Perdido Key Beach nourishment project: Gulf Islands National Seashore 1992 annual report

This report is the third annual report in a continuing series documenting a field project within the Gulf Islands National Seashore at Perdido Key, Florida. The field project includes the monitoring of a number of physical parameters related to the evolution of the Perdido Key beach nourishment project. Approximately 4.1 million m3 of dredge spoil from Pensacola Pass were placed upon approximately 7 km of the Gulf of Mexico beaches and 3 million m3 offshore of Perdido Key between November, 1989, and October, 1991. Beach profile data describing the evolution of the nourished beach are included, as well as wave, current, tide, wind, temperature, and rainfall data to describe the forces influencing the evolution. Data describing the sediment sizes throughout the project area are also included. A brief discussion of the data is included with an emphasis on evolution of the beach and offshore nourishment. (Document contains 249 pages.

KINERJA SIMPANG TAK BERSINYAL DI KOTA MANADO (STUDI KASUS: JALAN SAM RATULANGI, WINANGUN)

Kota Manado adalah salah satu kota di Indonesia yang memiliki luas wilayah sebesar 157,26 km2 serta jumlah penduduknya kurang lebih 527.007 jiwa, mamiliki berbagai permasalahan lalu lintas yang sangat kompleks sehingga menejemen lalu lintas serta pengaturan geometrik jalan perlu dilakukan demi kelancaran sistem transportasi yang ada di Manado dan permasalahan simpang menjadi salah satu hal yang perlu menjadi perhatian khusus. Pada simpang Jalan Sam Ratulangi dan Jalan Harapan kelurahan Winangun 1 kecamatan Malalayang kota Manado adalah simpang lengan tiga tak bersinyal. Simpang tersebut merupakan kawasan komersil yang sering terjadi kemacetan yang di sebabkan oleh berbagai faktor. Dari hasil penelitian yang dilakukan selama 6 hari (senin-sabtu) dan berpedoman Manual Kapasitas Jalan Indonesia 1997, volume lalu lintas tertingggi mencpai 379 smp/jam, derajat kejenuhan (Degree Saturation/DS) sebesar 1,048, dengan tundaan rata-rata 27 det/smp serta peluang antrian dengan rentang nilai 44,275% - 88,011 %. Hal ini mengindikasikan simpang tersebut sudah sangat jenuh (over saturated). Oleh karena itu simpang di winangun ini sudah seharusnya dilakukan pelebaran jalan serta membuat trotoar yang memadai untuk pejalan kaki agar tidak berjalan di badan jalan, sehingga diharapkan tidak terjadi gangguan hambatan samping yang mengganggu kinerja simpang. Kata Kunci: Simpang tak bersinyal, Derajat kejenuhan, Tundaan, Peluang Antria

ANALISIS BIAYA RANSUM PENGGUNAAN SERBUK GERGAJI HASIL REKAYASA SEBAGAI PENGANTI SEBAGIAN RANSUM ITIK PETELUR DI DESA TOUNELET KECAMATAN KAKAS KABUPATEN MINAHASA

ABSTRACT   ANALYSIS OF FEED COST USING SAWDUST ENGINEERING AS PART IN RATION OF LAYER DUCK AT TOUNELET VILLAGE, KAKAS DISTRICT, MINAHASA REGENCY. Duck was one animal species developed by communities as their source of income at Tounelet village. Animal feed cost was the main problem due to limitation of feed ingredient materials. Sawdust was saw-mill by-product containing high lignin. Lignin could be reduced by engineering method. The objective of this study was to evaluate feed cost using sawdust engineering as part in ration of layer duck at Tounelet village, Kakas district of Minahasa regency. Total oh sixty layer duck was used in this study fed ration containing part of sawdust engineering. Primer and secunder data were collected during two months. Results showed that the highest feed cost of layer duck was found in ration without sawdust engineering. The lowest feed cost was found in ration consisted of 40 percents based ration and 60 percents parts of sawdust engineering. Therefore, it can be concluded that utilization of parts of sawdust engineering was more efficient in layer duck ration. Key words: ration, sawdust engineering, layer duck

PERCEPÇÃO DA ENFERMAGEM EM RELAÇÃO A ATENÇÃO HOSPITALAR DADA PARA PESSOAS QUE VIVEM COM HIV

Given the epidemiological context in Chile concerning the increased quantities of people with HIV, improving the care given to these patients becomes relevant. The objective of this research is to find about the perception of nurses concerning the care given to people living with HIV (PLHIV) in a tertiary health care hospital service, seeking to contribute to nursing improvements. In order to accomplish this task a qualitative research paradigm was used as a type of case study, collecting the information with a semi-structured interview, ending with a semiotic analysis of the discourse. It was pointed out that in the first sessions there is some fear generated in the attention to PLHIV, which gradually disappears with the increase of the professional’s knowledge. Participating nurses referred to the lack of differences in care between PLHIV and other patients, evidencing incongruence between the speech and the action by taking greater precautions when performing procedures for PLHIV. The strengths identified in the attention to PLHIV were the no discrimination to these patients, the ability to face different contexts of attention and the procedural skills, among others, while aspects to improvement in care were linked to the relationship that is generated with PLHIV and their families. In conclusion, nurses do not make noticeable distinctions in the care of PLVIH. It is important that professionals recognize their skills and the aspects that can be improved in order to continue humanizing the attention to PLHIV, acting as educators and agents of change.Dado el contexto epidemiológico en Chile referente al alza de la cantidad de personas con VIH, cobra relevancia el fortalecimiento del cuidado otorgado a estos pacientes. Por esto, el objetivo de esta investigación es conocer la percepción de enfermeras(os) respecto a la atención otorgada a personas que viven con VIH (PVVIH) en un servicio hospitalario de atención terciaria de salud, buscando contribuir a la enfermería. Para ello se utilizó un paradigma de investigación cualitativo tipo estudio de caso, recolectando la información con una entrevista semiestructurada, finalizando con un análisis del discurso de tipo semiótico. Se destacó que en las primeras atenciones se generaba “temor” en la atención a PVVIH, el que desaparecía a medida que aumentaban los conocimientos de la(el) profesional. Enfermeras(os) participantes refirieron la inexistencia de diferencias en la atención entre PVVIH y otros pacientes, evidenciándose una incongruencia entre el discurso y el actuar en enfermería al ocupar mayores medidas de precaución al realizar procedimientos a PVVIH. Como fortalezas identificadas en la atención a PVVIH se encontró el no discriminar a pacientes, la capacidad de enfrentar distintos contextos de atención y la destreza procedimental, entre otras, mientras que los aspectos a mejorar en la atención se vincularon con la relación que se genera con los PVVIH y sus familiares. Como conclusión, las(os) enfermeras(os) no hacen mayores distinciones en la atención con PVVIH. Es importante que las(os) profesionales reconozcan sus habilidades y aspectos a mejorar para seguir humanizando la atención a PVVIH, siendo agentes educadores y de cambio.Dado o contexto epidemiológico no Chile referente ao aumento das pessoas com HIV, é relevante a necessidade de fortalecer os cuidados desses pacientes. Devido a isso, o objetivo de esta pesquisa é conhecer a percepção de enfermeiros(as) em relação a atenção fornecida para as pessoas que vivem com HIV num serviço hospitalar de atenção terciária em saúde, buscando contribuir para a disciplina e profissão de enfermagem. Para isso se utilizou um paradigma de pesquisa qualitativo tipo estudo de caso, o meio para reunir informação foi a entrevista semiestruturada, finalizando com uma análise de discurso.Destacou que nas primeiras atenções de pessoas portadoras de HIV o “temor” era perceptível. “Temor” que desaparecia à medida que o conhecimento do profissional aumentava. Enfermeiros(as) participantes falaram que não existe diferença alguma na forma de atenção de pacientes portadores de HIV, mas se notou uma incongruência entre o discurso e a atuação da enfermagem ao tomar maiores medidas de precaução no momento de realizar procedimentos com esses pacientes. Pontos fortes identificados na atenção de portadores de HIV foram a não discriminação dos pacientes, a capacidade de enfrentar-se a distintos contextos na atenção, as habilidades de procedimentos, entre outras. Enquanto aos aspectos a melhorar na atenção se vincularam com a relação que se gera como os pacientes portadores de HIV e seus familiares Como conclusão os enfermeiros(as) não fazem maiores distinções na atenção de pacientes com HIV. É importante que os profissionais reconheçam suas habilidades e pontos para melhorar e assim continuar avançando na humanização da atenção dos portadores de HIV conseguindo ser agentes educadores e de mudança

A Hybrid Fuzzy Multi-criteria Decision Making Model to Evaluate the Overall Performance of Public Emergency Departments: A Case Study

[EN] Performance evaluation is relevant for supporting managerial decisions related to the improvement of public emergency departments (EDs). As different criteria from ED context and several alternatives need to be considered, selecting a suitable Multicriteria Decision-Making (MCDM) approach has become a crucial step for ED performance evaluation. Although some methodologies have been proposed to address this challenge, a more complete approach is still lacking. This paper bridges this gap by integrating three potent MCDM methods. First, the Fuzzy Analytic Hierarchy Process (FAHP) is used to determine the criteria and sub-criteria weights under uncertainty, followed by the interdependence evaluation via fuzzy Decision-Making Trial and Evaluation Laboratory(FDEMATEL). The fuzzy logic is merged with AHP and DEMATEL to illustrate vague judgments. Finally, the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) is used for ranking EDs. This approach is validated in a real 3-ED cluster. The results revealed the critical role of Infrastructure (21.5%) in ED performance and the interactive nature of Patient safety (C+R =12.771). Furthermore, this paper evidences the weaknesses to be tackled for upgrading the performance of each ED.Ortiz-Barrios, M.; Alfaro Saiz, JJ. (2020). A Hybrid Fuzzy Multi-criteria Decision Making Model to Evaluate the Overall Performance of Public Emergency Departments: A Case Study. International Journal of Information Technology & Decision Making. 19(6):1485-1548. https://doi.org/10.1142/S0219622020500364S14851548196Lord, K., Parwani, V., Ulrich, A., Finn, E. B., Rothenberg, C., Emerson, B., … Venkatesh, A. K. (2018). Emergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service. The American Journal of Emergency Medicine, 36(7), 1246-1248. doi:10.1016/j.ajem.2018.03.043Sørup, C. M., Jacobsen, P., & Forberg, J. L. (2013). 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K., Govindan, K., Antucheviciene, J., & Turskis, Z. (2016). Hybrid multiple criteria decision-making methods: a review of applications for sustainability issues. Economic Research-Ekonomska Istraživanja, 29(1), 857-887. doi:10.1080/1331677x.2016.1237302Lolli, F., Balugani, E., Ishizaka, A., Gamberini, R., Butturi, M. A., Marinello, S., & Rimini, B. (2019). On the elicitation of criteria weights in PROMETHEE-based ranking methods for a mobile application. Expert Systems with Applications, 120, 217-227. doi:10.1016/j.eswa.2018.11.030De Almeida Filho, A. T., Clemente, T. R. N., Morais, D. C., & de Almeida, A. T. (2018). Preference modeling experiments with surrogate weighting procedures for the PROMETHEE method. European Journal of Operational Research, 264(2), 453-461. doi:10.1016/j.ejor.2017.08.006Sun, G., Guan, X., Yi, X., & Zhou, Z. (2018). An innovative TOPSIS approach based on hesitant fuzzy correlation coefficient and its applications. Applied Soft Computing, 68, 249-267. doi:10.1016/j.asoc.2018.04.004Frazão, T. D. C., Camilo, D. G. G., Cabral, E. L. S., & Souza, R. P. (2018). Multicriteria decision analysis (MCDA) in health care: a systematic review of the main characteristics and methodological steps. BMC Medical Informatics and Decision Making, 18(1). doi:10.1186/s12911-018-0663-1Ortiz-Barrios, M. A., Herrera-Fontalvo, Z., Rúa-Muñoz, J., Ojeda-Gutiérrez, S., De Felice, F., & Petrillo, A. (2018). An integrated approach to evaluate the risk of adverse events in hospital sector. Management Decision, 56(10), 2187-2224. doi:10.1108/md-09-2017-0917Al Salem, A. A., & Awasthi, A. (2018). Investigating rank reversal in reciprocal fuzzy preference relation based on additive consistency: Causes and solutions. Computers & Industrial Engineering, 115, 573-581. doi:10.1016/j.cie.2017.11.027Aires, R. F. de F., & Ferreira, L. (2019). A new approach to avoid rank reversal cases in the TOPSIS method. Computers & Industrial Engineering, 132, 84-97. doi:10.1016/j.cie.2019.04.023Emrouznejad, A., & Yang, G. (2018). A survey and analysis of the first 40 years of scholarly literature in DEA: 1978–2016. Socio-Economic Planning Sciences, 61, 4-8. doi:10.1016/j.seps.2017.01.008Arya, A., & Yadav, S. P. (2017). Development of FDEA Models to Measure the Performance Efficiencies of DMUs. International Journal of Fuzzy Systems, 20(1), 163-173. doi:10.1007/s40815-017-0325-yMufazzal, S., & Muzakkir, S. M. (2018). A new multi-criterion decision making (MCDM) method based on proximity indexed value for minimizing rank reversals. Computers & Industrial Engineering, 119, 427-438. doi:10.1016/j.cie.2018.03.045Kaliszewski, I., & Podkopaev, D. (2016). Simple additive weighting—A metamodel for multiple criteria decision analysis methods. Expert Systems with Applications, 54, 155-161. doi:10.1016/j.eswa.2016.01.042Mousavi-Nasab, S. H., & Sotoudeh-Anvari, A. (2018). A new multi-criteria decision making approach for sustainable material selection problem: A critical study on rank reversal problem. Journal of Cleaner Production, 182, 466-484. doi:10.1016/j.jclepro.2018.02.062Chen, Z., Ming, X., Zhang, X., Yin, D., & Sun, Z. (2019). A rough-fuzzy DEMATEL-ANP method for evaluating sustainable value requirement of product service system. Journal of Cleaner Production, 228, 485-508. doi:10.1016/j.jclepro.2019.04.145Jumaah, F. M., Zadain, A. A., Zaidan, B. B., Hamzah, A. K., & Bahbibi, R. (2018). Decision-making solution based multi-measurement design parameter for optimization of GPS receiver tracking channels in static and dynamic real-time positioning multipath environment. Measurement, 118, 83-95. doi:10.1016/j.measurement.2018.01.011Singh, A., & Prasher, A. (2017). Measuring healthcare service quality from patients’ perspective: using Fuzzy AHP application. Total Quality Management & Business Excellence, 30(3-4), 284-300. doi:10.1080/14783363.2017.1302794Otay, İ., Oztaysi, B., Cevik Onar, S., & Kahraman, C. (2017). Multi-expert performance evaluation of healthcare institutions using an integrated intuitionistic fuzzy AHP&DEA methodology. Knowledge-Based Systems, 133, 90-106. doi:10.1016/j.knosys.2017.06.028Awasthi, A., Govindan, K., & Gold, S. (2018). Multi-tier sustainable global supplier selection using a fuzzy AHP-VIKOR based approach. International Journal of Production Economics, 195, 106-117. doi:10.1016/j.ijpe.2017.10.013Gul, M., Guneri, A. F., & Nasirli, S. M. (2018). A fuzzy-based model for risk assessment of routes in oil transportation. International Journal of Environmental Science and Technology, 16(8), 4671-4686. doi:10.1007/s13762-018-2078-zKazancoglu, Y., Kazancoglu, I., & Sagnak, M. (2018). Fuzzy DEMATEL-based green supply chain management performance. 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Multi-criteria decision analysis for supporting the selection of medical devices under uncertainty. European Journal of Operational Research, 247(1), 216-228. doi:10.1016/j.ejor.2015.05.075Kovacs, E., Strobl, R., Phillips, A., Stephan, A.-J., Müller, M., Gensichen, J., & Grill, E. (2018). Systematic Review and Meta-analysis of the Effectiveness of Implementation Strategies for Non-communicable Disease Guidelines in Primary Health Care. Journal of General Internal Medicine, 33(7), 1142-1154. doi:10.1007/s11606-018-4435-5Morley, C., Unwin, M., Peterson, G. M., Stankovich, J., & Kinsman, L. (2018). Emergency department crowding: A systematic review of causes, consequences and solutions. PLOS ONE, 13(8), e0203316. doi:10.1371/journal.pone.0203316Hermann, R. M., Long, E., & Trotta, R. L. (2019). Improving Patients’ Experiences Communicating With Nurses and Providers in the Emergency Department. Journal of Emergency Nursing, 45(5), 523-530. doi:10.1016/j.jen.2018.12.001Hawley, K. L., Mazer-Amirshahi, M., Zocchi, M. S., Fox, E. R., & Pines, J. M. (2015). Longitudinal Trends in U.S. Drug Shortages for Medications Used in Emergency Departments (2001-2014). Academic Emergency Medicine, 23(1), 63-69. doi:10.1111/acem.12838Stang, A. S., Crotts, J., Johnson, D. W., Hartling, L., & Guttmann, A. (2015). Crowding Measures Associated With the Quality of Emergency Department Care: A Systematic Review. Academic Emergency Medicine, 22(6), 643-656. doi:10.1111/acem.12682Chanamool, N., & Naenna, T. (2016). Fuzzy FMEA application to improve decision-making process in an emergency department. Applied Soft Computing, 43, 441-453. doi:10.1016/j.asoc.2016.01.007Farup, P. G. (2015). Are measurements of patient safety culture and adverse events valid and reliable? Results from a cross sectional study. BMC Health Services Research, 15(1). doi:10.1186/s12913-015-0852-xCarter, E. J., Pouch, S. M., & Larson, E. L. (2013). The Relationship Between Emergency Department Crowding and Patient Outcomes: A Systematic Review. Journal of Nursing Scholarship, 46(2), 106-115. doi:10.1111/jnu.12055Ebben, R. H. A., Siqeca, F., Madsen, U. R., Vloet, L. C. M., & van Achterberg, T. (2018). Effectiveness of implementation strategies for the improvement of guideline and protocol adherence in emergency care: a systematic review. BMJ Open, 8(11), e017572. doi:10.1136/bmjopen-2017-017572Innes, G. D., Sivilotti, M. L. A., Ovens, H., McLelland, K., Dukelow, A., Kwok, E., … Chochinov, A. (2018). Emergency overcrowding and access block: A smaller problem than we think. CJEM, 21(2), 177-185. doi:10.1017/cem.2018.446Di Somma, S., Paladino, L., Vaughan, L., Lalle, I., Magrini, L., & Magnanti, M. (2014). Overcrowding in emergency department: an international issue. Internal and Emergency Medicine, 10(2), 171-175. doi:10.1007/s11739-014-1154-8Uthman, O. 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Olimpik eğitim ilkelerinin, kalkınma ve barış için spor hedefleri ile uyumluluğunun incelenmesi

Amaç: Bu araştırmanın amacı, Olimpizm değerleri ile şekillenen “Olimpik Eğitim” ilkelerinin, toplumsal kalkınmayı ve barış unsurunu, spor yolu ile desteklemeyi amaçlayan “Kalkınma ve Barış için Spor” hedefleri ile uyumluluğunun, ilgili kavramların fikirsel gelişimi, uygulama alanları ve uygulama sonrası değerlendirmeleri temelinde incelenmesidir. Gereç ve Yöntem: Bu çalışmada Nitel Araştırma Yöntemi kullanılmış, veri toplama ve analiz için olgubilim (fenomenoloji/phenomenology) deseni seçilmiştir. Amaçlı örnekleme yöntemi ile olgu ve olayların keşfedilmesi ve açıklanması hedeflenmiştir. Araştırma konusunu oluşturan kavramlar ile ilgili bilgi ve birikime sahip olduğu düşünülen kişiler ile yüzyüze görüşmeler gerçekleştirilmiştir. Görüşme sonucu elde edilen veriler betimsel analiz yolu ile derlenmiş, içerik analizi yolu ile incelenmiştir.Bulgular: Yapılan analiz sonucunda, kavramsal çerçeveyi oluşturan beş ana başlık temelinde konumlandırılan 11 ana tema ve iki alt tema belirlenmiş ve açıklanmıştır.Sonuçlar: Olimpik Eğitim ile Kalkınma ve Barış için Spor kavram ve uygulamalarının birbirini tamamladığı; uygulamaların yöneltildiği hedef kitlenin süreçte aktif rol alması, söz konusu kavramlar ile ilgili politika belgelerinde kabul gören kararların uygulamaya etkin bir şekilde aktarılması, konuya paydaş olan tüm unsurların iş birliği ve koordinasyon içinde olması, sürdürülebilirlik ilkesinin her aşamada gözetilmesi, Birleşmiş Milletler ve Uluslararası Olimpiyat Komitesi’nin stratejik ortaklığının dengeli ve kavramlara eşit mesafede, aktif olarak sürdürülmesi gerektiği sonuçlarına varılmıştır.--------------------Aim: The aim of this study is to explore the compatibility between “Olympic Education”, which has been shaped by Olympism values and “Sport for Development and Peace” that aims to support development and peace through sport, by examining their historical evolution in terms of ideas; the scopes of practice and the critics about their goals and implementation.Materials and Methods: In this research, Qualitative Descriptive Research Methods have been used and Phenomenology has been chosen as the research design which is considered as an instructive method for collecting and analyzing data. It has been aimed to explore the subject by using Purposive sampling method. As data collection method Interview technique has been used to gather the opinions of the interviewers whom are thought to have knowledge and experience upon the research subject. The data has been organized through Descriptive analysis and assessed through Content analysis method.Results: Accordingly, 11 main themes, two sub-themes have been identified that are built upon five concepts of conceptual framework.Conclusion: It has been deduced that Olympic Education and Sport for Development and Peace programme complement each other in terms of conceptual basis and practice. It has been also conceived that the target groups of the programmes have to take active roles in the process; the measures of the policy resolutions on these subjects, have to be fully and effectively implemented; all stakeholders should be in cooperation / coordination; sustainability should be maintained through the process; the strategic partnership between UN and IOC should be sustained on equal basis