Evaluation of the Role of Advocacy and the Quality of Care in Reducing Health Inequalities for People with Autism, Intellectual and Developmental Disabilities at Sheffield Teaching Hospitals

Individuals with Autism, Intellectual and Developmental disabilities (AIDD) are one of the most vulnerable groups in society, hampered not only by their own limitations to understand and interact with the wider society, but also societal limitations in perception and understanding. Communication to express their needs and wishes is fundamental to enable such individuals to live and prosper in society. This research project was designed as an organisational case study, in a large secondary health care hospital within the National Health Service (NHS), to assess the quality of care provided to people with AIDD and to review the role of advocacy to reduce health inequalities in these individuals. Methods: The research methodology adopted was as an “insider researcher”. Data collection included both quantitative and qualitative data i.e. a mixed method approach. A semi-structured interview schedule was designed and used to obtain qualitative and quantitative primary data from a wide range of interdisciplinary frontline health care workers to assess their understanding and awareness of systems, processes and evidence based practice to offer a quality service to people with AIDD. Secondary data were obtained from sources within the organisation, in keeping with “Case Study” as a primary method, and organisational performance data were then compared against national benchmarking standards. Further data sources were accessed to help evaluate the effectiveness of different types of advocacy that were present in the organisation. This was gauged by measures of user and carer experience in the form of retrospective survey analysis, incidents and complaints. Results: Secondary data demonstrate near compliance of the Organisation with the current national benchmarking standard (Monitor Compliance Framework). However, primary data demonstrate poor knowledge of the Mental Capacity Act 2005, poor knowledge of organisational systems, processes and evidence based practice applied for people with AIDD. In addition there was poor knowledge and awareness of frontline health care workers of advocacy and advocacy schemes for this group. Conclusions: A significant amount of work needs to be undertaken to improve the quality of care delivered to individuals with AIDD. An operational strategy promoting the widespread dissemination of information may not be the best approach to deliver quality care and optimal patient experience and patient advocacy. In addition, a more robust set of standards, with appropriate metrics, needs to be developed to assess organisational performance which will stand the test of professional and public scrutiny.

Association of Smoking with Chest Radiographic and Lung Function Findings in Retired Bauxite Mining Workers

Inhalation hazards are associated with potentially injurious exposure and increased risk for lung diseases, within the bauxite mining industry, especially for the smelter workers. Smoking is related to decreased lung function and leads to chronic lung diseases. This study had the objective to evaluate whether smoking is related to functional and radiographic respiratory changes in retired bauxite mining workers. Methods: This was a retrospective and cross-sectional study involving the analysis of database information of 140 retired bauxite mining workers from Poços de Caldas-MG evaluated at Worker’s Health Reference Center and at the Social Security Brazilian National Institute, from July 1st, 2015 until June 30th, 2016. The workers were divided into three groups: non-smokers (n = 47), ex-smokers (n = 46), and smokers (n = 47). The data included: age, gender, spirometry results, and the presence or not of pulmonary pleural and/or parenchymal changes in chest radiographs. Chi-Squared test was used (p < 0,05). Results: In the smokers’ group, 83% of spirometry tests and 64% of chest x-rays were altered. In the non-smokers’ group, 19% of spirometry tests and 13% of chest x-rays were altered. In the ex-smokers’ group, 35% of spirometry tests and 30% of chest x-rays were altered. Most of the results were statistically significant. Results demonstrated a significant difference between smokers’ and non-smokers’ groups in regard to spirometric and radiographic pulmonary alterations. Ex-smokers’ and non-smokers’ group demonstrated better results when compared to the smokers’ group in relation to altered spirometry and radiograph findings. These data may contribute to planning strategies to enhance smoking cessation programs within the bauxite mining industry.

Triple Intercell Bar for Electrometallurgical Processes: A Design to Increase PV Energy Utilization

PV energy prices are declining rapidly. To take advantage of the benefits of those prices and lower the carbon footprint, operational practices must be modified. Undoubtedly, it challenges the electrowinning practice to operate at constant current throughout the day. This work presents a technology that contributes in providing modulation capacity to the electrode current distribution system. This is to raise the day time dc current and lower it at night. The system is a triple intercell bar that operates in current-source mode. The design is a capping board free dogbone type of bar that ensures an operation free of short circuits, hot swapability repairs and improved current balance. This current-source system eliminates the resetting currents circulating in equipotential bars. Twin auxiliary connectors are added to the main connectors providing secure current paths to bypass faulty or impaired contacts. All system conductive elements are positioned over a baseboard offering a large heat sink area to the ventilation of a facility. The system works with lower temperature than a conventional busbar. Of these attributes, the cathode current balance property stands out and is paramount for day/night modulation and the use of photovoltaic energy. A design based on a 3D finite element method model predicting electric and thermal performance under various industrial scenarios is presented. Preliminary results obtained in an electrowinning facility with industrial prototypes are included.

Influence of Alccofine on Semi-Light Weight Concrete under Accelerated Curing and Conventional Curing Regimes

This paper deals with the performance of semi-light weight concrete, prepared by using wood ash pellets as coarse aggregates which were improved by partial replacement of cement with alccofine. Alccofine is a mineral admixture which contains high glass content obtained through the process of controlled granulation. This is finer than cement which carries its own pozzolanic property. Therefore, cement could be replaced by alccofine as 0%, 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, and 70% to enhance the strength and durability properties of concrete. High range water reducing admixtures (HRWA) were used in these mixes which were dosed up to 1.5% weight of the total cementitious content (alccofine & cement). It also develops the weaker transition zone into more impermeable layer. Specimens were subjected in both the accelerated curing method as well as conventional curing method. Experimental results were compared and reported, in that the maximum compressive strength of 32.6 MPa was achieved on 28th day with 30% replacement level in a density of 2200 kg/m3 to a conventional curing, while in the accelerated curing, maximum compressive strength was achieved at 40% replacement level. Rapid chloride penetration test (RCPT) output results for the conventional curing method at 0% and 70% give 3296.7 and 545.6 coulombs.

Comparative Study of Seismic Isolation as Retrofit Method for Historical Constructions

Seismic isolation can be used as a retrofit method for historical buildings with the advantage that minimum intervention on super-structure is required. However, selection of isolation devices depends on weight and stiffness of upper structure. In this study, two buildings are considered for analyses to evaluate the applicability of this retrofitting methodology. Both buildings are located at Akita prefecture in the north part of Japan. One building is a wooden structure that corresponds to the old council meeting hall of Noshiro city. The second building is a brick masonry structure that was used as house of a foreign mining engineer and it is located at Ani town. Ambient vibration measurements were performed on both buildings to estimate their dynamic characteristics. Then, target period of vibration of isolated systems is selected as 3 seconds is selected to estimate required stiffness of isolation devices. For wooden structure, which is a light construction, it was found that natural rubber isolators in combination with friction bearings are suitable for seismic isolation. In case of masonry building elastomeric isolator can be used for its seismic isolation. Lumped mass systems are used for seismic response analysis and it is verified in both cases that seismic isolation can be used as retrofitting method of historical construction. However, in the case of the light building, most of the weight corresponds to the reinforced concrete slab that is required to install isolation devices.

Low-Level Modeling for Optimal Train Routing and Scheduling in Busy Railway Stations

This paper studies a train routing and scheduling problem for busy railway stations. Our objective is to allow trains to be routed in dense areas that are reaching saturation. Unlike traditional methods that allocate all resources to setup a route for a train and until the route is freed, our work focuses on the use of resources as trains progress through the railway node. This technique allows a larger number of trains to be routed simultaneously in a railway node and thus reduces their current saturation. To deal with this problem, this study proposes an abstract model and a mixed-integer linear programming formulation to solve it. The applicability of our method is illustrated on a didactic example.

Optimization of Process Parameters for Friction Stir Welding of Cast Alloy AA7075 by Taguchi Method

This investigation proposes Friction stir welding technique to solve the fusion welding problems. Objectives of this investigation are fabrication of AA7075-10%wt. Silicon carbide (SiC) aluminum metal matrix composite and optimization of optimal process parameters of friction stir welded AA7075-10%wt. SiC Composites. Composites were prepared by the mechanical stir casting process. Experiments were performed with four process parameters such as tool rotational speed, weld speed, axial force and tool geometry considering three levels of each. The quality characteristics considered is joint efficiency (JE). The welding experiments were conducted using L27 orthogonal array. An orthogonal array and design of experiments were used to give best possible welding parameters that give optimal JE. The fabricated welded joints using rotational speed of 1500 rpm, welding speed (1.3 mm/sec), axial force (7 k/n) of and tool geometry (square) give best possible results. Experimental result reveals that the tool rotation speed, welding speed and axial force are the significant process parameters affecting the welding performance. The predicted optimal value of percentage JE is 95.621. The confirmation tests also have been done for verifying the results.

Electromagnetic Wave Propagation Equations in 2D by Finite Difference Method

In this paper, the techniques to solve time dependent electromagnetic wave propagation equations based on the Finite Difference Method (FDM) are proposed by comparing the results with Finite Element Method (FEM) in 2D while discussing some special simulation examples.  Here, 2D dynamical wave equations for lossy media, even with a constant source, are discussed for establishing symbolic manipulation of wave propagation problems. The main objective of this contribution is to introduce a comparative study of two suitable numerical methods and to show that both methods can be applied effectively and efficiently to all types of wave propagation problems, both linear and nonlinear cases, by using symbolic computation. However, the results show that the FDM is more appropriate for solving the nonlinear cases in the symbolic solution. Furthermore, some specific complex domain examples of the comparison of electromagnetic waves equations are considered. Calculations are performed through Mathematica software by making some useful contribution to the programme and leveraging symbolic evaluations of FEM and FDM.

From Electroencephalogram to Epileptic Seizures Detection by Using Artificial Neural Networks

Seizure is the main factor that affects the quality of life of epileptic patients. The diagnosis of epilepsy, and hence the identification of epileptogenic zone, is commonly made by using continuous Electroencephalogram (EEG) signal monitoring. Seizure identification on EEG signals is made manually by epileptologists and this process is usually very long and error prone. The aim of this paper is to describe an automated method able to detect seizures in EEG signals, using knowledge discovery in database process and data mining methods and algorithms, which can support physicians during the seizure detection process. Our detection method is based on Artificial Neural Network classifier, trained by applying the multilayer perceptron algorithm, and by using a software application, called Training Builder that has been developed for the massive extraction of features from EEG signals. This tool is able to cover all the data preparation steps ranging from signal processing to data analysis techniques, including the sliding window paradigm, the dimensionality reduction algorithms, information theory, and feature selection measures. The final model shows excellent performances, reaching an accuracy of over 99% during tests on data of a single patient retrieved from a publicly available EEG dataset.

Multi-Objective Optimization of Combined System Reliability and Redundancy Allocation Problem

This paper presents established 3n enumeration procedure for mixed integer optimization problems for solving multi-objective reliability and redundancy allocation problem subject to design constraints. The formulated problem is to find the optimum level of unit reliability and the number of units for each subsystem. A number of illustrative examples are provided and compared to indicate the application of the superiority of the proposed method.

Producing and Mechanical Testing of Urea-Formaldehyde Resin Foams Reinforced by Waste Phosphogypsum

Many of thermosetting resins have application only in filled state, reinforced with different mineral fillers. The co-filling of polymers with mineral filler and gases creates a possibility for production of polymer composites materials with low density. This processing leads to forming of new materials – gas-filled plastics (polymer foams). The properties of these materials are determined mainly by the shape and size of internal structural elements (pores). The interactions on the phase boundaries have influence on the materials properties too. In the present work, the gas-filled urea-formaldehyde resins were reinforced by waste phosphogypsum. The waste phosphogypsum (CaSO4.2H2O) is a solid by-product in wet phosphoric acid production processes. The values of the interactions polymer-filler were increased by using two modifying agents: polyvinyl acetate for polymer matrix and sodium metasilicate for filler. Technological methods for gas-filling and recipes of urea-formaldehyde based materials with apparent density 20-120 kg/m3 were developed. The heat conductivity of the samples is between 0.024 and 0.029 W/moK. Tensile analyses were carried out at 10 and 50% deformation and show values 0.01-0.14 MPa and 0.01-0.09 MPa, respectively. The apparent density of obtained materials is between 20 and 92 kg/m3. The changes in the tensile properties and density of these materials according to sodium metasilicate content were studied too. The mechanism of phosphogypsum adsorption modification was studied using methods of FT-IR spectroscopy. The structure of the gas-filled urea-formaldehyde resins was described by results of electron scanning microscopy at three different magnification ratios – x50, x150 and x 500. The aim of present work is to study the possibility of the usage of phosphogypsum as mineral filler for urea-formaldehyde resins and development of a technology for the production of gas-filled reinforced polymer composite materials. The structure and the properties of obtained composite materials are suitable for thermal and sound insulation applications.

Measurement and Evaluation of Outdoor Lighting Environment at Night in Residential Community in China: A Case Study of Hangzhou

With the improvement of living quality and demand for nighttime activities in China, the current situation of outdoor lighting environment at night needs to be assessed. Lighting environment at night plays an important role to guarantee night safety. Two typical residential communities in Hangzhou were selected. A comprehensive test method of outdoor lighting environment at night was established. The road, fitness area, landscape, playground and entrance were included. Field measurements and questionnaires were conducted in these two residential communities. The characteristics of residents’ habits and the subjective evaluation on different aspects of outdoor lighting environment at night were collected via questionnaire. A safety evaluation system on the outdoor lighting environment at night in the residential community was established. The results show that there is a big difference in illumination in different areas. The lighting uniformities of roads cannot meet the requirement of lighting standard in China. Residents pay more attention to the lighting environment of the fitness area and road than others. This study can provide guidance for the design and management of outdoor lighting environment at night.

Identifying Critical Success Factors for Data Quality Management through a Delphi Study

Organizations support their operations and decision making on the data they have at their disposal, so the quality of these data is remarkably important and Data Quality (DQ) is currently a relevant issue, the literature being unanimous in pointing out that poor DQ can result in large costs for organizations. The literature review identified and described 24 Critical Success Factors (CSF) for Data Quality Management (DQM) that were presented to a panel of experts, who ordered them according to their degree of importance, using the Delphi method with the Q-sort technique, based on an online questionnaire. The study shows that the five most important CSF for DQM are: definition of appropriate policies and standards, control of inputs, definition of a strategic plan for DQ, organizational culture focused on quality of the data and obtaining top management commitment and support.

Simultaneous Optimization of Design and Maintenance through a Hybrid Process Using Genetic Algorithms

In general, issues related to design and maintenance are considered in an independent manner. However, the decisions made in these two sets influence each other. The design for maintenance is considered an opportunity to optimize the life cycle cost of a product, particularly in the nuclear or aeronautical field, where maintenance expenses represent more than 60% of life cycle costs. The design of large-scale systems starts with product architecture, a choice of components in terms of cost, reliability, weight and other attributes, corresponding to the specifications. On the other hand, the design must take into account maintenance by improving, in particular, real-time monitoring of equipment through the integration of new technologies such as connected sensors and intelligent actuators. We noticed that different approaches used in the Design For Maintenance (DFM) methods are limited to the simultaneous characterization of the reliability and maintainability of a multi-component system. This article proposes a method of DFM that assists designers to propose dynamic maintenance for multi-component industrial systems. The term "dynamic" refers to the ability to integrate available monitoring data to adapt the maintenance decision in real time. The goal is to maximize the availability of the system at a given life cycle cost. This paper presents an approach for simultaneous optimization of the design and maintenance of multi-component systems. Here the design is characterized by four decision variables for each component (reliability level, maintainability level, redundancy level, and level of monitoring data). The maintenance is characterized by two decision variables (the dates of the maintenance stops and the maintenance operations to be performed on the system during these stops). The DFM model helps the designers choose technical solutions for the large-scale industrial products. Large-scale refers to the complex multi-component industrial systems and long life-cycle, such as trains, aircraft, etc. The method is based on a two-level hybrid algorithm for simultaneous optimization of design and maintenance, using genetic algorithms. The first level is to select a design solution for a given system that considers the life cycle cost and the reliability. The second level consists of determining a dynamic and optimal maintenance plan to be deployed for a design solution. This level is based on the Maintenance Free Operating Period (MFOP) concept, which takes into account the decision criteria such as, total reliability, maintenance cost and maintenance time. Depending on the life cycle duration, the desired availability, and the desired business model (sales or rental), this tool provides visibility of overall costs and optimal product architecture.

Forecast of Polyethylene Properties in the Gas Phase Polymerization Aided by Neural Network

A major problem that affects the quality control of polymer in the industrial polymerization is the lack of suitable on-line measurement tools to evaluate the properties of the polymer such as melt and density indices. Controlling the polymerization in ordinary method is performed manually by taking samples, measuring the quality of polymer in the lab and registry of results. This method is highly time consuming and leads to producing large number of incompatible products. An online application for estimating melt index and density proposed in this study is a neural network based on the input-output data of the polyethylene production plant. Temperature, the level of reactors' bed, the intensity of ethylene mass flow, hydrogen and butene-1, the molar concentration of ethylene, hydrogen and butene-1 are used for the process to establish the neural model. The neural network is taught based on the actual operational data and back-propagation and Levenberg-Marquart techniques. The simulated results indicate that the neural network process model established with three layers (one hidden layer) for forecasting the density and the four layers for the melt index is able to successfully predict those quality properties.

Simulation Study on Comparison of Thermal Comfort during Heating with All-Air System and Radiant Floor System

Radiant heating systems work fundamentally differently from air systems by taking advantage of both radiant and convective heat transfer to remove space heating load. There are rare studies on differences of heating systems between all-air system and radiant floor system. This paper uses the method of simulation based on state-space to calculate the indoor temperature and wall temperature of each system and shows how the dynamic heat transfer in rooms conditioned by a radiant system is different from an air system. Then this paper analyses the changes of indoor temperature of these two systems, finding out the differences between all-air heating system and radiant floor heating system to help the designer choose a more suitable heating system.

Making Waves: Preparing the Next Generation of Bilingual Medical Doctors

Introduction: This research describes the existing medical school program which supports a multicultural setting and bilingualism. The rise of Spanish speakers in the United States has led to the recruitment of bilingual medical students who can serve the evolving demographics. This paper includes anecdotal evidence, narratives and the latest research on the outcomes of supporting a multilingual academic experience in medical school and beyond. People in the United States will continue to need health care from physicians who have experience with multicultural competence. Physicians who are bilingual and possess effective communication skills will be in high demand. Methodologies: This research is descriptive. Through this descriptive research, the researcher will describe the qualities and characteristics of the existing medical school programs, curriculum, and student services. Additionally, the researcher will shed light on the existing curriculum in the medical school and also describe specific programs which help to serve as safety nets to support diverse populations. The method included observations of the existing program and the implementation of the medical school program, specifically the Accelerated Review Program, the Language Education and Professional Communication Program, student organizations and the Global Health Institute. Concluding Statement: This research identified and described characteristics of the medical school’s program. The research explained and described the current and present phenomenon of this medical program, which has focused on increasing the graduation of bilingual and minority physicians. The findings are based on observations of the curriculum, programs and student organizations which evolves and remains innovative to stay current with student enrollment.

Make Up Flash: Web Application for the Improvement of Physical Appearance in Images Based on Recognition Methods

This paper presents a web application for the improvement of images through recognition. The web application is based on the analysis of picture-based recognition methods that allow an improvement on the physical appearance of people posting in social networks. The basis relies on the study of tools that can correct or improve some features of the face, with the help of a wide collection of user images taken as reference to build a facial profile. Automatic facial profiling can be achieved with a deeper study of the Object Detection Library. It was possible to improve the initial images with the help of MATLAB and its filtering functions. The user can have a direct interaction with the program and manually adjust his preferences.

Determination of the Thermophysical Characteristics of the Composite Material Clay Cement Paper

In Morocco, the building sector is largely responsible for the evolution of energy consumption. The control of energy in this sector remains a major issue despite the rise of renewable energies. The design of an environmentally friendly building requires mastery and knowledge of energy and bioclimatic aspects. This implies taking into consideration of all the elements making up the building and the way in which energy exchanges take place between these elements. In this context, thermal insulation seems to be an ideal starting point for reducing energy consumption and greenhouse gas emissions. In this context, thermal insulation seems to be an ideal starting point for reducing energy consumption and greenhouse gas emissions. The aim of this work is to provide some solutions to reduce energy consumption while maintaining thermal comfort in the building. The objective of our work is to present an experimental study on the characterization of local materials used in the thermal insulation of buildings. These are paper recycling stabilized with cement and clay. The thermal conductivity of these materials, which were constituted based on sand, clay, cement; water, as well as treated paper, was determined by the guarded-hot-plate method. It involves the design of two materials that will subsequently be subjected to thermal and mechanical tests to determine their thermophysical properties. The results show that the thermal conductivity decreases as well in the case of the paper-cement mixture as that of the paper-clay and seems to stabilize around 40%. Measurements of mechanical properties such as flexural strength have shown that the enrichment of the studied material with paper makes it possible to reduce the flexural strength by 20% while optimizing the conductivity.

Electrification Strategy of Hybrid Electric Vehicle as a Solution to Decrease CO2 Emission in Cities

Recently hybrid vehicles have become a major concern as one alternative vehicles. This type of hybrid vehicle contributes greatly to reducing pollution. Therefore, this work studies the influence of electrification phase of hybrid electric vehicle on emission of vehicle at different road conditions. To accomplish this investigation, a simulation model was used to evaluate the external characteristics of the hybrid electric vehicle according to variant conditions of road resistances. Therefore, this paper reports a methodology to decrease the vehicle emission especially greenhouse gas emission inside cities. The results show the effect of electrification on vehicle performance characteristics. The results show that CO2 emission of vehicle decreases up to 50.6% according to an urban driving cycle due to applying the electrification strategy for hybrid electric vehicle.