412 research outputs found
Enhancing the Properties of Marl Soils for Effective Construction in Saudi Arabian Region
Marl, containing primarily carbonate (CaCO3) and clays of different percentages with occasional traces of organic matter, silt or sand is usually used as bases and sub-bases for roads and highways. Marl is usually used as sub-grade layers or as a backfill in base and sub-base layers for roads and highways. This type of soil has poor strength and high water sensitivity; a drastic loss of bearing capacity may occur upon immersion.Due to its poor strength and high water sensitivity, appropriate treatment from engineering perspective is necessary before such soils are recommended for use in any construction project. Critical analysis of different stabilization techniques employed in Saudi Arabia for last 30 years has been carried to find the best technique. Mechanical and chemical treatments were found to be more economical than Drainage, dewatering and other techniques. It has been noticed that no study was done in stabilization of Marl Soil using Geo-synthetics technique Hence, it can be an alternate way for future research to improve marl.Marl, containing primarily carbonate (CaCO3) and clays of different percentages with occasional traces of organic matter, silt or sand is usually used as bases and sub-bases for roads and highways. Marl is usually used as sub-grade layers or as a backfill in base and sub-base layers for highway pavements. This type of soil has poor strength and high water sensitivity; a drastic loss of bearing capacity may occur upon immersion. Due to its poor strength and high water sensitivity, appropriate treatment from engineering perspective is necessary before such soils are recommended for use in any construction project effectively. Critical analysis of different stabilization techniques employed for enhancing the marl soil properties in Saudi Arabia for the last 30 years has been carried out to find the best engineering solution. Mechanical and chemical treatments were found to be more economical than drainage, dewatering and other techniques. It has been noticed that no study was done in stabilization of Marl Soil using Geo-synthetics technique Hence, it can be an alternate way for future research to improve marl
Impact of Removing Cost Sharing Under the Affordable Care Act (Aca) on Mammography and Pap Test Use
Background The Affordable Care Act (ACA) required private insurers and Medicare to cover recommended preventive services without any cost sharing to improve utilization of these services. This study is an attempt to identify the impact of removing cost sharing on mammography and pap test utilization rates.
Methods Counterfactual analysis was used to predict what would have been the screening rates in post-ACA if ACA was not there. This was done by estimating a model that examines determinants of dependent variable for the pre-ACA year (pre-ACA year is 2009). The estimated model was then used to predict the dependent variable for the post-ACA year using individual characteristics and other relevant variables unlikely to be affected by ACA (post-ACA year is 2016). Effect of ACA is defined as the difference between the values of dependent variables in post-ACA and the predicted values of dependent variables in the post-ACA year using counterfactual.
Results The counterfactual analysis show that the utilization of mammogram and pap test did not improve following ACA.
Conclusion Removal of cost-sharing under the ACA did not improve mammography or pap test rates. Therefore, financial barrier may not be an important factor in affecting utilization of the screening tests and policy makers should focus on other non-financial barriers in order to improve coverage of the tests
Case-control study of suicide in Karachi, Pakistan
Background: In recent years suicide has become a major public health problem in Pakistan. Aims: To identify major risk factors associated with suicides in Karachi, Pakistan. Method: A matched case-control psychological autopsy study. interviews were conducted for 100 consecutive suicides, which were matched for age, gender and area of residence with 100 living controls. Results: Both univariate analysis and conditional logistic regression model results indicate that predictors of suicides in Pakistan are psychiatric disorders (especially depression), marital status (being married), unemployment, and negative and stressful life events. only a few individuals were receiving treatment at the time of suicide. None of the victims had been in contact with a health professional in the month before suicide. Conclusions: Suicide in Pakistan is strongly associated with depression, which is under-recognised and under-treated, The absence of an effective primary healthcare system in which mental health could be integrated poses unique challenges for suicide prevention in Pakistan
Impact of Medicaid Coverage Expansion Under the Affordable Care Act on Mammography and Pap Tests Utilization Among Low-Income Women
Introduction The Affordable Care Act (ACA) expanded the coverage of Medicaid to include entire population with income below 138% of federal poverty line. It remains unclear whether this policy change has improved access to and utilization of health care, particularly use of mammography and Pap tests among poor women.
Methods We used a difference-in-difference (DID) design to estimate the impact of Medicaid expansion on mammography and Pap tests utilization among low-income women. Expansion states are the treatment group and non-expansion states are the control group. The years 2012–13 are the pre-expansion period and 2015–16 are the post-expansion period for the purpose of estimating the DID parameters.
Results The difference-in-difference estimate show that likelihood of utilizing mammograms did not change significantly among low-income women after the implementation of Medicaid expansion (DID coefficient -0.0476 with t-statistics at -1.26), Pap test decreased (coefficient -0.0615, t-statistics -2.76), and Medicaid enrollment has increased significantly among low-income women living in expansion states (coefficient 0.0889 with t-value of 3.68).
Conclusion Expansion of Medicaid was associated with increased Medicaid enrollment but did not yield near-term improvement in use of mammography and Pap tests among low-income women. Factors beyond health insurance coverage may be important in determining the likelihood of obtaining these screenings. Policy makers should try to identify other barriers to cancer screenings among low-income women in the USA
Antenatal Care Satisfaction in a Developing Country: A Cross-Sectional Study From Nigeria
Background
Utilization of Antenatal Care (ANC) is very low in Nigeria. Self-reported patient satisfaction may be useful to identify provider- and facility-specific factors that can be improved to increase ANC satisfaction and utilization. Methods
Exit interview data collected from ANC users and facility assessment survey data from 534 systematically selected facilities in four northern Nigerian states were used. Associations between patient satisfaction (satisfied, not-satisfied) and patient ratings of the provider’s interactions, care processes, out-of-pocket costs, and quality of facility infrastructure were studied. Results
Of 1336 mothers, 90% were satisfied with ANC. Patient satisfaction was positively associated with responsive service (prompt, unrushed service, convenient clinic hours and privacy during consultation, AOR 2.42, 95% CI 2.05–2.87), treatment-facilitation (medical care-related provider communication and ease of receiving medicines, AOR 2.03, 95% CI 1.46–2.80), equipment availability (AOR 1.10, 95% CI 1.01–1.21), staff empathy (AOR 1.82, 95% CI 1.03–3.23), non-discriminatory treatment regardless of patient’s socioeconomic status (AOR: 1.87, 95% CI 1.09–3.22), provider assurance (courtesy and patient’s confidence in provider’s competence, AOR 1.48, 95% CI 1.26–1.75), and number of clinical examinations received (AOR 1.28, 95% CI 1.10–1.50). ANC satisfaction was negatively impacted by out-of-pocket payment for care (vs. free care, AOR 0.44, 95% CI 0.23–0.82). Conclusions
ANC satisfaction in Nigeria may be enhanced by improving responsiveness to clients, clinical care quality, ensuring equipment availability, optimizing easy access to medicines, and expanding free ANC services
Potential benefits of the 19-nor-clerodane trans-dehydrocrotonin on the central nervous system
This study examined the effect of trans-dehydrocrotonin (DCTN), a 19-nor-clerodane diterpene isolated from Croton cajucara Benth (Euphorbiaceae), as analgesic and its effect on the central nervous system (CNS) of rodents using different animal models. The DCTN intraperitoneally exhibited mild analgesic activity on hot-plate test, but exhibited strong antinociceptive activity against acetic acid-induced abdominal writhing and the ED50 was calculated to be 44.88 mg/kg. At higher doses (100 mg/kg) it exhibited mild CNS depressant activities in laboratory animals. Moreover, it has negligible antidepressant activity. After taking consideration of the drug interaction, the DCTN can be used as a potent analgesic agent in case of peripheral algesia, without affecting the CNS. Neste estudo avaliou-se o efeito analgésico do diterpeno 19-nor-clerodano trans-desidrocrotonina (DCTN) isolado de Croton cajucara Benth (Euphorbiaceae), bem como seu efeito no sistema nervoso central utilizando-se diferentes tipos de modelos de animais roedores. A administração intraperitoneal deste diterpeno, no teste da placa quente, revelou sua atividade analgésica moderada. No entanto, no teste de contrações abdominais desencadeadas por ácido acético, a DCTN apresentou forte atividade antinociceptiva com DE50 de 44,88 mg/kg. Doses elevadas de DCTN (100 mg/kg) apresentaram moderada atividade depressiva do sistema nervoso central (SNC), não tendo sido evidenciado ação antidepressiva. Após algumas considerações da ação de DCTN em algesia periférica, concluiu-se que esta substância pode ser utilizada como um potente agente analgésico, sem afetar o SNC
Environmental footprint assessment of a cleanup at hypothetical contaminated site
Contaminated site management is currently a critical problem area all over the world, which opens a wide discussion in the areas of policy, research and practice at national and international levels. Conventional site management and remediation techniques are often aimed at reducing the contaminant levels to an acceptable level in a short period of time at low cost. Owing to the fact that the conventional approach may not be sustainable as it overlooks many ancillary environmental effects, there is an immense need of “sustainable” or “green” approaches. Green approaches address environmental, social and economic impacts throughout the remediation process and are capable of conserving the natural resources and protecting air, water and soil quality through reduced emissions and other waste burdens. This paper presents a methodology to quantify the environmental footprint of a cleanup for a hypothetical contaminated site by using the US Environmental Protection Agency’s (EPA) Spreadsheet for Environmental Footprint Assessment (SEFA). The hypothetical contaminated site is selected from a metropolitan city of Pakistan and the environmental footprint of the cleanup is analyzed under three different scenarios: cleanup without any renewable energy sources at all, cleanup with a small share of renewable energy sources, and cleanup with a large share of renewable energy sources. It is concluded that integration of renewable energy sources into the remedial system design is a promising idea which can reduce CO2, NOx, SOx, PM and HAP emissions up to 68%
Insight into the impact of COVID-19 on Australian transportation sector : an economic and community-based perspective
The Coronavirus Disease 2019 (COVID-19) is a major virus outbreak of the 21st century. The Australian government and local authorities introduced some drastic strategies and policies to control the outspread of this virus. The policies related to lockdown, quarantine, social distancing, shut down of educational institute, work from home, and international and interstate travel bans significantly affect the lifestyle of citizens and, thus, influence their activity patterns. The transport system is, thus, severely affected due to the COVID-19 related restrictions. This paper analyses how the transport system is impacted because of the policies adopted by the Australian government for the containment of the COVID-19. Three main components of the transport sector are studied. These are air travel, public transport, and freight transport. Various official sources of data such as the official website of the Australian government, Google mobility trends, Apple Mobility trends, and Moovit were consulted along with recently published research articles on COVID-19 and its impacts. The secondary sources of data include databases, web articles, and interviews that were conducted with the stakeholders of transport sectors in Australia to analyse the relationship between COVID-19 prevention measures and the transport system. The results of this study showed reduced demand for transport with the adoption of COVID-19 prevention measures. Declines in revenues in the air, freight, and public transport sectors of the transport industry are also reported. The survey shows that transport sector in Australia is facing a serious financial downfall as the use of public transport has dropped by 80%, a 31.5% drop in revenues earned by International airlines in Australia has been predicted, and a 9.5% reduction in the freight transport by water is expected. The recovery of the transport sector to the pre-pandemic state is only possible with the relaxation of COVID-19 containment policies and financial support by the government
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