events supports the evaluation of the financial losses for the whole area, also accounting for correlations between different locations in different scenarios. Finally, the solution shows a detailed analysis for the Thames River, leveraging the information available on flood barriers and levees. Two realistic disaster scenarios for the Greater London area are simulated: In the first scenario, the storm surge intensity is not high enough to fail London’s flood defences, but in the second scenario, London’s flood defences fail, highlighting the potential losses from a catastrophic coastal flood event.

Keywords: storm surge, stochastic model, levee failure, Thames River

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2110 Optimism, Skepticism, and Uncertainty: A Qualitative Study on the Knowledge and Perceived Impact of the Affordable Care Act among Adult Patients Seeking Care in a Free Clinic

Authors: Mike Wei, Mario Cedillo, Jiahui Lin, Carol Lorraine Storey-Johnson, Carla Boutin-Foster

Abstract:

Purpose: The extent to which health insurance enrollment succeeds under the Affordable Care Act (ACA) rests heavily on the ability to reach the uninsured and motivate them to enroll. We sought to identify perceptions about the ACA among uninsured patients at a free clinic in New York City. Background: The ACA holds tremendous promise for reducing the number of uninsured Americans. As of April 2014, nearly 8 million people had signed up for health insurance through the Health Insurance Marketplace. Despite this early success, future and continued enrollment rests heavily on the degree of public awareness. Reaching eligible individuals and increasing their awareness and understanding remains a fundamental challenge to realizing the full potential of the ACA. Reaching out to uninsured patients who are seeking care through safety net facilities such as free clinics may provide important avenues for reaching potential enrollees. This project focuses on the experience at the free clinic at Weill Cornell Medical College, the Weill Cornell Community Clinic (WCCC), and seeks to understand perceptions about the ACA among its patient population. Methods: This was a cross-sectional study of all patients who visited the free clinic at Weill Cornell Medical College, the Weill Cornell Community Clinic, from July 2013 to May 2014. Patients who provided informed consent at their visit and completed a semi-structured questionnaire were included (N=62). The questionnaire comprised of questions about demographic characteristics and open-ended questions about their knowledge and perception of the impact of the ACA. Descriptive statistics were used to characterize the population demographics. Qualitative coding techniques were used for open-ended items. Results: Approximately one third of patients surveyed never had health insurance. Of the remaining 65%, 20% lost their insurance within the past year. Only 55% had heard about the ACA, and only 10% knew about the Health Benefits Exchange. Of those who had heard about the ACA, sentiments were tinged with optimistic misperceptions, such as “it will be free health care for all.” While optimistic, most of the responses focused on the economic implications of the ACA. Conclusions: These findings reveal the immense amount of misconception and lack of understanding with regards to the ACA. As such, the study highlights the need to educate and address the concerns of those who remain skeptical or uncertain about the implications of the ACA.

Keywords: Affordable Care Act, demographics, free clinics, underserved.

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2109 Adaptable Buildings for More Sustainable Housing: Energy Life Cycle Analysis

Authors: Rafael Santos Fischer, Aloísio Leoni Schmid, Amanda Dalla-Bonna

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The life cycle analysis and the energy life cycle analysis are useful design support tools when sustainability becomes imperative. The final phase of buildings life cycle is probably the least known, on which less knowledge is available. In the Brazilian building industry, the lifespan of a building design rarely is treated as a definite design parameter. There is rather a common sense attitude to take any building demands as permanent, and to take for granted that buildings solutions are durable and solid. Housing, being a permanent issue in any society, presents a real challenge to the choice of a design lifespan. In Brazilian history, there was a contrast of the native solutions of collective, non-durable houses built by several nomadic tribes, and the stone and masonry buildings introduced by the sedentary Portuguese conquerors. Durable buildings are commonly associated with welfare. However, social dynamics makes traditional families of both parents and children be just one of several possible arrangements. In addition, a more liberal attitude towards family leads to an increase in the number of people living in alternative arrangements. Japan is an example of country where houses have been made intentionally ephemeral since the half of 20th century. The present article presents the development of a flexible housing design solution on the basis of the Design Science Research approach. A comparison in terms of energy life cycle shows how flexibility and dematerialization may point at a feasible future for housing policies in Brazil.

Keywords: adaptability, adaptable building, embodied energy, life cyclce analysis, social housing

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2108 The Antecedents of Customer-to-Customer Interaction to Brand and Communication Strategy: A Marketer’s Perspective

Authors: Kartina Sury Kariman

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Brand-to-customer (B2C) engagement has been well established through the traditional platform such as direct sales, advertising, customer service center, customer hotline as well as brand usage experiences. Increasingly, interest to B2C has evolved to include customer-to-customer (C2C) interaction analysis aligned with the vast growth of web 2.0. Hence, discussion on C2C interaction and brand strategy have captured social media as it enables brands and C2C interaction to be connected in various ways, providing opportunities for marketers to shape their brand engagement strategy while reaching C2C as the targeted outcomes. The objective here is to provide a preliminary review of C2C interaction consisting the antecedents and consequences while highlighting areas of research interest within the context from marketers perspective and the business outcomes. This paper discusses how C2C interaction defines marketers’ brand and communication strategy and how social media trend shapes the strategy when promoting the awareness of life insurance industry and educating the target market.

Keywords: social media, brand engagement, customer interaction, customer engagement, brand strategy, life insurance

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2107 A Study on How Newlyweds Handle the Difference with Parents on Wedding Arrangements and Its Implication for Services in Hong Kong

Authors: K. M. Yuen

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This research examined the literature review of wedding preparation’s challenges and its developmental tasks of family transition under family life cycle. Five interviewees were invited to share their experiences on the differences with their parents in regard to wedding preparations and coping strategies. Some coping strategies and processes were highlighted for facilitating the family to achieve the developmental tasks during the wedding preparation. However, those coping strategies and processes may only act as the step and the behavior, while “concern towards parents” was found to be the essential element behind these behaviors. In addition to pre-marital counseling, a developmental group was suggested to develop under the framework of family life cycle and its related coping strategies on working with the newlyweds who encountered intergenerational differences in regard to their wedding preparations.

Keywords: wedding preparation, difference, parents, family life cycle, developmental tasks, coping strategies, process

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2106 Analysis of Human Toxicity Potential of Major Building Material Production Stage Using Life Cycle Assessment

Authors: Rakhyun Kim, Sungho Tae

Abstract:

Global environmental issues such as abnormal weathers due to global warming, resource depletion, and ecosystem distortions have been escalating due to rapid increase of population growth, and expansion of industrial and economic development. Accordingly, initiatives have been implemented by many countries to protect the environment through indirect regulation methods such as Environmental Product Declaration (EPD), in addition to direct regulations such as various emission standards. Following this trend, life cycle assessment (LCA) techniques that provide quantitative environmental information, such as Human Toxicity Potential (HTP), for buildings are being developed in the construction industry. However, at present, the studies on the environmental database of building materials are not sufficient to provide this support adequately. The purpose of this study is to analysis human toxicity potential of major building material production stage using life cycle assessment. For this purpose, the theoretical consideration of the life cycle assessment and environmental impact category was performed and the direction of the study was set up. That is, the major material in the global warming potential view was drawn against the building and life cycle inventory database was selected. The classification was performed about 17 kinds of substance and impact index, such as human toxicity potential, that it specifies in CML2001. The environmental impact of analysis human toxicity potential for the building material production stage was calculated through the characterization. Meanwhile, the environmental impact of building material in the same category was analyze based on the characterization impact which was calculated in this study. In this study, establishment of environmental impact coefficients of major building material by complying with ISO 14040. Through this, it is believed to effectively support the decisions of stakeholders to improve the environmental performance of buildings and provide a basis for voluntary participation of architects in environment consideration activities.

Keywords: human toxicity potential, major building material, life cycle assessment, production stage

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2105 Comparative Life Cycle Assessment of Roofing System for Abu Dhabi

Authors: Iyasu Eibedingil

Abstract:

The construction industry is one of the major factors responsible for causing a negative impact on the environment. It has the largest share in the use of natural resources including land use, material extraction, and greenhouse gases emissions. For this reason, it is imperative to reduce its environmental impact through the construction of sustainable buildings with less impact. These days, it is possible to measure the environmental impact by using different tools such as the life cycle assessment (LCA) approach. Given this premise, this study explored the environmental impact of two types of roofing systems through comparative life cycle assessment approach. The tiles were analyzed to select the most environmentally friendly roofing system for the villa at Khalifa City A, Abu Dhabi, United Arab Emirates. These products are available in various forms; however, in this study concrete roof tiles and clay roof tiles were considered. The results showed that concrete roof tiles have lower environmental impact. In all scenarios considered, manufacturing the roof tiles locally, using recovered fuels for firing clay tiles, and using renewable energy (electricity from PV plant) showed that the concrete roof tiles were found to be excellent in terms of its embodied carbon, embodied the energy and various other environmental performance indicators.

Keywords: clay roof tile, concrete roof tile, life cycle assessment, sensitivity analysis

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2104 An Approach to Electricity Production Utilizing Waste Heat of a Triple-Pressure Cogeneration Combined Cycle Power Plant

Authors: Soheil Mohtaram, Wu Weidong, Yashar Aryanfar

Abstract:

This research investigates the points with heat recovery potential in a triple-pressure cogeneration combined cycle power plant and determines the amount of waste heat that can be recovered. A modified cycle arrangement is then adopted for accessing thermal potentials. Modeling the energy system is followed by thermodynamic and energetic evaluation, and then the price of the manufactured products is also determined using the Total Revenue Requirement (TRR) method and term economic analysis. The results of optimization are then presented in a Pareto chart diagram by implementing a new model with dual objective functions, which include power cost and produce heat. This model can be utilized to identify the optimal operating point for such power plants based on electricity and heat prices in different regions.

Keywords: heat loss, recycling, unused energy, efficient production, optimization, triple-pressure cogeneration

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2103 Lumbar Punctures: Re-Audit of Procedure Documentation Following the Introduction of a Standardised Procedure Checklist

Authors: Hayley Lawrence, Nabi Shah, Sarah Dyer

Abstract:

Aims: Lumbar punctures are a common bedside procedure performed in acute medicine. Published guidance exists on the standardised documentation of invasive procedures in order to reduce the risk of complications. The audit aim was to assess current standards of documentation in accordance with both the GMC and the National Standards for Invasive Procedures guidelines. A second cycle was conducted after introducing a standardised sticker created using current guidelines. This would assess whether the sticker improved documentation, aiming for 100% standard in each step of the procedure. Methods: An initial prospective audit of current practice was conducted over a 3-month period. Patients were identified by their presenting complaints and by colleagues assessing acute medical patients. Initial findings were presented locally, and a further prospective audit was conducted following the implementation of a standardised sticker. Results: 19 lumbar punctures were included in the first cycle and 13 procedures in the second. Pre-procedure documentation was collected for each cycle, whereby documentation of ‘Indication’ improved from 5.3% to 84.6%, ‘Consent’ from 84.2% to 100%, ‘Coagulopathy’ from 0% to 61.5%, ‘Drug Chart checked’ from 0% to 100%, ‘Position of patient’ from 26.3% to 100% and use of ‘Aseptic Technique’ from 83.3% to 100% from the first to the second cycle respectively. ‘Level of Doctor’ and ‘Supervision’ decreased from 53% to 31% and 53% to 46%, respectively, in the second cycle. Documentation of the procedure itself also demonstrated improvements, with ‘Level of Insertion’ 15.8% to 100%, ‘Name of Antiseptic Used’ 11.1% to 69.2%, ‘Local Anaesthetic Used’ 26.3% to 53.8%, ‘Needle Gauge’ 42.1% to 76.9%, ‘Number of Attempts’ 78.9% to 100% and ‘Traumatic/Atraumatic’ procedure 26.3% to 92.3%, respectively. A similar number of opening pressures were documented in each cycle at 57.9% and 53.8%, respectively, but its documentation was deemed ‘Not Applicable’ in a higher number of patients in the second cycle. Post-procedure documentation improved, with ‘Number of Samples obtained’ increasing from 52.6% to 92.3% and documentation of ‘Immediate Complications’ increasing from 78.9% to 100%. ‘Dressing Applied’ was poorly documented in the first cycle at 16.7%. This was not included on the standardised sticker, resulting in 0% documentation in the second cycle. Documentation of Clinicians’ Name and Bleep reduced from 63.2% to 15.4%, but when the name only was analysed, this increased to 84.6%. Conclusions: Standardised stickers for lumbar punctures do improve documentation and hence should result in improved patient safety. There is still room for improvement to reach 100% standard in each area, especially with respect to the clinician’s name and contact details being documented. Final adjustments will be made to the sticker before being included in a lumbar puncture kit, which will be made readily available in the acute medical wards. Future audits could be extended to include other common bedside procedures performed in acute medicine to ensure documentation of all these procedures reaches 100% standard.

Keywords: invasive procedure, lumbar puncture, medical record keeping, procedure checklist, procedure documentation, standardised documentation

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2102 Exergetic and Life Cycle Assessment Analyses of Integrated Biowaste Gasification-Combustion System: A Study Case

Authors: Anabel Fernandez, Leandro Rodriguez-Ortiz, Rosa RodríGuez

Abstract:

Due to the negative impact of fossil fuels, renewable energies are promising sources to limit global temperature rise and damage to the environment. Also, the development of technology is focused on obtaining energetic products from renewable sources. In this study, a thermodynamic model including Exergy balance and a subsequent Life Cycle Assessment (LCA) were carried out for four subsystems of the integrated gasification-combustion of pinewood. Results of exergy analysis and LCA showed the process feasibility in terms of exergy efficiency and global energy efficiency of the life cycle (GEELC). Moreover, the energy return on investment (EROI) index was calculated. The global exergy efficiency resulted in 67 %. For pretreatment, reaction, cleaning, and electric generation subsystems, the results were 85, 59, 87, and 29 %, respectively. Results of LCA indicated that the emissions from the electric generation caused the most damage to the atmosphere, water, and soil. GEELC resulted in 31.09 % for the global process. This result suggested the environmental feasibility of an integrated gasification-combustion system. EROI resulted in 3.15, which determinates the sustainability of the process.

Keywords: exergy analysis, life cycle assessment (LCA), renewability, sustainability

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2101 A Comparison of Sulfur Mustard Cytotoxic Effects on the Two Human Lung Origin Cell Lines

Authors: P. Jost, L. Muckova, M. Matula, J. Pejchal, D. Jun, R. Stetina

Abstract:

Sulfur mustard (bis(2-chlorethyl) sulfide) is highly toxic, chemical warfare agent that has been used in the past in several armed conflicts. Except for the skin, respiratory tract is one of the important routes of exposure. The elucidation and understanding of the mechanism of toxicity of SM have been effort intensive research. The multiple targets character of SM caused cellular damage resulted in activation of many different mechanisms which contribute to cellular response and participate in the final cytopathology effect. In our present work, we compared time-dependent changes in sulfur mustard exposed adult human lung fibroblasts NHLF and lung epithelial alveolar cell line A-549. Cell viability (MTT assay, Calcein-AM assay, and xCELLigence - real-time cell analysis), apoptosis (flow cytometry), mitochondrial membrane potential (Δψm, flow cytometry), reactive oxygen species induction (DC and cell cycle distribution (flow cytometry) were studied. We observed significantly decreased mitochondrial membrane potential and subsequent induction of apoptosis correlating with decreased cellular viability in the sulfur mustard exposed cells. In low concentrations, sulfur mustard-induced S-phase cell cycle arrest, on the other hand, high concentrations, cell cycle phase distribution of sulfur mustard exposed cells resembled cell cycle phase distribution of control group, which implies nonspecific cell cycle inhibition. Epithelial cells A-549 was found as more sensible to sulfur mustard toxicity. Acknowledgements: This work was supported by a long-term organization development plan Medical Aspects of Weapons of Mass Destruction of the Faculty of Military Health Sciences, University of Defence.

Keywords: apoptosis, cell cycle, cytotoxicity, sulfur mustard

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2100 Testing the Life Cycle Theory on the Capital Structure Dynamics of Trade-Off and Pecking Order Theories: A Case of Retail, Industrial and Mining Sectors

Authors: Freddy Munzhelele

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Setting: the empirical research has shown that the life cycle theory has an impact on the firms’ financing decisions, particularly the dividend pay-outs. Accordingly, the life cycle theory posits that as a firm matures, it gets to a level and capacity where it distributes more cash as dividends. On the other hand, the young firms prioritise investment opportunities sets and their financing; thus, they pay little or no dividends. The research on firms’ financing decisions also demonstrated, among others, the adoption of trade-off and pecking order theories on the dynamics of firms capital structure. The trade-off theory talks to firms holding a favourable position regarding debt structures particularly as to the cost and benefits thereof; and pecking order is concerned with firms preferring a hierarchical order as to choosing financing sources. The case of life cycle hypothesis explaining the financial managers’ decisions as regards the firms’ capital structure dynamics appears to be an interesting link, yet this link has been neglected in corporate finance research. If this link is to be explored as an empirical research, the financial decision-making alternatives will be enhanced immensely, since no conclusive evidence has been found yet as to the dynamics of capital structure. Aim: the aim of this study is to examine the impact of life cycle theory on the capital structure dynamics trade-off and pecking order theories of firms listed in retail, industrial and mining sectors of the JSE. These sectors are among the key contributors to the GDP in the South African economy. Design and methodology: following the postpositivist research paradigm, the study is quantitative in nature and utilises secondary data obtainable from the financial statements of sampled firm for the period 2010 – 2022. The firms’ financial statements will be extracted from the IRESS database. Since the data will be in panel form, a combination of the static and dynamic panel data estimators will used to analyse data. The overall data analyses will be done using STATA program. Value add: this study directly investigates the link between the life cycle theory and the dynamics of capital structure decisions, particularly the trade-off and pecking order theories.

Keywords: life cycle theory, trade-off theory, pecking order theory, capital structure, JSE listed firms

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2099 Characteristics and Feature Analysis of PCF Labeling among Construction Materials

Authors: Sung-mo Seo, Chang-u Chae

Abstract:

The Product Carbon Footprint Labeling has been run for more than four years by the Ministry of Environment and there are number of products labeled by KEITI, as for declaring products with their carbon emission during life cycle stages. There are several categories for certifying products by the characteristics of usage. Building products which are applied to a building as combined components. In this paper, current status of PCF labeling has been compared with LCI DB for data composition. By this comparative analysis, we suggest carbon labeling development.

Keywords: carbon labeling, LCI DB, building materials, life cycle assessment

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2098 Hamiltonian Paths and Cycles Passing through Prescribed Edges in the Balanced Hypercubes

Authors: Dongqin Cheng

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The n-dimensional balanced hypercube BHn (n ≥ 1) has been proved to be a bipartite graph. Let P be a set of edges whose induced subgraph consists of pairwise vertex-disjoint paths. For any two vertices u, v from different partite sets of V (BHn). In this paper, we prove that if |P| ≤ 2n − 2 and the subgraph induced by P has neither u nor v as internal vertices, or both of u and v as end-vertices, then BHn contains a Hamiltonian path joining u and v passing through P. As a corollary, if |P| ≤ 2n−1, then the BHn contains a Hamiltonian cycle passing through P.

Keywords: interconnection network, balanced hypercube, Hamiltonian cycle, prescribed edges

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