Design drivers for affordable and sustainable housing in developing countries

Current demand for housing worldwide has reached unprecedented levels due to factors such as human population growth, natural disasters and conflict. This is felt no more so than in developing countries which have experienced disproportionate levels of demand due to their innate vulnerability. Many current approaches to housing delivery in developing countries continue to utilize inappropriate construction methods and implementation procedures that are often problematic and unsustainable. As such affordability and sustainability are now vital considerations in the international development debate for housing the poor in developing countries in order to meet the long term sustainable development goals and needs of housing inhabitants. This paper utilized an extensive scoping study to examine the various facets impacting on design decision making relative to sustainable and affordable housing delivery in developing country contexts. Aspects of affordability, sustainability, design decision making, appropriate technology use, cultural awareness, as well as current barriers to affordable and sustainable construction in developing countries are examined in detail. Results highlighted the capability of indigenous knowledge, skills and materials as well as selected appropriate technology transfer and cultural awareness by foreign bodies can be utilized in innovative ways in addressing current housing needs in many developing country contexts

Factors accounting for the association between anxiety and depression, and eczema: the Hordaland health study (HUSK)

<p>Abstract</p> <p>Background</p> <p>The association between anxiety and depression, and eczema is well known in the literature, but factors underlying this association remain unclear. Low levels of omega-3 fatty acids and female gender have been found to be associated with both depression and eczema. Somatization and health anxiety are known to be associated with anxiety and depression, further, somatization symptoms and health anxiety have also been found in several dermatological conditions. Accordingly, omega-3 fatty acid supplement, female gender, somatization and health anxiety are possible contributing factors in the association between anxiety and depression, and eczema. The aim of the study is to examine the relevance of proposed contributing factors for the association between anxiety and depression, and eczema, including, omega-3 fatty acid supplement, female gender, health anxiety and somatization.</p> <p>Methods</p> <p>Anxiety and depression was measured in the general population (n = 15715) employing the Hospital Anxiety and Depression Scale (HADS). Information on eczema, female gender, omega-3 fatty acid supplement, health anxiety and somatization was obtained by self-report.</p> <p>Results</p> <p>Somatization and health anxiety accounted for more than half of the association between anxiety/depression, and eczema, while the other factors examined were of minor relevance for the association of interest.</p> <p>Conclusions</p> <p>We found no support for female gender and omega-3 fatty acid supplement as contributing factors in the association between anxiety/depression, and eczema. Somatization and health anxiety accounted for about half of the association between anxiety/depression, and eczema, somatization contributed most. The association between anxiety/depression, and eczema was insignificant after adjustment for somatization and health anxiety. Biological mechanisms underlying the mediating effect of somatization are yet to be revealed.</p

Factors Influencing Post-disaster Reconstruction Project Management for Housing Provision in the Gaza Strip, Occupied Palestinian Territories

In the Occupied Palestinian Territories, the Gaza Strip has suffered regular cycles of reconstruction due to systematic destruction during Israeli military operations, as in 2006, 2008–2009, 2012, and 2014. In this context of ongoing conflict this article aims to identify, rank, and discuss the most important factors influencing post-disaster reconstruction project management (PDRPM) for housing in the Gaza Strip. A set of key factors that influence PDRPM were assembled as a result of a global literature review. A questionnaire survey was conducted, and the obtained data were analyzed using a relative importance index for each PDRPM factor. Findings are presented in six groups: housing approaches, organizational behavior, project funding, supply chain and logistics, communication and coordination, and PDRPM context. Findings indicate that the most significant factors that influence PDRPM for housing provision in the Gaza Strip are related to issues associated with financial resources. It is critical that sufficient funding should be available in order to allow organizations to undertake housing projects in an effective and efficient way. Joint efforts are required from international donors and local organizations in order to effectively manage financial resources with the ultimate goal of improving PDRPM for housing provision

Polyethylene thickness is a risk factor for wear necessitating insert exchange

PURPOSE: The aim of this observational study was to investigate the optimal minimal polyethylene (PE) thickness in total knee arthroplasty (TKA) and identify other risk factors associated with revision of the insert due to wear. METHODS: A total of 84 TKA were followed for 11-16 years. All patients received the same prosthesis design (Interax; Howmedica/ Stryker) with halfbearings: separate PE-inserts medially and laterally. Statistical analysis comprised Cox-regression to correct for confounding. RESULTS: Eight knees (9.5%) had been revised due to thinning inserts and an additional patient is scheduled for revision. PE thickness, diagnosis, BMI and weight are risk factors for insert exchange. For each millimetre decrease in PE thickness, the risk of insert exchange increases 3.0 times, which remains after correction for age, gender, weight, diagnosis and femoral-tibial angle. Insert exchange was 4.73 times more likely in OA-patients compared to RA-patients. For every unit increase in BMI and weight the risk for insert exchange increases 1.40 times and 1.14 times, respectively. CONCLUSIONS: In conclusion we therefore advise against the use of thin PE inserts in modular TKA and recommend PE inserts with a minimal 8-mm thickness.Optimising joint reconstruction management in arthritis and bone tumour patient

The effect of high tibial osteotomy on the results of total knee arthroplasty: a matched case control study

BACKGROUND: We performed a matched case control study to assess the effect of prior high tibia valgus producing osteotomy on results and complications of total knee arthroplasty (TKA). METHODS: From 1996 until 2003 356 patients underwent all cemented primary total knee replacement in our institution. Twelve patients with a history of 14 HTO were identified and matched to a control group of 12 patients with 14 primary TKA without previous HTO. The match was made for gender, age, date of surgery, body mass index, aetiology and type of prosthesis. Clinical and radiographic outcome were evaluated after a median duration of follow-up of 3.7 years (minimum, 2.3 years). The SPSS program was used for statistical analyses. RESULTS: The index group had more perioperative blood loss and exposure difficulties with one tibial tuberosity osteotomy and three patients with lateral retinacular releases. No such procedures were needed in the control group. Mid-term HSS, KSS and WOMAC scores were less favourable for the index group, but these differences were not significant. The tibial slope of patients with prior HTO was significantly decreased after this procedure. The tibial posterior inclination angle was corrected during knee replacement but posterior inclination was significantly less compared to the control group. No deep infection or knee component loosening were seen in the group with prior HTO. CONCLUSION: We conclude that TKA after HTO seems to be technically more demanding than a primary knee arthroplasty, but clinical outcome was almost identical to a matched group that had no HTO previously