Current Deflecting Wall: A Promising Structure for Minimising Siltation in Semi-Enclosed Docks

Many estuarine harbours in the world are facing the problem of siltation in docks, channel entrances, etc. The harbours in India are not an exception and require maintenance dredging to achieve navigable depths for keeping them operable. Hence, dredging is inevitable and is a costly affair. The heavy siltation in docks in well mixed tide dominated estuaries is mainly due to settlement of cohesive sediments in suspension. As such there is a need to have a permanent solution for minimising the siltation in such docks to alter the hydrodynamic flow field responsible for siltation by constructing structures outside the dock. One of such docks on the west coast of India, wherein siltation of about 2.5-3 m/annum prevails, was considered to understand the hydrodynamic flow field responsible for siltation. The dock is situated in such a region where macro type of semi-diurnal tide (range of about 5m) prevails. In order to change the flow field responsible for siltation inside the dock, suitability of Current Deflecting Wall (CDW) outside the dock was studied, which will minimise the sediment exchange rate and siltation in the dock. The well calibrated physical tidal model was used to understand the flow field during various phases of tide for the existing dock in Mumbai harbour. At the harbour entrance where the tidal flux exchanges in/out of the dock, measurements on water level and current were made to estimate the sediment transport capacity. The distorted scaled model (1:400 (H) & 1:80 (V)) of Mumbai area was used to study the tidal flow phenomenon, wherein tides are generated by automatic tide generator. Hydraulic model studies carried out under the existing condition (without CDW) reveal that, during initial hours of flood tide, flow hugs the docks breakwater and part of flow which enters the dock forms number of eddies of varying sizes inside the basin, while remaining part of flow bypasses the entrance of dock. During ebb, flow direction reverses, and part of the flow re-enters the dock from outside and creates eddies at its entrance. These eddies do not allow water/sediment-mass to come out and result in settlement of sediments in dock both due to eddies and more retention of sediment. At latter hours, current strength outside the dock entrance reduces and allows the water-mass of dock to come out. In order to improve flow field inside the dockyard, two CDWs of length 300 m and 40 m were proposed outside the dock breakwater and inline to Pier-wall at dock entrance. Model studies reveal that, during flood, major flow gets deflected away from the entrance and no eddies are formed inside the dock, while during ebb flow does not re-enter the dock, and sediment flux immediately starts emptying it during initial hours of ebb. This reduces not only the entry of sediment in dock by about 40% but also the deposition by about 42% due to less retention. Thus, CDW is a promising solution to significantly reduce siltation in dock.

Characterization of Ajebo Kaolinite Clay for Production of Natural Pozzolan

Calcined kaolinite clay (CKC) is a pozzolanic material that is current drawing research attention. This work investigates the conditions for the best performance of a CKC from a kaolinite clay source in Ajebo, Abeokuta (southwest Nigeria) known for its commercial availability. Samples from this source were subjected to X-ray diffractometry (XRD) and differential scanning calorimetry (DSC). XRD shows that kaolinite is the main mineral in the clay source. This mineral is responsible for the pozzolanic behavior of CKC. DSC indicates that the transformation from the clay to CKC occurred between 550 and 750 oC. Using this temperature range, clay samples were milled and different CKC samples were produced in an electric muffle furnace using temperatures of 550, 600, 650, 700, 750 and 800 oC respectively for 1 hour each. This was also repeated for 2 hours. The degree of de-hydroxylation (dtg) and strength activity index (SAI) were also determined for each of the CKC samples. The dtg and SAI tests were repeated two more times for each sample and averages were taken. Results showed that peak dtg occurred at 750 oC for 1 hour calcining combination (94.27%) whereas marginal differences were recorded at some lower temperatures (90.97% for 650 oC for 2 hours; 91.05% for 700 oC for 1 hour and 92.77% for 700 oC for 2 hours). Optimum SAI was reported at 700 oC for 1 hour (99.05%). Rating SAI as a better parameter than dtg, 700 oC for 1 hour combination was adopted as the best calcining condition. The paper recommends the adoption of this clay source for pozzolan production by adopting the calcining conditions established in this work.

Automated User Story Driven Approach for Web-Based Functional Testing

Manual writing of test cases from functional requirements is a time-consuming task. Such test cases are not only difficult to write but are also challenging to maintain. Test cases can be drawn from the functional requirements that are expressed in natural language. However, manual test case generation is inefficient and subject to errors.  In this paper, we have presented a systematic procedure that could automatically derive test cases from user stories. The user stories are specified in a restricted natural language using a well-defined template.  We have also presented a detailed methodology for writing our test ready user stories. Our tool “Test-o-Matic” automatically generates the test cases by processing the restricted user stories. The generated test cases are executed by using open source Selenium IDE.  We evaluate our approach on a case study, which is an open source web based application. Effectiveness of our approach is evaluated by seeding faults in the open source case study using known mutation operators.  Results show that the test case generation from restricted user stories is a viable approach for automated testing of web applications.

The Requirements of Developing a Framework for Successful Adoption of Quality Management Systems in the Construction Industry

Quality management systems (QMSs) in the construction industry are often implemented to ensure that sufficient effort is made by companies to achieve the required levels of quality for clients. Attainment of these quality levels can result in greater customer satisfaction, which is fundamental to ensure long-term competitiveness for construction companies. However, the construction sector is still lagging behind other industries in terms of its successful adoption of QMSs, due to the relative lack of acceptance of the benefits of these systems among industry stakeholders, as well as from other barriers related to implementing them. Thus, there is a critical need to undertake a detailed and comprehensive exploration of adoption of QMSs in the construction sector. This paper comprehensively investigates in the construction sector setting, the impacts of all the salient factors surrounding successful implementation of QMSs in building organizations, especially those of external factors. This study is part of an ongoing PhD project, which aims to develop a new framework that integrates both internal and external factors affecting QMS implementation. To achieve the paper aim and objectives, interviews will be conducted to define the external factors influencing the adoption of QMSs, and to obtain holistic critical success factors (CSFs) for implementing these systems. In the next stage of data collection, a questionnaire survey will be developed to investigate the prime barriers facing the adoption of QMSs, the CSFs for their implementation, and the external factors affecting the adoption of these systems. Following the survey, case studies will be undertaken to validate and explain in greater detail the real effects of these factors on QMSs adoption. Specifically, this paper evaluates the effects of the external factors in terms of their impact on implementation success within the selected case studies. Using findings drawn from analyzing the data obtained from these various approaches, specific recommendations for the successful implementation of QMSs will be presented, and an operational framework will be developed. Finally, through a focus group, the findings of the study and the new developed framework will be validated. Ultimately, this framework will be made available to the construction industry to facilitate the greater adoption and implementation of QMSs. In addition, deployment of the applicable recommendations suggested by the study will be shared with the construction industry to more effectively help construction companies to implement QMSs, and overcome the barriers experienced by businesses, thus promoting the achievement of higher levels of quality and customer satisfaction.

Analysis of Stress and Strain in Head Based Control of Cooperative Robots through Tetraplegics

Industrial robots as part of highly automated manufacturing are recently developed to cooperative (light-weight) robots. This offers the opportunity of using them as assistance robots and to improve the participation in professional life of disabled or handicapped people such as tetraplegics. Robots under development are located within a cooperation area together with the working person at the same workplace. This cooperation area is an area where the robot and the working person can perform tasks at the same time. Thus, working people and robots are operating in the immediate proximity. Considering the physical restrictions and the limited mobility of tetraplegics, a hands-free robot control could be an appropriate approach for a cooperative assistance robot. To meet these requirements, the research project MeRoSy (human-robot synergy) develops methods for cooperative assistance robots based on the measurement of head movements of the working person. One research objective is to improve the participation in professional life of people with disabilities and, in particular, mobility impaired persons (e.g. wheelchair users or tetraplegics), whose participation in a self-determined working life is denied. This raises the research question, how a human-robot cooperation workplace can be designed for hands-free robot control. Here, the example of a library scenario is demonstrated. In this paper, an empirical study that focuses on the impact of head movement related stress is presented. 12 test subjects with tetraplegia participated in the study. Tetraplegia also known as quadriplegia is the worst type of spinal cord injury. In the experiment, three various basic head movements were examined. Data of the head posture were collected by a motion capture system; muscle activity was measured via surface electromyography and the subjective mental stress was assessed via a mental effort questionnaire. The muscle activity was measured for the sternocleidomastoid (SCM), the upper trapezius (UT) or trapezius pars descendens, and the splenius capitis (SPL) muscle. For this purpose, six non-invasive surface electromyography sensors were mounted on the head and neck area. An analysis of variance shows differentiated muscular strains depending on the type of head movement. Systematically investigating the influence of different basic head movements on the resulting strain is an important issue to relate the research results to other scenarios. At the end of this paper, a conclusion will be drawn and an outlook of future work will be presented.

Linguistic Competence Analysis and the Development of Speaking Instructional Material

Linguistic oral competence plays a vital role in attaining effective communication. Since the English language is considered as universally used language and has a high demand skill needed in the work-place, mastery is the expected output from learners. To achieve this, learners should be given integrated differentiated tasks which help them develop and strengthen the expected skills. This study aimed to develop speaking instructional supplementary material to enhance the English linguistic competence of Grade 9 students in areas of pronunciation, intonation and stress, voice projection, diction and fluency. A descriptive analysis was utilized to analyze the speaking level of performance of the students in order to employ appropriate strategies. There were two sets of respondents: 178 Grade 9 students selected through a stratified sampling and chosen at random. The other set comprised English teachers who evaluated the usefulness of the devised teaching materials. A teacher conducted a speaking test and activities were employed to analyze the speaking needs of students. Observation and recordings were also used to evaluate the students’ performance. The findings revealed that the English pronunciation of the students was slightly unclear at times, but generally fair. There were lapses but generally they rated moderate in intonation and stress, because of other language interference. In terms of voice projection, students have erratic high volume pitch. For diction, the students’ ability to produce comprehensible language is limited, and as to fluency, the choice of vocabulary and use of structure were severely limited. Based on the students’ speaking needs analyses, the supplementary material devised was based on Nunan’s IM model, incorporating context of daily life and global work settings, considering the principle that language is best learned in the actual meaningful situation. To widen the mastery of skill, a rich learning environment, filled with a variety instructional material tends to foster faster acquisition of the requisite skills for sustained learning and development. The role of IM is to encourage information to stick in the learners’ mind, as what is seen is understood more than what is heard. Teachers say they found the IM “very useful.” This implied that English teachers could adopt the materials to improve the speaking skills of students. Further, teachers should provide varied opportunities for students to get involved in real life situations where they could take turns in asking and answering questions and share information related to the activities. This would minimize anxiety among students in the use of the English language.

Evaluation of Microleakage of a New Generation Nano-Ionomer in Class II Restoration of Primary Molars

Objective: This in vitro study was carried out to assess the microleakage properties of nano-filled glass ionomer in comparison to resin-reinforced glass ionomers. Material and Methods: 40 deciduous molar teeth were included in this study. Class-II cavity was prepared in a standard form for all the specimens. The teeth were randomly distributed into two groups (20 per group) according to the restorative material used either nano-glass ionomer or Photac Fill glass ionomer restoration. All specimens were thermocycled for 1000 cycles between 5 and 55 °C. After that, the teeth were immersed in 2% methylene blue dye then sectioned and evaluated under a stereomicroscope. Microleakage was assessed using linear dye penetration and on a scale from zero to five. Results: Two way ANOVA test revealed a statistically significant lower degree of microleakage in both occlusal and gingival restorations (0.4±0.2), (0.9±0.1) for nano-filled glass ionomer group in comparison to resin modified glass ionomer (2.3±0.7), (2.4±0.5). No statistical difference was found between gingival and occlusal leakage regarding the effect of the measured site. Conclusion: Nano-filled glass ionomer shows superior sealing ability which enables this type of restoration to be used in minimum invasive treatment.

Solid Dispersions of Cefixime Using β-Cyclodextrin: Characterization and in vitro Evaluation

Cefixime, a BCS class II drug, is insoluble in water but freely soluble in acetone and in alcohol. The aqueous solubility of cefixime in water is poor and exhibits exceptionally slow and intrinsic dissolution rate. In the present study, cefixime and β-Cyclodextrin (β-CD) solid dispersions were prepared with a view to study the effect and influence of β-CD on the solubility and dissolution rate of this poorly aqueous soluble drug. Phase solubility profile revealed that the solubility of cefixime was increased in the presence of β-CD and was classified as AL-type. Effect of variable, such as drug:carrier ratio, was studied. Physical characterization of the solid dispersion was characterized by Fourier transform infrared spectroscopy (FT-IR) and Differential scanning calorimetry (DSC). These studies revealed that a distinct loss of drug crystallinity in the solid molecular dispersions is ostensibly accounting for enhancement of dissolution rate in distilled water. The drug release from the prepared solid dispersion exhibited a first order kinetics. Solid dispersions of cefixime showed a 6.77 times fold increase in dissolution rate over the pure drug.

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

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.

Biculturalism and Educational Success: The Case of the Social Justice High School in Chicago, Illinois, USA

The aim of this contribution is to present the experience of the U.S. secondary school Social Justice High School (SoJo), part of the larger Campus of Little Village Lawndale High School (LVLHS) located in Chicago, Illinois (USA). This experience can be considered a concrete application of the principles of the educational perspective known, in the United States, as Social Justice Education, aimed at ensuring quality education and educational success for students from disadvantaged groups, particularly those characterized by “biculturalism”, i.e. students with a dual cultural and linguistic background. The contribution will retrace the historical and social events that led to the birth of the SoJo, explaining the principles and methods used by the school to achieve its objectives and giving also some statistical data.

Multi-Criteria Optimization of High-Temperature Reversed Starter-Generator

The paper presents another structural scheme of high-temperature starter-generator with external rotor to be installed on High Pressure Shaft (HPS) of aircraft engines (AE) to implement More Electrical Engine concept. The basic materials to make this starter-generator (SG) were selected and justified. Multi-criteria optimization of the developed structural scheme was performed using a genetic algorithm and Pareto method. The optimum (in Pareto terms) active length and thickness of permanent magnets of SG were selected as a result of the optimization. Using the dimensions obtained, allowed to reduce the weight of the designed SG by 10 kg relative to a base option at constant thermal loads. Multidisciplinary computer simulation was performed on the basis of the optimum geometric dimensions, which proved performance efficiency of the design. We further plan to make a full-scale sample of SG of HPS and publish the results of its experimental research.

Effects of Thermal Radiation on Mixed Convection in a MHD Nanofluid Flow over a Stretching Sheet Using a Spectral Relaxation Method

The effects of thermal radiation, Soret and Dufour parameters on mixed convection and nanofluid flow over a stretching sheet in the presence of a magnetic field are investigated. The flow is subject to temperature dependent viscosity and a chemical reaction parameter. It is assumed that the nanoparticle volume fraction at the wall may be actively controlled. The physical problem is modelled using systems of nonlinear differential equations which have been solved numerically using a spectral relaxation method. In addition to the discussion on heat and mass transfer processes, the velocity, nanoparticles volume fraction profiles as well as the skin friction coefficient are determined for different important physical parameters. A comparison of current findings with previously published results for some special cases of the problem shows an excellent agreement.

Production Optimization through Ejector Installation at ESA Platform Offshore North West Java Field

The offshore facilities condition of Pertamina Hulu Energi Offshore North West Java (PHE ONWJ) varies greatly from place to place, depending on the characteristics of the presently installed facilities. In some locations, such as ESA platform, gas trap is mainly caused by the occurrence of flash gas phenomenon which is known as mechanical-physical separation process of multiphase flow. Consequently, the presence of gas trap at main oil line would accumulate on certain areas result in a reduced oil stream throughout the pipeline. Any presence of discrete gaseous along continuous oil flow represents a unique flow condition under certain specific volume fraction and velocity field. From gas lift source, a benefit line is used as a motive flow for ejector which is designed to generate a syphon effect to minimize the gas trap phenomenon. Therefore, the ejector’s exhaust stream will flow to the designated point without interfering other systems.

Meaning in Life, Hope, and Mental Health: Relation between Meaning in Life, Hope, Depression, Anxiety, and Stress among Afghan Refugees in Iran

The present research was carried out in order to investigate the relationship between meaning in life and hope with depression, anxiety and stress in Afghan Refugees in Alborz province in Iran. In this research, method of study is a descriptive correlation type. One hundred and fifty-eight Afghan refugees (64 male, 94 female) participated in this study. All participants completed the Meaning in Life Questionnaires (MLQ), Hope Scale (HS), and The Depression Anxiety Stress Scales (DASS-21). The results revealed that Meaning in Life was positively associated with hope, presence of meaning, search of meaning, and negatively associated with depression and anxiety. Hope was positively associated with presence of meaning and search of meaning, and hope was negatively associated with depression, anxiety, and stress. Depression, anxiety, and stress were positively correlated with each other. Meaning in life and hope could influence on mental health.

Effect of Two Different Biochars on Germination and Seedlings Growth of Salad, Cress and Barley

The application of biochar to soils is becoming more and more common. Its application which is generally reported to improve the physical, chemical, and biological properties of soils, has an indirect effect on soil health and increased crop yields. However, many of the previous results are highly variable and dependent mainly on the initial soil properties, biochar characteristics, and production conditions. In this study, two biochars which are biochar II (BC II) derived from a blend of paper sludge and wheat husks and biochar 005 (BC 005) derived from sewage sludge with a KCl additive, are used, and the physical and chemical properties of BC II are characterized. To determine the potential impact of salt stress and toxic and volatile substances, the second part of this study focused on the effect biochars have on germination of salad (Lactuca sativa L.), barley (Hordeum vulgare), and cress (Lepidium sativum) respectively. Our results indicate that Biochar II showed some unique properties compared to the soil, such as high EC, high content of K, Na, Mg, and low content of heavy metals. Concerning salad and barley germination test, no negative effect of BC II and BC 005 was observed. However, a negative effect of BC 005 at 8% level was revealed. The test of the effect of volatile substances on germination of cress revealed a positive effect of BC II, while a negative effect was observed for BC 005. Moreover, the water holding capacities of biochar-sand mixtures increased with increasing biochar application. Collectively, BC II could be safely used for agriculture and could provide the potential for a better plant growth.

Stop Texting While Learning: A Meta-Analysis of Social Networks Use and Academic Performances

Teachers and university lecturers face an unsolved problem, which is students’ multitasking behaviors during class time, such as texting or playing a game. It is important to examine the most powerful predictor that can result in students’ educational performances. Meta-analysis was used to analyze the research articles, which were published with the keywords, multitasking, class performance, and texting. We selected 14 research articles published during 2008-2013 from online databases, and four articles met the predetermined inclusion criteria. Effect size of each pair of variables was used as the dependent variable. The findings revealed that the students’ expectancy and value on SNSs usages is the best significant predictor of their educational performances, followed by their motivation and ability in using SNSs, prior educational performances, usage behaviors of SNSs in class, and their personal characteristics, respectively. Future study should conduct a longitudinal design to better understand the effect of multitasking in the classroom.

In vitro Effects of Viscum album on the Functionality of Rabbit Spermatozoa

This study aimed to assess the in vitro effects of different concentrations of the Viscum album extract on the motility, viability, and reactive oxygen species (ROS) production by rabbit spermatozoa during different time periods (0, 2, and 8h). Spermatozoa motility was assessed by using the CASA (Computer aided sperm analysis) system. Cell viability was evaluated by using the metabolic activity MTT assay, and the luminol-based luminometry was applied to quantify the ROS formation. The CASA analysis revealed that low Viscum concentrations were able to prevent a rapid decline of spermatozoa motility, especially in the case of concentrations ranging between 1 and 5 µg/mL (P

In vitro Effects of Salvia officinalis on Bovine Spermatozoa

In vitro storage and processing of animal semen represents a risk factor to spermatozoa vitality, potentially leading to reduced fertility. A variety of substances isolated from natural sources may exhibit protective or antioxidant properties on the spermatozoon, thus extending the lifespan of stored ejaculates. This study compared the ability of different concentrations of the Salvia officinalis extract on the motility, mitochondrial activity, viability and reactive oxygen species (ROS) production by bovine spermatozoa during different time periods (0, 2, 6 and 24 h) of in vitro culture. Spermatozoa motility was assessed using the Computer-assisted sperm analysis (CASA) system. Cell viability was examined using the metabolic activity MTT assay, the eosin-nigrosin staining technique was used to evaluate the sperm viability and ROS generation was quantified using luminometry. The CASA analysis revealed that the motility in the experimental groups supplemented with 0.5-2 µg/mL Salvia extract was significantly lower in comparison with the control (P

An Optimization Model for the Arrangement of Assembly Areas Considering Time Dynamic Area Requirements

Large-scale products are often assembled according to the job-site principle, meaning that during the assembly the product is located at a fixed position, while the area requirements are constantly changing. On one hand, the product itself is growing with each assembly step, whereas varying areas for storage, machines or working areas are temporarily required. This is an important factor when arranging products to be assembled within the factory. Currently, it is common to reserve a fixed area for each product to avoid overlaps or collisions with the other assemblies. Intending to be large enough to include the product and all adjacent areas, this reserved area corresponds to the superposition of the maximum extents of all required areas of the product. In this procedure, the reserved area is usually poorly utilized over the course of the entire assembly process; instead a large part of it remains unused. If the available area is a limited resource, a systematic arrangement of the products, which complies with the dynamic area requirements, will lead to an increased area utilization and productivity. This paper presents the results of a study on the arrangement of assembly objects assuming dynamic, competing area requirements. First, the problem situation is extensively explained, and existing research on associated topics is described and evaluated on the possibility of an adaptation. Then, a newly developed mathematical optimization model is introduced. This model allows an optimal arrangement of dynamic areas, considering logical and practical constraints. Finally, in order to quantify the potential of the developed method, some test series results are presented, showing the possible increase in area utilization.

Understanding Help Seeking among Black Women with Clinically Significant Posttraumatic Stress Symptoms

Understanding the help seeking decision making process and experiences of health disparity populations with posttraumatic stress disorder (PTSD) is central to development of trauma-informed, culturally centered, and patient focused services. Yet, little is known about the decision making process among adult Black women who are non-treatment seekers as they are, by definition, not engaged in services. Methods: Audiotaped interviews were conducted with 30 African American adult women with clinically significant PTSD symptoms who were engaged in primary care, but not in treatment for PTSD despite symptom burden. A qualitative interview guide was used to elucidate key themes. Independent coding of themes mapped to theory and identification of emergent themes were conducted using qualitative methods. An existing quantitative dataset was analyzed to contextualize responses and provide a descriptive summary of the sample. Results: Emergent themes revealed that active mental avoidance, the intermittent nature of distress, ambivalence, and self-identified resilience as undermining to help seeking decisions. Participants were stuck within the help-seeking phase of ‘recognition’ of illness and retained a sense of “it is my decision” despite endorsing significant social and environmental negative influencers. Participants distinguished ‘help acceptance’ from ‘help seeking’ with greater willingness to accept help and importance placed on being of help to others. Conclusions: Elucidation of the decision-making process from the perspective of non-treatment seekers has implications for outreach and treatment within models of integrated and specialty systems care. The salience of responses to trauma symptoms and stagnation in the help seeking recognition phase are findings relevant to integrated care service design and community engagement.