Perceptions of Physician Influence on Healthcare Accessibility

A significant portion of the U.S. population across the country has limited access to quality healthcare; however, this situation is more pronounced in rural areas. One potential solution is for healthcare practitioners to move their services to underserved rural areas to improve healthcare coverage. No previous studies have explored the perceptions of practitioners regarding their influence on healthcare access, particularly the potential impact of moving healthcare services to underserved areas. Thus, the purpose of this research was to address this gap. A qualitative phenomenological approach was adopted. A sample of 24 participants was selected using purposive sampling, from the target population of medical doctors in the southeastern area of the United States. Open-ended interview questions used during data collection, prompted respondents to provide insightful feedback. A deductive coding procedure was used to mirror the 6 dimensions of healthcare access. The results point to 3 major themes: (a) physicians increase healthcare acceptability and awareness through their knowledge and experience; (b) physicians increase accommodation through consideration of patients’ needs and coordination of care, and (c) physicians increase resource availability through use of electronic medical records. This research study affords a clearer understanding of physicians’ perceptions and may guide the development of informational awareness-raising materials for physicians and also alludes to the need to promote positive relationships between physicians and patients to maximize healthcare accessibility in the United States

Performance of Sustainable Road Pavements Founded on Clay Subgrades Treated with Eco-Friendly Cementitious Materials

Clays encountered during road construction are mostly weak and result in major pavement failures due to their low California bearing ratio (CBR) and high swelling potential. In this study, sustainable and eco-friendly waste materials including brick dust waste (BDW), ground granulated blastfurnance slag (GGBS), recycled plastic (RP) and recycled glass (RG) at varying proportions of 11.75% and 23.5% were used as partial replacement for cement and lime in clay treatment. After determining the water content by conducting Atterberg limit and compaction test, A CBR and swell characteristics of treated and untreated clay were also conducted. A road pavement design was conducted using the Design Manual for Road and Bridges (DMRB) as a guide to determine the performance of treated clay with varying CBR values. A road pavement failure analysis was also conducted to understand the defect formation within pavement structures supported by eco-friendly treated clay. The embodied carbon of treated clay was calculated and a life cycle cost analysis (LCCA) of flexible pavement with treated clay and road with imported materials was conducted. The results show a liquid limit of 131.26 and plastic limit of 28.74 for high plasticity index (clay 1) and liquid limit of 274.07 and a plastic limit of 45.38 for extremely high plasticity index (clay 2). An increase in CBR values from 8% and 9% to 57% and 97% with a reduction in swell values from 4.11% and 5.03% to 0.38% and 0.56% were recorded. This resulted in a reduction in pavement thickness and stresses within the road pavement leading to reduced susceptibility of the pavement to fatigue, rutting and permanent deformation. Very low embodied carbon was recorded for eco-friendly treated clay and a high life cycle cost (LCC) with clay removed and replaced with imported materials compared with clay treated using eco-friendly waste materials. The study concluded that carbon and overall construction costs can be reduced using waste materials in road construction. Owners and operators can save money when clay is treated and used in road construction instead of removing clay and replacing it with imported materials

Alternative Bait Marker Systems for White-Tailed Deer

We compared alternative bait markers for a study of free-ranging white-tailed deer (Odocoileus virginianus) based on the following criteria: 1) detectability in fecal matter; 2) incorporation into corn bait; 3) palatability; and 4) cost. We used penned sheep (Ovis aries) as an experimental model to evaluate Microtaggants, metallic flakes, plastic chips, and rare earth elements as bait markers, and molasses and soy lecithin as marker adhesives. The metallic flake­-soy lecithin combination best met our criteria. It was also successful in a field study evaluating supplemental feeding on deer behavior and activity in central Wisconsin. Metallic flakes were easily detected under field conditions, readily adhered to shelled corn bait, enabled assessment of deer activity at distinct feeding sites and could be used in studies of feeding behavior and movements of other free-ranging herbivores

DMRB flexible road pavement design using re-engineered expansive road subgrade materials with varying plasticity index

Pavement thickness is a very vital component during the design stage of a road construction project. Pavement design helps to determine the costs of the project over a certain period to ascertain how the cost of road pavement construction affect the life cycle cost of the road. Road pavements are designed based on the type of subgrade material and the expected traffic load to help clients and decision-makers make decisions on the project. In this study, expansive road subgrade materials were improved using lime and cement and their California Bearing Ratio (CBR) was used in road pavement design. The study used the Design and Manual for Roads and Bridges (DMRB) as a guide to investigating the effect of stabilised expansive road subgrade with varying CBR values on road pavement design. The mineral structure, characteristics, Atterberg limit, compaction CBR, swell and microstructural analysis (scanning electron microscopy (SEM) and Energy Dispersive X-ray (EDX)) of stabilised subgrade materials were investigated. The results show an increase in California Bearing Ratio (CBR) values and a reduction in swell values while curing age increased for stabilised subgrade materials. Treated samples show high Calcium Silicate Hydrate (C-S-H) gel formation after 7 and 28 days of curing. The thickness of road pavement was observed with an increase in CBR values. The study established that the thickness of road pavement and overall construction cost can be reduced using cement and lime as additives in subgrade stabilisation

Swell and microstructural characteristics of high-plasticity clay blended with cement

This study presents the effect of high plasticity on swell potential, swelling pressure and micro structural characteristics of kaolinite-bentonite mixed clays. Five different combining ratios of kaolinite bentonite mixture of 100:0, 90:10, 75:25, 50:50 and 25:75 in % by weight of dry kaolinite were used. All five synthesised soils were then mixed with 0%, 5% and 8% of cement by weight of dry soil, cured for 28days and subjected to Atterberg limit, one dimensional oedometer and scanning electron microscope test. The inclusions of 5% and 8% cement reduces the plasticity index of the treated soils as the percentage of bentonite increases. The effects of plasticity of treatment with 5% and 8% cement after 28 days curing period, was evaluated, and the results show that reduction in plasticity index resulted to decrease in swell potential and swelling pressure of the kaolinite-bentonite mixed clays. The results of micro-structural analysis of 5% cement treated soils show formation of flocculated fabric and cementation of soil particles, and filling with cementitious compounds of the voids of flocculated fabric in the soil. The reduction in swell can be attributed to the resulting compacted and dense mass of treated soils due to cementation of soil particles and cation exchange. The complex behaviour of swell of high plasticity kaolinite-bentonite mix has been explained using one dimensional oedometer test, by further experimental study and examination of the micro-structure of treated soils

Investigation of wood properties and resistance of 25-year-old Gmelina arborea wood selected from crown region to termite attack

Gmelina arborea is widely planted and produces many useful products. However, the upper portion of the stem might be useful for some practical applications if properly managed and harvested. In order to explore the potential of this residues, this study investigated the physical, mechanical properties, and resistance of 25-year-old Gmelina arborea (gamhar) wood from the crown region to termite attack. This is with a view to enhance the use of harvesting residues of Gmelina arborea (gamhar) such that the wood in the crown region is used as the main trunk in various applications. The following wood properties including density, modulus of elasticity, modulus of rupture, and compression strength were investigated on crown wood of 25-year-old Gmelina arborea (gamhar). This study compared with results obtained from previous studies for the bole. Test for the natural resistance of the crown wood was carried out at the timber graveyard where the samples were exposed to termites for 10 weeks to determine the weight loss. The wood samples were rated weekly according to the America Standard of Testing Material. Our results showed that there were significant differences in the density of the crown wood of the three selected 25-year-old Gmelina arborea (gamhar) stands. The results for the mechanical properties of the crown wood of the three selected 25-year-old Gmelina arborea (gamhar) trees showed that there were significant differences in the compression and modulus of rupture of the wood samples from the crown region while there was no significant difference in the modulus of elasticity among the selected stands. Visual rating results showed that termite attack ranged from moderate to heavy attack, while the weight loss was not significantly different among the sampled trees. This study has shown that the den- sity and mechanical properties of the crown wood are comparable to those from the trunk. Hence, the crown wood can be used in application as the stem wood. Also, the study has shown that wood from crown region of Gmelina arborea (gamhar) are prone to termite attack and non-durable as the wood obtained from the stem. Therefore, there is a need to apply treatments that can improve its durability and enhance its service life

Dynamic analysis of Footbridge to Eurocode (case study on Leventis Footbridge, Aba Road, Port Harcourt)

This research project presents a dynamic structural analysis of footbridges as per Eurocode (case study on Leventis Footbridge, Aba Road, Port Harcourt). The footbridge was simulated using a commercial finite element software; Midas FEA. The crowd-footbridge is modelled as a structural oscillator to which some external load is applied. Therefore, the crowd is taken as an imposed load rather than as a dynamical system. The eigenvalue analysis was carried out to obtain the natural frequency ⍵n, which is obtained as the eigenvalue of the characteristic equation and the corresponding mode shape is obtained as the eigenvector of the characteristic equation. The values are compared to Eurocode specification for comfort criteria on footbridges. Time history analysis was also carried out. This method was used to construct time histories of variables, such as displacement and acceleration, by calculating the response at the end of a succession of very small time steps. The peak deck acceleration is obtained and compared to Eurocode specification for comfort criteria on footbridges. From the time history graph, it was observed that the maximum acceleration of the footbridge is 0.56m/s2 which is greater than the value stated in the Eurocode standard specification of 0.5m/s2 for maximum comfort. This implies that the footbridge acceleration obtained is not satisfactory and that some measures need to be taken in order to remediate this effect and control the vibrations. Some measures to reduce vibration are recommended