Search results for: Reliable facility
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 833

Search results for: Reliable facility

23 Impact of Interface Soil Layer on Groundwater Aquifer Behaviour

Authors: Hayder H. Kareem, Shunqi Pan

Abstract:

The geological environment where the groundwater is collected represents the most important element that affects the behaviour of groundwater aquifer. As groundwater is a worldwide vital resource, it requires knowing the parameters that affect this source accurately so that the conceptualized mathematical models would be acceptable to the broadest ranges. Therefore, groundwater models have recently become an effective and efficient tool to investigate groundwater aquifer behaviours. Groundwater aquifer may contain aquitards, aquicludes, or interfaces within its geological formations. Aquitards and aquicludes have geological formations that forced the modellers to include those formations within the conceptualized groundwater models, while interfaces are commonly neglected from the conceptualization process because the modellers believe that the interface has no effect on aquifer behaviour. The current research highlights the impact of an interface existing in a real unconfined groundwater aquifer called Dibdibba, located in Al-Najaf City, Iraq where it has a river called the Euphrates River that passes through the eastern part of this city. Dibdibba groundwater aquifer consists of two types of soil layers separated by an interface soil layer. A groundwater model is built for Al-Najaf City to explore the impact of this interface. Calibration process is done using PEST 'Parameter ESTimation' approach and the best Dibdibba groundwater model is obtained. When the soil interface is conceptualized, results show that the groundwater tables are significantly affected by that interface through appearing dry areas of 56.24 km² and 6.16 km² in the upper and lower layers of the aquifer, respectively. The Euphrates River will also leak water into the groundwater aquifer of 7359 m³/day. While these results are changed when the soil interface is neglected where the dry area became 0.16 km², the Euphrates River leakage became 6334 m³/day. In addition, the conceptualized models (with and without interface) reveal different responses for the change in the recharge rates applied on the aquifer through the uncertainty analysis test. The aquifer of Dibdibba in Al-Najaf City shows a slight deficit in the amount of water supplied by the current pumping scheme and also notices that the Euphrates River suffers from stresses applied to the aquifer. Ultimately, this study shows a crucial need to represent the interface soil layer in model conceptualization to be the intended and future predicted behaviours more reliable for consideration purposes.

Keywords: Al-Najaf City, groundwater aquifer behaviour, groundwater modelling, interface soil layer, Visual MODFLOW.

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22 Aircraft Selection Using Multiple Criteria Decision Making Analysis Method with Different Data Normalization Techniques

Authors: C. Ardil

Abstract:

This paper presents an original application of multiple criteria decision making analysis theory to the evaluation of aircraft selection problem. The selection of an optimal, efficient and reliable fleet, network and operations planning policy is one of the most important factors in aircraft selection problem. Given that decision making in aircraft selection involves the consideration of a number of opposite criteria and possible solutions, such a selection can be considered as a multiple criteria decision making analysis problem. This study presents a new integrated approach to decision making by considering the multiple criteria utility theory and the maximal regret minimization theory methods as well as aircraft technical, economical, and environmental aspects. Multiple criteria decision making analysis method uses different normalization techniques to allow criteria to be aggregated with qualitative and quantitative data of the decision problem. Therefore, selecting a suitable normalization technique for the model is also a challenge to provide data aggregation for the aircraft selection problem. To compare the impact of different normalization techniques on the decision problem, the vector, linear (sum), linear (max), and linear (max-min) data normalization techniques were identified to evaluate aircraft selection problem. As a logical implication of the proposed approach, it enhances the decision making process through enabling the decision maker to: (i) use higher level knowledge regarding the selection of criteria weights and the proposed technique, (ii) estimate the ranking of an alternative, under different data normalization techniques and integrated criteria weights after a posteriori analysis of the final rankings of alternatives. A set of commercial passenger aircraft were considered in order to illustrate the proposed approach. The obtained results of the proposed approach were compared using Spearman's rho tests. An analysis of the final rank stability with respect to the changes in criteria weights was also performed so as to assess the sensitivity of the alternative rankings obtained by the application of different data normalization techniques and the proposed approach.

Keywords: Normalization Techniques, Aircraft Selection, Multiple Criteria Decision Making, Multiple Criteria Decision Making Analysis, MCDMA

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21 A Study of Semantic Analysis of LED Illustrated Traffic Directional Arrow in Different Style

Authors: Chia-Chen Wu, Chih-Fu Wu, Pey-Weng Lien, Kai-Chieh Lin

Abstract:

In the past, the most comprehensively adopted light source was incandescent light bulbs, but with the appearance of LED light sources, traditional light sources have been gradually replaced by LEDs because of its numerous superior characteristics. However, many of the standards do not apply to LEDs as the two light sources are characterized differently. This also intensifies the significance of studies on LEDs. As a Kansei design study investigating the visual glare produced by traffic arrows implemented with LEDs, this study conducted a semantic analysis on the styles of traffic arrows used in domestic and international occasions. The results will be able to reduce drivers’ misrecognition that results in the unsuccessful arrival at the destination, or in traffic accidents. This study started with a literature review and surveyed the status quo before conducting experiments that were divided in two parts. The first part involved a screening experiment of arrow samples, where cluster analysis was conducted to choose five representative samples of LED displays. The second part was a semantic experiment on the display of arrows using LEDs, where the five representative samples and the selected ten adjectives were incorporated. Analyzing the results with Quantification Theory Type I, it was found that among the composition of arrows, fletching was the most significant factor that influenced the adjectives. In contrast, a “no fletching” design was more abstract and vague. It lacked the ability to convey the intended message and might bear psychological negative connotation including “dangerous,” “forbidden,” and “unreliable.” The arrow design consisting of “> shaped fletching” was found to be more concrete and definite, showing positive connotation including “safe,” “cautious,” and “reliable.” When a stimulus was placed at a farther distance, the glare could be significantly reduced; moreover, the visual evaluation scores would be higher. On the contrary, if the fletching and the shaft had a similar proportion, looking at the stimuli caused higher evaluation at a closer distance. The above results will be able to be applied to the design of traffic arrows by conveying information definitely and rapidly. In addition, drivers’ safety could be enhanced by understanding the cause of glare and improving visual recognizability.

Keywords: LED, arrow, Kansei research, preferred imagery.

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20 Agreement between Basal Metabolic Rate Measured by Bioelectrical Impedance Analysis and Estimated by Prediction Equations in Obese Groups

Authors: Orkide Donma, Mustafa M. Donma

Abstract:

Basal metabolic rate (BMR) is widely used and an accepted measure of energy expenditure. Its principal determinant is body mass. However, this parameter is also correlated with a variety of other factors. The objective of this study is to measure BMR and compare it with the values obtained from predictive equations in adults classified according to their body mass index (BMI) values. 276 adults were included into the scope of this study. Their age, height and weight values were recorded. Five groups were designed based on their BMI values. First group (n = 85) was composed of individuals with BMI values varying between 18.5 and 24.9 kg/m2. Those with BMI values varying from 25.0 to 29.9 kg/m2 constituted Group 2 (n = 90). Individuals with 30.0-34.9 kg/m2, 35.0-39.9 kg/m2, > 40.0 kg/m2 were included in Group 3 (n = 53), 4 (n = 28) and 5 (n = 20), respectively. The most commonly used equations to be compared with the measured BMR values were selected. For this purpose, the values were calculated by the use of four equations to predict BMR values, by name, introduced by Food and Agriculture Organization (FAO)/World Health Organization (WHO)/United Nations University (UNU), Harris and Benedict, Owen and Mifflin. Descriptive statistics, ANOVA, post-Hoc Tukey and Pearson’s correlation tests were performed by a statistical program designed for Windows (SPSS, version 16.0). p values smaller than 0.05 were accepted as statistically significant. Mean ± SD of groups 1, 2, 3, 4 and 5 for measured BMR in kcal were 1440.3 ± 210.0, 1618.8 ± 268.6, 1741.1 ± 345.2, 1853.1 ± 351.2 and 2028.0 ± 412.1, respectively. Upon evaluation of the comparison of means among groups, differences were highly significant between Group 1 and each of the remaining four groups. The values were increasing from Group 2 to Group 5. However, differences between Group 2 and Group 3, Group 3 and Group 4, Group 4 and Group 5 were not statistically significant. These insignificances were lost in predictive equations proposed by Harris and Benedict, FAO/WHO/UNU and Owen. For Mifflin, the insignificance was limited only to Group 4 and Group 5. Upon evaluation of the correlations of measured BMR and the estimated values computed from prediction equations, the lowest correlations between measured BMR and estimated BMR values were observed among the individuals within normal BMI range. The highest correlations were detected in individuals with BMI values varying between 30.0 and 34.9 kg/m2. Correlations between measured BMR values and BMR values calculated by FAO/WHO/UNU as well as Owen were the same and the highest. In all groups, the highest correlations were observed between BMR values calculated from Mifflin and Harris and Benedict equations using age as an additional parameter. In conclusion, the unique resemblance of the FAO/WHO/UNU and Owen equations were pointed out. However, mean values obtained from FAO/WHO/UNU were much closer to the measured BMR values. Besides, the highest correlations were found between BMR calculated from FAO/WHO/UNU and measured BMR. These findings suggested that FAO/WHO/UNU was the most reliable equation, which may be used in conditions when the measured BMR values are not available.

Keywords: Adult, basal metabolic rate, FAO/WHO/UNU, obesity, prediction equations.

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19 Teaching Material, Books, Publications versus the Practice: Myths and Truths about Installation and Use of Downhole Safety Valve

Authors: Robson da Cunha Santos, Caio Cezar R. Bonifacio, Diego Mureb Quesada, Gerson Gomes Cunha

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The paper is related to the safety of oil wells and environmental preservation on the planet, because they require great attention and commitment from oil companies and people who work with these equipments. This must occur from drilling the well until it is abandoned in order to safeguard the environment and prevent possible damage. The project had as main objective the constitution resulting from comparatives made among books, articles and publications with information gathered in technical visits to operational bases of Petrobras. After the visits, the information from methods of utilization and present managements, which were not available before, became available to the general audience. As a result, it is observed a huge flux of incorrect and out-of-date information that comprehends not only bibliographic archives, but also academic resources and materials. During the gathering of more in-depth information on the manufacturing, assembling, and use aspects of DHSVs, several issues that were previously known as correct, customary issues were discovered to be uncertain and outdated. Information of great importance resulted in affirmations about subjects as the depth of the valve installation that was before installed to 30 meters from the seabed (mud line). Despite this, the installation should vary in conformity to the ideal depth to escape from area with the biggest tendency to hydrates formation according to the temperature and pressure. Regarding to valves with nitrogen chamber, in accordance with books, they have their utilization linked to water line ≥ 700 meters, but in Brazilian exploratory fields, their use occurs from 600 meters of water line. The valves used in Brazilian fields are able to be inserted to the production column and self-equalizing, but the use of screwed valve in the column of production and equalizing is predominant. Although these valves are more expensive to acquire, they are more reliable, efficient, with a bigger shelf life and they do not cause restriction to the fluid flux. It follows that based on researches and theoretical information confronted to usual forms used in fields, the present project is important and relevant. This project will be used as source of actualization and information equalization that connects academic environment and real situations in exploratory situations and also taking into consideration the enrichment of precise and easy to understand information to future researches and academic upgrading.

Keywords: Downhole, Teaching Material, Books, Practice.

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18 Surface Topography Assessment Techniques based on an In-process Monitoring Approach of Tool Wear and Cutting Force Signature

Authors: A. M. Alaskari, S. E. Oraby

Abstract:

The quality of a machined surface is becoming more and more important to justify the increasing demands of sophisticated component performance, longevity, and reliability. Usually, any machining operation leaves its own characteristic evidence on the machined surface in the form of finely spaced micro irregularities (surface roughness) left by the associated indeterministic characteristics of the different elements of the system: tool-machineworkpart- cutting parameters. However, one of the most influential sources in machining affecting surface roughness is the instantaneous state of tool edge. The main objective of the current work is to relate the in-process immeasurable cutting edge deformation and surface roughness to a more reliable easy-to-measure force signals using a robust non-linear time-dependent modeling regression techniques. Time-dependent modeling is beneficial when modern machining systems, such as adaptive control techniques are considered, where the state of the machined surface and the health of the cutting edge are monitored, assessed and controlled online using realtime information provided by the variability encountered in the measured force signals. Correlation between wear propagation and roughness variation is developed throughout the different edge lifetimes. The surface roughness is further evaluated in the light of the variation in both the static and the dynamic force signals. Consistent correlation is found between surface roughness variation and tool wear progress within its initial and constant regions. At the first few seconds of cutting, expected and well known trend of the effect of the cutting parameters is observed. Surface roughness is positively influenced by the level of the feed rate and negatively by the cutting speed. As cutting continues, roughness is affected, to different extents, by the rather localized wear modes either on the tool nose or on its flank areas. Moreover, it seems that roughness varies as wear attitude transfers from one mode to another and, in general, it is shown that it is improved as wear increases but with possible corresponding workpart dimensional inaccuracy. The dynamic force signals are found reasonably sensitive to simulate either the progressive or the random modes of tool edge deformation. While the frictional force components, feeding and radial, are found informative regarding progressive wear modes, the vertical (power) components is found more representative carrier to system instability resulting from the edge-s random deformation.

Keywords: Dynamic force signals, surface roughness (finish), tool wear and deformation, tool wear modes (nose, flank)

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17 Association of Maternal Diet Quality Indices and Dietary Patterns during Lactation and the Growth of Exclusive Breastfed Infant

Authors: Leila Azadbakht, Maedeh Moradi, Mohammad Reza Merasi, Farzaneh Jahangir

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Maternal dietary intake during lactation might affect the growth rate of an exclusive breastfed infant. The present study was conducted to evaluate the effect of maternal dietary patterns and quality during lactation on the growth of the exclusive breastfed infant. Methods: 484 healthy lactating mothers with their infant were enrolled in this study. Only exclusive breastfed infants were included in this study which was conducted in Iran. Dietary intake of lactating mothers was assessed using a validated and reliable semi-quantitative food frequency questionnaire. Diet quality indices such as alternative Healthy eating index (HEI), Dietary energy density (DED), and adherence to Mediterranean dietary pattern score, Nordic and dietary approaches to stop hypertension (DASH) eating pattern were created. Anthropometric features of infant (weight, height, and head circumference) were recorded at birth, two and four months. Results: Weight, length, weight for height and head circumference of infants at two months and four months age were mostly in the normal range among those that mothers adhered more to the HEI in lactation period (normal weight: 61%; normal height: 59%). The prevalence of stunting at four months of age among those whose mothers adhered more to the HEI was 31% lower than those with the least adherence to HEI. Mothers in the top tertiles of HEI score had the lowest frequency of having underweight infants (18% vs. 33%; P=0.03). Odds ratio of being overweight or obese at four months age was the lowest among those infants whose mothers adhered more to the HEI (OR: 0.67 vs 0.91; Ptrend=0.03). However, there was not any significant association between adherence of mothers to Mediterranean diet as well as DASH diet and Nordic eating pattern and the growth of infants (none of weight, height or head circumference). Infant weight, length, weight for height and head circumference at two months and four months did not show significant differences among different tertile categories of mothers’ DED. Conclusions: Higher diet quality indices and more adherence of lactating mother to HEI (as an indicator of diet quality) may be associated with better growth indices of the breastfed infant. However, it seems that DED of the lactating mother does not affect the growth of the breastfed infant. Adherence to the different dietary patterns such as Mediterranean, DASH or Nordic among mothers had no different effect on the growth indices of the infants. However, higher diet quality indices and more adherence of lactating mother to HEI may be associated with better growth indices of the breastfed infant. Breastfeeding is a complete way that is not affected much by the dietary patterns of the mother. However, better diet quality might be associated with better growth.

Keywords: Breastfeeding, growth, infant, maternal diet.

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16 An Effort at Improving Reliability of Laboratory Data in Titrimetric Analysis for Zinc Sulphate Tablets Using Validated Spreadsheet Calculators

Authors: M. A. Okezue, K. L. Clase, S. R. Byrn

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The requirement for maintaining data integrity in laboratory operations is critical for regulatory compliance. Automation of procedures reduces incidence of human errors. Quality control laboratories located in low-income economies may face some barriers in attempts to automate their processes. Since data from quality control tests on pharmaceutical products are used in making regulatory decisions, it is important that laboratory reports are accurate and reliable. Zinc Sulphate (ZnSO4) tablets is used in treatment of diarrhea in pediatric population, and as an adjunct therapy for COVID-19 regimen. Unfortunately, zinc content in these formulations is determined titrimetrically; a manual analytical procedure. The assay for ZnSO4 tablets involves time-consuming steps that contain mathematical formulae prone to calculation errors. To achieve consistency, save costs, and improve data integrity, validated spreadsheets were developed to simplify the two critical steps in the analysis of ZnSO4 tablets: standardization of 0.1M Sodium Edetate (EDTA) solution, and the complexometric titration assay procedure. The assay method in the United States Pharmacopoeia was used to create a process flow for ZnSO4 tablets. For each step in the process, different formulae were input into two spreadsheets to automate calculations. Further checks were created within the automated system to ensure validity of replicate analysis in titrimetric procedures. Validations were conducted using five data sets of manually computed assay results. The acceptance criteria set for the protocol were met. Significant p-values (p < 0.05, α = 0.05, at 95% Confidence Interval) were obtained from students’ t-test evaluation of the mean values for manual-calculated and spreadsheet results at all levels of the analysis flow. Right-first-time analysis and principles of data integrity were enhanced by use of the validated spreadsheet calculators in titrimetric evaluations of ZnSO4 tablets. Human errors were minimized in calculations when procedures were automated in quality control laboratories. The assay procedure for the formulation was achieved in a time-efficient manner with greater level of accuracy. This project is expected to promote cost savings for laboratory business models.

Keywords: Data integrity, spreadsheets, titrimetry, validation, zinc sulphate tablets.

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15 Ethnic Andean Concepts of Health and Illness in the Post-Colombian World and Its Relevance Today

Authors: Elizabeth J. Currie, Fernando Ortega Perez

Abstract:

—‘MEDICINE’ is a new project funded under the EC Horizon 2020 Marie-Sklodowska Curie Actions, to determine concepts of health and healing from a culturally specific indigenous context, using a framework of interdisciplinary methods which integrates archaeological-historical, ethnographic and modern health sciences approaches. The study will generate new theoretical and methodological approaches to model how peoples survive and adapt their traditional belief systems in a context of alien cultural impacts. In the immediate wake of the conquest of Peru by invading Spanish armies and ideology, native Andeans responded by forming the Taki Onkoy millenarian movement, which rejected European philosophical and ontological teachings, claiming “you make us sick”. The study explores how people’s experience of their world and their health beliefs within it, is fundamentally shaped by their inherent beliefs about the nature of being and identity in relation to the wider cosmos. Cultural and health belief systems and related rituals or behaviors sustain a people’s sense of identity, wellbeing and integrity. In the event of dislocation and persecution these may change into devolved forms, which eventually inter-relate with ‘modern’ biomedical systems of health in as yet unidentified ways. The development of new conceptual frameworks that model this process will greatly expand our understanding of how people survive and adapt in response to cultural trauma. It will also demonstrate the continuing role, relevance and use of TM in present-day indigenous communities. Studies will first be made of relevant pre-Colombian material culture, and then of early colonial period ethnohistorical texts which document the health beliefs and ritual practices still employed by indigenous Andean societies at the advent of the 17th century Jesuit campaigns of persecution - ‘Extirpación de las Idolatrías’. Core beliefs drawn from these baseline studies will then be used to construct a questionnaire about current health beliefs and practices to be taken into the study population of indigenous Quechua peoples in the northern Andean region of Ecuador. Their current systems of knowledge and medicine have evolved within complex historical contexts of both the conquest by invading Inca armies in the late 15th century, followed a generation later by Spain, into new forms. A new model will be developed of contemporary  Andean concepts of health, illness and healing demonstrating  the way these have changed through time. With this, a ‘policy tool’ will be constructed as a bridhging facility into contemporary global scenarios relevant to other Indigenous, First Nations, and migrant peoples to provide a means through which their traditional health beliefs and current needs may be more appropriately understood and met. This paper presents findings from the first analytical phases of the work based upon the study of the literature and the archaeological records. The study offers a novel perspective and methods in the development policies sensitive to indigenous and minority people’s health needs.

Keywords: Andean ethnomedicine, andean health beliefs, health beliefs models, traditional medicine.

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14 Concept of a Pseudo-Lower Bound Solution for Reinforced Concrete Slabs

Authors: M. De Filippo, J. S. Kuang

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In construction industry, reinforced concrete (RC) slabs represent fundamental elements of buildings and bridges. Different methods are available for analysing the structural behaviour of slabs. In the early ages of last century, the yield-line method has been proposed to attempt to solve such problem. Simple geometry problems could easily be solved by using traditional hand analyses which include plasticity theories. Nowadays, advanced finite element (FE) analyses have mainly found their way into applications of many engineering fields due to the wide range of geometries to which they can be applied. In such cases, the application of an elastic or a plastic constitutive model would completely change the approach of the analysis itself. Elastic methods are popular due to their easy applicability to automated computations. However, elastic analyses are limited since they do not consider any aspect of the material behaviour beyond its yield limit, which turns to be an essential aspect of RC structural performance. Furthermore, their applicability to non-linear analysis for modeling plastic behaviour gives very reliable results. Per contra, this type of analysis is computationally quite expensive, i.e. not well suited for solving daily engineering problems. In the past years, many researchers have worked on filling this gap between easy-to-implement elastic methods and computationally complex plastic analyses. This paper aims at proposing a numerical procedure, through which a pseudo-lower bound solution, not violating the yield criterion, is achieved. The advantages of moment distribution are taken into account, hence the increase in strength provided by plastic behaviour is considered. The lower bound solution is improved by detecting over-yielded moments, which are used to artificially rule the moment distribution among the rest of the non-yielded elements. The proposed technique obeys Nielsen’s yield criterion. The outcome of this analysis provides a simple, yet accurate, and non-time-consuming tool of predicting the lower-bound solution of the collapse load of RC slabs. By using this method, structural engineers can find the fracture patterns and ultimate load bearing capacity. The collapse triggering mechanism is found by detecting yield-lines. An application to the simple case of a square clamped slab is shown, and a good match was found with the exact values of collapse load.

Keywords: Computational mechanics, lower bound method, reinforced concrete slabs, yield-line.

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13 A New Model to Perform Preliminary Evaluations of Complex Systems for the Production of Energy for Buildings: Case Study

Authors: Roberto de Lieto Vollaro, Emanuele de Lieto Vollaro, Gianluca Coltrinari

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The building sector is responsible, in many industrialized countries, for about 40% of the total energy requirements, so it seems necessary to devote some efforts in this area in order to achieve a significant reduction of energy consumption and of greenhouse gases emissions. The paper presents a study aiming at providing a design methodology able to identify the best configuration of the system building/plant, from a technical, economic and environmentally point of view. Normally, the classical approach involves a building's energy loads analysis under steady state conditions, and subsequent selection of measures aimed at improving the energy performance, based on previous experience made by architects and engineers in the design team. Instead, the proposed approach uses a sequence of two wellknown scientifically validated calculation methods (TRNSYS and RETScreen), that allow quite a detailed feasibility analysis. To assess the validity of the calculation model, an existing, historical building in Central Italy, that will be the object of restoration and preservative redevelopment, was selected as a casestudy. The building is made of a basement and three floors, with a total floor area of about 3,000 square meters. The first step has been the determination of the heating and cooling energy loads of the building in a dynamic regime by means, which allows simulating the real energy needs of the building in function of its use. Traditional methodologies, based as they are on steady-state conditions, cannot faithfully reproduce the effects of varying climatic conditions and of inertial properties of the structure. With this model is possible to obtain quite accurate and reliable results that allow identifying effective combinations building-HVAC system. The second step has consisted of using output data obtained as input to the calculation model, which enables to compare different system configurations from the energy, environmental and financial point of view, with an analysis of investment, and operation and maintenance costs, so allowing determining the economic benefit of possible interventions. The classical methodology often leads to the choice of conventional plant systems, while our calculation model provides a financial-economic assessment for innovative energy systems and low environmental impact. Computational analysis can help in the design phase, particularly in the case of complex structures with centralized plant systems, by comparing the data returned by the calculation model for different design options.

Keywords: Energy, Buildings, Systems, Evaluation.

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12 Decision Support System for Hospital Selection in Emergency Medical Services: A Discrete Event Simulation Approach

Authors: D. Tedesco, G. Feletti, P. Trucco

Abstract:

The present study aims to develop a Decision Support System (DSS) to support operational decisions in Emergency Medical Service (EMS) systems regarding the assignment of medical emergency requests to Emergency Departments (ED). This problem is called “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of a first phase of review of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a mission. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the travelling time and to free-up the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs also considering the expected time performance in the subsequent phases of the process, such as the case mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to compare different hospital selection policies. The model was implemented with the AnyLogic software and finally validated on a realistic case. The hospital selection policy that returned the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, based on a retrospective estimation of the TTP, and a dynamic approach, focused on a predictive estimation of the TTP which is determined with a constantly updated Winters forecasting model. Findings reveal that considering the minimization of TTP is the best hospital selection policy. It allows to significantly reducing service throughput times in the ED with a negligible increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms on TTP estimation, than a retrospective approach. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: Emergency medical services, hospital selection, discrete event simulation, forecast model.

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11 Predicting Mortality among Acute Burn Patients Using BOBI Score vs. FLAMES Score

Authors: S. Moustafa El Shanawany, I. Labib Salem, F. Mohamed Magdy Badr El Dine, H. Tag El Deen Abd Allah

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Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.

Keywords: BOBI, Burns, FLAMES, scoring systems, outcome.

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10 Funding Innovative Activities in Firms: The Ownership Structure and Governance Linkage - Evidence from Mongolia

Authors: Ernest Nweke, Enkhtuya Bavuudorj

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The harsh realities of the scandalous failure of several notable corporations in the past two decades have inextricably resulted in a surge in corporate governance studies. Nevertheless, little or no attention has been paid to corporate governance studies in Mongolian firms and much less to the comprehension of the correlation among ownership structure, corporate governance mechanisms and trend of innovative activities. Innovation is the bed rock of enterprise success. However, the funding and support for innovative activities in many firms are to a great extent determined by the incentives provided by the firm’s internal and external governance mechanisms. Mongolia is an East Asian country currently undergoing a fast-paced transition from socialist to democratic system and it is a widely held view that private ownership as against public ownership fosters innovation. Hence, following the privatization policy of Mongolian Government which has led to the transfer of the ownership of hitherto state controlled and state directed firms to private individuals and organizations, expectations are high that sufficient motivation would be provided for firm managers to engage in innovative activities. This research focuses on the relationship between ownership structure, corporate governance on one hand and the level of innovation on the hand. The paper is empirical in nature and derives data from both reliable secondary and primary sources. Secondary data for the study was in respect of ownership structure of Mongolian listed firms and innovation trend in Mongolia generally. These were analyzed using tables, charts, bars and percentages. Personal interviews and surveys were held to collect primary data. Primary data was in respect of corporate governance practices in Mongolian firms and were collected using structured questionnaire. Out of a population of three hundred and twenty (320) companies listed on the Mongolian Stock Exchange (MSE), a sample size of thirty (30) randomly selected companies was utilized for the study. Five (5) management level employees were surveyed in each selected firm giving a total of one hundred and fifty (150) respondents. Data collected were analyzed and research hypotheses tested using Chi-Square test statistic. Research results showed that corporate governance mechanisms were better and have significantly improved overtime in privately held as opposed to publicly owned firms. Consequently, the levels of innovation in privately held firms were considerably higher. It was concluded that a significant and positive relationship exists between private ownership and good corporate governance on one hand and the level of funding provided for innovative activities in Mongolian firms on the other hand.

Keywords: Corporate governance, innovation, ownership structure, stock exchange.

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9 Factors Influencing Intention to Engage in Long-term Care Services among Nursing Aide Trainees and the General Public

Authors: Ju-Chun Chien

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Rapid aging and depopulation could lead to serious problems, including workforce shortages and health expenditure costs. The current and predicted future LTC workforce shortages could be a real threat to Taiwan’s society. By means of comparison of data from 144 nursing aide trainees and 727 general public, the main purpose of the present study was to determine whether there were any notable differences between the two groups toward engaging in LTC services. Moreover, this study focused on recognizing the attributes of the general public who had the willingness to take LTC jobs but continue to ride the fence. A self-developed questionnaire was designed based on Ajzen’s Theory of Planned Behavior model. After conducting exploratory factor analysis (EFA) and reliability analysis, the questionnaire was a reliable and valid instrument for both nursing aide trainees and the general public. The main results were as follows: Firstly, nearly 70% of nursing aide trainees showed interest in LTC jobs. Most of them were middle-aged female (M = 46.85, SD = 9.31), had a high school diploma or lower, had unrelated work experience in healthcare, and were mostly unemployed. The most common reason for attending the LTC training program was to gain skills in a particular field. The second most common reason was to obtain the license. The third and fourth reasons were to be interested in caring for people and to increase income. The three major reasons that might push them to leave LTC jobs were physical exhaustion, payment is bad, and being looked down on. Secondly, the variables that best-predicted nursing aide trainees’ intention to engage in LTC services were having personal willingness, perceived behavior control, with high school diploma or lower, and supported from family and friends. Finally, only 11.80% of the general public reported having interest in LTC jobs (the disapproval rating was 50% for the general public). In comparison to nursing aide trainees who showed interest in LTC settings, 64.8% of the new workforce for LTC among the general public was male and had an associate degree, 54.8% had relevant healthcare experience, 67.1% was currently employed, and they were younger (M = 32.19, SD = 13.19) and unmarried (66.3%). Furthermore, the most commonly reason for the new workforce to engage in LTC jobs were to gain skills in a particular field. The second priority was to be interested in caring for people. The third and fourth most reasons were to give back to society and to increase income, respectively. The top five most commonly reasons for the new workforce to quitting LTC jobs were listed as follows: physical exhaustion, being looked down on, excessive working hours, payment is bad, and excessive job stress.

Keywords: Long-term care services, nursing aide trainees, Taiwanese people, theory of planned behavior.

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8 The Digital Microscopy in Organ Transplantation: Ergonomics of the Tele-Pathological Evaluation of Renal, Liver and Pancreatic Grafts

Authors: C. S. Mammas, A. Lazaris, A. S. Mamma-Graham, G. Kostopanagiotou, C. Lemonidou, J. Mantas, E. Patsouris

Abstract:

Introduction: The process to build a better safety culture, methods of error analysis, and preventive measures, starts with an understanding of the effects when human factors engineering refer to remote microscopic diagnosis in surgery and specially in organ transplantation for the remote evaluation of the grafts. It has been estimated that even in well-organized transplant systems an average of 8% to 14% of the grafts (G) that arrive at the recipient hospitals may be considered as diseased, injured, damaged or improper for transplantation. Digital microscopy adds information on a microscopic level about the grafts in Organ Transplant (OT), and may lead to a change in their management. Such a method will reduce the possibility that a diseased G, will arrive at the recipient hospital for implantation. Aim: Ergonomics of Digital Microscopy (DM) based on virtual slides, on Telemedicine Systems (TS) for Tele-Pathological (TPE) evaluation of the grafts (G) in organ transplantation (OT). Material and Methods: By experimental simulation, the ergonomics of DM for microscopic TPE of Renal Graft (RG), Liver Graft (LG) and Pancreatic Graft (PG) tissues is analyzed. In fact, this corresponded to the ergonomics of digital microscopy for TPE in OT by applying Virtual Slide (VS) system for graft tissue image capture, for remote diagnoses of possible microscopic inflammatory and/or neoplastic lesions. Experimentation included: a. Development of an OTE-TS similar Experimental Telemedicine System (Exp.-TS), b. Simulation of the integration of TS with the VS based microscopic TPE of RG, LG and PG applying DM. Simulation of the DM based TPE was performed by 2 specialists on a total of 238 human Renal Graft (RG), 172 Liver Graft (LG) and 108 Pancreatic Graft (PG) tissues digital microscopic images for inflammatory and neoplastic lesions on four electronic spaces of the four used TS. Results: Statistical analysis of specialist‘s answers about the ability to diagnose accurately the diseased RG, LG and PG tissues on the electronic space among four TS (A,B,C,D) showed that DM on TS for TPE in OT is elaborated perfectly on the ES of a Desktop, followed by the ES of the applied Exp.-TS. Tablet and Mobile-Phone ES seem significantly risky for the application of DM in OT (p<.001). Conclusion: To make the largest reduction in errors and adverse events referring to the quality of the grafts, it will take application of human factors engineering to procurement, design, audit, and aware ness-raising activities. Consequently, it will take an investment in new training, people, and other changes to management activities for DM in OT. The simulating VS based TPE with DM of RG, LG and PG tissues after retrieval; seem feasible and reliable and dependable on the size of the electronic space of the applied TS, for remote prevention of diseased grafts from being retrieved and/or sent to the recipient hospital and for post-grafting and pre-transplant planning.

Keywords: Organ Transplantation, Tele-Pathology, Digital Microscopy, Virtual Slides.

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7 Application of Unstructured Mesh Modeling in Evolving SGE of an Airport at the Confluence of Multiple Rivers in a Macro Tidal Region

Authors: A. A. Purohit, M. M. Vaidya, M. D. Kudale

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Among the various developing countries in the world like China, Malaysia, Korea etc., India is also developing its infrastructures in the form of Road/Rail/Airports and Waterborne facilities at an exponential rate. Mumbai, the financial epicenter of India is overcrowded and to relieve the pressure of congestion, Navi Mumbai suburb is being developed on the east bank of Thane creek near Mumbai. The government due to limited space at existing Mumbai Airports (domestic and international) to cater for the future demand of airborne traffic, proposes to build a new international airport near Panvel at Navi Mumbai. Considering the precedence of extreme rainfall on 26th July 2005 and nearby townships being in a low-lying area, wherein new airport is proposed, it is inevitable to study this complex confluence area from a hydrodynamic consideration under both tidal and extreme events (predicted discharge hydrographs), to avoid inundation of the surrounding due to the proposed airport reclamation (1160 hectares) and to determine the safe grade elevation (SGE). The model studies conducted using the application of unstructured mesh to simulate the Panvel estuarine area (93 km2), calibration, validation of a model for hydraulic field measurements and determine the maxima water levels around the airport for various extreme hydrodynamic events, namely the simultaneous occurrence of highest tide from the Arabian Sea and peak flood discharges (Probable Maximum Precipitation and 26th July 2005) from five rivers, the Gadhi, Kalundri, Taloja, Kasadi and Ulwe, meeting at the proposed airport area revealed that: (a) The Ulwe River flowing beneath the proposed airport needs to be diverted. The 120m wide proposed Ulwe diversion channel having a wider base width of 200 m at SH-54 Bridge on the Ulwe River along with the removal of the existing bund in Moha Creek is inevitable to keep the SGE of the airport to a minimum. (b) The clear waterway of 80 m at SH-54 Bridge (Ulwe River) and 120 m at Amra Marg Bridge near Moha Creek is also essential for the Ulwe diversion and (c) The river bank protection works on the right bank of Gadhi River between the NH-4B and SH-54 bridges as well as upstream of the Ulwe River diversion channel are essential to avoid inundation of low lying areas. The maxima water levels predicted around the airport keeps SGE to a minimum of 11m with respect to Chart datum of Ulwe Bundar and thus development is not only technologically-economically feasible but also sustainable. The unstructured mesh modeling is a promising tool to simulate complex extreme hydrodynamic events and provides a reliable solution to evolve optimal SGE of airport.

Keywords: Airport, hydrodynamics, hydrographs, safe grade elevation, tides.

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6 Analytical Study of Sedimentation Formation in Lined Canals using the SHARC Software- A Case Study of the Sabilli Canal in Dezful, Iran

Authors: A.H. Sajedipoor, N. Hedayat, A.Rohani, Z.Yazdi

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Sediment formation and its transport along the river course is considered as important hydraulic consideration in river engineering. Their impact on the morphology of rivers on one hand and important considerations of which in the design and construction of the hydraulic structures on the other has attracted the attention of experts in arid and semi-arid regions. Under certain conditions where the momentum energy of the flow stream reaches a specific rate, the sediment materials start to be transported with the flow. This can usually be analyzed in two different categories of suspended and bed load materials. Sedimentation phenomenon along the waterways and the conveyance of vast volume of materials into the canal networks can potentially influence water abstraction in the intake structures. This can pose a serious threat to operational sustainability and water delivery performance in the canal networks. The situation is serious where ineffective watershed management (poor vegetation cover in the water basin) is the underlying cause of soil erosion which feeds the materials into the waterways that intern would necessitate comprehensive study. The present paper aims to present an analytical investigation of the sediment process in the waterways on one hand and estimation of the sediment load transport into the lined canals using the SHARC software on the other. For this reason, the paper focuses on the comparative analysis of the hydraulic behaviors of the Sabilli main canal that feeds the pumping station with that of the Western canal in the Greater Dezful region to identify effective factors in sedimentation and ways of mitigating their impact on water abstraction in the canal systems. The method involved use of observational data available in the Dezful Dastmashoon hydrometric station along a 6 km waterway of the Sabilli main canal using the SHARC software to estimate the suspended load concentration and bed load materials. Results showed the transport of a significant volume of sediment loads from the waterways into the canal system which is assumed to have arisen from the absence of stilling basin on one hand and the gravity flow on the other has caused serious challenges. This is contrary to what occurs in the Sabilli canal, where the design feature which incorporates a settling basin just before the pumping station is the major cause of reduced sediment load transport into the canal system.Results showed that modification of the present design features by constructing a settling basin just upstream of the western intake structure can considerably reduce the entry of sediment materials into the canal system. Not only this can result in the sustainability of the hydraulic structures but can also improve operational performance of water conveyance and distribution system, all of which are the pre-requisite to secure reliable and equitable water delivery regime for the command area.

Keywords: Sedimentation, main canal, Sabilli, western canal, dez diversion weir.

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5 Sand Production Modelled with Darcy Fluid Flow Using Discrete Element Method

Authors: M. N. Nwodo, Y. P. Cheng, N. H. Minh

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In the process of recovering oil in weak sandstone formations, the strength of sandstones around the wellbore is weakened due to the increase of effective stress/load from the completion activities around the cavity. The weakened and de-bonded sandstone may be eroded away by the produced fluid, which is termed sand production. It is one of the major trending subjects in the petroleum industry because of its significant negative impacts, as well as some observed positive impacts. For efficient sand management therefore, there has been need for a reliable study tool to understand the mechanism of sanding. One method of studying sand production is the use of the widely recognized Discrete Element Method (DEM), Particle Flow Code (PFC3D) which represents sands as granular individual elements bonded together at contact points. However, there is limited knowledge of the particle-scale behavior of the weak sandstone, and the parameters that affect sanding. This paper aims to investigate the reliability of using PFC3D and a simple Darcy flow in understanding the sand production behavior of a weak sandstone. An isotropic tri-axial test on a weak oil sandstone sample was first simulated at a confining stress of 1MPa to calibrate and validate the parallel bond models of PFC3D using a 10m height and 10m diameter solid cylindrical model. The effect of the confining stress on the number of bonds failure was studied using this cylindrical model. With the calibrated data and sample material properties obtained from the tri-axial test, simulations without and with fluid flow were carried out to check on the effect of Darcy flow on bonds failure using the same model geometry. The fluid flow network comprised of every four particles connected with tetrahedral flow pipes with a central pore or flow domain. Parametric studies included the effects of confining stress, and fluid pressure; as well as validating flow rate – permeability relationship to verify Darcy’s fluid flow law. The effect of model size scaling on sanding was also investigated using 4m height, 2m diameter model. The parallel bond model successfully calibrated the sample’s strength of 4.4MPa, showing a sharp peak strength before strain-softening, similar to the behavior of real cemented sandstones. There seems to be an exponential increasing relationship for the bigger model, but a curvilinear shape for the smaller model. The presence of the Darcy flow induced tensile forces and increased the number of broken bonds. For the parametric studies, flow rate has a linear relationship with permeability at constant pressure head. The higher the fluid flow pressure, the higher the number of broken bonds/sanding. The DEM PFC3D is a promising tool to studying the micromechanical behavior of cemented sandstones.

Keywords: Discrete Element Method, fluid flow, parametric study, sand production/bonds failure.

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4 Engineering Topology of Photonic Systems for Sustainable Molecular Structure: Autopoiesis Systems

Authors: Moustafa Osman Mohammed

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This paper introduces topological order in descried social systems starting with the original concept of autopoiesis by biologists and scientists, including the modification of general systems based on socialized medicine. Topological order is important in describing the physical systems for exploiting optical systems and improving photonic devices. The stats of topologically order have some interesting properties of topological degeneracy and fractional statistics that reveal the entanglement origin of topological order, etc. Topological ideas in photonics form exciting developments in solid-state materials, that being; insulating in the bulk, conducting electricity on their surface without dissipation or back-scattering, even in the presence of large impurities. A specific type of autopoiesis system is interrelated to the main categories amongst existing groups of the ecological phenomena interaction social and medical sciences. The hypothesis, nevertheless, has a nonlinear interaction with its natural environment ‘interactional cycle’ for exchange photon energy with molecules without changes in topology (i.e., chemical transformation into products do not propagate any changes or variation in the network topology of physical configuration). The engineering topology of a biosensor is based on the excitation boundary of surface electromagnetic waves in photonic band gap multilayer films. The device operation is similar to surface Plasmonic biosensors in which a photonic band gap film replaces metal film as the medium when surface electromagnetic waves are excited. The use of photonic band gap film offers sharper surface wave resonance leading to the potential of greatly enhanced sensitivity. So, the properties of the photonic band gap material are engineered to operate a sensor at any wavelength and conduct a surface wave resonance that ranges up to 470 nm. The wavelength is not generally accessible with surface Plasmon sensing. Lastly, the photonic band gap films have robust mechanical functions that offer new substrates for surface chemistry to understand the molecular design structure, and create sensing chips surface with different concentrations of DNA sequences in the solution to observe and track the surface mode resonance under the influences of processes that take place in the spectroscopic environment. These processes led to the development of several advanced analytical technologies, which are automated, real-time, reliable, reproducible and cost-effective. This results in faster and more accurate monitoring and detection of biomolecules on refractive index sensing, antibody–antigen reactions with a DNA or protein binding. Ultimately, the controversial aspect of molecular frictional properties is adjusted to each other in order to form unique spatial structure and dynamics of biological molecules for providing the environment mutual contribution in investigation of changes due the pathogenic archival architecture of cell clusters.

Keywords: autopoiesis, engineering topology, photonic system molecular structure, biosensor

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3 Clinical and Methodological Issues in the Research on the Rape Myth

Authors: Ana Pauna, Zbigniew Pleszewski

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The purpose of this study is to revisit the concept of rape as represented by professionals in the literature as well as its perception (beliefs and attitudes) in the population at large and to propose methodological improvements to its measurement tool. Rape is a serious crime threatening its victim-s physical and mental health and integrity; and as such is legally prosecuted in all modern societies. The problem is not in accepting or rejecting rape as a criminal act, but rather in the vagueness of its interpretations and “justifications" maintained in the mentality of modern societies - known in the literature as the phenomenon of "rape-myth". The rapemyth can be studied from different perspectives: criminology, sociology, ethics, medicine and psychology. Its investigation requires rigorous scientific objectivity, free of passion (victims of rape are at risk of emotional bias), free of activism (social activists, even if wellintentioned are also biased), free of any pre-emptive assumptions or prejudices. To apply a rigorous scientific procedure, we need a solid, valid and reliable measurement. Rape is a form of heterosexual or homosexual aggression, violently forcing the victim to give-in in the sexual activity of the aggressor against her/his will. Human beings always try to “understand" or find a reason justifying their acts. Psychological literature provides multiple clinical and experimental examples of it; just to mention the famous studies by Milgram on the level of electroshock delivered by the “teacher" towards the “learner" if “scientifically justifiable" or the studies on the behavior of “prisoners" and the “guards" and many other experiments and field observations. Sigmund Freud presented the phenomenon of unconscious justification and called it rationalization. The multiple justifications, rationalizations and repeated opinions about sexual behavior contribute to a myth maintained in the society. What kind of “rationale" our societies apply to “understand" the non-consensual sexual behavior? There are many, just to mention few: • Sex is a ludistic activity for both participants, therefore – even if not consented – it should bring pleasure to both. • Everybody wants sex, but only men are allowed to manifest it openly while women have to pretend the opposite, thus men have to initiate sexual behavior and women would follow. • A person who strongly needs sex is free to manifest it and struggle to get it; the person who doesn-t want it must not reveal her/his sexual attraction and avoid risky situations; otherwise she/he is perceived as a promiscuous seducer. • A person who doesn-t fight against the sexual initiator unconsciously accepts the rape (does it explain why homosexual rapes are reported less frequently than rapes against women?). • Women who are raped deserve it because their wardrobe is very revealing and seducing and they ''willingly'' go to highly risky places (alleys, dark roads, etc.). • Men need to ventilate their sexual energy and if they are deprived of a partner their urge to have sex is difficult to control. • Men are supposed to initiate and insist even by force to have sex (their testosterone makes them both sexual and aggressive). The paper overviews numerous cultural beliefs about masculine versus feminine behavior and their impact on the “rape myth".

Keywords: Rape Myth components, psycho-social factors, testing, Likert-type scale

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2 Validation of an Acuity Measurement Tool for Maternity Services

Authors: Cherryl Lowe

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Background - The TrendCare Patient Dependency System is currently used by a large number of maternity Services across Australia, New Zealand and Singapore. In 2012, 2013 and 2014 validation studies were initiated in all three countries to validate the acuity tools used for women in labour, and postnatal mothers and babies. This paper will present the findings of the validation study. Aim - The aim of this study was to; identify if the care hours provided by the TrendCare acuity system was an accurate reflection of the care required by women and babies; obtain evidence of changes required to acuity indicators and/or category timings to ensure the TrendCare acuity system remains reliable and valid across a range of maternity care models in three countries. Method - A non-experimental action research methodology was used across maternity services in four District Health Boards in New Zealand, a large tertiary and a large secondary maternity service in Singapore and a large public maternity service in Australia. Standardised data collection forms and timing devices were used to collect midwife contact times, with women and babies included in the study. Rejection processes excluded samples when care was not completed/rationed, and contact timing forms were incomplete. The variances between actual timed midwife/mother/baby contact and the TrendCare acuity category times were identified and investigated. Results - Thirty two (88.9%) of the 36 TrendCare acuity category timings, fell within the variance tolerance levels when compared to the actual timings recorded for midwifery care. Four (11.1%) TrendCare categories provided less minutes of care than the actual timings and exceeded the variance tolerance level. These were all night shift category timings. Nine postnatal categories were not able to be compared as the sample size for these categories was statistically insignificant. 100% of labour ward TrendCare categories matched actual timings for midwifery care, all falling within the variance tolerance levels. The actual time provided by core midwifery staff to assist lead maternity carer (LMC) midwives in New Zealand labour wards showed a significant deviation to previous studies. The findings of the study demonstrated the need for additional time allocations in TrendCare to accommodate an increased level of assistance given to LMC midwives. Conclusion - The results demonstrated the importance of regularly validating the TrendCare category timings with actual timings of the care hours provided. It was evident from the findings that variances to models of care and length of stay in maternity units have increased midwifery workloads on the night shift. The level of assistance provided by the core labour ward staff to the LMC midwife has increased substantially. Outcomes - As a consequence of this study, changes were made to the night duty TrendCare maternity categories, additional acuity indicators were developed and times for assisting LMC midwives in labour ward increased. The updated TrendCare version was delivered to maternity services in 2014.

Keywords: Maternity, acuity, midwifery research, midwifery workloads.

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1 An Integrated Solid Waste Management Strategy for Semi-Urban and Rural Areas of Pakistan

Authors: Z. Zaman Asam, M. Ajmal, R. Saeed, H. Miraj, M. Muhammad Ahtisham, B. Hameed, A. -Sattar Nizami

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In Pakistan, environmental degradation and consequent human health deterioration has rapidly accelerated in the past decade due to solid waste mismanagement. As the situation worsens with time, establishment of proper waste management practices is urgently needed especially in semi urban and rural areas of Pakistan. This study uses a concept of Waste Bank, which involves a transfer station for collection of sorted waste fractions and its delivery to the targeted market such as recycling industries, biogas plants, composting facilities etc. The management efficiency and effectiveness of Waste Bank depend strongly on the proficient sorting and collection of solid waste fractions at household level. However, the social attitude towards such a solution in semi urban/rural areas of Pakistan demands certain prerequisites to make it workable. Considering these factors the objectives of this study are to: [A] Obtain reliable data about quantity and characteristics of generated waste to define feasibility of business and design factors, such as required storage area, retention time, transportation frequency of the system etc. [B] Analyze the effects of various social factors on waste generation to foresee future projections. [C] Quantify the improvement in waste sorting efficiency after awareness campaign. We selected Gujrat city of Central Punjab province of Pakistan as it is semi urban adjoined by rural areas. A total of 60 houses (20 from each of the three selected colonies), belonging to different social status were selected. Awareness sessions about waste segregation were given through brochures and individual lectures in each selected household. Sampling of waste, that households had attempted to sort, was then carried out in the three colored bags that were provided as part of the awareness campaign. Finally, refined waste sorting, weighing of various fractions and measurement of dry mass was performed in environmental laboratory using standard methods. It was calculated that sorting efficiency of waste improved from 0 to 52% as a result of the awareness campaign. The generation of waste (dry mass basis) on average from one household was 460 kg/year whereas per capita generation was 68 kg/year. Extrapolating these values for Gujrat Tehsil, the total waste generation per year is calculated to be 101921 tons dry mass (DM). Characteristics found in waste were (i) organic decomposable (29.2%, 29710 tons/year DM), (ii) recyclables (37.0%, 37726 tons/year DM) that included plastic, paper, metal and glass, and (iii) trash (33.8%, 34485 tons/year DM) that mainly comprised of polythene bags, medicine packaging, pampers and wrappers. Waste generation was more in colonies with comparatively higher income and better living standards. In future, data collection for all four seasons and improvements due to expansion of awareness campaign to educational institutes will be quantified. This waste management system can potentially fulfill vital sustainable development goals (e.g. clean water and sanitation), reduce the need to harvest fresh resources from the ecosystem, create business and job opportunities and consequently solve one of the most pressing environmental issues of the country.

Keywords: Integrated solid waste management, waste segregation, waste bank, community development.

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