Search results for: service transformation plan

Authors: Shanza Akram, Sameen Toor, Heba Harb Abu Alkass, Zainab Abdulsalam Altaha, Sara Taha Abdulla, Saleem Imran

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Acute pulmonary embolism (PE) is a common disease and can be fatal. The clinical presentation is variable and nonspecific, making accurate diagnosis difficult. Testing patients with suspected acute PE has increased dramatically. However, the overuse of some tests, particularly CT and D-dimer measurement, may not improve care while potentially leading to patient harm and unnecessary expense. CTPA is the investigation of choice for PE. Its easy availability, accuracy and ability to provide alternative diagnosis has lowered the threshold for performing it, resulting in its overuse. Guidelines have recommended the use of clinical pretest probability tools such as ‘Wells score’ to assess risk of suspected PE. Unfortunately, implementation of guidelines in clinical practice is inconsistent. This has led to low risk patients being subjected to unnecessary imaging, exposure to radiation and possible contrast related complications. Aim: To study the diagnostic yield of CT PA, clinical pretest probability of patients according to wells score and to determine whether or not there was an overuse of CTPA in our service. Methods: CT scans done on patients with suspected P.E in our hospital from 1st January 2014 to 31st December 2014 were retrospectively reviewed. Medical records were reviewed to study demographics, clinical presentation, final diagnosis, and to establish if Wells score and D-Dimer were used correctly in predicting the probability of PE and the need for subsequent CTPA. Results: 100 patients (51male) underwent CT PA in the time period. Mean age was 57 years (24-91 years). Majority of patients presented with shortness of breath (52%). Other presenting symptoms included chest pain 34%, palpitations 6%, collapse 5% and haemoptysis 5%. D Dimer test was done in 69%. Overall Wells score was low (<2) in 28 %, moderate (>2 - < 6) in 47% and high (> 6) in 15% of patients. Wells score was documented in medical notes of only 20% patients. PE was confirmed in 12% (8 male) patients. 4 had bilateral PE’s. In high-risk group (Wells > 6) (n=15), there were 5 diagnosed PEs. In moderate risk group (Wells >2 - < 6) (n=47), there were 6 and in low risk group (Wells <2) (n=28), one case of PE was confirmed. CT scans negative for PE showed pleural effusion in 30, Consolidation in 20, atelactasis in 15 and pulmonary nodule in 4 patients. 31 scans were completely normal. Conclusion: Yield of CT for pulmonary embolism was low in our cohort at 12%. A significant number of our patients who underwent CT PA had low Wells score. This suggests that CT PA is over utilized in our institution. Wells score was poorly documented in medical notes. CT-PA was able to detect alternative pulmonary abnormalities explaining the patient's clinical presentation. CT-PA requires concomitant pretest clinical probability assessment to be an effective diagnostic tool for confirming or excluding PE. . Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being considered. Combining Wells scores with clinical and laboratory assessment may reduce the need for CTPA.

Keywords: CT PA, D dimer, pulmonary embolism, wells score

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Authors: B. Sudhakara Reddy

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In modern economy, energy is fundamental to virtually every product and service in use. It has been developed on the dependence of abundant and easy-to-transform polluting fossil fuels. On one hand, increase in population and income levels combined with increased per capita energy consumption requires energy production to keep pace with economic growth, and on the other, the impact of fossil fuel use on environmental degradation is enormous. The conflicting policy objectives of protecting the environment while increasing economic growth and employment has resulted in this paradox. Hence, it is important to decouple economic growth from environmental degeneration. Hence, the search for green energy involving affordable, low-carbon, and renewable energies has become global priority. This paper explores a transition to a sustainable energy system using the socio-economic-technical scenario method. This approach takes into account the multifaceted nature of transitions which not only require the development and use of new technologies, but also of changes in user behaviour, policy and regulation. The scenarios that are developed are: baseline business as usual (BAU) as well as green energy (GE). The baseline scenario assumes that the current trends (energy use, efficiency levels, etc.) will continue in future. India’s population is projected to grow by 23% during 2010 –2030, reaching 1.47 billion. The real GDP, as per the model, is projected to grow by 6.5% per year on average between 2010 and 2030 reaching US$5.1 trillion or $3,586 per capita (base year 2010). Due to increase in population and GDP, the primary energy demand will double in two decades reaching 1,397 MTOE in 2030 with the share of fossil fuels remaining around 80%. The increase in energy use corresponds to an increase in energy intensity (TOE/US $ of GDP) from 0.019 to 0.036. The carbon emissions are projected to increase by 2.5 times from 2010 reaching 3,440 million tonnes with per capita emissions of 2.2 tons/annum. However, the carbon intensity (tons per US$ of GDP) decreases from 0.96 to 0.67. As per GE scenario, energy use will reach 1079 MTOE by 2030, a saving of about 30% over BAU. The penetration rate of renewable energy resources will reduce the total primary energy demand by 23% under GE. The reduction in fossil fuel demand and focus on clean energy will reduce the energy intensity to 0.21 (TOE/US$ of GDP) and carbon intensity to 0.42 (ton/US$ of GDP) under the GE scenario. The study develops new ‘pathways out of poverty’ by creating more than 10 million jobs and thus raise the standard of living of low-income people. Our scenarios are, to a great extent, based on the existing technologies. The challenges to this path lie in socio-economic-political domains. However, to attain a green economy the appropriate policy package should be in place which will be critical in determining the kind of investments that will be needed and the incidence of costs and benefits. These results provide a basis for policy discussions on investments, policies and incentives to be put in place by national and local governments.

Keywords: energy, renewables, green technology, scenario

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Authors: Dustin Schöder

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The potential benefits of the utilization of highly automated and autonomous trucks in logistics operations are the subject of interest to the entire logistics industry. The benefits of the use of these new technologies were scientifically investigated and implemented in roadmaps. So far, reliable data and experiences from real life use cases are still limited. A German research consortium of both academics and industry developed a highly automated (SAE level 4) vehicle for yard operations at railports and container depots. After development and testing, a several month field test at the DUSS Terminal in Ulm-Dornstadt (Germany) and the nearby DB Intermodal Services Container Depot in Ulm-Dornstadt was conducted. The truck was piloted in a shuttle service between both sites. In a holistic automation approach, the vehicle was integrated into a digital communication platform so that the truck could move autonomously without a driver and his manual interactions with a wide variety of stakeholders. The main goal is to investigate the effects of highly automated trucks in the key processes of container loading, unloading and container relocation on holistic railport yard operation. The field test data were used to investigate changes in process efficiency of key processes of railport and container yard operations. Moreover, effects on the capacity utilization and potentials for smothering peak workloads were analyzed. The results state that process efficiency in the piloted use case was significantly higher. The reason for that could be found in the digitalized data exchange and automated dispatch. However, the field test has shown that the effect is greatly varying depending on the ratio of highly automated and manual trucks in the yard as well as on the congestion level in the loading area. Furthermore, the data confirmed that under the right conditions, the capacity utilization of highly automated trucks could be increased. In regard to the potential for smothering peak workloads, no significant findings could be made based on the limited requirements and regulations of railway operation in Germany. In addition, an empirical survey among railport managers, operational supervisors, innovation managers and strategists (n=15) within the logistics industry in Germany was conducted. The goal was to identify key characteristics of future railports and terminals as well as requirements that railports will have to meet in the future. Furthermore, the railport processes where automation and autonomization make the greatest impact, as well as hurdles and challenges in the introduction of new technologies, have been surveyed. Hence, further potential use cases of highly automated and autonomous applications could be identified, and expectations have been mapped. As a result, a highly detailed and practice-based roadmap towards a ‘terminal 4.0’ was developed.

Keywords: highly automated driving, autonomous driving, SAE level 4, railport operations, container depot, intermodal logistics, potentials of autonomization

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Authors: Habib Muhammetoglu, I. Ethem Karadirek, Selami Kara, Ayse Muhammetoglu

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The problem of non-revenue water (NRW) from municipal water distribution networks is common in many countries such as Turkey, where the average yearly water losses are around 50% . Water losses can be divided into two major types namely: 1) Real or physical water losses, and 2) Apparent or commercial water losses. Total water losses in Antalya city, Turkey is around 45%. Methods: A research study was conducted to develop appropriate methodologies to reduce NRW. A pilot study area of about 60 thousands inhabitants was chosen to apply the study. The pilot study area has a supervisory control and data acquisition (SCADA) system for the monitoring and control of many water quantity and quality parameters at the groundwater drinking wells, pumping stations, distribution reservoirs, and along the water mains. The pilot study area was divided into 18 District Metered Areas (DMAs) with different number of service connections that ranged between a few connections to less than 3000 connections. The flow rate and water pressure to each DMA were on-line continuously measured by an accurate flow meter and water pressure meter that were connected to the SCADA system. Customer water meters were installed to all billed and unbilled water users. The monthly water consumption as given by the water meters were recorded regularly. Water balance was carried out for each DMA using the well-know standard IWA approach. There were considerable variations in the water losses percentages and the components of the water losses among the DMAs of the pilot study area. Old Class B customer water meters at one DMA were replaced by more accurate new Class C water meters. Hydraulic modelling using the US-EPA EPANET model was carried out in the pilot study area for the prediction of water pressure variations at each DMA. The data sets required to calibrate and verify the hydraulic model were supplied by the SCADA system. It was noticed that a number of the DMAs exhibited high water pressure values. Therefore, pressure reducing valves (PRV) with constant head were installed to reduce the pressure up to a suitable level that was determined by the hydraulic model. On the other hand, the hydraulic model revealed that the water pressure at the other DMAs cannot be reduced when complying with the minimum pressure requirement (3 bars) as stated by the related standards. Results: Physical water losses were reduced considerably as a result of just reducing water pressure. Further physical water losses reduction was achieved by applying acoustic methods. The results of the water balances helped in identifying the DMAs that have considerable physical losses. Many bursts were detected especially in the DMAs that have high physical water losses. The SCADA system was very useful to assess the efficiency level of this method and to check the quality of repairs. Regarding apparent water losses reduction, changing the customer water meters resulted in increasing water revenue by more than 20%. Conclusions: DMA, SCADA, modelling, pressure management, leakage detection and accurate customer water meters are efficient for NRW.

Keywords: NRW, water losses, pressure management, SCADA, apparent water losses, urban water distribution networks

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Authors: Olga Sukhoveeva

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Carbon dioxide (CO2) is the main component of carbon biogeochemical cycle and one of the most important greenhouse gases (GHG). Agriculture, particularly arable soils, are one the largest sources of GHG emission for the atmosphere including CO2.Models may be used for estimation of GHG emission from agriculture if they can be adapted for different countries conditions. The only model used in officially at national level in United Kingdom and China for this purpose is DNDC (DeNitrification-DeComposition). In our research, the model DNDC is offered for estimation of GHG emission from arable soils in Russia. The aim of our research was to create the method of DNDC using for evaluation of CO2 emission in Russia based on official statistical information. The target territory was European part of Russia where many field experiments are located. At the first step of research the database on climate, soil and cropping characteristics for the target region from governmental, statistical, and literature sources were created. All-Russia Research Institute of Hydrometeorological Information – World Data Centre provides open daily data about average meteorological and climatic conditions. It must be calculated spatial average values of maximum and minimum air temperature and precipitation over the region. Spatial average values of soil characteristics (soil texture, bulk density, pH, soil organic carbon content) can be determined on the base of Union state register of soil recourses of Russia. Cropping technologies are published by agricultural research institutes and departments. We offer to define cropping system parameters (annual information about crop yields, amount and types of fertilizers and manure) on the base of the Federal State Statistics Service data. Content of carbon in plant biomass may be calculated via formulas developed and published by Ministry of Natural Resources and Environment of the Russian Federation. At the second step CO2 emission from soil in this region were calculated by DNDC. Modelling data were compared with empirical and literature data and good results were obtained, modelled values were equivalent to the measured ones. It was revealed that the DNDC model may be used to evaluate and forecast the CO2 emission from arable soils in Russia based on the official statistical information. Also, it can be used for creation of the program for decreasing GHG emission from arable soils to the atmosphere. Financial Support: fundamental scientific researching theme 0148-2014-0005 No 01201352499 ‘Solution of fundamental problems of analysis and forecast of Earth climatic system condition’ for 2014-2020; fundamental research program of Presidium of RAS No 51 ‘Climate change: causes, risks, consequences, problems of adaptation and regulation’ for 2018-2020.

Keywords: arable soils, carbon dioxide emission, DNDC model, European Russia

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Authors: Shayma Mohammed, Adel Trabelsi

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Radiopharmacy is the art of preparing high-quality, radioactive, medicinal products for use in diagnosis and therapy. Radiopharmaceuticals unlike normal medicines, this dual aspect (radioactive, medical) makes their management highly critical. One of the most convincing applications of modern technologies is the ability to delegate the execution of repetitive tasks to programming scripts. Automation has found its way to the most skilled jobs, to improve the company's overall performance by allowing human workers to focus on more important tasks than document filling. This project aims to contribute to implement a comprehensive system to insure rigorous management of radiopharmaceuticals through the use of a platform that links the Nuclear Medicine Service Management System to the Nuclear Radio-pharmacy Management System in accordance with the recommendations of World Health Organization (WHO) and International Atomic Energy Agency (IAEA). In this project we attempt to build a web application that targets radiopharmacies, the platform is built atop the inherently compatible web stack which allows it to work in virtually any environment. Different technologies are used in this project (PHP, Symfony, MySQL Workbench, Bootstrap, Angular 7, Visual Studio Code and TypeScript). The operating principle of the platform is mainly based on two parts: Radiopharmaceutical Backoffice for the Radiopharmacian, who is responsible for the realization of radiopharmaceutical preparations and their delivery and Medical Backoffice for the Doctor, who holds the authorization for the possession and use of radionuclides and he/she is responsible for ordering radioactive products. The application consists of sven modules: Production, Quality Control/Quality Assurance, Release, General Management, References, Transport and Stock Management. It allows 8 classes of users: The Production Manager (PM), Quality Control Manager (QCM), Stock Manager (SM), General Manager (GM), Client (Doctor), Parking and Transport Manager (PTM), Qualified Person (QP) and Technical and Production Staff. Digital platform bringing together all players involved in the use of radiopharmaceuticals and integrating the stages of preparation, production and distribution, Web technologies, in particular, promise to offer all the benefits of automation while requiring no more than a web browser to act as a user client, which is a strength because the web stack is by nature multi-platform. This platform will provide a traceability system for radiopharmaceuticals products to ensure the safety and radioprotection of actors and of patients. The new integrated platform is an alternative to write all the boilerplate paperwork manually, which is a tedious and error-prone task. It would minimize manual human manipulation, which has proven to be the main source of error in nuclear medicine. A codified electronic transfer of information from radiopharmaceutical preparation to delivery will further reduce the risk of maladministration.

Keywords: automated system, management, radiopharmacy, technical papers

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Authors: Moustafa Osman Mohammed

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This paper introduces Luhmann’s autopoietic social systems starting with the original concept of autopoiesis by biologists and scientists, including the modification of general systems based on socialized medicine. A specific type of autopoietic system is explained in the three existing groups of the ecological phenomena: interaction, social and medical sciences. This hypothesis model, nevertheless, has a nonlinear interaction with its natural environment ‘interactional cycle’ for the exchange of photon energy with molecular without any changes in topology. The external forces in the systems environment might be concomitant with the natural fluctuations’ influence (e.g. radioactive radiation, electromagnetic waves). The cantilever sensor deploys insights to the future chip processor for prevention of social metabolic systems. Thus, the circuits with resonant electric and optical properties are prototyped on board as an intra–chip inter–chip transmission for producing electromagnetic energy approximately ranges from 1.7 mA at 3.3 V to service the detection in locomotion with the least significant power losses. Nowadays, therapeutic systems are assimilated materials from embryonic stem cells to aggregate multiple functions of the vessels nature de-cellular structure for replenishment. While, the interior actuators deploy base-pair complementarity of nucleotides for the symmetric arrangement in particular bacterial nanonetworks of the sequence cycle creating double-stranded DNA strings. The DNA strands must be sequenced, assembled, and decoded in order to reconstruct the original source reliably. The design of exterior actuators have the ability in sensing different variations in the corresponding patterns regarding beat-to-beat heart rate variability (HRV) for spatial autocorrelation of molecular communication, which consists of human electromagnetic, piezoelectric, electrostatic and electrothermal energy to monitor and transfer the dynamic changes of all the cantilevers simultaneously in real-time workspace with high precision. A prototype-enabled dynamic energy sensor has been investigated in the laboratory for inclusion of nanoscale devices in the architecture with a fuzzy logic control for detection of thermal and electrostatic changes with optoelectronic devices to interpret uncertainty associated with signal interference. Ultimately, the controversial aspect of molecular frictional properties is adjusted to each other and forms its unique spatial structure modules for providing the environment mutual contribution in the investigation of mass temperature changes due to pathogenic archival architecture of clusters.

Keywords: autopoiesis, nanoparticles, quantum photonics, portable energy, photonic structure, photodynamic therapeutic system

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Authors: Arlinda Memetaj

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A sound system of administrative justice represents a vital element of democratic governance. The proper control of public administration consists not only of a sound civil service framework and legislative oversight, but empowerment of the public and courts to hold public officials accountable for their decision-making through the application of fair administrative procedural rules and the use of appropriate administrative appeals processes and judicial review. The establishment of both effective public administration and administrative justice system has been for a long period of time among the most ‘important and urgent’ final strategic objectives of almost any country in the Balkans region, including Macedonia, Albania and Kosovo. Closely related to this is their common strategic goal to enter the membership in the European Union, which requires fulfilling of many criteria and standards as incorporated in EU acquis communautaire. The latter is presently done with the framework of the Stabilization and Association Agreement which each of these countries has concluded with the EU accordingly. To above aims, each of the three countries has so far adopted a huge series of legislative and strategic documents related to any aspects of their individual administrative justice system. ‘Changes and reforms’ in this field have been thus the most frequent terms being used in any of these countries. The three countries have already established their own national administrative judiciary, while permanently amending their laws on the general administrative procedure introducing thereby considerable innovations concerned. National administrative courts are expected to have crucial important role within the broader judiciary systems-related reforms of these countries; they are designed to check the legality of decisions of the state administration with the aim to guarantee an effective protection of human rights and legitimate interests of private persons through a regular, conform, fast and reasonable judicial administrative process. Further improvements in this field are presently an integral crucial part of all the relevant national strategic documents including the ones on judiciary reform and public administration reform, as adopted by each of the three countries; those strategic documents are designed among others to provide effective protection of their citizens` rights` of administrative justice. On the basis of the later, the paper finally is aimed at highlighting selective common challenges and problems of the three countries on their European road, while claiming (among others) that the current status quo situation in each of them may be overcome only if there is a proper implementation of the administrative courts decisions and a far stricter international monitoring process thereof. A new approach and strong political commitment from the highest political leadership is thus absolutely needed to ensure the principles of transparency, accountability and merit in public administration. The main methods used in this paper include the analytical and comparative ones due to the very character of the paper itself.

Keywords: administrative courts , administrative justice, administrative procedure, benefit, effective administrative justice, human rights, implementation, monitoring, reform

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Authors: Oscar Nieto-Garzón, Angélica Lozano

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In urban areas, on-road freight transportation creates several social and environmental externalities. Then, it is crucial that freight transport considers not only economic aspects, like retailer distribution cost reduction and service improvement, but also environmental effects such as global CO2 and local emissions (e.g. Particulate Matter, NOX, CO) and noise. Inadequate infrastructure development, high rate of urbanization, the increase of motorization, and the lack of transportation planning are characteristics that urban areas from developing countries share. The Metropolitan Area of Mexico City (MAMC), the Metropolitan Area of São Paulo (MASP), and Bogota are three of the largest urban areas in Latin America where air pollution is often a problem associated with emissions from mobile sources. The effect of the lockdown due to COVID-19 was analyzedfor these urban areas, comparing the same period (January to August) of years 2016 – 2019 with 2020. A strong reduction in the concentration of primary criteria pollutants emitted by road traffic were observed at the beginning of 2020 and after the lockdown measures.Daily mean concentration of NOx decreased 40% in the MAMC, 34% in the MASP, and 62% in Bogota. Daily mean ozone levels increased after the lockdown measures in the three urban areas, 25% in MAMC, 30% in the MASP and 60% in Bogota. These changes in emission patterns from mobile sources drastically changed the ambient atmospheric concentrations of CO and NOX. The CO/NOX ratioat the morning hours is often used as an indicator of mobile sources emissions. In 2020, traffic from cars and light vehicles was significantly reduced due to the first lockdown, but buses and trucks had not restrictions. In theory, it implies a decrease in CO and NOX from cars or light vehicles, maintaining the levels of NOX by trucks(or lower levels due to the congestion reduction). At rush hours, traffic was reduced between 50% and 75%, so trucks could get higher speeds, which would reduce their emissions. By means an emission model, it was found that an increase in the average speed (75%) would reduce the emissions (CO, NOX, and PM) from diesel trucks by up to 30%. It was expected that the value of CO/NOXratio could change due to thelockdownrestrictions. However, although there was asignificant reduction of traffic, CO/NOX kept its trend, decreasing to 8-9 in 2020. Hence, traffic restrictions had no impact on the CO/NOX ratio, although they did reduce vehicle emissions of CO and NOX. Therefore, these emissions may not adequately represent the change in the vehicle emission patterns, or this ratio may not be a good indicator of emissions generated by vehicles. From the comparison of the theoretical data and those observed during the lockdown, results that the real NOX reduction was lower than the theoretical reduction. The reasons could be that there are other sources of NOX emissions, so there would be an over-representation of NOX emissions generated by diesel vehicles, or there is an underestimation of CO emissions. Further analysis needs to consider this ratioto evaluate the emission inventories and then to extend these results forthe determination of emission control policies to non-mobile sources.

Keywords: COVID-19, emissions, freight transport, latin American metropolis

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Authors: Mauro Callejas-Cuervo, Andrea C. Alarcon-Aldana, Andres F. Ruiz-Olaya, Juan C. Alvarez

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Motion capture (MC) is the construction of a precise and accurate digital representation of a real motion. Systems have been used in the last years in a wide range of applications, from films special effects and animation, interactive entertainment, medicine, to high competitive sport where a maximum performance and low injury risk during training and competition is seeking. This paper presents an inertial and magnetic sensor based technological platform, intended for particular amplitude monitoring and telerehabilitation processes considering an efficient cost/technical considerations compromise. Our platform particularities offer high social impact possibilities by making telerehabilitation accessible to large population sectors in marginal socio-economic sector, especially in underdeveloped countries that in opposition to developed countries specialist are scarce, and high technology is not available or inexistent. This platform integrates high-resolution low-cost inertial and magnetic sensors with adequate user interfaces and communication protocols to perform a web or other communication networks available diagnosis service. The amplitude information is generated by sensors then transferred to a computing device with adequate interfaces to make it accessible to inexperienced personnel, providing a high social value. Amplitude measurements of the platform virtual system presented a good fit to its respective reference system. Analyzing the robotic arm results (estimation error RMSE 1=2.12° and estimation error RMSE 2=2.28°), it can be observed that during arm motion in any sense, the estimation error is negligible; in fact, error appears only during sense inversion what can easily be explained by the nature of inertial sensors and its relation to acceleration. Inertial sensors present a time constant delay which acts as a first order filter attenuating signals at large acceleration values as is the case for a change of sense in motion. It can be seen a damped response of platform virtual in other images where error analysis show that at maximum amplitude an underestimation of amplitude is present whereas at minimum amplitude estimations an overestimation of amplitude is observed. This work presents and describes the platform virtual as a motion capture system suitable for telerehabilitation with the cost - quality and precision - accessibility relations optimized. These particular characteristics achieved by efficiently using the state of the art of accessible generic technology in sensors and hardware, and adequate software for capture, transmission analysis and visualization, provides the capacity to offer good telerehabilitation services, reaching large more or less marginal populations where technologies and specialists are not available but accessible with basic communication networks.

Keywords: inertial sensors, joint amplitude measurement, MEMS, telerehabilitation

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Authors: Robert H. Bradley

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Many minority adolescents in the United States live in adverse circumstances that pose long-term threats to their well-being. A strong sense of personal control and self-efficacy can help youth mitigate some of those risks and may help protect youth from influences connected with deviant peer groups. Accordingly, it is important to identify conditions that help foster feelings of efficacy in areas that seem critical for the accomplishment of developmental tasks during adolescence. The purpose of this study is to examine two aspects of the home environment (modeling and encouragement of maturity, family companionship and investment) and their relation to three components of self efficacy (self efficacy in enlisting social resources, self efficacy for engaging in independent learning, and self-efficacy for self-regulatory behavior) in three groups of minority adolescents (Native American, African American, Latino). The sample for this study included 54 Native American, 131 African American, and 159 Latino families, each with a child between 16 and 20 years old. The families were recruited from four states: Arizona, Arkansas, California, and Oklahoma. Each family was administered the Late Adolescence version of the Home Observation for Measurement of the Environment (HOME) Inventory and each adolescent completed a 30-item measure of perceived self-efficacy. Three areas of self-efficacy beliefs were examined for this study: enlisting social resources, independent learning, and self-regulation. Each of the three areas of self-efficacy was regressed on the two aspects of the home environment plus overall household risk. For Native Americans, modeling and encouragement were significant for self-efficacy pertaining to enlisting social resources and independent learning. For African Americans, companionship and investment was significant in all three models. For Latinos, modeling and encouragement was significant for self-efficacy pertaining to enlisting social resources and companionship and investment were significant for the other two areas of self-efficacy. The findings show that even as minority adolescents are becoming more individuated from their parents, the quality of experiences at home continues to be associated with their feelings of self-efficacy in areas important for adaptive functioning in adult life. Specifically, individuals can develop a sense that they are efficacious in performing key tasks relevant to work, social relationships, and management of their own behavior if they are guided in how to deal with key challenges and they have been exposed and supported by others who are competent in dealing with such challenges. The findings presented in this study would seem useful given that there is so little current research on home environmental factors connected to self-efficacy beliefs among adolescents in the three groups examined. It would seem worthwhile that personnel from health, human service and juvenile justice agencies give attention to supporting parents in communicating with adolescents, offering expectations to adolescents in mutually supportive ways, and in engaging with adolescents in productive activities. In comparison to programs for parents of young children, there are few specifically designed for parents of children in middle childhood and adolescence.

Keywords: family companionship, home environment, household income, modeling, self-efficacy

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Authors: Lan Cheng, Harry Qin, Yang Wang

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Background: COVID-19 has induced the largest digital learning experiment in history. There is also emerging research evidence that students have paid a high cost of learning loss from virtual learning. University-wide survey results demonstrate that digital learning remains difficult for students who struggle with learning challenges, isolation, or a lack of resources. Large-scale efforts are therefore increasingly utilized for digital education. To better prepare students in higher education for this grand scientific and technological transformation, STEM education has been prioritized and promoted as a strategic imperative in the ongoing curriculum reform essential for unfinished learning needs and whole-person development. Building upon five key elements identified in the STEM education literature: Problem-based Learning, Community and Belonging, Technology Skills, Personalization of Learning, Connection to the External Community, this case study explores the potential of pedagogical innovation that integrates computational and experimental methodologies to support, enrich, and navigate STEM education. Objectives: The goal of this case study is to create a high-fidelity prototype design for STEM education with knowledge transfer technology that contains a Cooperative Multi-Agent System (CMAS), which has the objectives of (1) conduct assessment to reveal a virtual learning mechanism and establish strategies to facilitate scientific learning engagement, accessibility, and connection within and beyond university setting, (2) explore and validate an interactional co-creation approach embedded in project-based learning activities under the STEM learning context, which is being transformed by both digital technology and student behavior change,(3) formulate and implement the STEM-oriented campaign to guide learning network mapping, mitigate the loss of learning, enhance the learning experience, scale-up inclusive participation. Methods: This study applied a case study strategy and a methodology informed by Social Network Analysis Theory within a cross-disciplinary communication paradigm (students, peers, educators). Knowledge transfer technology is introduced to address learning challenges and to increase the efficiency of Reinforcement Learning (RL) algorithms. A co-creation learning framework was identified and investigated in a context-specific way with a learning analytic tool designed in this study. Findings: The result shows that (1) CMAS-empowered learning support reduced students’ confusion, difficulties, and gaps during problem-solving scenarios while increasing learner capacity empowerment, (2) The co-creation learning phenomenon have examined through the lens of the campaign and reveals that an interactive virtual learning environment fosters students to navigate scientific challenge independently and collaboratively, (3) The deliverables brought from the STEM educational campaign provide a methodological framework both within the context of the curriculum design and external community engagement application. Conclusion: This study brings a holistic and coherent pedagogy to cultivates students’ interest in STEM and develop them a knowledge base to integrate and apply knowledge across different STEM disciplines. Through the co-designing and cross-disciplinary educational content and campaign promotion, findings suggest factors to empower evidence-based learning practice while also piloting and tracking the impact of the scholastic value of co-creation under the dynamic learning environment. The data nested under the knowledge transfer technology situates learners’ scientific journey and could pave the way for theoretical advancement and broader scientific enervators within larger datasets, projects, and communities.

Keywords: co-creation, cross-disciplinary, knowledge transfer, STEM education, social network analysis

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Authors: Cinthia G. P. Calou, Franz J. Antezana, Ana I. O. Nicolau, Eveliny S. Martins, Paula R. A. L. Soares, Glauberto S. Quirino, Dayanne R. Oliveira, Priscila S. Aquino, Régia C. M. B. Castro, Ana K. B. Pinheiro

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Introduction: As an integral part of the health-disease process, gestation is a period in which the social insertion of women can influence, in a positive or negative way, the course of the pregnancy-puerperal cycle. Thus, evaluating the quality of life of this population can redirect the implementation of innovative practices in the quest to make them more effective and real for the promotion of a more humanized care. This study explores the associations between the obstetric factors with affected areas of health-related quality of life of pregnant women with habitual risk. Methods: This is a cross-sectional, quantitative study conducted in three public facilities and a private service that provides prenatal care in the city of Fortaleza, Ceara, Brazil. The sample consisted of 261 pregnant women who underwent low-risk prenatal care and were interviewed from September to November 2014. The collection instruments were a questionnaire containing socio-demographic and obstetric variables, in addition to the Brazilian version of the Mother scale Generated Index (MGI) characterized by being a specific and objective instrument, consisting of a single sheet and subdivided into three stages. It allows identifying the areas of life of the pregnant woman that are most affected, which could go unnoticed by the pre-formulated measurement instruments. The obstetric data, as well as the data concerning the application of the MGI scale, were compiled and analyzed through the statistical program Statistical Package for the Social Sciences (SPSS), version 20.0. After the compilation, a descriptive analysis was carried out. Then, associations were made between some variables. The tests applied were the Pearson Chi-Square and the Fisher's exact test. The odds ratio was also calculated. These associations were considered statistically significant when the p (probability) value was less than or equal to a level of 5% (α = 0.05) in the tests performed. Results: The variables that negatively reflected the quality of life of the pregnant women and presented a significant association with the polaciuria were: gestational age (p = 0.022) and parity (p = 0.048). Episodes of nausea and vomiting also showed significant with gestational age correlation (p = 0.0001). Evaluating the crossing of stress, we observed a significant association with parity (p = 0.0001). In turn, emotional lability revealed dependence on the variable type of delivery (p = 0.009). Conclusion: The health professionals involved in the assistance to the pregnant woman can understand how the process of gestation is experienced, considering all its peculiar transformations; to meet their individual needs, stimulating their autonomy and their power of choice, envisaging the achievement of a better quality of life related to health in the perspective of health promotion.

Keywords: health-related quality of life, obstetric nursing, pregnant women, prenatal care

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Authors: Mustafa Mutahari, Nao Sugiki, Kojiro Matsuo

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The four decades of war, lack of job opportunities, poverty, lack of services, and natural disasters in different provinces of Afghanistan have contributed to a rapid increase in the population of Kabul, the capital city of Afghanistan. Population census has not been conducted since 1979, the first and last population census in Afghanistan. However, according to population estimations by Afghan authorities, the population of Kabul has been estimated at more than 4 million people, whereas the city was designed for two million people. Although the major transport mode of Kabul residents is public transport, responsible authorities within the country failed to supply the required means of transportation systems for the city. Besides, informal resettlement, lack of intersection control devices, presence of illegal vendors on streets, presence of illegal and unstandardized on-street parking and bus stops, driver`s unprofessional behavior, weak traffic law enforcement, and blocked roads and sidewalks have contributed to the extreme traffic congestion of Kabul. In 2018, the government of Afghanistan approved the Kabul city Urban Design Framework (KUDF), a vision towards the future of Kabul, which provides strategies and design guidance at different scales to direct urban development. Considering traffic congestion of the city and its budget limitations, the KUDF proposes a BRT route network with seven lines to reduce the traffic congestion, and it is said to facilitate more than 50% of Kabul population to benefit from this service. Based on the KUDF, it is planned to increase the BRT mode share from 0% to 17% and later to 30% in medium and long-term planning scenarios, respectively. Therefore, a detailed research study is needed to evaluate the proposed system before the implementation stage starts. The integrated land-use transport model is an effective tool to evaluate the Kabul BRT because of its future assessment capabilities that take into account the interaction between land use and transportation. This research aims to analyze and evaluate the proposed BRT route network with the application of an integrated land-use and transportation model. The research estimates the population distribution and travel behavior of Kabul within small boundary scales. The actual road network and land-use detailed data of the city are used to perform the analysis. The BRT corridors are evaluated not only considering its impacts on the spatial interactions in the city`s transportation system but also on the spatial developments. Therefore, the BRT are evaluated with the scenarios of improving the Kabul transportation system based on the distribution of land-use or spatial developments, planned development typology and population distribution of the city. The impacts of the new improved transport system on the BRT network are analyzed and the BRT network is evaluated accordingly. In addition, the research also focuses on the spatial accessibility of BRT stops, corridors, and BRT line beneficiaries, and each BRT stop and corridor are evaluated in terms of both access and geographic coverage, as well.

Keywords: accessibility, BRT, integrated land-use and transport model, travel behavior, spatial development

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Authors: Daniel Gredig, Annabelle Bartelsen-Raemy

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Social work services offered to people living with diabetes tend to be moulded by the prevailing understanding that social work is to support people living with diabetes in their adherence to medical prescription and/or life style changes. As diabetes has been conceived as a condition facing no stigma, discrimination of people living with diabetes has not been considered. However, there is growing evidence of stigma. To our knowledge, nevertheless, there have been no comprehensive, in-depth studies of stigma and its impact. Against this background and challenging the present layout of services for people living with diabetes, the present study aimed to establish whether: -people living with diabetes in Switzerland experience stigma, and if so, in what context and to what extent; -experiencing stigma impacts the quality of life of those affected. It was hypothesized that stigma would impact on their quality of life. It was further hypothesized that low self-esteem, psychological distress, depression, and a lack of social support would be mediating factors. For data collection an anonymous paper-and-pencil self-administered questionnaire was used which drew on a qualitative elicitation study. Data were analysed using descriptive statistics and structural equation modelling. To generate a large and diverse convenience sample the questionnaire was distributed to the readers of journal destined to diabetics living in Switzerland issued in German and French. The sample included 3347 people with type 1 and 2 diabetes, aged 16–96, living in diverse living conditions in the German- and French-speaking areas of Switzerland. Respondents reported experiences of discrimination in various contexts and stereotyping based on the belief that diabetics have a low work performance; are inefficient in the workplace; inferior; weak-willed in their ability to manage health-related issues; take advantage of their condition and are viewed as pitiful or sick people. Respondents who reported higher levels of perceived stigma reported higher levels of psychological distress (β = .37), more pronounced depressive symptoms (β=.33), and less social support (β = -.22). Higher psychological distress (β = -.29) and more pronounced depressive symptoms (β = -.28), in turn, predicted lower quality of life. These research findings challenge the prevailing understanding of social work services for people living with diabetes in Switzerland and beyond. They call for a less individualistic approach, the consideration of the social context service users are placed in their everyday life, and addressing stigma. So, social work could partner with people living with diabetes in order to fight against discrimination and stereotypes. This could include identifying and designing educational and public awareness strategies. In direct social work with people living with diabetes, this could include broaching experiences of stigma and modes of coping with. This study was carried out in collaboration with the Swiss Diabetes Association. The association accepted the challenging conclusions from this study. It connected to the results and is currently discussing the priorities and courses of action to be taken.

Keywords: diabetes, discrimination, quality of life, services, stigma

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Authors: Peter Palasti, Eva Kerepeczki

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Extensive fish farming is one of the most traditional forms of aquaculture in Europe, usually practiced in large pond systems with earthen beds, where the growth of fish is based on natural feed and supplementary foraging. These farms have semi-natural environmental conditions, sustaining diverse wildlife communities that have complex effects on fish production and also provide a livelihood for many wetland related taxa. Based on their characteristics, these communities could be sources of various ecosystem services (ESs), that could also enhance the value and enable the multifunctional use of these artificially constructed and maintained production zones. To identify and estimate the whole range of wildlife’s contribution we have conducted an integrated assessment in an extensively managed pond system in Biharugra, Hungary, where we studied 14 previously revealed ESs: fish and reed production, water storage, water and air quality regulation, CO2 absorption, groundwater recharge, aesthetics, recreational activities, inspiration, education, scientific research, presence of semi-natural habitats and useful/protected species. ESs were collected through structured interviews with the local experts of all major stakeholder groups, where we have also gathered information about the known forms, levels (none, low, high) and orientations (positive, negative) of the contributions of the wildlife community. After that, a quantitative analysis was carried out: we calculated the total mean value of the services being used between 2014-16, then we estimated the value and percentage of contributions. For the quantification, we mainly used biophysical indicators with the available data and empirical knowledge of the local experts. During the interviews, 12 of the previously listed services (85%) were mentioned to be related to wildlife community, consisting of 5 fully (e.g., recreation, reed production) and seven partially dependent ESs (e.g., inspiration, CO2 absorption) from our list. The orientation of the contributions was said to be positive almost every time; however, in the case of fish production, the feeding habit of some wild species (Phalacrocorax carbo, Lutra lutra) caused significant losses in fish stocks in the study period. During the biophysical assessment, we calculated the total mean value of the services and quantified the aid of wildlife community at the following services: fish and reed production, recreation, CO2 absorption, and the presence of semi-natural habitats and wild species. The combined results of our interviews and biophysical evaluations showed that the presence of wildlife community not just greatly increased the productivity of the fish farms in Biharugra (with ~53% of natural yield generated by planktonic and benthic communities) but also enhanced the multifunctionality of the system through expanding the quality and number of its services. With these abilities, extensively managed fishponds could play an important role in the future as refugia for wetland related services and species threatened by the effects of global warming.

Keywords: ecosystem services, fishpond systems, integrated assessment, wildlife community

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Authors: Paul Moses Ndegwa, Teresia Kabucho, Lucy Wanjiru, Esther Wanjiru, Brian Githaiga, Jecinta Wambui

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Health outcome has improved in the country since 2013 following the adoption of the new constitution in Kenya with devolved governance with administration and health planning functions transferred to county governments. 2018-2022 development agenda prioritized universal healthcare coverage, food security, and nutrition, however, the emergence of Covid-19 and the increase of non-communicable diseases pose a challenge and constrain in an already overwhelmed health system. A study was conducted July-November 2021 to establish key challenges in achieving universal healthcare coverage within the county and best practices for improved non-communicable disease control. 14 health workers ranging from nurses, doctors, public health officers, clinical officers, and pharmaceutical technologists were purposely engaged to provide critical information through questionnaires by a trained duo observing ethical procedures on confidentiality. Data analysis. Communicable diseases are major causes of morbidity and mortality. Non-communicable diseases contribute to approximately 39% of deaths. More than 45% of the population does not have access to safe drinking water. Study noted geographic inequality with respect to distribution and use of health resources including competing non-health priorities. 56% of health workers are nurses, 13% clinical officers, 7% doctors, 9%public health workers, 2% are pharmaceutical technologists. Poor-quality data limits the validity of disease-burdened estimates and research activities. Risk factors include unsafe water, sanitation, hand washing, unsafe sex, and malnutrition. Key challenge in achieving universal healthcare coverage is the rise in the relative contribution of non-communicable diseases. Improve targeted disease control with effective and equitable resource allocation. Develop high infectious disease control mechanisms. Improvement of quality data for decision making. Strengthen electronic data-capture systems. Increase investments in the health workforce to improve health service provision and achievement of universal health coverage. Create a favorable environment to retain health workers. Fill in staffing gaps resulting in shortages of doctors (7%). Develop a multi-sectional approach to health workforce planning and management. Need to invest in mechanisms that generate contextual evidence on current and future health workforce needs. Ensure retention of qualified, skilled, and motivated health workforce. Deliver integrated people-centered health services.

Keywords: multi-sectional approach, equity, people-centered, health workforce retention

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Authors: Alexander Suuk Laar, Emmanuel Bekyieriya, Sylvester Isang, Benjamin Baguune

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Introduction: In Ghana, despite the implementation of strategies and initiatives to ensure universal access to reproductive health and family planning (FP) services for the past two decades, interventions have not adequately addressed the access and utilization needs of women of reproductive age, especially in rural Ghana. To improve access and use of reproductive and maternal health services in Ghana, a free maternal care exemption policy under the universal health coverage of the National Health Insurance Scheme was implemented in 2005. Despite the importance of FP, this service was left out of the benefit package of the policy. Low or no use of FP services is often associated with poor health among women. However, to date, there has been limited research on perspectives of women for not making FP services as part of the benefit package of the free maternal health services. This qualitative study explored perceptions of women on the comprehensiveness of the free maternal health benefit package and the effects on utilisation of services in the rural Upper West region of Ghana to improve services. Methods: This exploratory qualitative study used focus group discussions with pregnant and lactating women in three rural districts in the Upper West region of Ghana. Six focus groups were held with both pregnant women and lactating mothers at the time of the interview. Three focus group discussions were organised with the same category of women in each district. We used a purposive sampling procedure to select the participants from the districts. The interviews with the written consent of the participants lasted between 60 minutes and 120 minutes. Interviews were audio-recorded and transcribed verbatim. Data were analysed using Braun and Clarke thematic framework guidelines. Results: This research presents an in-depth account of women's perceptions on the effects associated with the uptake of FP services and its exclusion from the benefit package of the free maternal health policy. Our study found that participants did not support the exclusion of FP services in the benefit package. Participants mentioned factors hampering their access to and use of FP and contraceptive services to include the cost of services, distance and cost of transport to health facilities, lack of knowledge about FP services, socio-cultural norms and negative attitude of healthcare professionals. Participants are of the view that making FP services part of the benefit package could have addressed the cost aspect of services which act as the main barrier to improve the use of services by poor rural women. Conclusion: Women of reproductive age face cost barriers that limit their access to and use of FP and contraception services in the rural Upper West region of Ghana and need health policymakers to revise the free maternal health package to include FP services. It is essential for policymakers to begin considering revising the free maternal health policy benefit package to include FP services to help address the cost barrier for rural poor women to use services.

Keywords: benefit package, free maternal policy, women, Ghana, rural Upper West Region, Universal Health Coverage.

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Authors: D. Pugazhenthi, B. Sree Vidya

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Cloud computing is one of the emerging technologies that enables end users to use the services of cloud on ‘pay per usage’ strategy. This technology grows in a fast pace and so is its security threat. One among the various services provided by cloud is storage. In this service, security plays a vital factor for both authenticating legitimate users and protection of information. This paper brings in efficient ways of authenticating users as well as securing information on the cloud. Initial phase proposed in this paper deals with an authentication technique using multi-factor and multi-dimensional authentication system with multi-level security. Unique identification and slow intrusive formulates an advanced reliability on user-behaviour based biometrics than conventional means of password authentication. By biometric systems, the accounts are accessed only by a legitimate user and not by a nonentity. The biometric templates employed here do not include single trait but multiple, viz., iris and finger prints. The coordinating stage of the authentication system functions on Ensemble Support Vector Machine (SVM) and optimization by assembling weights of base SVMs for SVM ensemble after individual SVM of ensemble is trained by the Artificial Fish Swarm Algorithm (AFSA). Thus it helps in generating a user-specific secure cryptographic key of the multimodal biometric template by fusion process. Data security problem is averted and enhanced security architecture is proposed using encryption and decryption system with double key cryptography based on Fuzzy Neural Network (FNN) for data storing and retrieval in cloud computing . The proposing scheme aims to protect the records from hackers by arresting the breaking of cipher text to original text. This improves the authentication performance that the proposed double cryptographic key scheme is capable of providing better user authentication and better security which distinguish between the genuine and fake users. Thus, there are three important modules in this proposed work such as 1) Feature extraction, 2) Multimodal biometric template generation and 3) Cryptographic key generation. The extraction of the feature and texture properties from the respective fingerprint and iris images has been done initially. Finally, with the help of fuzzy neural network and symmetric cryptography algorithm, the technique of double key encryption technique has been developed. As the proposed approach is based on neural networks, it has the advantage of not being decrypted by the hacker even though the data were hacked already. The results prove that authentication process is optimal and stored information is secured.

Keywords: artificial fish swarm algorithm (AFSA), biometric authentication, decryption, encryption, fingerprint, fusion, fuzzy neural network (FNN), iris, multi-modal, support vector machine classification

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Authors: Corentin Jankowiak, Aggelos Zacharopoulos, Caterina Brandoni

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In a context of increasing stress put on the electricity network by the decarbonization of many sectors, energy storage is likely to be the key mitigating element, by acting as a buffer between production and demand. In particular, the highest potential for storage is when connected closer to the loads. Yet, low voltage storage struggles to penetrate the market at a large scale due to the novelty and complexity of the solution, and the competitive advantage of fossil fuel-based technologies regarding regulations. Strong and reliable numerical simulations are required to show the benefits of storage located near loads and promote its development. The present study was restrained from excluding aggregated control of storage: it is assumed that the storage units operate independently to one another without exchanging information – as is currently mostly the case. A computationally light battery model is presented in detail and validated by direct comparison with a domestic battery operating in real conditions. This model is then used to develop Peak-Shaving (PS) control strategies as it is the decentralized service from which beneficial impacts are most likely to emerge. The aggregation of flatter, peak- shaved consumption profiles is likely to lead to flatter and arbitraged profile at higher voltage layers. Furthermore, voltage fluctuations can be expected to decrease if spikes of individual consumption are reduced. The crucial part to achieve PS lies in the charging pattern: peaks depend on the switching on and off of appliances in the dwelling by the occupants and are therefore impossible to predict accurately. A performant PS strategy must, therefore, include a smart charge recovery algorithm that can ensure enough energy is present in the battery in case it is needed without generating new peaks by charging the unit. Three categories of PS algorithms are introduced in detail. First, using a constant threshold or power rate for charge recovery, followed by algorithms using the State Of Charge (SOC) as a decision variable. Finally, using a load forecast – of which the impact of the accuracy is discussed – to generate PS. A performance metrics was defined in order to quantitatively evaluate their operating regarding peak reduction, total energy consumption, and self-consumption of domestic photovoltaic generation. The algorithms were tested on load profiles with a 1-minute granularity over a 1-year period, and their performance was assessed regarding these metrics. The results show that constant charging threshold or power are far from optimal: a certain value is not likely to fit the variability of a residential profile. As could be expected, forecast-based algorithms show the highest performance. However, these depend on the accuracy of the forecast. On the other hand, SOC based algorithms also present satisfying performance, making them a strong alternative when the reliable forecast is not available.

Keywords: decentralised control, domestic integrated batteries, electricity network performance, peak-shaving algorithm

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Authors: Mozhdeh Shirinzadeh, Richard Stroetmann

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Orthotropic steel deck bridge consists of a deck plate, longitudinal stiffeners under the deck plate, cross beams and the main longitudinal girders. Due to the several advantages, Orthotropic Steel Deck (OSD) systems have been utilized in many bridges worldwide. The significant feature of this structural system is its high load-bearing capacity while having relatively low dead weight. In addition, cost efficiency and the ability of rapid field erection have made the orthotropic steel deck a popular type of bridge worldwide. However, OSD bridges are highly susceptible to fatigue damage. A large number of welded joints can be regarded as the main weakness of this system. This problem is, in particular, evident in the bridges which were built before 1994 when the fatigue design criteria had not been introduced in the bridge design codes. Recently, an Orthotropic-composite slab (OCS) for road bridges has been experimentally and numerically evaluated and developed at Technische Universität Dresden as a part of AIF-FOSTA research project P1265. The results of the project have provided a solid foundation for the design and analysis of Orthotropic-composite decks with dowel strips as a durable alternative to conventional steel or reinforced concrete decks. In continuation, while using the achievements of that project, the application of a modified Ortho-composite deck for an existing typical OSD bridge is investigated. Composite action is obtained by using rows of dowel strips in a clothoid (CL) shape. Regarding Eurocode criteria for different fatigue detail categories of an OSD bridge, the effect of the proposed modification approach is assessed. Moreover, a numerical parametric study is carried out utilizing finite element software to determine the impact of different variables, such as the size and arrangement of dowel strips, the application of transverse or longitudinal rows of dowel strips, and local wheel loads. For the verification of the simulation technique, experimental results of a segment of an OCS deck are used conducted in project P1265. Fatigue assessment is performed based on the last draft of Eurocode 1993-2 (2024) for the most probable detail categories (Hot-Spots) that have been reported in the previous statistical studies. Then, an analytical comparison is provided between the typical orthotropic steel deck and the modified Ortho-composite deck bridge in terms of fatigue issues and durability. The load-bearing capacity of the bridge, the critical deflections, and the composite behavior are also evaluated and compared. Results give a comprehensive overview of the efficiency of the rehabilitation method considering the required design service life of the bridge. Moreover, the proposed approach is assessed with regard to the construction method, details and practical aspects, as well as the economic point of view.

Keywords: composite action, fatigue, finite element method, steel deck, bridge

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Authors: Chia-Yi Wu, Jung-Chen Chang, Wen-Yu Hu, Ming-Been Lee

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In nearly all physical health conditions, suicide risk is increased compared to healthy people even after adjustment for age, gender, mental health, and substance use diagnoses. In order to highlight the importance of suicide risk assessment for the inpatients and early identification and engagement for inpatients’ mental health problems, a study was designed aiming at developing a comprehensive psychosomatic nursing engagement (PSNE) model with standardized operation procedures informing how nurses communicate, assess, and engage with the inpatients with emotional distress. The purpose of the study was to promote the gatekeeping role of clinical nurses in performing brief assessment and interventions to detect depression and anxiety symptoms among the inpatients, particularly in non-psychiatric wards. The study will be carried out in a 2000-bed university hospital in Northern Taiwan in 2019. We will select a ward for trial and develop feasible procedures and in-job training course for the nurses to offer mental health care, which will also be validated through professional consensus meeting. The significance of the study includes the following three points: (1) The study targets at an important but less-researched area of PSNE model in the cultural background of Taiwan, where hospital service is highly accessible, but mental health and suicide risk assessment are hardly provided by non-psychiatric healthcare personnel. (2) The issue of PSNE could be efficient and cost-effective in the identification of suicide risks at an early stage to prevent inpatient suicide or to reduce future suicide risk by early treatment of mental illnesses among the high-risk group of hospitalized patients who are more than three-times lethal to suicide. (3) Utilizing a brief tool with its established APP ('The Five-item Brief Symptom Rating Scale, BSRS-5'), we will invent the standardized procedure of PSNE and referral steps in collaboration with the medical teams across the study hospital. New technological tools nested within nursing assessment/intervention will concurrently be invented to facilitate better care quality. The major outcome measurements will include tools for early identification of common mental distress and suicide risks, i.e., the BSRS-5, revised BSRS-5, and the 9-item Concise Mental Health Checklist (CMHC-9). The main purpose of using the CMHC-9 in clinical suicide risk assessment is mainly to provide care and build-up therapeutic relationship with the client, so it will also be used to nursing training highlighting the skills of supportive care. Through early identification of the inpatients’ depressive symptoms or other mental health care needs such as insomnia, anxiety, or suicide risk, the majority of the nursing clinicians would be able to engage in critical interventions that alleviate the inpatients’ suffering from mental health problems, given a feasible nursing input.

Keywords: mental health care, clinical outcome improvement, clinical nurses, suicide prevention, psychosomatic nursing

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Authors: Amunupura Kiriwandeiye Gedara, Asintha Saminda Gnanaratne

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The security forces can be described as a workforce that goes beyond the role of ensuring the national security and contributes to the development process of the country. Soldiers are following combatant training courses during their tenure, they are equipped with a variety of vocational training courses to satisfy the needs of the army, to equip them with vocational training capabilities to achieve the development and reconstruction goals of the country as well as for the betterment of society in the event of emergencies. But with retirement, their relationship with the military is severed, and they are responsible for the future of their lives. The main purpose of this study was to examine how such professional capabilities can contribute to the development of the country, the current socio-economic status of the retired soldiers, and the current application of the vocational training skills they have mastered in the army to develop and rebuild the country in an effective manner. After analyzing the available research literature related to this field, a conceptual framework was developed and according to qualitative research methodology, and data obtained from Case studies and interviews are analyzed by using thematic analysis. Factors influencing early retirement include a lack of understanding of benefits, delays in promotions, not being properly evaluated for work, getting married on hasty decisions, and not having enough time to spend on family and household chores. Most of the soldiers are not aware about various programs and benefits available to retirees. They do not have a satisfactory attitude towards the retirement guidance they receive from the army at the time of retirement. Also, due to the lack of understanding about how to use their vocational capabilities successfully pursue their retirement life, the majority of people are employed in temporary jobs, and some are successful in post-retirement life due to their successful use of training received. Some live on pensions without engaging in any income-generating activities, and those who retire after 12 years of service are facing severe economic hardships as they do not get pensions. Although they have received training in various fields, they do not use them for their benefit due to lack of proper guidance. Although the government implements programs, they are not clearly aware of them. Barriers to utilization of training include an absence of a system to identify the professional skills of retired soldiers, interest in civil society affairs, exploration of opportunities in the civil and private sectors, and politicization of services. If they are given the opportunity, they will be able to contribute to the development and reconstruction process. The findings of the study further show that it has many social, economic, political, and psychological benefits not only for individuals but also for a country. Entrepreneurship training for all retired soldiers, improving officers' understanding, streamlining existing mechanisms, creating new mechanisms, setting up a separate unit for retirees, and adapting them to civil society, private and non-governmental contributions, and training courses can be identified as potential means to improve the current situation.

Keywords: development, reconstruction, retired soldiers, vocational capabilities

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Authors: S. A. Abeykoon

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This study explores the empowerment potential of the mobile phone, the widely penetrated and greatly affordable communication technology in Sri Lanka, for female heads of households in Trincomalee District, Sri Lanka-an area recovering from the effects of a 30-year civil war and the 2004 Boxing Day Tsunami. It also investigates how the use of mobile phones by these women is shaped and appropriated by the gendered power relations and inequalities in their respective communities and by their socio-economic factors and demographic characteristics. This qualitative study is based on the epistemology of constructionism; interpretivist, functionalist and critical theory approaches; and the process of action research. The data collection was conducted from September 2014 to November 2014 in two Divisional Secretaries of the Trincomalee District, Sri Lanka. A total of 30 semi-structured depth interviews and six focus groups with the female heads of households of Sinhalese, Tamil and Muslim ethnicities were conducted using purposive, representative and snowball sampling methods. The Grounded theory method was used to analyze transcribed interviews, focus group discussions and field notes that were coded and categorized in accordance with the research questions and the theoretical framework of the study. The findings of the study indicated that the mobile phone has mainly enabled the participants to balance their income earning activities and family responsibilities and has been useful in maintaining their family and social relationships, occupational duties and in making decisions. Thus, it provided them a higher level of security, safety, reassurance and self-confidence in carrying out their daily activities. They also practiced innovative strategies for the effective and efficient use of their mobile expenses. Although participants whose husbands or relatives have migrated were more tended to use smart phones, mobile literacy level of the majority of the participants was at a lower level limited to making and receiving calls and using SMS (Short Message Service) services. However, their interaction with the mobile phone was significantly shaped by the gendered power relations and their multiple identities based on their ethnicity, religion, class, education, profession and age. Almost all the participants were precautious of giving their mobile numbers to and have been harassed with ‘nuisance calls’ from men. For many, ownership and use of their mobile phone was shaped and influenced by their children and migrated husbands. Although these practices limit their use of the technology, there were many instances that they challenged these gendered harassments. While man-made and natural destructions have disempowered and victimized the women in the Sri Lankan society, they have also liberated women making them stronger and transforming their agency and traditional gender roles. Therefore, their present position in society is reflected in their mobile phone use as they assist such women to be more self-reliant and liberated, yet making them disempowered at some time.

Keywords: mobile phone, gender power relations, empowerment, female heads of households

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Authors: Sadia Munir, Diana White, Aya Albahri, Pratiwi Hastania, Eltahir Mohamed, Mahmood Khan, Fathima Mohamed, Ayat Kadhi, Haila Saleem

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Preeclampsia is a major complication of pregnancy. Prediction and management of preeclampsia is a challenge for obstetricians. To our knowledge, no major progress has been achieved in the prevention and early detection of preeclampsia. There is very little known about the clear treatment path of this disorder. Preeclampsia puts both mother and baby at risk of several short term- and long term-health problems later in life. There is huge health service cost burden in the health care system associated with preeclampsia and its complications. Preeclampsia is divided into two different types. Early onset preeclampsia develops before 34 weeks of gestation, and late onset develops at or after 34 weeks of gestation. Different genetic and environmental factors, prognosis, heritability, biochemical and clinical features are associated with early and late onset preeclampsia. Prevalence of preeclampsia greatly varies all over the world and is dependent on ethnicity of the population and geographic region. To authors best knowledge, no published data on preeclampsia exist in Qatar. In this study, we are reporting the incidence of preeclampsia in Qatar. The purpose of this study is to compare the incidence and risk factors of both early onset and late onset preeclampsia in Qatar. This retrospective longitudinal cohort study was conducted using data from the hospital record of Women’s Hospital, Hamad Medical Corporation (HMC), from May 2014-May 2016. Data collection tool, which was approved by HMC, was a researcher made extraction sheet that included information such as blood pressure during admission, socio demographic characteristics, delivery mode, and new born details. A total of 1929 patients’ files were identified by the hospital information management when they apply codes of preeclampsia. Out of 1929 files, 878 had significant gestational hypertension without proteinuria, 365 had preeclampsia, 364 had severe preeclampsia, and 188 had preexisting hypertension with superimposed proteinuria. In this study, 78% of the data was obtained by hospital electronic system (Cerner) and the remaining 22% was from patient’s paper records. We have gone through detail data extraction from 560 files. Initial data analysis has revealed that 15.02% of pregnancies were complicated with preeclampsia from May 2014-May 2016. We have analyzed difference in the two different disease entities in the ethnicity, maternal age, severity of hypertension, mode of delivery and infant birth weight. We have identified promising differences in the risk factors of early onset and late onset preeclampsia. The data from clinical findings of preeclampsia will contribute to increased knowledge about two different disease entities, their etiology, and similarities/differences. The findings of this study can also be used in predicting health challenges, improving health care system, setting up guidelines, and providing the best care for women suffering from preeclampsia.

Keywords: preeclampsia, incidence, risk factors, maternal

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Authors: Istvan Csarnovics, Attila Bonyar, Miklos Veres, Laszlo Himics, Attila Csik, Judit Kaman, Julia Burunkova, Geza Szanto, Laszlo Balazs, Sandor Kokenyesi

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In this work, the performance of gold nanoparticles were investigated for stimulation of photosensitive materials for photonic applications. It was widely used for surface plasmon resonance experiments, not in the last place because of the manifestation of optical resonances in the visible spectral region. The localized surface plasmon resonance is rather easily observed in nanometer-sized metallic structures and widely used for measurements, sensing, in semiconductor devices and even in optical data storage. Firstly, gold nanoparticles on silica glass substrate satisfy the conditions for surface plasmon resonance in the green-red spectral range, where the chalcogenide glasses have the highest sensitivity. The gold nanostructures influence and enhance the optical, structural and volume changes and promote the exciton generation in gold nanoparticles/chalcogenide layer structure. The experimental results support the importance of localized electric fields in the photo-induced transformation of chalcogenide glasses as well as suggest new approaches to improve the performance of these optical recording media. Results may be utilized for direct, micrometre- or submicron size geometrical and optical pattern formation and used also for further development of the explanations of these effects in chalcogenide glasses. Besides of that, gold nanoparticles could be added to the organic light-sensitive material. The acrylate-based materials are frequently used for optical, holographic recording of optoelectronic elements due to photo-stimulated structural transformations. The holographic recording process and photo-polymerization effect could be enhanced by the localized plasmon field of the created gold nanostructures. Finally, gold nanoparticles widely used for electrochemical and optical sensor applications. Although these NPs can be synthesized in several ways, perhaps one of the simplest methods is the thermal annealing of pre-deposited thin films on glass or silicon surfaces. With this method, the parameters of the annealing process (time, temperature) and the pre-deposited thin film thickness influence and define the resulting size and distribution of the NPs on the surface. Localized surface plasmon resonance (LSPR) is a very sensitive optical phenomenon and can be utilized for a large variety of sensing purposes (chemical sensors, gas sensors, biosensors, etc.). Surface-enhanced Raman spectroscopy (SERS) is an analytical method which can significantly increase the yield of Raman scattering of target molecules adsorbed on the surface of metallic nanoparticles. The sensitivity of LSPR and SERS based devices is strongly depending on the used material and also on the size and geometry of the metallic nanoparticles. By controlling these parameters the plasmon absorption band can be tuned and the sensitivity can be optimized. The technological parameters of the generated gold nanoparticles were investigated and influence on the SERS and on the LSPR sensitivity was established. The LSPR sensitivity were simulated for gold nanocubes and nanospheres with MNPBEM Matlab toolbox. It was found that the enhancement factor (which characterize the increase in the peak shift for multi-particle arrangements compared to single-particle models) depends on the size of the nanoparticles and on the distance between the particles. This work was supported by GINOP- 2.3.2-15-2016-00041 project, which is co-financed by the European Union and European Social Fund. Istvan Csarnovics is grateful for the support through the New National Excellence Program of the Ministry of Human Capacities, supported by the ÚNKP-17-4 Attila Bonyár and Miklós Veres are grateful for the support of the János Bolyai Research Scholarship of the Hungarian Academy of Sciences.

Keywords: light sensitive nanocomposites, metallic nanoparticles, photonic application, plasmonic nanostructures

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Authors: Magdalena Idzikowska, Katarzyna Pająk, Kamil Kowalczyk

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Seafloor topography is a fundamental issue in geological, geophysical, and oceanographic studies. Single-beam or multibeam sonars attached to the hulls of ships are used to emit a hydroacoustic signal from transducers and reproduce the topography of the seabed. This solution provides relevant accuracy and spatial resolution. Bathymetric data from ships surveys provides National Centers for Environmental Information – National Oceanic and Atmospheric Administration. Unfortunately, most of the seabed is still unidentified, as there are still many gaps to be explored between ship survey tracks. Moreover, such measurements are very expensive and time-consuming. The solution is raster bathymetric models shared by The General Bathymetric Chart of the Oceans. The offered products are a compilation of different sets of data - raw or processed. Indirect data for the development of bathymetric models are also measurements of gravity anomalies. Some forms of seafloor relief (e.g. seamounts) increase the force of the Earth's pull, leading to changes in the sea surface. Based on satellite altimetry data, Sea Surface Height and marine gravity anomalies can be estimated, and based on the anomalies, it’s possible to infer the structure of the seabed. The main goal of the work is to create regional bathymetric models and models of the sea surface in the area of the east coast of North America – a region of seamounts and undulating seafloor. The research includes an analysis of the methods and techniques used, an evaluation of the interpolation algorithms used, model thickening, and the creation of grid models. Obtained data are raster bathymetric models in NetCDF format, survey data from multibeam soundings in MB-System format, and satellite altimetry data from Copernicus Marine Environment Monitoring Service. The methodology includes data extraction, processing, mapping, and spatial analysis. Visualization of the obtained results was carried out with Geographic Information System tools. The result is an extension of the state of the knowledge of the quality and usefulness of the data used for seabed and sea surface modeling and knowledge of the accuracy of the generated models. Sea level is averaged over time and space (excluding waves, tides, etc.). Its changes, along with knowledge of the topography of the ocean floor - inform us indirectly about the volume of the entire water ocean. The true shape of the ocean surface is further varied by such phenomena as tides, differences in atmospheric pressure, wind systems, thermal expansion of water, or phases of ocean circulation. Depending on the location of the point, the higher the depth, the lower the trend of sea level change. Studies show that combining data sets, from different sources, with different accuracies can affect the quality of sea surface and seafloor topography models.

Keywords: seafloor, sea surface height, bathymetry, satellite altimetry

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Authors: Anita Burgund Isakov, Cristina Nunes, Nevenka Zegarac, Ana Antunes

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Contemporary societies are facing a noticeable shift in family realities, urging to need for the development of new policies, service, and practice orientation that has application across different sectors who serves families with children across the world. A challenge for the field of family support is diversity in conceptual assumptions and epistemological frameworks. Since many disciplines and professionals are working in the family support field, there is a need to map and gain a deeper insight into the skills for the workforce in this field. Under the umbrella of the COST action 'The Pan-European Family Support Research Network: A bottom-up, evidence-based and multidisciplinary approach', a review of the current state of knowledge published from the European studies on family support workforce skills standards is performed. Contributing to the aim of mapping and catalogization of skills standards, key stages of literature review were identified in order to extract and systematize the data. We have considered inclusion and exclusion criteria for this literature review. Inclusion criteria were: a) families living with their children and families using family support services; different methodological approaches were included: qualitative, quantitative, mix method, literature review and theoretical reflections various topic appeared in journals like working with families that are facing difficulties or culturally sensitive practice and relationship-based approaches; b) the dates ranged from 1995 to February 2020. Articles published prior to 1995 were excluded due to modernization of family support services across world; c) the sources and languages included peer-reviewed articles published in scientific journals in English. Six databases were searched and once we have extracted all the relevant papers (n=29), we searched the list of reference in each and we found 11 additional papers. In total 40 papers have been extracted from six data basis. Findings could be summarized in: 1) only five countries emerged with production in the specific topic, that is, workforce skills to family support (UK, USA, Canada, Australia, and Spain), 2) studies revealed that diverse skills support family topics were investigated, namely the professional support skills to help families of neglected/abused children or in care; the professional support skills to help families with children who suffer from behavioral problems and families with children with disabilities; and the professional support skills to help minority ethnic parents, 3) social workers were the main targeted professionals' studies albeit other child protection workers were studied too, 4) the workforce skills to family support were grouped in three topics: the qualities of the professionals (attitudes and attributes); technical skills, and specific knowledge. The framework of analyses, literature strategy and findings with study limitations will be further discussed. As an implication, this study contributes and advocates for the structuring of a common base for cross-sectoral and interdisciplinary qualification standards for the family support workforce.

Keywords: family support, skill standards, systemic review, workforce

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Authors: D. Mulligan, D. Casey

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Introductory Statement: Delegation is when a registered nurse (RN) transfers a task or activity that is normally within their scope of practice to another person (delegatee). RN delegation is common practice with unregistered staff, e.g., student nurses and health care assistants (HCAs). As the role of the HCA is increasingly embedded as a direct care and support role, especially in long-term residential care for older adults, there is RN uncertainty as to their role as a delegator. The assignment is when a task is transferred to a person that is within the role specification of the delegatee. RNs in long-term care (LTC) for older people are increasingly working in teams where there are less RNs and more HCAs providing direct care to the residents. The RN is responsible and accountable for their decision to delegate and assign tasks to HCAs. In an interpretive, multiple case studies to explore how delegation of tasks by RNs to HCAs occurred in long-term care settings in Ireland the importance of the RN understanding their scope of practice emerged. Methodology: Focus group interviews and individual interviews were undertaken as part of a multiple case study. Both cases, anonymized as Case A and Case B, were within the public health service in Ireland. The case study sites were long-term care settings for older adults located in different social care divisions, and in different geographical areas. Four focus group interviews with staff nurses and three individual interviews with CNMs were undertaken. The interactive data analysis approach was the analytical framework used, with within-case and cross-case analysis. The theoretical lens of organizational role theory, applying the role episode model (REM), was used to understand, interpret, and explain the findings. Study Findings: RNs and CNMs understood the role of the nurse regulator and the scope of practice. RNs understood that the RN was accountable for the care and support provided to residents. However, RNs and CNM2s could not describe delegation in the context of their scope of practice. In both cases, the RNs did not have a standardized process for assessing HCA competence to undertake nursing tasks or interventions. RNs did not routinely supervise HCAs. Tasks were assigned and not delegated. There were differences between the cases in relation to understanding which nursing tasks required delegation. HCAs in Case A undertook clinical vital sign assessments and documentation. HCAs in Case B did not routinely undertake these activities. Delegation and assignment were influenced by the organizational factors, e.g., model of care, absence of delegation policies, inadequate RN education on delegation, and a lack of RN and HCA role clarity. Concluding Statement: Nurse staffing levels and skill mix in long-term care settings continue to change with more HCAs providing more direct care and support. With decreasing RN staffing levels RNs will be required to delegate and assign more direct care to HCAs. There is a requirement to distinguish between RN assignment and delegation at policy, regulation, and organizational levels.

Keywords: assignment, delegation, registered nurse, scope of practice

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Authors: Innocent Atuhe, Babra Nalwadda, Grace Mulyowa Kitunzi, Annabella Haninka Ejiri

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Background: Atopic Dermatitis (AD) is one of the most prevalent and growing chronic inflammatory skin diseases in African prisons. AD care is limited in African due to lack of information about the disease amongst primary care workers, limited access to dermatologists, lack of proper training of healthcare workers, and shortage of appropriate treatments. We designed and implemented the Prisons Telederma project based on the recommendations of the International Society of Atopic Dermatitis. Our overall goal was to increase access to dermatologist-led care for prisoners with AD through teledermatology in Uganda. We aimed to; i) to increase awareness and understanding of teledermatology among prison health workers; and ii) to improve treatment outcomes of prisoners with atopic dermatitis through increased access to and utilization of consultant dermatologists through teledermatology in Uganda prisons: Approach: We used Store-and-forward Teledermatology (SAF-TD) to increase access to dermatologist-led care for prisoners and prisons staff with AD. We conducted a five days training for prison health workers using an adapted WHO training guide on recognizing neglected tropical diseases through changes on the skin together with an adapted American Academy of Dermatology (AAD) Childhood AD Basic Dermatology Curriculum designed to help trainees develop a clinical approach to the evaluation and initial management of patients with AD. This training was followed by blended e-learning, webinars facilitated by consultant Dermatologists with local knowledge of medication and local practices, apps adjusted for pigmented skin, WhatsApp group discussions, and sharing pigmented skin AD pictures and treatment via zoom meetings. We hired a team of Ugandan Senior Consultant dermatologists to draft an iconographic atlas of the main dermatoses in pigmented African skin and shared this atlas with prison health staff for use as a job aid. We had planned to use MySkinSelfie mobile phone application to take and share skin pictures of prisoners with AD with Consultant Dermatologists, who would review the pictures and prescribe appropriate treatment. Unfortunately, the National Health Service withdrew the app from the market due to technical issues. We monitored and evaluated treatment outcomes using the Patient Oriented Eczema Measure (POEM) tool. We held four advocacy meetings to persuade relevant stakeholders to increase supplies and availability of first-line AD treatments such as emollients in prison health facilities. Results: Draft iconographic atlas of the main dermatoses in pigmented African skin Increased proportion of prison health staff with adequate knowledge of AD and teledermatology from 20% to 80% Increased proportion of prisoners with AD reporting improvement in disease severity (POEM scores) from 25% to 35% in one year. Increased proportion of prisoners with AD seen by consultant dermatologist through teledermatology from 0% to 20% in one year. Increased the availability of AD recommended treatments in prisons health facilities from 5% to 10% in one year

Keywords: teledermatology, prisoners, reaching, un-reachable

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