Bluetooth Piconet System for Child Care Applications

This study mainly concerns a safety device designed for child care. When children are out of sight or the caregivers cannot always pay attention to the situation, through the functions of this device, caregivers can immediately be informed to make sure that the children do not get lost or hurt, and thus, ensure their safety. Starting from this concept, a device is produced based on the relatively low-cost Bluetooth piconet system and a three-axis gyroscope sensor. This device can transmit data to a mobile phone app through Bluetooth, in order that the user can learn the situation at any time. By simply clipping the device in a pocket or on the waist, after switching on/starting the device, it will send data to the phone to detect the child’s fall and distance. Once the child is beyond the angle or distance set by the app, it will issue a warning to inform the phone owner.

Anisotropic Total Fractional Order Variation Model in Seismic Data Denoising

In seismic data processing, attenuation of random noise is the basic step to improve quality of data for further application of seismic data in exploration and development in different gas and oil industries. The signal-to-noise ratio of the data also highly determines quality of seismic data. This factor affects the reliability as well as the accuracy of seismic signal during interpretation for different purposes in different companies. To use seismic data for further application and interpretation, we need to improve the signal-to-noise ration while attenuating random noise effectively. To improve the signal-to-noise ration and attenuating seismic random noise by preserving important features and information about seismic signals, we introduce the concept of anisotropic total fractional order denoising algorithm. The anisotropic total fractional order variation model defined in fractional order bounded variation is proposed as a regularization in seismic denoising. The split Bregman algorithm is employed to solve the minimization problem of the anisotropic total fractional order variation model and the corresponding denoising algorithm for the proposed method is derived. We test the effectiveness of theproposed method for synthetic and real seismic data sets and the denoised result is compared with F-X deconvolution and non-local means denoising algorithm.

The Influence of Fashion Bloggers on the Pre-Purchase Decision for Online Fashion Products among Generation Y Female Malaysian Consumers

This study explores how fashion consumers are influenced by fashion bloggers towards pre-purchase decision for online fashion products in a non-Western context. Malaysians rank among the world’s most avid online shoppers, with apparel the third most popular purchase category. However, extant research on fashion blogging focuses on the developed Western market context. Numerous international fashion retailers have entered the Malaysian market from luxury to fast fashion segments of the market; however Malaysian fashion consumers must balance religious and social norms for modesty with their dress style and adoption of fashion trends. Consumers increasingly mix and match Islamic and Western elements of dress to create new styles enabling them to follow Western fashion trends whilst paying respect to social and religious norms. Social media have revolutionised the way that consumers can search for and find information about fashion products. For online fashion brands with no physical presence, social media provide a means of discovery for consumers. By allowing the creation and exchange of user-generated content (UGC) online, they provide a public forum that gives individual consumers their own voices, as well as access to product information that facilitates their purchase decisions. Social media empower consumers and brands have important roles in facilitating conversations among consumers and themselves, to help consumers connect with them and one another. Fashion blogs have become an important fashion information sources. By sharing their personal style and inspiring their followers with what they wear on popular social media platforms such as Instagram, fashion bloggers have become fashion opinion leaders. By creating UGC to spread useful information to their followers, they influence the pre-purchase decision. Hence, successful Western fashion bloggers such as Chiara Ferragni may earn millions of US dollars every year, and some have created their own fashion ranges and beauty products, become judges in fashion reality shows, won awards, and collaborated with high street and luxury brands. As fashion blogging has become more established worldwide, increasing numbers of fashion bloggers have emerged from non-Western backgrounds to promote Islamic fashion styles, such as Hassanah El-Yacoubi and Dian Pelangi. This study adopts a qualitative approach using netnographic content analysis of consumer comments on two famous Malaysian fashion bloggers’ Instagram accounts during January-March 2016 and qualitative interviews with 16 Malaysian Generation Y fashion consumers during September-October 2016. Netnography adapts ethnographic techniques to the study of online communities or computer-mediated communications. Template analysis of the data involved coding comments according to the theoretical framework, which was developed from the literature review. Initial data analysis shows the strong influence of Malaysian fashion bloggers on their followers in terms of lifestyle and morals as well as fashion style. Followers were guided towards the mix and match trend of dress with Western and Islamic elements, for example, showing how vivid colours or accessories could be worked into an outfit whilst still respecting social and religious norms. The blogger’s Instagram account is a form of online community where followers can communicate and gain guidance and support from other followers, as well as from the blogger.

Forecasting Electricity Spot Price with Generalized Long Memory Modeling: Wavelet and Neural Network

This aims of this paper is to forecast the electricity spot prices. First, we focus on modeling the conditional mean of the series so we adopt a generalized fractional -factor Gegenbauer process (k-factor GARMA). Secondly, the residual from the -factor GARMA model has used as a proxy for the conditional variance; these residuals were predicted using two different approaches. In the first approach, a local linear wavelet neural network model (LLWNN) has developed to predict the conditional variance using the Back Propagation learning algorithms. In the second approach, the Gegenbauer generalized autoregressive conditional heteroscedasticity process (G-GARCH) has adopted, and the parameters of the k-factor GARMA-G-GARCH model has estimated using the wavelet methodology based on the discrete wavelet packet transform (DWPT) approach. The empirical results have shown that the k-factor GARMA-G-GARCH model outperform the hybrid k-factor GARMA-LLWNN model, and find it is more appropriate for forecasts.

Archaic Ontologies Nowadays: Music of Rituals

Many of the interrogations or dilemmas of the contemporary world found the answer in what was generically called the appeal to matrix. This genuine spiritual exercise of re-connection of the present to origins, to the primary source, revealed the ontological condition of timelessness, ahistorical, immutable (epi)phenomena, of those pure essences concentrated in the archetypal-referential layer of the human existence. The musical creation was no exception to this trend, the impasse generated by the deterministic excesses of the whole serialism or, conversely, by some questionable results of the extreme indeterminism proper to the avant-garde movements, stimulating the orientation of many composers to rediscover a universal grammar, as an emanation of a new ‘collective’ order (reverse of the utopian individualism). In this context, the music of oral tradition and therefore the world of the ancient modes represented a true revelation for the composers of the twentieth century, who were suddenly in front of some unsuspected (re)sources, with a major impact on all levels of edification of the musical work: morphology, syntax, timbrality, semantics etc. For the contemporary Romanian creators, the music of rituals, existing in the local archaic culture, opened unsuspected perspectives for which it meant to be a synthetic, inclusive and recoverer vision, where the primary (archetypal) genuine elements merge with the latest achievements of language of the European composers. Thus, anchored in a strong and genuine modal source, the compositions analysed in this paper evoke, in a manner as modern as possible, the atmosphere of some ancestral rituals such as: the invocation of rain during the drought (Paparudele, Scaloianul), funeral ceremony (Bocetul), traditions specific to the winter holidays and new year (Colinda, Cântecul de stea, Sorcova, Folklore traditional dances) etc. The reactivity of those rituals in the sound context of the twentieth century meant potentiating or resizing the archaic spirit of the primordial symbolic entities, in terms of some complexity levels generated by the technique of harmonies of chordal layers, of complex aggregates (gravitational or non-gravitational, geometric), of the mixture polyphonies and with global effect (group, mass), by the technique of heterophony, of texture and cluster, leading to the implementation of some processes of collective improvisation and instrumental theatre.

Electromagnetic Tuned Mass Damper Approach for Regenerative Suspension

This study is aimed at exploring the possibility of energy recovery through the suppression of vibrations. The article describes design of electromagnetic dynamic damper. The magnetic part of the device performs the function of a tuned mass damper, thereby providing both energy regeneration and damping properties to the protected mass. According to the theory of tuned mass damper, equations of mathematical models were obtained. Then, under given properties of current system, amplitude frequency response was investigated. Therefore, main ideas and methods for further research were defined.

Synthesis of Mg/B Containing Compound in a Modified Microwave Oven

Magnesium containing boron compounds with hexagonal structure have been drawn much attention due to their superconductive nature. The main target of this work is new modified microwave oven by on our own has an ability about passing through a gas in the oven medium for attainment of oxygen-free compounds such as c-BN.  Mg containing boride was synthesized by modified-microwave method under nitrogen atmosphere using amorphous boron and magnesium source in appropriate molar ratio. Microwave oven with oxygen free environment has been modified to aimed to obtain magnesium boride without oxygen. Characterizations were done by powder X-ray diffraction (XRD), and Fourier transform infrared (FTIR) spectroscopy. Mg containing boride, generally named magnesium boride, with amorphous character without oxygen is obtained via designed microwave oven system.

Customer Relations and Use of Online Shopping Sites

At the present time, online marketing has become the common target of small and full-scale organizations. Today’s humanbeing who has to spend most of their time in front of the computer because of his job, prefers to socialize by internet due to the easy access to technology. So online marketing area expands day by day. All business organizations from the smallest to the biggest are in a race in order to get a cut from the virtual market share in an extreme competitive environment. However these organizations which use the internet to reach more consumers cannot determine their target group accurately, so this is the biggest handicap of online marketing sales nowadays. The aim of this study is to determine some significant elements about need for communicating efficiently with the consumer on the internet on online marketing. The strategies that can be used in order to increase sales and the limitations of virtual environment where cannot be communicated with the consumer face to face are argued in this study’s scope. As a consequence it is thought that to study on this subject because of lacking and also being limited efficiency of researches and outputs. Within this scope suggesting some proposals about how to communicate efficiently with the consumer and also offering the consumers’ demands efficiently is the essential objective of this study.

The Effect of Reducing Superimposed Dead Load on the Lateral Seismic Deformations of Structures

The vast majority of the Middle East countries are prone to earthquakes. Despite that and from a seismic hazard point of view, the higher values of the superimposed dead load intensity of partitions and wearing materials of the constructed reinforced concrete slabs in these countries can increase the earthquake vulnerability of the structures. The primary objective of this paper is to investigate the effect of reducing superimposed dead load on the lateral seismic deformations of structures, the inter-story drifts and the seismic pounding damages. The study utilizes a group of three reinforced concrete structures at three different site conditions. These structures are assumed to be constructed in Nablus city of Palestine, and having superimposed dead load value as 1 kN/m2, 3 kN/m2, and 5 kN/m2, respectively. SAP2000 program, Version 18.1.1, is used to perform the response spectrum analysis to obtain the potential lateral seismic deformations of the studied models. Amazingly, the study points that, at the same site, superimposed dead load has a minor effect on the lateral deflections of the models. This, however, promotes the hypothesis that buildings failed during earthquakes mainly because they were not designed appropriately against gravity loads.

Characterization of Penicillin V Acid and Its Related Compounds by HPLC

Background: 'Penicillin V' is a narrow, bactericidal antibiotic of the beta-lactam family of the naturally occurring penicillin group. It is limited to infections due to the germs defined as sensitive. The objective of this work was to identify and to characterize Penicillin V acid and its related compounds by High-performance liquid chromatography (HPLC). Methods: Firstly phenoxymethylpenicillin was identified by an infrared absorption. The organoleptic characteristics, pH, and determination of water content were also studied. The dosage of Penicillin V acid active substance and the determination of its related compounds were carried on waters HPLC, equipped with a UV detector at 254 nm and Discovery HS C18 column (250 mm X 4.6 mm X 5 µm) which is maintained at room temperature. The flow rate was about 1 ml per min. A mixture of water, acetonitrile and acetic acid (65:35:01) was used as mobile phase for phenoxyacetic acid ‘impurity B' and a mixture of water, acetonitrile and acetic acid (650:150:5.75) for the assay and 4-hydroxypenicillin V 'impurity D'. Results: The identification of Penicillin V acid active substance and the evaluation of its chemical quality showed conformity with USP 35th edition. The Penicillin V acid content in the raw material is equal to 1692.22 UI/mg. The percentage content of phenoxyacetic acid and 4-hydroxypenicillin V was respectively: 0.035% and 0.323%. Conclusion: Through these results, we can conclude that the Penicillin V acid active substance tested is of good physicochemical quality.

Power and Wear Reduction Using Composite Links of Crank-Rocker Mechanism with Optimum Transmission Angle

Reducing energy consumption became the major concern for all countries of the world during the recent decades. In general, power saving is currently the nominal goal of most industrial countries. It is well known that fossil fuels are the main pillar of development of world countries. Unfortunately, the increased rate of fossil fuel consumption will lead to serious problems caused by an expected depletion of fuels. Moreover, dangerous gases and vapors emission lead to severe environmental problems during fuel burning. Consequently, most engineering sectors especially the mechanical sectors are looking for improving any machine accompanied by reducing its energy consumption. Crank-Rocker planar mechanism is the most applied in mechanical systems. Besides, it is one of the most significant parts of the machines for obtaining the oscillatory motion. The transmission angle of this mechanism can be considered as an optimum value when its extreme values are equally varied around 90°. In addition, the transmission angle plays an important role in decreasing the required driving power and improving the dynamic properties of the mechanism. Hence, appropriate selection of mechanism links lengthens, which assures optimum transmission angle leads to decreasing the driving power. Moreover, mechanism's links manufactured from composite materials afford link's lightweight, which decreases the required driving torque. Furthermore, wear and corrosion problems can be treated through using composite links instead of using metal ones. This paper is dealing with improving the performance of crank-rocker mechanism using composite links due to their flexural elastic modulus values and stiffness in addition to high damping of composite materials.

The Security Trade-Offs in Resource Constrained Nodes for IoT Application

The concept of the Internet of Things (IoT) has received much attention over the last five years. It is predicted that the IoT will influence every aspect of our lifestyles in the near future. Wireless Sensor Networks are one of the key enablers of the operation of IoTs, allowing data to be collected from the surrounding environment. However, due to limited resources, nature of deployment and unattended operation, a WSN is vulnerable to various types of attack. Security is paramount for reliable and safe communication between IoT embedded devices, but it does, however, come at a cost to resources. Nodes are usually equipped with small batteries, which makes energy conservation crucial to IoT devices. Nevertheless, security cost in terms of energy consumption has not been studied sufficiently. Previous research has used a security specification of 802.15.4 for IoT applications, but the energy cost of each security level and the impact on quality of services (QoS) parameters remain unknown. This research focuses on the cost of security at the IoT media access control (MAC) layer. It begins by studying the energy consumption of IEEE 802.15.4 security levels, which is followed by an evaluation for the impact of security on data latency and throughput, and then presents the impact of transmission power on security overhead, and finally shows the effects of security on memory footprint. The results show that security overhead in terms of energy consumption with a payload of 24 bytes fluctuates between 31.5% at minimum level over non-secure packets and 60.4% at the top security level of 802.15.4 security specification. Also, it shows that security cost has less impact at longer packet lengths, and more with smaller packet size. In addition, the results depicts a significant impact on data latency and throughput. Overall, maximum authentication length decreases throughput by almost 53%, and encryption and authentication together by almost 62%.

Formulation of Mortars with Marine Sediments

The transition to a more sustainable economy is directed by a reduction in the consumption of raw materials in equivalent production. The recovery of byproducts and especially the dredged sediment as mineral addition in cements matrix represents an alternative to reduce raw material consumption and construction sector’s carbon footprint. However, the efficient use of sediment requires adequate and optimal treatment. Several processing techniques have so far been applied in order to improve some physicochemical properties. The heat treatment by calcination was effective in removing the organic fraction and activates the pozzolanic properties. In this article, the effect of the optimized heat treatment of marine sediments in the physico-mechanical and environmental properties of mortars are shown. A finding is that the optimal substitution of a portion of cement by treated sediments by calcination at 750 °C helps to maintain or improve the mechanical properties of the cement matrix in comparison with a standard reference mortar. The use of calcined sediment enhances mortar behavior in terms of mechanical strength and durability. From an environmental point of view and life cycle, mortars formulated containing treated sediments are considered inert with respect to the inert waste storage facilities reference (ISDI-France).

A Multi-Agent Smart E-Market Design at Work for Shariah Compliant Islamic Banking

Though quite fast on growth, Islamic financing at large, and its diverse instruments, is a controversial matter among scholars. This is evident from the ongoing debates on its Shariah compliance. Arguments, however, are inciting doubts and concerns among clients about its credibility, which is harming this lucrative sector. The work here investigates, particularly, some issues related to the Tawarruq instrument. The work examines the issues of linking Murabaha and Wakala contracts, the reselling of commodities to same traders, and the transfer of ownerships. The work affirms that a multi-agent smart electronic market design would facilitate Shariah compliance. The smart market exploits the rational decision-making capabilities of autonomous proxy agents that enable the clients, traders, brokers, and the bank buy and sell commodities, and manage transactions and cash flow. The smart electronic market design delivers desirable qualities that terminate the need for Wakala contracts and the reselling of commodities to the same traders. It also resolves the ownership transfer issues by allowing stakeholders to trade independently. The bank administers the smart electronic market and assures reliability of trades, transactions and cash flow. A multi-agent simulation is presented to validate the concept and processes. We anticipate that the multi-agent smart electronic market design would deliver Shariah compliance of personal financing to the aspiration of scholars, banks, traders and potential clients.

The Search of Anomalous Higgs Boson Couplings at the Large Hadron Electron Collider and Future Circular Electron Hadron Collider

The Higgs boson was discovered by the ATLAS and CMS experimental groups in 2012 at the Large Hadron Collider (LHC). Production and decay properties of the Higgs boson, Standard Model (SM) couplings, and limits on effective scale of the Higgs boson’s couplings with other bosons are investigated at particle colliders. Deviations from SM estimates are parametrized by effective Lagrangian terms to investigate Higgs couplings. This is a model-independent method for describing the new physics. In this study, sensitivity to neutral gauge boson anomalous couplings with the Higgs boson is investigated using the parameters of the Large Hadron electron Collider (LHeC) and the Future Circular electron-hadron Collider (FCC-eh) with a model-independent approach. By using MadGraph5_aMC@NLO multi-purpose event generator with the parameters of LHeC and FCC-eh, the bounds on the anomalous Hγγ, HγZ and HZZ couplings in e− p → e− q H process are obtained. Detector simulations are also taken into account in the calculations.

Emergence of Fluoroquinolone Resistance in Pigs, Nigeria

A comparison of resistance to quinolones was carried out on isolates of Shiga toxin-producing Escherichia coliO157:H7 from cattle and mecA and nuc genes harbouring Staphylococcus aureus from pigs. The isolates were separately tested in the first and current decades of the 21st century. The objective was to demonstrate the dissemination of resistance to this frontline class of antibiotic by bacteria from food animals and bring to the limelight the spread of antibiotic resistance in Nigeria. A total of 10 isolates of the E. coli O157:H7 and 9 of mecA and nuc genes harbouring S. aureus were obtained following isolation, biochemical testing, and serological identification using the Remel Wellcolex E. coli O157:H7 test. Shiga toxin-production screening in the E. coli O157:H7 using the verotoxin E. coli reverse passive latex agglutination (VTEC-RPLA) test; and molecular identification of the mecA and nuc genes in S. aureus. Detection of the mecA and nuc genes were carried out using the protocol by the Danish Technical University (DTU) using the following primers mecA-1:5'-GGGATCATAGCGTCATTATTC-3', mecA-2: 5'-AACGATTGTGACACGATAGCC-3', nuc-1: 5'-TCAGCAAATGCATCACAAACAG-3', nuc-2: 5'-CGTAAATGCACTTGCTTCAGG-3' for the mecA and nuc genes, respectively. The nuc genes confirm the S. aureus isolates and the mecA genes as being methicillin-resistant and so pathogenic to man. The fluoroquinolones used in the antibiotic resistance testing were norfloxacin (10 µg) and ciprofloxacin (5 µg) in the E. coli O157:H7 isolates and ciprofloxacin (5 µg) in the S. aureus isolates. Susceptibility was tested using the disk diffusion method on Muller-Hinton agar. Fluoroquinolone resistance was not detected from isolates of E. coli O157:H7 from cattle. However, 44% (4/9) of the S. aureus were resistant to ciprofloxacin. Resistance of up to 44% in isolates of mecA and nuc genes harbouring S. aureus is a compelling evidence for the rapid spread of antibiotic resistance from bacteria in food animals from Nigeria. Ciprofloxacin is the drug of choice for the treatment of Typhoid fever, therefore widespread resistance to it in pathogenic bacteria is of great public health significance. The study concludes that antibiotic resistance in bacteria from food animals is on the increase in Nigeria. The National Food and Drug Administration and Control (NAFDAC) agency in Nigeria should implement the World Health Organization (WHO) global action plan on antimicrobial resistance. A good starting point can be coordinating the WHO, Office of International Epizootics (OIE), Food and Agricultural Organization (FAO) tripartite draft antimicrobial resistance monitoring and evaluation (M&E) framework in Nigeria.

Simulation of Reflection Loss for Carbon and Nickel-Carbon Thin Films

Maximal radar wave absorbing cannot be achieved by shaping alone. We have to focus on the parameters of absorbing materials such as permittivity, permeability, and thickness so that best absorbing according to our necessity can happen. The real and imaginary parts of the relative complex permittivity (εr' and εr") and permeability (µr' and µr") were obtained by simulation. The microwave absorbing property of carbon and Ni(C) is simulated in this study by MATLAB software; the simulation was in the frequency range between 2 to 12 GHz for carbon black (C), and carbon coated nickel (Ni(C)) with different thicknesses. In fact, we draw reflection loss (RL) for C and Ni-C via frequency. We have compared their absorption for 3-mm thickness and predicted for other thicknesses by using of electromagnetic wave transmission theory. The results showed that reflection loss position changes in low frequency with increasing of thickness. We found out that, in all cases, using nanocomposites as absorbance cannot get better results relative to pure nanoparticles. The frequency where absorption is maximum can determine the best choice between nanocomposites and pure nanoparticles. Also, we could find an optimal thickness for long wavelength absorbing in order to utilize them in protecting shields and covering.

Damage Assessment and Repair for Older Brick Buildings

The experience of engineers and architects practicing today is typically limited to current building code requirements and modern construction methods and materials. However, many cities have a mix of new and old buildings with many buildings constructed over one hundred years ago when building codes and construction methods were much different. When a brick building sustains damage, a structural engineer is often hired to determine the cause of damage as well as determine the necessary repairs. Forensic studies of dozens of brick buildings shows an appreciation of historical building methods and materials is needed to correctly identify the cause of damage and design an appropriate repair. Damage on an older, brick building can be mistakenly attributed to storms or seismic events when the real source of the damage is deficient original construction. Assessing and remediating damaged brickwork on older brick buildings requires an understanding of the original construction, an understanding of older repair methods, and, an understanding of current building code requirements.

Maternal and Child Health Care: A Study among the Rongmeis of Manipur, India

Background: Maternal and child health (MCH) cares are the health services provided to mothers and children. It includes the health promotion, preventive, curative and rehabilitation health care for mothers and children. Materials and method: The present study sample comprises of 208 women within the age range 15-69 years from two remote villages of Tamenglong District in Manipur. They were randomly chosen for assessing their health as well as the child’s health adopting an interview schedule method. Results: The findings of the study revealed that majority (80%) of the women have their first conception in their first year of married life. A decadal change has been observed with regard to the last pregnancy i.e., antenatal check-up, place of delivery as well as the service provider. However, irrespective of age of the women, home delivery is still preferred though very few are locally trained. Pre- and post-delivery resting period vary depending on the busy schedule of the agricultural works as the population under study is basically agriculturist. Postnatal care remains to be traditional as they are strongly associated with cultural beliefs and practices that continue to prevail in the studied community. Breast feeding practices such as colostrums given, initiation of breastfeeding, weaning was all taken into account.  Immunization of children has not reached the expected target owing to a variety of reasons. Maternal health care also includes use of birth control measures. The health status of women would invariably improve if family planning is meaningfully adopted. Only 10.1% of the women adopted the modern birth control implying its deep-rooted value attached to the children. Based on the self-assessment report on their health treatment a good number of the respondents resorted to self-medication even to the extent of buying allopathic medicine without a doctor’s prescription. One important finding from the study is the importance attributed to the traditional health care system which is easily affordable and accessible to the villagers. Conclusion: The overall condition of maternal and child care is way behind till now as no adequate/proper health services are available.

Qualitative Data Analysis for Health Care Services

This study was designed enable application of multivariate technique in the interpretation of categorical data for measuring health care services satisfaction in Turkey. The data was collected from a total of 17726 respondents. The establishment of the sample group and collection of the data were carried out by a joint team from The Ministry of Health and Turkish Statistical Institute (Turk Stat) of Turkey. The multiple correspondence analysis (MCA) was used on the data of 2882 respondents who answered the questionnaire in full. The multiple correspondence analysis indicated that, in the evaluation of health services females, public employees, younger and more highly educated individuals were more concerned and complainant than males, private sector employees, older and less educated individuals. Overall 53 % of the respondents were pleased with the improvements in health care services in the past three years. This study demonstrates the public consciousness in health services and health care satisfaction in Turkey. It was found that most the respondents were pleased with the improvements in health care services over the past three years. Awareness of health service quality increases with education levels. Older individuals and males would appear to have lower expectancies in health services.