380 research outputs found

    Punching shear behavior of fiber reinforced polymers reinforced concrete flat slabs: experimental study

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    This paper presents the results of a two-phase experimental program investigating the punching shear behavior of fiber reinforced polymer reinforced concrete (FRP RC) flat slabs with and without carbon fiber reinforced polymer (CFRP) shear reinforcement. In the first phase, problems of bond slip and crack localization were identified. Decreasing the flexural bar spacing in the second phase successfully eliminated those problems and resulted in punching shear failure of the slabs. However, CFRP shear reinforcement was found to be inefficient in enhancing significantly the slab capacity due to its brittleness. A model, which accurately predicts the punching shear capacity of FRP RC slabs without shear reinforcement, is proposed and verified. For slabs with FRP shear reinforcement, it is proposed that the concrete shear resistance is reduced, but a strain limit of 0.0045 is recommended as maximum strain for the reinforcement. Comparisons of the slab capacities with ACI 318-95, ACI 440-98, and BS 8110 punching shear code equations, modified to incorporate FRP reinforcement, show either overestimated or conservative results

    A methodology for the economic evaluation of power storage technologies in the UK market

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    In this thesis, we present a methodology for assessing the economic impact of power storage technologies. The methodology is founded on classical approaches to the optimal stopping of stochastic processes. Power storage is regarded as a complement to the intermittent output of renewable energy generators, and is important in contributing to the reduction of carbon intensive power generation. Therefore, the recommendations to study the future economic storage assessment have been increased. Our aim is to present a methodology suitable for use by policy makers that is simple to maintain, adapt to different technologies and is easy to interpret. The thesis start by giving an overview of the UK power market and an introduction to storage technologies in Chapter 2. Chapter 3 summarize the mathematical tools, that the methodology is based on, more precisely the discretionary stopping theory based on dynamic programming techniques. An algorithm to assess the storage is presented in Chapter 4, where the storage problem is formulated as an entry, exit problem, which allow the investigation of different optimal strategies to fill and empty a storage facility. An analysis of power demand, and an approximation of power prices through the merit order curve of the UK power market presented in Chapter 5. Based on a theoretical study, the methodology is applied to a Compressed Air Energy Storage (CAES) in Chapter 6. Chapter 7 present an empirical study that applied the methodology directly on the observed data, this approach is shown to have benefits over current techniques and is able to value, by identifying a viable optimal operational strategy for a CAES operating in the UK market

    A methodology to assess the economic impact of power storage technologies

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    We present a methodology for assessing the economic impact of power storage technologies. The methodology is founded on classical approaches to the optimal stopping of stochastic processes but involves an innovation that circumvents the need to, ex ante , identify the form of a driving process and works directly on observed data, avoiding model risks. Power storage is regarded as a complement to the intermittent output of renewable energy generators and is therefore important in contributing to the reduction of carbon-intensive power generation. Our aim is to present a methodology suitable for use by policy makers that is simple to maintain, adaptable to different technologies and easy to interpret. The methodology has benefits over current techniques and is able to value, by identifying a viable optimal operational strategy, a conceived storage facility based on compressed air technology operating in the UK. This article is part of the themed issue ‘Energy management: flexibility, risk and optimization’.</jats:p

    Complex Hydrocephalus

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    Role of Endoscopy in Management of Hydrocephalus

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    Towards more pedestrian-friendly streets in Cairo

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    This research explores the factors that make the streets of Cairo better places for walking, more inviting, and adaptable to be used by pedestrians. In order to closely examine how far Cairo streets are pedestrian-friendly, walkable environments, the research investigates one street in Cairo as a case study. The case study uses qualitative research to investigate the street characteristics through participants’ observation technique, while the local pedestrians’ needs and perceptions towards the street’s walkability are explored through interviews. In addition, an in-depth interview is conducted with an expert in order to have deeper insights into the issue of pedestrian-friendly streets from a professional perspective. The existing models reviewed through the literature have contributed to the development of the proposed conceptual framework. The study’s empirical findings have shown that safety and cleanliness of streets are the main factors that influence people’s walking experience. Besides, pavement and sidewalks conditions, street furniture and lighting, along with other street user’s behavior, such as car drivers and shopkeepers, are other factors that implicitly and/or explicitly affect street walkability. The analysis of the findings contributes to the limited qualitative research on walkable streets and pedestrians’ walking experience specifically in Cairo. Thus, this study offers a set of recommendations for policy makers and city managers in terms of conducting further research that covers other geographic areas in Cairo, adopting a participatory planning approach, enforcing laws and regulations on street occupancy, applying people-oriented planning paradigms, and raising public awareness on walkability

    Landscrapers : arkitektur och landskap i dialog

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    This thesis is discussing one aspect of design which is common in two interrelated professions (Architecture and Landscape Architecture). This aspect is designing a building with a green roof that can fit in both an architectural and a landscape context. Landscrapers is the name of this aspect. Moreover, the space that will be a result of using this aspect could be a public, private, semi-public or semi-private space. In other words, how people would use these spaces? The thesis is exploring the evolution of this aspect, and how it is developed by discussing different situation from past and present. Also I am discussing the linkage between landscape and architecture in different aspects, exploring the different levels of integration between landscape and architecture. Finally, I will use this knowledge for experimenting to build landscrapers in a residential area called Kronetorp in Arlöv, Sweden to test the concept of Landscrapers, and see if it will be suitable for the area and discuss if it will be acceptable by people

    Les facteurs influençant l'adoption du dossier de santé électronique personnel (DSE-P) pour le suivi et la gestion des maladies chroniques en premiÚre ligne de soins au Québec

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    Au QuĂ©bec, l’implantation du dossier de santĂ© Ă©lectronique personnel (DSE-P) fait l’objet d’une expĂ©rimentation dans le cadre du projet Ma PremiĂšre Ligne NumĂ©rique en SantĂ© (MPLNS). Cependant, peu de donnĂ©es sont actuellement disponibles sur les conditions d’implantation, de fonctionnement, d’adoption et d’utilisation du DSE-P dans les organisations de soins au QuĂ©bec ainsi que sur ses impacts potentiels. Principalement, l’adoption du DSE-P constitue une importante prĂ©occupation de mise en Ɠuvre. En effet, malgrĂ© leurs avantages potentiels avancĂ©s, la littĂ©rature note que le taux d'adoption de ces systĂšmes demeure encore trĂšs faible. Également, les Ă©tudes explorant l’adoption du DSE-P se sont principalement focalisĂ©es sur la perspective des patients et peu de recherche s’est intĂ©ressĂ©e Ă  celles des professionnels et des organisations. De ce fait, l’objectif principal de cette Ă©tude est de dĂ©crire, analyser et comprendre les facteurs influençant l’adoption par les utilisateurs potentiels, les patients et les professionnels, d’un DSE-P pour le suivi et la gestion des maladies chroniques dans le contexte de la premiĂšre ligne de soins au QuĂ©bec selon les perspectives des patients, des professionnels et celle des gestionnaires. Une recherche par Ă©tude de cas avec mĂ©thodologie mixte, Ă  prĂ©dominance qualitative, a Ă©tĂ© rĂ©alisĂ©e dans une organisation de premiĂšre ligne qui a implantĂ© le DSE-P dans le cadre du projet MPLNS, financĂ© par le gouvernement du QuĂ©bec en partenariat avec des partenaires privĂ©s. Les stratĂ©gies de collecte de donnĂ©es privilĂ©giĂ©es dans cette recherche Ă©taient : 1) une enquĂȘte quantitative rĂ©alisĂ©e en phase de prĂ©implantation du projet auprĂšs de la clientĂšle d’un groupe de mĂ©decine de famille, 2) des entrevues individuelles semi-structurĂ©es auprĂšs des patients, des professionnels et des gestionnaires et 3) le recours Ă  des sources documentaires afin de mieux dĂ©crire le contexte et l’évolution du projet. Nous avons principalement menĂ© une analyse statistique descriptive des donnĂ©es quantitative et une analyse de contenu des donnĂ©es collectĂ©es lors des entrevues et celles issues des documents consultĂ©s. Cinquante-sept participants ont rempli le questionnaire dans le cadre de l’enquĂȘte en prĂ©implantation et nous avons rĂ©alisĂ© des entrevues individuelles auprĂšs de quarante-trois personnes des trois groupes d’acteurs impliquĂ©s dans l’implantation du DSE-P : vingt-neuf patients soient dix-huit utilisateurs et onze non-utilisateurs, onze professionnels et trois gestionnaires. Notre Ă©tude a permis d’identifier un ensemble de thĂšmes principaux regroupant des facilitateurs ou des barriĂšres Ă  l’adoption du DSE-P par les patients et les professionnels, et Ă  son intĂ©gration dans la pratique clinique. Il s’agit des caractĂ©ristiques individuelles des patients et des professionnels; de la qualitĂ© de la relation patients-professionnels et du contexte de la pratique clinique en premiĂšre ligne; des caractĂ©ristiques de la technologie offerte et des conditions et du soutien organisationnels offerts aux utilisateurs : patients et professionnels. La nouveautĂ© et l’apport de notre recherche se situent Ă  deux niveaux. En premier, nous avons pu identifier et discuter les conditions les plus saillantes pouvant influencer l’adoption du DSE-P auprĂšs des patients et des professionnels et vĂ©rifier leur pertinence pour la gestion des maladies chroniques dans le contexte particulier de la premiĂšre ligne au QuĂ©bec. Également, nous avons pu appliquer, pour la premiĂšre fois, un nouveau cadre conceptuel Ă  l’analyse des conditions organisationnelles influençant l’adoption du DSE-P par les professionnels selon une nouvelle approche pragmatique qui lie l’adoption sur le plan organisationnel Ă  des prĂ©curseurs de l’efficacitĂ© de l’implantation. En conclusion, le DSE-P peut reprĂ©senter un outil prometteur pour soutenir un rĂŽle plus actif des patients atteints de maladies chroniques dans la gestion de leur Ă©tat de santĂ© et de leurs soins en collaboration avec l’équipe clinique de premiĂšre ligne. Ainsi, le DSE-P semble avoir une place importante en premiĂšre ligne de soins au QuĂ©bec. Cependant, l’implantation et l’adoption d’un tel outil sont Ă  envisager dans le cadre de nouveau modĂšle organisationnel impliquant la participation du patient et sa collaboration avec son Ă©quipe clinique, dont il constitue la principale prĂ©misse. NĂ©anmoins, une telle approche doit s’appuyer sur un changement de culture et requiert de repenser plusieurs processus cliniques et organisationnels et une redĂ©finition des rĂŽles et des responsabilitĂ©s des diffĂ©rents acteurs dans le rĂ©seau pour un nouveau partenariat patient-Ă©quipe clinique oĂč les TIC doivent aussi ĂȘtre adaptĂ©es pour soutenir de nouvelles pratiques et une rĂ©organisation des services. Ceci conduirait alors Ă  privilĂ©gier le dĂ©veloppement et l’intĂ©gration d’outils informationnels et communicationnels novateurs beaucoup plus imprĂ©gnĂ©s des rĂ©alitĂ©s cliniques et organisationnelles. Le DSE-P peut ainsi ĂȘtre complĂ©mentaire au dossier mĂ©dical Ă©lectronique, outil de travail des professionnels de la premiĂšre ligne, avec lequel il constituerait un mĂȘme ensemble d’outils informationnels. Mots clĂ©s : Dossier de santĂ© Ă©lectronique personnel, Adoption, Implantation, Gestion des maladies chroniques, PremiĂšre ligne de soins, Étude de cas, QuĂ©bec.In Quebec, My Digital Primary Health Care (MDPHC) is the first electronic personal health record (ePHR) implementation project funded by the province. However, little is known about ePHR implementation, adoption and use in healthcare organizations in Quebec as well as there is little information on their potential impacts. Mainly, adoption is a major concern for ePHR implementation. Indeed, despite the numerous potential benefits associated with ePHR use, the literature reports low adoption rates. Therefore, this research aimed to explore the perspective of chronically ill patients, professionals and managers regarding ePHR adoption, and to examine perceived barriers and facilitators to adoption among users enrolled in an ePHR pilot project in a primary care organization in Quebec. We conducted a case study with mixed method research, predominantly qualitative, in a primary care organization that has implemented an ePHR as part of the MDPHC project funded by the Government of Quebec. In this research, the strategies for data collection were: 1) a quantitative survey carried out in the project pre-implementation phase within a family medicine group, 2) individual semi structured interviews and 3) documentary analysis in order to describe the project context and evolution. We mainly conducted a descriptive statistical analysis of the quantitative data, and a content analysis of data collected during individual interviews and from project documents. Fifty-seven participants completed the questionnaire, and 43 people, including 29 patients (18 users and 11 users), 11 professionals and three managers were interviewed. We identified the most salient facilitators and barriers to ePHR adoption by chronically ill patients and professionals, and to ePHR integration into clinical practice. The main factors are patients’ and professionals’ individual characteristics; the quality of the patient-professional relationship and the clinical practice context in primary care organizations; the characteristics of the offered technology and organizational conditions and support to ePHR use. The contribution of our research was at two levels. First, we were able to identify the most salient conditions that can influence ePHR adoption by chronically ill patients and healthcare professionals and we verified their relevance to the context of the primary care in Quebec. Also, we applied for the first time a new conceptual framework for the analysis of the organizational conditions influencing ePHR adoption by professionals based on a new practical approach that links ePHR adoption by professionals to the project effectiveness of the implementation. ePHR represents a promising tool to support a more active role for chronically ill patients in their individual health condition and healthcare management in collaboration with clinical teams. Moreover, by improving chronically ill patients’ experience of care and increasing their interactions with professionals, ePHR seems to have a prominent place in primary care organizations in Quebec. However, the implementation and adoption of such tools have to be considered under new organizational model involving the patient participation and his collaboration with the clinical team, which it is the main premise. However, such an approach must rely on a change in culture, and requires rethinking several clinical and organizational processes and a negotiation and redefinition of roles and responsibilities of actors in the health network for a new patient- clinical team partnership where ICT should also be adapted to support new practices and a reorganization of the services. This would then lead to focus on the development and integration of informational and communicational innovative tools much more steeped in the clinical and organizational realities. ePHR can be complementary to the electronic medical record, the primary health care professionals’ working tool, with which it is the same set. Keywords: Electronic Personal Health Record, Adoption, Implementation, Chronic Disease Management, Primary Health Care, Case Study, Quebec

    Contractors’ perception towards causes of claims in construction projects

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    The construction industry is an important sector for the development of the Gaza Strip. A key factor to a successful construction project is to complete the project without any claims occurrence. Nonetheless, claims are very common in the construction industry of Palestine. The aim of this paper is to identify and rank the existing causes of claims according to their relative importance in the construction industry from the perspective of the local contractors. The paper reports on a questionnaire-based research investigation targeting local contractors by analyzing their perception towards causes of claims. The results found the main causes of claims and they are: awarding bid to the lower bidder; border closures; residents’ interference during project implementation; road blockage and difficulties in passing between cities and governorate It was found that owners may not award the contract to the lowest responsive bidder

    L'évaluation de la prédisposition organisationnelle à l'adoption du dossier de santé électronique (DSE) par les médecins de l'est du Québec

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    Le dossier de santĂ© Ă©lectronique (DSE) reprĂ©sente une application importante des technologies de l’information et des communications (TIC) pour le secteur des soins de santĂ©. Le DSE est considĂ©rĂ© comme ayant un grand potentiel pour amĂ©liorer la qualitĂ©, la continuitĂ©, la sĂ©curitĂ© et l’efficacitĂ© des soins de santĂ©. Or, ces avantages ne peuvent ĂȘtre atteints sans une implantation adĂ©quate qui doit passer obligatoirement par l’adoption du DSE par les professionnels de la santĂ©, notamment par les mĂ©decins qui en sont les principaux utilisateurs. La prĂ©sente Ă©tude a pour but d’explorer la contribution des facteurs organisationnels dans la prĂ©disposition organisationnelle Ă  l’adoption et l’utilisation du DSE par les mĂ©decins dans les organisations de soins de santĂ© de premiĂšre ligne de l’est du QuĂ©bec. Nous avons menĂ© une Ă©tude quantitative exploratoire auprĂšs des dĂ©cideurs de 24 organisations de soins de premiĂšre ligne de l’est du QuĂ©bec. La collecte de donnĂ©es a Ă©tĂ© rĂ©alisĂ©e Ă  l’aide d’un questionnaire adaptĂ© au contexte quĂ©bĂ©cois et au secteur de la santĂ©, et dont les caractĂ©ristiques psychomĂ©triques ont Ă©tĂ© vĂ©rifiĂ©es par la mĂȘme occasion. La collecte de donnĂ©es a Ă©tĂ© rĂ©alisĂ©e entre mai et juillet 2011. Les analyses des donnĂ©es ont Ă©tĂ© effectuĂ©es dans le but d’amĂ©liorer l’outil de mesure, de dĂ©montrer sa validitĂ© sur le plan psychomĂ©trique et d’établir la pertinence du modĂšle thĂ©orique proposĂ©. Nous avons menĂ© des statistiques descriptives et nous avons explorĂ© les corrĂ©lations possibles entre les diffĂ©rentes variables mesurĂ©es et la qualitĂ© de l’utilisation du DSE dans les organisations participantes. Notre travail a permis de traduire au français et d’adapter au contexte quĂ©bĂ©cois un nouvel instrument de mesure pour Ă©valuer la prĂ©disposition organisationnelle Ă  l’adoption des TIC au QuĂ©bec. Nous avons pu mener la majoritĂ© des Ă©tapes de validation transculturelle de l’instrument Ă©laborĂ©. Les rĂ©sultats de cette Ă©tude sont en accord avec les donnĂ©es de la littĂ©rature et permettent de noter une corrĂ©lation significative entre l’efficacitĂ© de la mise en Ɠuvre et le climat de l’implantation. Aucune corrĂ©lation significative n’a Ă©tĂ© notĂ©e entre l’efficacitĂ© de l’implantation du DSE et les autres construits du modĂšle. Ces rĂ©sultats fournissent des pistes intĂ©ressantes afin de poursuivre la recherche sur la prĂ©disposition organisationnelle Ă  l’adoption du DSE et contribuent Ă  la comprĂ©hension des facteurs liĂ©s Ă  l’implantation du DSE dans les organisations de soins de santĂ© de premiĂšre ligne au QuĂ©bec.Electronic health records (EHR) are an important application of information and communications technology (ICT) for the health care sector. The EHR is considered to have great potential to improve the quality, continuity, safety and effectiveness of health care. However, these benefits cannot be achieved without proper implementation witch must necessarily pass through the adoption of EHR by health care professionals, notably by physicians who are the main users. This study aims to explore the contribution of organizational factors in organizational readiness for adoption and use of EHR by physicians in primary health care facilities in eastern Quebec. We conducted an exploratory quantitative survey among decision-makers from 24 primary care organizations in eastern Quebec. Data collection was performed using a questionnaire adapted to the Quebec context and the health sector, and whose psychometric properties were tested at the same time. Data collection was conducted between May and July 2011. The data analysis was conducted to improve the measurement tool, and to demonstrate its psychometric validity and the relevance of the theoretical model proposed. We performed descriptive statistics and exploratory correlation analyses. Our results are consistent with the literature and we can note a significant correlation between the effectiveness of the implementation and the climate for implementation. However, only the dimension “time for utilisation” of the “climate for implementation” construct predicts the quality of the use of EHR by physicians. No significant correlations were noted between the effectiveness of the implementation and the other constructs. These results provide interesting avenues for further research on organizational readiness for EHR adoption and contribute to our understanding of organizational factors related to the implementation of the EHR in primary care organizations of Quebec
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