Household recovery and housing reconstruction after the 2003 Bam earthquake in Iran

La reconstruction de logements après désastre est un processus complexe qui joue un rôle crucial dans le rétablissement des ménages affectés. Dans les dernières décennies, les chercheurs ont examiné les programmes de rétablissement des ménages (à travers les concepts de la résilience, de la vulnérabilité, et du développement durable), et ils ont essayé de déterminer les variables à l’origine de leur succès et ou de leur échec. Cependant, plusieurs lacunes subsistent, notamment à propos du degré inégal de rétablissement parmi les différentes catégories de ménages, des compromis sur les objectifs du rétablissement, et de la collaboration insuffisante parmi les différentes parties prenantes. Cette étude vise à expliquer pourquoi et comment les projets de reconstruction ne réussissent pas à atteindre les objectifs de rétablissement. Elle cherche à révéler les principaux défis dans les initiatives visant à permettre aux ménages d’avoir un rétablissement équivalent et effectif durant les programmes de reconstruction. Cette recherche se base sur une étude de cas détaillée, longitudinale et qualitative, portant sur le programme de reconstruction après désastre conduit après le tremblement de terre qui a frappé la ville de Bam en Iran en 2003. Elle examine l’expérience de reconstruction à Bam à partir de quatre angles : les objectifs de rétablissement, la politique, la stratégie et l’implémentation. L’étude adopte une stratégie de résonnement déductif, à travers lequel une revue détaillée de la littérature a mené à la formulation de propositions théoriques basées sur les théories de la résilience et de la vulnérabilité et d’autres concepts additionnels en lien avec le logement, la planification urbaine et l’aménagement de projets. Ces propositions théoriques ont par la suite été empiriquement testées pour vérifier si les modèles prévus se produisent réellement. Les résultats de Bam ont ainsi été comparés aux modèles prévus, nous permettant de valider (mais aussi de nuancer) les propositions théoriques déduites. Les résultats mettent en évidence quatre défis usuellement rencontrés dans les programmes de reconstruction après désastres. Premièrement, les politiques de reconstruction omettent souvent de prendre en considération la diversité des ménages affectés, notamment par rapport à leur statut pré et post désastre. La conséquence de la « même politique pour tous » est que cette approche ne peut pas mener au rétablissement des familles affectées. Le rétablissement de plusieurs types de ménages exige la coexistence d’une multiplicité de mesures et de programmes leur permettant de choisir la solution qui correspond à leurs besoins, leurs conditions de vie et leurs attentes. Deuxièmement, l’intégration d’une politique générale du logement et de politiques spécifiques de reconstruction est nécessaire pour faire face aux vulnérabilités et assurer un rétablissement à long terme. Troisièmement, le défi d’inclure et d’impliquer toutes les parties prenantes dans une approche participative de prise de décision menace souvent la réalisation des objectifs de rétablissement. Finalement (et conséquemment du dernier point abordé), les programmes de reconstruction doivent prendre en considération les conflits entre les parties prenantes et la fragmentation institutionnelle, à partir des structures et des mécanismes d’une gouvernance appropriée. En définitive, ces résultats nous rappellent que les programmes de reconstruction sont des processus dynamiques et complexes selon lesquels le rétablissement des ménages affectés dépend de plusieurs variables telles que la condition pré et post désastre, la sensibilité des politiques par rapport aux besoins et aux désirs variés des familles, la participation active des ménages dans la prise de décisions, et la collaboration réussie entre toutes les parties prenantes. Décidément, une recherche plus approfondie est nécessaire pour explorer la relation de cause à effet entre les variables et ce processus complexe.Post-disaster housing reconstruction is a complex process that plays a crucial role in promoting affected households’ recovery. In the last few decades, researchers have examined housing recovery programs (through resilience, vulnerability, and sustainable development lenses), and made considerable endeavours to determine the variables behind their success or failure. However, several knowledge gaps about, for instance, unequal level of recovery among differently affected household categories, compromises on recovery objectives, and insufficient collaboration between stakeholders in housing reconstruction programs, still exist. This dissertation aims at explaining why and how housing reconstruction projects typically fail to fulfill recovery objectives. It seeks to reveal the main challenges in initiatives aimed at helping affected households to recover sustainably. This study is based on a detailed, longitudinal, qualitative case study of the housing reconstruction program conducted after the earthquake that struck the city of Bam, Iran, in 2003. It specifically examines Bam’s experience from four perspectives: recovery objectives, policy, strategy, and implementation. The study adopts a deductive reasoning strategy, in which detailed literature reviews led to the formulation of theoretical propositions based on the resilience and the vulnerability theories and additional concepts borrowed from the housing, urban planning, and project management fields. These theoretical propositions were later empirically tested to explore whether the expected patterns actually occurred. Findings from the case of Bam were thus matched with predicted patterns, allowing us to validate (but also to nuance) the theoretical propositions. Results highlight four main challenges typically faced in housing reconstruction programs. First, housing reconstruction policies often overlook the diversity of affected households, notably with regard to their pre-disaster status and post-disaster situation. As a consequence, the common one-policy-for-all approach cannot adequately lead to the recovery of affected families. The recovery of different household types requires the coexistence of a multiplicity of measures and programs to allow them to choose the solution that best fits their needs, conditions, and expectations. Second, the integration of general housing policy and specific reconstruction policies is necessary to both address vulnerabilities and ensure long-term recovery. Third, challenges in involving the diversity of stakeholders in participatory decision-making often threaten the fulfillment of recovery objectives. Finally (and as a consequence of the latter), housing reconstruction programs need to address stakeholder conflicts and institutional fragmentation through appropriate governance structures and mechanisms. These results remind us that housing reconstruction programs are complex, dynamic processes where affected households’ recovery depends on several variables such as their pre- and post-disaster conditions, recovery policy’s sensitivity to families’ varied needs and desires, households’ active participation in decision-making, and successful collaboration between stakeholders. Indeed, further research is still required to explore the cause and effect relationships between variables in this complex process

Connected Vehicles at Signalized Intersections: Traffic Signal Timing Estimation and Optimization

Summary: While traffic signals ensure safety of conflicting movements at intersections, they also cause much delay, wasted fuel, and tailpipe emissions. Frequent stops and goes induced by a series of traffic lights often frustrates passengers. However, the connectivity provided by connected vehicles applications can improve this situation. A uni-directional traffic signal to vehicle communication can be used to guide the connected vehicles to arrive at green which increases their energy efficiency; and in the first part of the dissertation, we propose a traffic signal phase and timing estimator as a complementary solution in situations where timing information is not available directly from traffic signals or a city’s Traffic Management Center. Another approach for improving the intersection flow is optimizing the timing of traditional traffic signals informed by uni-directional communication from connected vehicles. Nevertheless, one can expect further increase in energy efficiency and intersection flow with bi-directional vehicle-signal communication where signals adjust their timings and vehicles their speeds. Autonomous vehicles can further benefit from traffic signal information because they not only process the incoming information rather effortlessly but also can precisely control their speed and arrival time at a green light. The situation can get even better with 100%penetration of autonomous vehicles since a physical traffic light is not needed anymore. However, the optimal scheduling of the autonomous vehicle arrivals at such intersections remains an open problem. The second part of the dissertation attempts to address the scheduling problem formulation and to show its benefits in microsimulation as well as experiments. Intellectual Merit: In the first part of this research, we study the statistical patterns hidden in the connected vehicle historical data stream in order to estimate a signal’s phase and timing (SPaT). The estimated SPaT data communicated in real-time to connected vehicles can help drivers plan over time the best vehicle velocity profile and route of travel. We use low-frequency probe data streams to show what the minimum achievable is in estimating SPaT. We use a public feed of bus location and velocity data in the city of San Francisco as an example data source. We show it is possible to estimate, fairly accurately, cycle times and duration of reds for pre-timed traffic lights traversed by buses using a few days worth of aggregated bus data. Furthermore, we also estimate the start of greens in real-time by monitoring movement of buses across intersections. The results are encouraging, given that each bus sends an update only sporadically (≈ every 200 meters) and that bus passages are infrequent (every 5-10 minutes). The accuracy of the SPaT estimations are ensured even in presence of queues; this is achieved by extending our algorithms to include the influence of queue delay. A connected vehicle test bed is implemented in collaboration with industry. Our estimated SPaT information is communicated uni-directionally to a connected test vehicle for those traffic signals which are not connected. In the second part of the dissertation, another test bed, but with bi-directional communication capability, is implemented to transfer the connected vehicle data to an intelligent intersection controller through cellular network. We propose a novel intersection control scheme at the cyber layer to encourage platoon formation and facilitate uninterrupted intersection passage. The proposed algorithm is presented for an all autonomous vehicle environment at an intersection with no traffic lights. Our three key contributions are in communica-tion, control, and experimental evaluation: i) a scalable mechanism allowing a large number of vehicles to subscribe to the intersection controller, ii) reducing the vehicle-intersection coordination problem to a Mixed Integer Linear Program (MILP), and iii) a Vehicle-in-the-Loop (VIL) test bed with a real vehicle interacting with the intersection control cyber-layer and with our customized microsimulations in a virtual road network environment. The proposed MILP-based controller receives information such as location and speed from each subscribing vehicle and advises vehicles of the optimal time to access the intersection. The access times are computed by periodically solving a MILP with the objective of minimizing intersection delay, while ensuring intersection safety and considering each vehicle’s desired velocity. In order to estimate the fuel consumption reduction potential of the implemented system, a new method is proposed for estimating fuel consumption using the basic engine diagnostic information of the vehicle-in-the-loop car. Broader Impacts: This research can transform not only the way we drive our vehicles at signalized intersec-tions but also the way intersections are managed. As we evaluated in a connected test vehicle in the first part of the dissertation, our SPaT estimations in conjunction with the SPaT information available directly from Traffic Management Centers, enables the drivers to plan over time the best vehicle velocity profile to reduce idling at red lights. Other fuel efficiency and safety functionalities in connected vehicles can also benefit from such information about traffic signals’ phase and timing. For example, advanced engine management strategies can shut down the engine in anticipation of a long idling interval at red, and intersection collision avoidance and active safety systems could foresee potential signal violations at signalized intersections. In addition, as shown in the second part of the dissertation, when a connected traffic signal or intersection con-troller is available, intelligent control methods can plan in real-time the best timings and the lengths of signal phases in response to prevailing traffic conditions with the use of connected vehicle data. Our MILP-based intersection control is proposed for an all autonomous driving environment; and right now, it can be utilized in smart city projects where only autonomous vehicles are allowed to travel. This is expected to transform driving experience in the sense that our linear formulations minimizes the intersection delay and number of stops significantly compared to pre-timed intersections

Vascularisation of Skeletal Muscle

Skeletal muscle is mainly involved in physical activity and movement, which requires a large amount of glucose, fatty acids, and oxygen. These materials are supplied by blood vessels and incorporated into the muscle fiber through the cell membrane. In contrast, metabolic waste is discarded outside the cell membrane and removed by blood vessels. The formation of a functional, integrated vascular network is a fundamental process in the growth and maintenance of skeletal muscle. On the other hand, vascularization is one of the main central components in skeletal muscle regeneration. In order for regeneration to occur, blood vessels must invade the transplanted muscle. This is confirmed by the fact that muscle regeneration occurred from the outside of the muscle bundle toward the inner regions. In fact, it is likely that capillary formation is a key process to start muscle regeneration. Thus, vascularization activates muscle regeneration, and a decrease in vascularization could lead to disruption the process of muscle regeneration. Also, a better understanding of vascularization of skeletal muscle necessary for the successful formation of collateral arteries and recovery of injured skeletal muscle may lead to more successful strategies for skeletal muscle regeneration and engineering. So, in this chapter, we want to review vascularization in skeletal muscle

Endodontic Surgery of a Symptomatic Overfilled MTA Apical Plug: A Histological and Clinical Case Report

This case report presents the successful surgical treatment of a symptomatic open apex upper central incisor with a failed overfilled mineral trioxide aggregate (MTA) apical plug. Unintentional overextension of the MTA had occurred two years before the initial visit. An apical lesion adjacent to the excess MTA was radiographically detectable. Endodontic surgery was performed using calcium-enriched mixture (CEM) cement as a root-end filling material. Curettage of the apical lesion showed a mass of unset MTA particles; histopathological examination revealed fragments of MTA and granulation tissues. Up to 18-month follow-up, the tooth was clinically asymptomatic and fully functional. Periapical radiograph and CBCT images showed a normal periodontal ligament around the root. In conclusion, favorable outcomes in this case study suggested that root-end filling with CEM cement might be an appropriate approach; in addition, however many factors probably related to the initial failure of the case, the extrusion of MTA into the periapical area should be avoided.Keywords: Apical barrier; Apicoectomy; Calcium-Enriched Mixture; CEM Cement; Endodontics; MTA; Surgical treatmen

Patient-centered endodontic outcomes: a narrative review.

IntroductionRoot canal treatment (RCT) success criteria inform us of the path to bony healing and of prognostic factors, but tell little about how the patient perceives, feels, or values RCT. Patients choose, undergo, and pay for RCT, they live with the result, and inform their community. The purpose of this narrative review was to appraise patient-centered outcomes of initial non-surgical RCT and nonsurgical retreatment, in adults.Materials and methodsPatient-centered RCT outcome themes were identified in the extant literature: quality of life, satisfaction, anxiety, fear, pain, tooth survival and cost. Narrative review was applied because the disparate themes and data were unsuited to systematic review or meta-analysis.ResultsApplication of the Oral Health Impact Profile (OHIP) demonstrated that disease of pulpal origin affects quality of life with moderate severity, primarily through physical pain and psychological discomfort, and that RCT results in broad improvement of quality of life. Satisfaction with RCT is extremely high, but cost is the primary reason for dissatisfaction. Anxiety and fear affect RCT patients, profoundly influencing their behaviors, including treatment avoidance, and their pain experience. Fear of pain is "fair" to "very much" prior to RCT. Pain is widely feared, disliked, and remembered; however, disease of pulpal origin generally produces moderate, but not severe pain. RCT causes a dramatic decrease in pain prevalence and severity over the week following treatment. Survival rates of teeth after RCT are very high; complication rates are low. Cost is a barrier to RCT, but initial costs, lifetime costs, cost effectiveness, cost utility, and cost benefit all compare extremely well to the alternatives involving replacement using implants or fixed prostheses.ConclusionDentists must strive to reduce anxiety, fear, experienced and remembered pain, and to accurately inform and educate their patients with respect to technical, practical and psychosocial aspects of RCT

Designing Biologically Inspired Movements into the Esthetics of Interactive Artifacts

Biological creatures have a variety of qualities that inspire design esthetics such as form, color, texture, structure, mechanics, and dynamics. This paper presents a biology-to-design approach as a design research method for adapting biological movements into the design of the kinetic and interactive esthetics of jewelry artifacts. It describes a preliminary study in which prototypes were developed by identifying and classifying the biophilic movements of small creatures, in consultation and collaboration with a biologist. It details how the biological insights were adapted into ideation concepts: beginning with a brainstorming workshop followed by further iterative sketching and prototyping. It adds to the literature on methods for taking design inspiration from nature, in particular, in the area of kinetic product esthetics

Correlation of vascularization and inflammation with severity of oral Leukoplakia

Background & objective: Changes in submucosal vascularization and inflammation, determined by immunohistochemistry staining, were shown to be correlated with the development of dysplasia and invasiveness of epithelial cells in premalignant and malignant lesions. This study evaluated changes in sections routinely stained with Hematoxylin and Eosin (H&E) in order to investigate vascular density and intensity of inflammatory cells infiltration during the progression of oral leukoplakia with mild dysplasia to Squamous Cell Carcinoma (SCC).The aim of the research was to determine whether changes in sub-mucosal vascularity and inflammatory infiltration of leukoplakia in routine H&E-stained sections could contribute to the assessment of severity of the lesion. Methods: In this cross-sectional, comparative and descriptive study, vascular density and inflammation intensity of 125 available samples of H&E-stained sections, consisting of 35 cases of mild and moderate dysplasia, 38 severe dysplasia and carcinoma in situ, and 52 SCC, were investigated. To analyze the data, chi-square test, Mann-Whitney test, Kruskal-Wallis test, Tukey’s post hoc test, and cumulative ordinal logistic regression were conducted. Results: There was a significantly higher vascular density in cases with severe dysplasia, in situ carcinoma, and SCC compared to those with mild to moderate dysplasia (P<0.0001). However, the difference in vascularity was not statically significant between severe dysplasia, carcinoma in situ, and SCC (P=0.78). Intensity of inflammatory cells infiltration in the underlying connective tissue was significantly different among the three groups (P<0.0001), and the highest intensity of inflammatory cells infiltration was seen in the SCC group. Conclusions: Increased submucosal vascularization and inflammatory cells infiltration can contribute further to predicting more aggressive epithelial dysplasia

Effect of home-based walking on performance and quality of life in patients with heart failure

Introduction: Chronic heart failure defined as the inability of the heart to meet the demands of the tissues, which results in symptoms of fatigue or dyspnoea on energy progressing to dyspnoea at rest. The inability to perform the exercise without discomfort and poor quality of life may be one of the first symptoms experienced by patients with heart failure and is often the principal reason for seeking medical care. Objectives: The aim of the study was to find the effect of a home walking programme on the performance and quality of life in the patients with heart failure. Methods and results: Sixty patients with New York Heart Association class II and III heart failure were divided into two matched and equal groups. The quality of life scores and 6-minute walking scores were measured for each patient at entry and after 8weeks. Both groups were followed for 8weeks. The results showed between mean walking distance on the 6minutes at entry and after 8weeks in the training group (p<0.001), but no significance was seen between the control groups (p=0.351). Furthermore, results showed a significant difference between mean of quality of life scores at entry and after 8weeks in the training group, but such significance was not reported between before and after control group scores. Conclusion: The home-based walking showed improvement in the performance, exercise tolerance time and quality of life in heart failure patients. Therefore, Nurses should employ alternatives such as home exercises in the caring of heart failure patients. © 2012 Nordic College of Caring Science

Survey of the foot care status in type II diabetic patients: application of the theory of Planned Behavior

زمینه و هدف: در بین عوارض ناشی از بیماری دیابت، مشکلات پا نظیر زخم یا عفونت پاها و آمپوتاسیون های اندام تحتانی ناشی از عدم رعایت مسائل ایمنی و پیشگیرانه در حال افزایش است؛ لذا مطالعه حاضر با هدف ارزیابی وضعیت مراقبت از پا در مبتلایان به دیابت با استفاده از نظریه رفتار برنامه ریزی شده انجام شد. روش بررسی: در این مطالعه توصیفی- مقطعی، 69 بیمار مبتلا به دیابت نوع دو مراجعه کننده به کلینیک دیابت بیمارستان گلستان اهواز طی یک دوره سه ماهه از خرداد تا شهریور ماه 1392 به صورت تصادفی انتخاب شدند. داده ها با استفاده از پرسشنامه پژوهشگر ساخته (59 سوال) مشتمل بر سه بخش اطلاعات دموگرافیک، طبی و آگاهی، ابعاد نظریه رفتار برنامه ریزی شده (نگرش، هنجار انتزاعی، کنترل رفتاری درک شده و قصد رفتاری) و عملکرد مراقبت از پا جمع آوری و ارزیابی شدند. یافته ها: آگاهی 60/53 از شرکت کنندگان در زمینه فعالیت های مراقبت از پا ضعیف بود؛ در حالی که 71/79 نگرش بالایی به انجام این فعالیت ها داشتند. 17/52 فشارها و حمایت های اجتماعی را در حد بالا و 10/52 سطح متوسطی از کنترل بر این فعالیت ها را گزارش نمودند. اکثریت افراد (70/79) قصد بالایی جهت انجام این فعالیت ها را گزارش نمودند؛ در حالی که 40/43 عملکرد ضعیفی داشتند. همبستگی مستقیم و معنی داری بین میانگین نمره آگاهی و عملکرد با تمام سازه های نظریه رفتار برنامه ریزی شده مشاهده شد (05/0>P). نتیجه گیری: نتایج این مطالعه بر لزوم توجه به مجموعه ای از عوامل موثر در تغییر رفتار مبتلایان به دیابت تآکید داشته و می تواند مبنای توسعه مداخلات آموزشی نظریه محور با هدف ارتقای عملکرد مراقبت از پا قرار گیرد