Search results for: structural healthcare monitoring

Authors: E. A. Krasikov

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Dependence of the materials properties on neutron irradiation intensity (flux) is a key problem while usage data of the accelerated materials irradiation in test reactors for forecasting of their capacity for work in realistic (practical) circumstances of operation. Investigations of the reactor pressure vessel steel radiation degradation dependence on fast neutron fluence (embrittlement kinetics) at low flux reveal the instability in the form of the scatter of the experimental data and wave-like sections of embrittlement kinetics appearance. Disclosure of the steel degradation oscillating is a sign of the steel structure cyclic self-recovery transformation as it take place in self-organization processes. This assumption has received support through the discovery of the similar ‘anomalous’ data in scientific publications and by means of own additional experiments. Data obtained stimulate looking-for ways to management of the structural steel radiation stability (for example, by means of nano - structure modification for radiation defects annihilation intensification) for creation of the intelligent self-recovering material. Expected results: - radiation degradation theory and mechanisms development, - more adequate models of the radiation embrittlement elaboration, - surveillance specimen programs improvement, - methods and facility development for usage data of the accelerated materials irradiation for forecasting of their capacity for work in realistic (practical) circumstances of operation, - search of the ways for creating of the radiation stable self-recovery intelligent materials.

Keywords: degradation, radiation, steel, wave-like kinetics

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Authors: William Gallagher, Harriet Bothwell, Lowri Evans, Kevin Jones

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Background: Worldwide, a third of adult deaths are caused by cardiovascular disease, a high proportion occurring in the developing world. Contributing to these poor outcomes are suboptimal assessments, treatments and monitoring of the acutely unwell patient. Successful training in trauma and neonates is recognised in the developing world but there is little literature supporting adult resuscitation. As far as the authors are aware no literature has been published on resuscitation training in Uganda since 2000 when a resuscitation training officer ran sessions in neonatal and paediatric resuscitation. The aim of this project was to offer training in Basic Life Support ( BLS) to staff and healthcare students based at Villa Maria Hospital in the Kalungu District, Central Uganda. This project was undertaken as a student selected component (SSC) offered by Swindon Academy, based at the Great Western Hospital, to medical students in their fourth year of the undergraduate programme. Methods: Semi-structured, informal interviews and focus groups were conducted with different clinicians in the hospital. These interviews were designed to focus on the level of training and understanding of BLS. A training session was devised which focused on BLS (excluding the use of an automatic external defribrillator) involving pre and post-training questionnaires and clinical assessments. Three training sessions were run for different cohorts: a pilot session for 5 Ugandan medical students, a second session for a group of 8 nursing and midwifery students and finally, a third was devised for physicians. The data collected was analysed in excel. Paired T-Tests determined statistical significance between pre and post-test scores and confidence before and after the sessions. Average clinical skill assessment scores were converted to percentages based on the area of BLS being assessed. Results: 27 participants were included in the analysis. 14 received ‘small group training’ whilst 13 received’ large group training’ 88% of all participants had received some form of resuscitation training. Of these, 46% had received theory training, 27% practical training and only 15% received both. 12% had received no training. On average, all participants demonstrated a significant increase of 5.3 in self-assessed confidence (p <0.05). On average, all participants thought the session was very useful. Analysis of qualitative date from clinician interviews in ongoing but identified themes identified include rescue breaths being considered the most important aspect resuscitation and doubts of a ‘good’ outcome from resuscitation. Conclusions: The results of this small study reflect the need for regular formal training in BLS in low resource settings. The active engagement and positive opinions concerning the utility of the training are promising as well as the evidence of improvement in knowledge.

Keywords: basic life support, education, resuscitation, sub-Saharan Africa, training, Uganda

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Authors: Hadj Sahraoui Omar, Kebir Lahcen Wahib, Bennia Ahmed

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Interferometric Synthetic Aperture Radar (InSAR) coherence is a crucial parameter for accurately monitoring ground deformation and environmental changes. However, coherence can be degraded by various factors such as temporal decorrelation, atmospheric disturbances, and geometric misalignments, limiting the reliability of InSAR measurements (Omar Hadj‐Sahraoui and al. 2019). To address this challenge, we propose an innovative hybrid approach that combines artificial intelligence (AI) with advanced filtering techniques to optimize interferometric coherence in InSAR data. Specifically, we introduce a Convolutional Neural Network (CNN) integrated with the Lee filter to enhance the performance of radar interferometry. This hybrid method leverages the strength of CNNs to automatically identify and mitigate the primary sources of decorrelation, while the Lee filter effectively reduces speckle noise, improving the overall quality of interferograms. We develop a deep learning-based model trained on multi-temporal and multi-frequency SAR datasets, enabling it to predict coherence patterns and enhance low-coherence regions. This hybrid CNN-SAR with Lee filtering significantly reduces noise and phase unwrapping errors, leading to more precise deformation maps. Experimental results demonstrate that our approach improves coherence by up to 30% compared to traditional filtering techniques, making it a robust solution for challenging scenarios such as urban environments, vegetated areas, and rapidly changing landscapes. Our method has potential applications in geohazard monitoring, urban planning, and environmental studies, offering a new avenue for enhancing InSAR data reliability through AI-powered optimization combined with robust filtering techniques.

Keywords: CNN-SAR, Lee Filter, hybrid optimization, coherence, InSAR phase unwrapping, speckle noise reduction

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Authors: Asem Alhnity, Nicholas Pickett

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The leisure home industry is experiencing an increase in sales due to the rise in popularity of staycations. However, there is also a demand for improvements in thermal and structural behaviour from customers. Existing standards and codes of practice outline the requirements for leisure home design. However, there is a lack of expertise in applying Finite Element Analysis (FEA) to complex structures in this industry. As a result, manufacturers rely on standardized design approaches, which often lead to excessively engineered or inadequately designed products. This study aims to address this issue by investigating the impact of the habitation structure on chassis performance in leisure homes. The aim of this research is to comprehensively analyse the impact of the habitation structure on chassis performance in leisure homes. By employing FEA on the entire unit, including both the habitation structure and the chassis, this study seeks to develop a novel framework for designing and analysing leisure homes. The objectives include material reduction, enhancing structural stability, resolving existing design issues, and developing innovative modular and wooden chassis designs. The methodology used in this research is quantitative in nature. The study utilizes FEA to analyse the performance of leisure home chassis under various loads. The analysis procedures involve running the FEA simulations on the numerical model of the leisure home chassis. Different load scenarios are applied to assess the stress and deflection performance of the chassis under various conditions. FEA is a numerical method that allows for accurate analysis of complex systems. The research utilizes flexible mesh sizing to calculate small deflections around doors and windows, with large meshes used for macro deflections. This approach aims to minimize run-time while providing meaningful stresses and deflections. Moreover, it aims to investigate the limitations and drawbacks of the popular approach of applying FEA only to the chassis and replacing the habitation structure with a distributed load. The findings of this study indicate that the popular approach of applying FEA only to the chassis and replacing the habitation structure with a distributed load overlooks the strengthening generated from the habitation structure. By employing FEA on the entire unit, it is possible to optimize stress and deflection performance while achieving material reduction and enhanced structural stability. The study also introduces innovative modular and wooden chassis designs, which show promising weight reduction compared to the existing heavily fabricated lattice chassis. In conclusion, this research provides valuable insights into the impact of the habitation structure on chassis performance in leisure homes. By employing FEA on the entire unit, the study demonstrates the importance of considering the strengthening generated from the habitation structure in chassis design. The research findings contribute to advancements in material reduction, structural stability, and overall performance optimization. The novel framework developed in this study promotes sustainability, cost-efficiency, and innovation in leisure home design.

Keywords: static homes, caravans, motor homes, holiday homes, finite element analysis (FEA)

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Authors: Rofaida Ashour

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This study discusses the implementation of quality improvement initiatives aimed at reducing contamination rates in cultured karyotyping samples. The primary objective was to enhance patient outcomes through systematic audits and targeted staff engagement. Recognizing the critical impact of sample integrity on diagnostic accuracy, a thorough analysis was conducted to identify the root causes of contamination. The project involved two audit cycles, which facilitated a comprehensive assessment of adherence to local protocols. Key issues identified included lapses in the use of personal protective equipment (PPE) and inadequate awareness of proper sample handling procedures among staff. To address these challenges, a multi-faceted approach was adopted. Firstly, a presentation was delivered to the laboratory team emphasizing the significance of strict adherence to PPE guidelines during the collection and handling of samples. This session aimed to raise awareness and foster a culture of safety within the unit. Additionally, informative posters illustrating the correct procedures were strategically placed around the laboratory to serve as ongoing visual reminders for staff. Recognizing the heightened risk associated with patients exhibiting fever or signs of infection, special measures were introduced to manage their sample collection. These proactive strategies were designed to minimize the likelihood of introducing contaminated samples into the culture process. The results of the audits demonstrated a significant reduction in contamination rates, underscoring the effectiveness of the interventions. This experience reinforced the importance of continuous quality improvement in healthcare settings, particularly in ensuring the delivery of high-quality, safe, and efficient services. Conducting regular audits not only provided valuable insights into operational practices but also highlighted the critical role of active team engagement and a data-driven approach in decision-making. Effective communication and collaboration among team members emerged as essential components for the success of quality improvement initiatives.

Keywords: quality improvement, contamination rates, karyotyping samples, healthcare protocols, staff engagement

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Authors: Warinthorn Kiadtikornthaweeyot Evans, Nawattakorn Kaikaew

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The communication system between the ground station and the satellite is very important to guarantee contact between both sides. Thailand, led by Geo-Informatics and Space Technology Development Agency (GISTDA), has received satellite images from other nation's satellites for a number of years. In 2008, Thailand Earth Observation Satellite (THEOS) was the first Earth observation satellite owned by Thailand. The mission was monitoring our country with affordable access to space-based Earth imagery. At this time, the control ground station was initially used to control the THEOS satellite by our Thai engineers. The Tele-commands were sent to the satellite according to requests from government and private sectors. Since then, GISTDA's engineers have gained their skill and experience to operate the satellite. Recently the desire to use satellite data is increasing rapidly due to space technology moving fast and giving us more benefits. It is essential to ensure that Thailand remains competitive in space technology. Thai Engineers have started to improve the performance of the control ground station in many different sections, also developing skills and knowledge in areas of satellite communication. Human resource skills are being enforced with development projects through capacity building. This paper focuses on the hands-on capacity building of GISTDA's engineers to develop a small automatic tracking antenna. The final achievement of the project is the first phase prototype of a small automatic tracking antenna to support the new technology of the satellites. There are two main subsystems that have been developed and tested; the tracking system and the monitoring and control software. The prototype first phase functions testing has been performed with Two Line Element (TLE) and the mission planning plan (MPP) file calculated from THEOS satellite by GISTDA.

Keywords: capacity building, small tracking antenna, automatic tracking system, project development procedure

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Authors: Flóra Pomázi, Sándor Baranya, Zoltán Szalai

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A harmonized monitoring of the suspended sediment transport along such a large river as the world’s most international river, the Danube River, is a rather challenging task. The traditional monitoring method in Hungary is obsolete but using indirect measurement devices and techniques like optical backscatter sensors (OBS), laser diffraction or acoustic backscatter sensors (ABS) could provide a fast and efficient alternative option of direct methods. However, these methods are strongly sensitive to the particle characteristics (i.e. particle shape, particle size and mineral composition). The current method does not provide sufficient information about particle size distribution, mineral analysis is rarely done, and the shape of the suspended sediment particles have not been examined yet. The aims of the study are (1) to determine the particle characterisation of suspended sediment in the Danube River using advanced particle characterisation methods as laser diffraction and automated imaging, and (2) to perform a sensitivity analysis of the indirect methods in order to determine the impact of suspended particle characteristics. The particle size distribution is determined by laser diffraction. The particle shape and mineral composition analysis is done by the Morphologi G3ID image analyser. The investigated indirect measurement devices are the LISST-Portable|XR, the LISST-ABS (Sequoia Inc.) and the Rio Grande 1200 kHz ADCP (Teledyne Marine). The major findings of this study are (1) the statistical shape of the suspended sediment particle - this is the first research in this context, (2) the actualised particle size distribution – that can be compared to historical information, so that the morphological changes can be tracked, (3) the actual mineral composition of the suspended sediment in the Danube River, and (4) the reliability of the tested indirect methods has been increased – based on the results of the sensitivity analysis and the previous findings.

Keywords: advanced particle characterisation, automated imaging, indirect methods, laser diffraction, mineral composition, suspended sediment

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Authors: Getaneh Berie Tarekegn

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A precise localization system is crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarming, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. The most common method for providing continuous positioning services in outdoor environments is by using a global navigation satellite system (GNSS). Due to nonline-of-sight, multipath, and weather conditions, GNSS systems do not perform well in dense urban, urban, and suburban areas.This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a novel semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. We also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 39 cm, and more than 90% of the errors are less than 82 cm. That is, numerical results proved that, in comparison to traditional methods, the proposed SRCLoc method can significantly improve positioning performance and reduce radio map construction costs.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

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Authors: Sonia Bautista Carrascosa, Carlos Renedo Sanchez

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The effect of a rapid drawdown is a classical scenario to be considered in slope stability under submerged conditions. This situation arises when totally or partially submerged slopes experience a descent of the external water level and is a typical verification to be done in a dam engineering discipline, as reservoir water levels commonly fluctuate noticeably during seasons and due to operational reasons. Although the scenario is well known and predictable in general, site conditions can increase the complexity of its assessment and external factors are not always expected, can cause a reduction in the stability or even a failure in a slope under a rapid drawdown situation. The present paper describes and discusses the interaction between two different infrastructures, a dam and a highway, and the impact on the stability of a natural rock slope overlaid by the north abutment of a viaduct of the A-44 Highway due to the rapid drawdown of the Rules Dam, in the province of Granada (south of Spain). In the year 2011, with both infrastructures, the A-44 Highway and the Rules Dam already constructed, delivered and under operation, some movements start to be recorded in the approximation embankment and north abutment of the Guadalfeo Viaduct, included in the highway and developed to solve the crossing above the tail of the reservoir. The embankment and abutment were founded in a low-angle natural rock slope formed by grey graphic phyllites, distinctly weathered and intensely fractured, with pre-existing fault and weak planes. After the first filling of the reservoir, to a relative level of 243m, three consecutive drawdowns were recorded in the autumns 2010, 2011 and 2012, to relative levels of 234m, 232m and 225m. To understand the effect of these drawdowns in the weak rock mass strength and in its stability, a new geological model was developed, after reviewing all the available ground investigations, updating the geological mapping of the area and supplemented with an additional geotechnical and geophysical investigations survey. Together with all this information, rainfall and reservoir level evolution data have been reviewed in detail to incorporate into the monitoring interpretation. The analysis of the monitoring data and the new geological and geotechnical interpretation, supported by the use of limit equilibrium software Slide2, concludes that the movement follows the same direction as the schistosity of the phyllitic rock mass, coincident as well with the direction of the natural slope, indicating a deep-seated movement of the whole slope towards the reservoir. As part of these conclusions, the solutions considered to reinstate the highway infrastructure to the required FoS will be described, and the geomechanical characterization of these weak rocks discussed, together with the influence of water level variations, not only in the water pressure regime but in its geotechnical behavior, by the modification of the strength parameters and deformability.

Keywords: monitoring, rock slope stability, water drawdown, weak rock

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Authors: Abu Afree Andalib, M. Mezbah Uddin, M. Rafiur Rahman, M. Abir Hossain, Rajia Sultana Kamol

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This paper deals with the analysis of flow past the marine turbine blade which is designed by using the blade element theory and momentum theory for the purpose of using in the field of renewable energy. The designed blade is analyzed for various parameters using FSI module of Ansys. Computational Fluid Dynamics is used for the study of fluid flow past the blade and other fluidic phenomena such as lift, drag, pressure differentials, energy dissipation in water. Finite Element Analysis (FEA) module of Ansys was used to analyze the structural parameter such as stress and stress density, localization point, deflection, force propagation. Fine mesh is considered in every case for more accuracy in the result according to computational machine power. The relevance of design, search and optimization with respect to complex fluid flow and structural modeling is considered and analyzed. The relevancy of design and optimization with respect to complex fluid for minimum drag force using Ansys Adjoint Solver module is analyzed as well. The graphical comparison of the above-mentioned parameter using CFD and FEA and subsequently FSI technique is illustrated and found the significant conformity between both the results.

Keywords: blade element theory, computational fluid dynamics, finite element analysis, fluid-structure interaction, momentum theory

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Authors: Selim Kara, Ertan Arda, Fahrettin Dolastir, Önder Pekcan

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Biomaterials and thin film coatings play a fundamental role in medical, food and pharmaceutical industries. Carrageenan is a linear sulfated polysaccharide extracted from algae and seaweeds. To date, such biomaterials have been used in many smart drug delivery systems due to their biocompatibility and antimicrobial activity properties. Poly (N-isopropylacrylamide) (PNIPAm) gels and copolymers have also been used in medical applications. PNIPAm shows lower critical solution temperature (LCST) property at about 32-34 °C which is very close to the human body temperature. Below and above the LCST point, PNIPAm gels exhibit distinct phase transitions between swollen and collapsed states. A special class of gels are microgels which can react to environmental changes significantly faster than microgels due to their small sizes. Quartz crystal microbalance (QCM) measurement technique is one of the attractive techniques which has been used for monitoring the thin-film formation process. A sensitive QCM system was designed as to detect 0.1 Hz difference in resonance frequency and 10-7 change in energy dissipation values, which are the measures of the deposited mass and the film rigidity, respectively. PNIPAm microgels with the diameter around few hundred nanometers in water were produced via precipitation polymerization process. 5 MHz quartz crystals with functionalized gold surfaces were used for the deposition of the carrageenan molecules and microgels in the solutions which were slowly pumped through a flow cell. Interactions between charged carrageenan and microgel particles were monitored during the formation of the film layers, and the Sauerbrey masses of the deposited films were calculated. The critical phase transition temperatures around the LCST were detected during the heating and cooling cycles. It was shown that it is possible to monitor the interactions between PNIPAm microgels and biopolymer molecules, and it is also possible to specify the critical phase transition temperatures by using a QCM system.

Keywords: carrageenan, phase transitions, PNIPAm microgels, quartz crystal microbalance (QCM)

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Authors: Mona G. Alharbi

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A new family of methionine-sulfoxide reductase (Msr) was recently discovered and was named free methionine sulfoxide reductase (fRMsr). This family includes enzymes with a reductase activity toward the free R isomer of a methionine sulfoxide substrate. The fRMsrs have a GAF domain topology, a domain, which was previously identified as having in some cases a cyclic nucleotide phosphodiesterase activity. The classification of fRMsrs as GAF domains revealed a new function can be added to the GAF domain family. Interestingly the four members identified in the fRMsr family share the GAF domain structure and the presence of three conserved cysteines in the active site with free R methionine sulfoxide substrate specificity. This thesis presents the crystal structures of reduced, free Met-SO substrate-bound and MES-bound forms of a new fRMsr from Burkholderia pseudomallei (BPSL2418). BPSL2418 was cloned, overexpressed and purified to enable protein crystallization. The crystallization trials for reduced, Met-SO-bound and MES-bound forms of BPSL2418 were prepared and reasonable crystals of each form were produced. The crystal structures of BPSL2418MES, BPSL2418Met-SO and BPSL2418Reduced were solved at 1.18, 1.4 and 2.0Å, respectively by molecular replacement. The BPSL2418MES crystal belongs to space group P 21 21 21 while BPSL2418Met-SO and BPSL2418Reduced crystals belong to space group P 1 21 1. All three forms share the GAF domain structure of six antiparallel β-strands and four α-helices with connecting loops. The antiparallel β-strands (β1, β2, β5 and β6) are located in the center of the BPSL2418 structure flanked on one side by a three α-helices (α1, α2 and α4) and on the other side by a (loop1, β3, loop2, α3, β4 loop4) unit where loop4 forms a capping flap and covers the active site. The structural comparison of the three forms of BPSL2418 indicates that the catalytically important cysteine is CYS109, where the resolving cysteine is CYS75, which forms a disulfide bond with CYS109. They also suggest that the third conserved cysteine in the active site, CYS85, which is located in α3, is a non-essential cysteine for the catalytic function but it may play a role in the binding of the substrate. The structural comparison of the three forms reveals that conformational changes appear in the active site particularly involving loop4 and CYS109 during catalysis. The 3D structure of BPSL2418 shows strong structure similarity to fRMsrs enzymes, which further suggests that BPSL2418 acts as a free Met-R-SO reductase and shares the catalytic mechanism of fRMsr family.

Keywords: Burkholderia pseudomallei, GAF domain protein, methionine sulfoxide reductase, protein crystallization

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Authors: N. S. A. Rahim, N. N. Abu Mansor, M. I. Saidi, N. R. A. Rahim, K. F. Adrutdin

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The use of coaching as one of organizational culture with the contribution of the involvement of line manager roles is an important to update employees’ knowledge and skills continuously. In healthcare sector, it is dynamic that nurse must update their knowledge and skills to keep pace with change. This paper attempts to discuss the involvement of line manager roles towards creating a coaching culture who give their support and innovation towards motivate nurses to give their best performance either in public or private hospitals.

Keywords: nursing, line managers’ roles, coaching, coaching culture

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Authors: Arlett A. Rosado-Torres, Ismael Marino-Tapia

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Changes in benthic cover of coral dominated systems to macroalgae dominance are widely studied worldwide. Watershed pollutants are potentially as important as overfishing causing phase shift. In certain regions of the world most of the continental inputs are through submarine groundwater discharges (SGD), which can play a significant ecological role because the concentration of its nutrients is usually greater that the one found in surface seawater. These stressors have adversely affected coral reefs, particularly in the Caribbean. Measurements of benthic cover (with video tracing, through a Go Pro camera), reef roughness (acoustic estimates with an Acoustic Doppler Current Velocity profiler and a differential GPS), thermohaline conditions (conductivity-temperature-depth (CTD) instrument) and nutrient measurements were taken in different sites in the reef lagoon of Puerto Morelos, Q. Roo, Mexico including those with influence of SGD and without it. The results suggest a link between SGD, macroalgae cover and structural complexity. Punctual water samples and data series from a CTD Diver confirm the presence of the SGD. On the site where the SGD is, the macroalgae cover is larger than in the other sites. To establish a causal link between this phase shift and SGD, the DELFT 3D hydrodynamic model (FLOW and WAVE modules) was performed under different environmental conditions and discharge magnitudes. The model was validated using measurements of oceanographic instruments anchored in the lagoon and forereef. The SGD is consistently favoring macroalgae populations and affecting structural complexity of the reef.

Keywords: hydrodynamic model, macroalgae, nutrients, phase shift

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Authors: Mohd Tahseen Islam Talukder, Sheikh Adnan Enam, Latifa Akter Lithi, Soebur Rahman

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Composite structures have made significant advances in construction applications during the last few decades. Composite structures are composed of structural steel shapes and reinforced concrete combined with shear connectors, which benefit each material's unique properties. Significant research has been conducted on different types of connectors’ behavior and shear capacity. Moreover, the AISC 360-16 “Specification for Steel Structural Buildings” consists of a formula for channel shear connectors' shear capacity. This research compares the behavior of C type and L type shear connectors using Finite Element Analysis. Experimental results from published literature are used to validate the finite element models. The 3-D Finite Element Model (FEM) was built using ABAQUS 2017 to investigate non-linear capabilities and the ultimate load-carrying potential of the connectors using push-out tests. The changes in connector dimensions were analyzed using this non-linear model in parametric investigations. The parametric study shows that by increasing the length of the shear connector by 10 mm, its shear strength increases by 21%. Shear capacity increased by 13% as the height was increased by 10 mm. The thickness of the specimen was raised by 1 mm, resulting in a 2% increase in shear capacity. However, the shear capacity of channel connectors was reduced by 21% due to an increase of thickness by 2 mm.

Keywords: finite element method, channel shear connector, angle shear connector, ABAQUS, composite structure, shear connector, parametric study, ultimate shear capacity, push-out test

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Authors: Valentin Nickolai, Florian Pfeffel, Christian Louis Kühner

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In many industrialized nations, the demand for skilled workers rises, causing the current market for employees to be more candidate-driven than employer-driven. Therefore, losing highly skilled and experienced employees due to early or partial retirement negatively impacts firms. Therefore, finding new ways to incentivize older employees (Silver Workers) to stay longer with the company and in their job can be crucial for the success of a firm. This study analyzes how working remotely can be a valid incentive for experienced Silver Workers to stay in their job and instead work from home with more flexible working hours. An online survey with n = 684 respondents, who are employed in the service sector, has been conducted based on 13 constructs that influence job satisfaction. These have been further categorized into three groups “classic influencing factors,” “influencing factors changed by remote working,” and new remote working influencing factors,” and were analyzed using structural equation modeling (SEM). Here, Cronbach’s alpha of the individual constructs was shown to be suitable. Furthermore, the construct validity of the constructs was confirmed by face validity, content validity, convergent validity (AVE > 0.5: CR > 0.7), and discriminant validity. Additionally, confirmatory factor analysis (CFA) confirmed the model fit for the investigated sample (CMIN/DF: 2.567; CFI: 0.927; RMSEA: 0.048). It was shown in the SEM-analysis that the influencing factor on job satisfaction, “identification with the work,” is the most significant with β = 0.540, followed by “Appreciation” (β = 0.151), “Compensation” (β = 0.124), “Work-Life-Balance” (β = 0.116), and “Communication and Exchange of Information” (β = 0.105). While the significance of each factor can vary depending on the work model, the SEM-analysis also shows that the identification with the work is the most significant factor in all three work models mentioned above and, in the case of the traditional office work model, it is the only significant influencing factor. The study shows that employees between the ages of 56 and 65 years have the highest job satisfaction when working entirely from home or remotely. Furthermore, their job satisfaction score of 5.4 on a scale from 1 (very dissatisfied) to 7 (very satisfied) is the highest amongst all age groups in any of the three work models. Due to the significantly higher job satisfaction, it can be argued that giving Silver Workers the offer to work from home or remotely can incentivize them not to opt for early retirement or partial retirement but to stay in their job full-time Furthermore, these findings can indicate that employees in the Silver Worker age are much more inclined to leave their job for early retirement if they have to entirely work in the office.

Keywords: home office, remote work instead of early or partial retirement, silver worker, structural equation modeling

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Authors: Sophia El Ouazzani, Amer M. Burhan, Mary Wickenden

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Background: Despite improvements in recent years, the Moroccan mental healthcare system still face disparity between available resources and the current population’sneeds. The societal stigma, and limited economic, political, and human resources are all factors in shaping the psychiatric system, exacerbating the discontinuity of services for users after discharged from the hospital. As a result, limited opportunities for social inclusion and meaningful community engagement undermines human rights and recovery potential for people with mental health problems, especially those with psychiatric disabilities from serious mental illness (SMI). Recovery-oriented practice, such as mental health rehabilitation, addresses the complex needs of patients with SMI and support their community inclusion. The cultural acceptability of recovery-oriented practice is an important notion to consider for a successful implementation. Exploring the extent to which recovery-oriented practices are used in Morocco is a necessary first step to assess the cultural relevance of such a practice model. Aims: This study aims to explore understanding and knowledge, perception, and perspective about core concepts in mental health rehabilitation, including psychiatric disability, recovery, and engagement in meaningful occupations for people with SMI in Morocco. Methods: A pilot qualitative study was undertaken. Data was collected via semi-structured interviews and focusgroup discussions with healthcare professional students. Questions were organised around the following themes: 1) students’ perceptions, understanding, and expectations around concepts such as SMI, mental health disability, and recovery, and 2) changes in their views and expectations after starting their professional training. Further analysis of students’ perspectives on the concept of ‘meaningful occupation’ and how is this viewed within the context of the research questions was done. The data was extracted using an inductive thematic analysis approach. This is a pilot stage of a doctoral project, further data will be collected and analysed until saturation is reached. Results: A total of eight students were included in this study which included occupational therapy and mental health nursing students receiving training in Morocco. The following themes emerged as influencing students’ perceptions and views around the main concepts: 1) Stigma and discrimination, 2) Fatalism and low expectations, 3) Gendered perceptions, 4) Religious causation, 5) Family involvement, 6) Professional background, 7) Inaccessibility of services and treatment. Discussion/Contribution: Preliminary analysis of the data suggests that students’ perceptions changed after gaining more clinical experiences and being exposed to people with psychiatric disabilities. Prior to their training, stigma shaped greatly how they viewed people with SMI. The fear, misunderstanding, and shame around SMI and their functional capacities may contribute to people with SMI being stigmatizedand marginalised from their family and their community. Religious causations associated to SMIsare understood as further deepening the social stigma around psychiatric disability. Perceptions are influenced by gender, with women being doubly discriminated against in relation to recovery opportunities. Therapeutic pessimism seems to persist amongst students and within the mental healthcare system in general and regarding the recovery potential and opportunities for people with SMI. The limited resources, fatalism, and stigma all contribute to the low expectations for recovery and community inclusion. Implications and future directions will be discussed.

Keywords: disability, mental health rehabilitation, recovery, serious mental illness, transcultural psychiatry

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Authors: Alok Madan, Ashok Gupta, Arshad K. Hashmi

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Non-linear dynamic time history analysis is considered as the most advanced and comprehensive analytical method for evaluating the seismic response and performance of multi-degree-of-freedom building structures under the influence of earthquake ground motions. However, effective and accurate application of the method requires the implementation of advanced hysteretic constitutive models of the various structural components including masonry infill panels. Sophisticated computational research tools that incorporate realistic hysteresis models for non-linear dynamic time-history analysis are not popular among the professional engineers as they are not only difficult to access but also complex and time-consuming to use. And, commercial computer programs for structural analysis and design that are acceptable to practicing engineers do not generally integrate advanced hysteretic models which can accurately simulate the hysteresis behavior of structural elements with a realistic representation of strength degradation, stiffness deterioration, energy dissipation and ‘pinching’ under cyclic load reversals in the inelastic range of behavior. In this scenario, push-over or non-linear static analysis methods have gained significant popularity, as they can be employed to assess the seismic performance of building structures while avoiding the complexities and difficulties associated with non-linear dynamic time-history analysis. “Push-over” or non-linear static analysis offers a practical and efficient alternative to non-linear dynamic time-history analysis for rationally evaluating the seismic demands. The present paper is based on the analytical investigation of the effect of distribution of masonry infill panels over the elevation of planar masonry infilled reinforced concrete (R/C) frames on the seismic demands using the capacity spectrum procedures implementing nonlinear static analysis (pushover analysis) in conjunction with the response spectrum concept. An important objective of the present study is to numerically evaluate the adequacy of the capacity spectrum method using pushover analysis for performance based design of masonry infilled R/C frames for near-field earthquake ground motions.

Keywords: nonlinear analysis, capacity spectrum method, response spectrum, seismic demand, near-field earthquakes

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Authors: Damilohun D. Ayoyo, Anthony Mpiani, Temitope B. Oriola

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The debate on women’s roles in insurgencies and terrorist organizations continues to garner scholarly attention. While some scholars view women insurgents and terrorists as perpetrators, others have argued that they are non-agents and victims. This paper de/reconstructs the notion of ‘women as perpetrators’ of terrorism. Drawing on the narratives of rescued female Boko Haram operatives, and Boko Haram’s tactics for recruiting and deploying women and girls, the paper advances three main arguments. First, the growing social construction of women as perpetrators of terrorism – particularly radical Islamic terrorism – downplays the socio-cultural and structural processes leading to women’s involvement with terrorist organizations. Second, women agency in Boko Haram activities is better understood when grounded in the cultural and structural contexts of Northern Nigeria, Boko Haram’s construction of ‘female,’ and the experiences of female Boko Haram operatives. Third, the mechanisms through which female Boko Haram operatives are recruited and deployed make them more of non-agents and victims than perpetrators of terrorism. The paper draws on the agency-structure approach and argues that the gendered power asymmetries embedded in the cultures and structures of Northern Nigeria –the base of Boko Haram– contribute to the nature and dynamics of women’s involvement in the insurgency. Although the paper does not negate the agency of women in terrorism, it aligns with the studies that consider women insurgents as more victims than perpetrators of terror.

Keywords: Boko Haram, female agency, Northern Nigeria, patriarchy, perpetrator of terror, radical Islamic terrorism, sharia, victim of terror, women insurgents

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Authors: Abdelhammid Chibane

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Often, for architectural reasons or designs, several buildings have a non-uniform profile in elevation. Depending on the configuration of the construction and the arrangements structural elements, the non-uniform profile in elevation (the recess) is considered concept of a combination of non-uniform distributions of strength, stiffness, weight and geometry along the height of irregular structures. Therefore, this type of configuration can induce irregular distribution load causing a serious concentration stresses at the discontinuity. This therefore requires a serious behavioral treatment buildings in an earthquake. If appropriate measures are not taken into account, structural irregularity may become a major source of damage during earthquakesEarth. In the past, several research investigations have identified differences in dynamic response of irregular and regular porches. Among the most notable differences are the increments of displacements and ductility applications in floors located above the level of the shoulder and an increase in the contribution of the higher modes cisaillement1 efforts, ..., 10. The para -ssismiques codes recommend the methods of analysis Dynamic (or modal history) to establish the forces of calculation instead of the static method equivalent, which is basically applicable only to regular structures without major discontinuities in the mass, rigidity and strength along the height 11, 12 .To investigate the effects of irregular profiles on the structures, the main objective of this study was the assessment of the inelastic response, in terms of applications of ductility four types of non-uniform multi-stage structures subjected to relatively severe earthquakes. In the This study, only the parallel responses are analyzed setback.

Keywords: buildings, concentration stresses, ductility, ductility, designs, irregular structures

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Authors: Qirat Naz, Abasiokpon Udoakah

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In developed countries, global migration is diversifying. The minority ethnic population, including refugees and asylum seekers who, fled their home countries due to war, terrorism, oppression, or natural disasters, and returning home is dangerous for them. They need sanctuary and peaceful environment in host countries. They begin the process of acculturation, in which a person adopts the social mores and behavioral patterns of the dominant culture, yet they still have unique multicultural needs that the dominant society fails to address. The aim of this research is to provide a holistic understanding of the living experiences of a minority population, particularly migrants, including asylum seekers and refugees, in the health and social care system of South Wales. The purpose of this study is to investigate three research objectives: the multicultural health care needs of minorities, as well as the barriers to seeking health and social care facilities. There are Welsh policies for promoting cultural competence in the health and social care sectors; this research will explore the implications and impact of these policies on the target population. This research study will be conducted using qualitative research methods, tools, and techniques. This research is an inductive approach to coming up with a grounded theory. The sample will be divided into two groups: migrants and professionals providing any kind of services to migrants; each group will contain 30 participants. Interpretive phenomenological analysis would be utilized during the process of coding and developing the main themes of this research. The positionality of the researcher would be minimized by unloaded and open-ended questions, researcher’s work experience in research, continuous evaluation of her positionality, daily base reflection of fieldwork and seeking the help of male and female gatekeepers. The research findings would be based on emic perspective, and by documenting the emic perspective of minorities, this research will contribute to the knowledge of appropriate channels, including organizations, academics, and policymakers, to discover possible solutions and coping mechanisms to deal with the challenges and meet the multicultural demands of minorities. This research will provide a more in-depth understanding of minorities and will help to promote the diversity of health and social care in South Wales.

Keywords: migration, migrants, cultural competence, cultural barriers, healthcare challenges

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Authors: Khalifa Abdunaser, Salem Eljawashi

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Study area is threatened by numerous petroleum activities. The most important risk is associated with dramatic dangers of misuse and oil and gas pollutions, such as significant volumes of produced water, which refers to waste water generated during the production of oil and natural gas and disposed on the surface surrounded oil and gas fields. This work concerns the impact of oil exploration and production activities on the physical and environment fate of the area, focusing on the investigation and observation of crude oil migration as toxic fluid. Its penetration in groundwater resulted from the produced water impacted by oilfield operations disposed to the earth surface in Al Wahat area. Describing the areal distribution of the dominant groundwater quality constituents has been conducted to identify the major hydro-geochemical processes that affect the quality of water and to evaluate the relations between rock types and groundwater flow to the quality and geochemistry of water in Post-Eocene aquifer. The chemical and physical characteristics of produced water, where it is produced, and its potential impacts on the environment and on oil and gas operations have been discussed. Field work survey was conducted to identify and locate a large number of monitoring wells previously drilled throughout the study area. Groundwater samples were systematically collected in order to detect the fate of spills resulting from the various activities at the oil fields in the study area. Spatial distribution maps of the water quality parameters were built using Kriging methods of interpolation in ArcMap software. Thematic maps were generated using GIS and remote sensing techniques, which were applied to include all these data layers as an active database for the area for the purpose of identifying hot spots and prioritizing locations based on their environmental conditions as well as for monitoring plans.

Keywords: Sirt Basin, produced water, Al Wahat area, Ground water

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Authors: Mantas Sriubas, Kristina Bockute, Darius Virbukas, Giedrius Laukaitis

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In this work, the doped TiO2 (dopants – Ca, Mg) was investigated. The comparison between the physical vapour deposition methods as electron beam vapour deposition and magnetron sputtering was performed and the structural and electrical properties of the formed thin films were investigated. Thin films were deposited on different type of substrates: SiO2, Alloy 600 (Fe-Ni-Cr) and Al2O3 substrates. The structural properties were investigated using Ambios XP-200 profilometer, scanning electron microscope (SEM) Hitachi S-3400N, X-ray energy-dispersive spectroscope (EDS) Quad 5040 (Bruker AXS Microanalysis GmbH), X-ray diffractometer (XRD) D8 Discover (Bruker AXS GmbH) with glancing angles focusing geometry in a 20 – 70° range using the Cu Kα1 λ = 0.1540562 nm radiation). The impedance spectroscopy measurements were performed using Probostat® (NorECs AS) measurement cell in the frequency range from 10-1-106 Hz under reducing and oxidizing conditions in temperature range of 200 °C to 1200 °C. The investigation of the e-beam deposited Ca and Mg doped-TiO2 thin films shows that the thin films are dense without any visible pores and cavities and the thin films grow in zone T according Barna-Adamik SZM. Substrate temperature was kept 600 °C during the deposition and Ts/Tm ≈ 0.32 (substrate temperature (Ts) and coating material melting temperature (Tm)). The surface diffusion is high however, the grain boundary migration is strongly limited at this temperature. This means that structure is inhomogeneous and the columnar structure is mostly visible in the upper part of the films. According to XRD, the increasing of the Ca dopants’ concentration increases the crystallinity of the formed thin films and the crystallites size increase linearly and Ca dopants act as prohibitors. Thin films are comprised of anatase TiO2 phase with an exception of 2 % Ca doped TiO2, where a small peak of Ca arise. In the case of Mg doped-TiO2 the intensities of the XRD peaks decreases with increasing Mg molar concentration. It means that there are less diffraction planes of the particular orientation in thin films with higher impurities concentration. Thus, the crystallinity decreases with increasing Mg concentration and Mg dopants act as inhibitors. The impedance measurements show that the dopants changed the conductivity of the formed thin films. The conductivity varies from 10-3 S/cm to 10-4 S/cm at 800 °C under wet reducing conditions. The microstructure of the magnetron sputtered thin TiO2 films is different comparing to the thin films deposited using e-beam deposition therefore influencing other structural and electrical properties.

Keywords: electrical properties, electron beam deposition, magnetron sputtering, microstructure, titanium dioxide

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Authors: Mahmoud A. Mahmoud, Ashraf Osman

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In this study, the different approaches currently followed by design codes to assess the stability of buildings utilizing concrete moment resisting frames structural system are evaluated. For such purpose, a parametric study was performed. It involved analyzing group of concrete moment resisting frames having different slenderness ratios (height/width ratios), designed for different lateral loads to vertical loads ratios and constructed using ordinary reinforced concrete and high strength concrete for stability check and overall buckling using code approaches and computer buckling analysis. The objectives were to examine the influence of such parameters that directly linked to frames’ lateral stiffness on the buildings’ stability and evaluates the code approach in view of buckling analysis results. Based on this study, it was concluded that, the most susceptible buildings to instability and magnification of second order effects are buildings having high aspect ratios (height/width ratio), having low lateral to vertical loads ratio and utilizing construction materials of high strength. In addition, the study showed that the instability limits imposed by codes are mainly mathematical to ensure reliable analysis not a physical ones and that they are in general conservative. Also, it has been shown that the upper limit set by one of the codes that second order moment for structural elements should be limited to 1.4 the first order moment is not justified, instead, the overall story check is more reliable.

Keywords: buckling, lateral stability, p-delta, second order

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Authors: M. Meddi, A. Boufekane

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The Mitidja coastal groundwater which extends over an area of 1450 km2 is a strategic resource in the Algiers region. The high dependence of the regional economy on the use of this groundwater forces us to have recourse to its artificial recharge from the Wadi El Harrach in its upstream part. This system of artificial recharge has shown its effectiveness in the development of water resource mentioned in the succeeding works in several regions of the world. The objective of this study is to: Increase the reserves of water inputs by infiltration, raise the water level and its good quality in wells and boreholes, reduce losses to the sea, and address seawater intrusion by maintaining balance in the freshwater-saltwater interface in the downstream part of the groundwater basin. After analyzing the situation, it was noticed that a qualitative monitoring of the Wadi water for the groundwater recharge has to be done. For this purpose, we proceeded during three successive years (2010, 2011, and 2012) to the monthly sampling of water in the upstream part of the Wadi El Harrach for chemical analysis. The variation of the sediment transport concentration will be also measured. This monitoring aims to characterize the water quality and avoid clogging in the proposed recharge area. The results of these analyses showed the good chemical quality according to the analyses we performed in the laboratory during the three years, but they are too loaded with suspended matters. We noticed that these fine particles come from the grinding of limestone of sandpit located upstream of the area of the proposed recharge system. This problem can be solved by a water supply upstream of sandpit. For the recharge, we propose the method of using two wells for dual use, which means that it can be used for water supply and extraction. This solution is inexpensive in our case and could easily be used as wells are already drilled in the upstream part. This solution increases over time the piezometric level and also reduce groundwater contamination by saltwater in the downstream part.

Keywords: water quality, artificial groundwater recharge, Mitidja, North Algeria

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Authors: Jerzy Banski

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The basic aim of this study is to discuss and assess different classifications and research approaches to small towns that take their social and economic functions into account, as well as relations with surrounding areas. The subject literature typically includes three types of approaches to the classification of small towns: 1) the structural, 2) the location-related, and 3) the mixed. The structural approach allows for the grouping of towns from the point of view of the social, cultural and economic functions they discharge. The location-related approach draws on the idea of there being a continuum between the center and the periphery. A mixed classification making simultaneous use of the different approaches to research brings the most information to bear in regard to categories of the urban locality. Bearing in mind the approaches to classification, it is possible to propose a synthetic method for classifying small towns that takes account of economic structure, location and the relationship between the towns and their surroundings. In the case of economic structure, the small centers may be divided into two basic groups – those featuring a multi-branch structure and those that are specialized economically. A second element of the classification reflects the locations of urban centers. Two basic types can be identified – the small town within the range of impact of a large agglomeration, or else the town outside such areas, which is to say located peripherally. The third component of the classification arises out of small towns’ relations with their surroundings. In consequence, it is possible to indicate 8 types of small-town: from local centers enjoying good accessibility and a multi-branch economic structure to peripheral supra-local centers characterised by a specialized economic structure.

Keywords: small towns, classification, functional structure, localization

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Authors: Yiping Meng, Yiming Sun

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The traditional construction industry is unable to meet the requirements for novel fabrication and construction. Automated construction and digital design have emerged as industry development trends that compensate for this shortcoming under the backdrop of Industrial Revolution 4.0. Benefitting from more flexible working space and more various end-effector tools compared to CNC methods, robot fabrication and construction techniques have been used in irregular architectural design. However, there is a lack of a systematic and comprehensive design and optimisation workflow considering geometric form, material, and fabrication methods. This paper aims to propose a design optimisation workflow for improving the rationality of a free-form timber structure fabricated by the robotic arm. Firstly, the free-form surface is described by NURBS, while its structure is calculated using the finite element analysis method. Then, by considering the characteristics and limiting factors of robotic timber fabrication, strain energy and robustness are set as optimisation objectives to optimise structural morphology by gradient descent method. As a result, an optimised structure with axial force as the main force and uniform stress distribution is generated after the structure morphology optimisation process. With the decreased strain energy and the improved robustness, the generated structure's bearing capacity and mechanical properties have been enhanced. The results prove the feasibility and effectiveness of the proposed optimisation workflow for free-form timber structure morphology design.

Keywords: robotic fabrication, free-form timber structure, Multi-objective optimisation, Structural morphology, rational design

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Authors: S. Cafiso, B. Capace, A. Di Graziano, C. D’Agostino

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Systematic monitoring of the trackbed is necessary to assure safety and quality of service in the railway system. Moreover, to produce effective management of the maintenance treatments, the assessment of bearing capacity of the railway trackbed must include ballast, sub-ballast and subgrade layers at different depths. Consequently, there is an increasing interest in obtaining a consistent measure of ballast bearing capacity with no destructive tests (NDTs) able to work in the physical and time restrictions of railway tracks in operation. Moreover, in the case of the local railway with reduced gauge, the use of the traditional high-speed track monitoring systems is not feasible. In that framework, this paper presents results from in site investigation carried out on ballast and sleepers with Ground Penetrating Radar (GPR) and Light Falling Weight Deflectometer (LWD). These equipment are currently used in road pavement maintenance where they have shown their reliability and effectiveness. Application of such Non-Destructive Tests in railway maintenance is promising but in the early stage of the investigation. More specifically, LWD was used to estimate the stiffness of ballast and sleeper support, as well. LWD, despite the limited load (6 kN in the trial test) applied directly on the sleeper, was able to detect defects in the bearing capacity at the Sleeper/Ballast interface. A dual frequency GPR was applied to detect the presence of layers’ discontinuities at different depths due to fouling phenomena that are the main causes of changing in the layer dielectric proprieties within the ballast thickness. The frequency of 2000Mhz provided high-resolution data to approximately 0.4m depth, while frequency of 600Mhz showed greater depth penetration up to 1.5 m. In the paper literature review and trial in site experience are used to identify Strengths, Weaknesses, Opportunities, and Threats (SWOT analysis) of the application of GPR and LWD for the assessment of bearing capacity of railway track-bed.

Keywords: bearing capacity, GPR, LWD, no destructive test, railway track

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Authors: Yichin Chen

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Taiwan is an island characterized by an active tectonics and high erosion rates. Monitoring the dynamic landscape of Taiwan is an important issue for disaster mitigation, geomorphological research, and watershed management. Long-term and high spatiotemporal landform data is essential for quantifying and simulating the geomorphological processes and developing warning systems. Recently, the advances in unmanned aerial vehicle (UAV) and computational photogrammetry technology have provided an effective way to rebuild and monitor the topography changes in high spatio-temporal resolutions. This study rebuilds the 30-years landform change in the Aiyuzi watershed in 1986-2017 by using the aerial photogrammetry-based techniques. The Aiyuzi watershed, located in central Taiwan and has an area of 3.99 Km², is famous for its frequent landslide and debris flow disasters. This study took the aerial photos by using UAV and collected multi-temporal historical, stereo photographs, taken by the Aerial Survey Office of Taiwan’s Forestry Bureau. To rebuild the orthoimages and digital surface models (DSMs), Pix4DMapper, a photogrammetry software, was used. Furthermore, to control model accuracy, a set of ground control points was surveyed by using eGPS. The results show that the generated DSMs have the ground sampling distance (GSD) of ~10 cm and ~0.3 cm from the UAV’s and historical photographs, respectively, and vertical error of ~1 m. By comparing the DSMs, there are many deep-seated landslides (with depth over 20 m) occurred on the upstream in the Aiyuzi watershed. Even though a large amount of sediment is delivered from the landslides, the steep main channel has sufficient capacity to transport sediment from the channel and to erode the river bed to ~20 m in depth. Most sediments are transported to the outlet of watershed and deposits on the downstream channel. This case study shows that UAV and photogrammetry technology are useful for topography change monitoring effectively.

Keywords: aerial photogrammetry, landslide, landform change, Taiwan

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Authors: Wisit Wichitkosoom

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Objective:The majority of the hisk-risk patients (ST-elevation myocardial infarction (STEMI), Acute cerebrovascular accident, Sepsis, Acute Traumatic patient ) are admitted to district or lacal hospitals (average 1-1.30 hr. from Udonthani general hospital, Northeastern province, Thailand) without proper facilities. The referral system was support to early care and early management at pre-hospital stage and prepare for the patient data to higher hospital. This study assessed the reduction in treatment delay achieved by pre-hospital diagnosis and referral directly to Udonthani General Hospital. Methods and results: Four district or local hospitals without proper facilities for treatment the very high-risk patient were serving the study region. Pre-hospital diagnoses were established with the simple technology such as LINE, SMS, telephone and Fax for concept of LEAN process and then the telemedicine, by ambulance monitoring (ECG, SpO2, BT, BP) in both real time and snapshot mode was administrated during the period of transfer for safety transfer concept (inter-hospital stage). The standard treatment for patients with STEMI, Intracranial injury and acute cerebrovascular accident were done. From 1 October 2012 to 30 September 2013, the 892 high-risk patients transported by ambulance and transferred to Udonthani general hospital were registered. Patients with STEMI diagnosed pre-hospitally and referred directly to the Udonthani general hospital with telemedicine closed monitor (n=248). The mortality rate decreased from 11.69% in 2011 to 6.92 in 2012. The 34 patients were arrested on the way and successful to CPR during transfer with the telemedicine consultation were 79.41%. Conclusion: The proper innovation could apply for health care system. The very high-risk patients must had the closed monitoring with two-way communication for the “safety transfer period”. It could modified to another high-risk group too.

Keywords: safety transfer, telemedicine, critical patients, medical and health sciences

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