Sustainable development through innovative underground infrastructure construction practices

Underground infrastructure systems require repair or rehabilitation due to deterioration or third-party damage; while new installations are performed as a result of increase population growth and/or development. In particular, water and sewer networks are the lifeline for society’s stability. Unfortunately, a large percentage of worldwide population lack access to clean water and sanitation. Today, engineers are being tasked with the requirement of selecting suitable construction methods that not only offer the most economical solution, but also minimizes impact to the environment. Trenchless construction methods offer such sustainable solutions for installing new utilities and rehabilitating existing infrastructure using “green” principles. The environmental benefits of trenchless technologies for urban environments are discussed in this paper through a case study comparision between trenchless pipe replacement (or pipe bursting) and traditional open cut excavation. An emissions calculator program quantifies the impact of emitted emissions such as carbon dioxide (CO2), carbon monoxide (CO), nitrogen oxide (NOX), hydrocarbons (HC), sulphur oxide (SOX), and particulate matter (TM) into the atmosphere. The presented case study found trenchless pipe replacement to emit an average of 80% fewer emissions compared to the open cut alternative. These results demonstrate the merits of adopting trenchless technologies for sustainable development of underground infrastructure systems

Depression, anxiety and stress symptoms among diabetics in Malaysia: a cross sectional study in an urban primary care setting

BACKGROUND: Diabetes mellitus is a highly prevalent condition in Malaysia, increasing from 11.6% in 2006 to 15.2% in 2011 among individuals 18 years and above. Co-morbid depression in diabetics is associated with hyperglycemia, diabetic complications and increased health care costs. The aims of this study are to determine the prevalence and predictors of depression, anxiety and stress symptoms in Type II diabetics attending government primary care facilities in the urban area of Klang Valley, Malaysia. METHODS: The study was cross sectional in design and carried out in 12 randomly selected primary care government clinics in the Klang Valley, Malaysia. A total of 2508 eligible consenting respondents participated in the study. The Depression, Anxiety and Stress Scale (DASS) 21 questionnaire was used to measure depression, anxiety and stress symptoms. Data was analyzed using the SPSS version 16 software using both descriptive and inferential statistics. RESULTS: The prevalence of depression, anxiety and stress symptoms among Type II diabetics were 11.5%, 30.5% and 12.5% respectively. Using multiple logistic regression, females, Asian Indians, marital status (never married, divorced/widowed/separated), a family history of psychiatric illness, less than 2 years duration of diabetes and current alcohol consumption were found to be significant predictors of depression. For anxiety, unemployment, housewives, HbA1c level of more than 8.5%, a family history of psychiatric illness, life events and lack of physical activity were independent risk factors. Stress was significantly associated with females, HbA1c level of more than 8.5%, presence of co-morbidity, a family history of psychiatric illness, life events and current alcohol consumption. For depression (adjusted OR 2.8, 95% CI 1.1; 7.0), anxiety (adjusted OR 2.4, 95% CI 1.1;5.5) and stress (adjusted OR 4.2, 95% CI 1.8; 9.8), a family history of psychiatric illness was the strongest predictor. CONCLUSION: We found the prevalence of depression, anxiety and stress symptoms to be high among Type II diabetics, with almost a third being classified as anxious. Screening of high risk Type II diabetics for depression, anxiety and stress symptoms in the primary care setting is recommended at regular intervals

Bridging the gap in ageing: Translating policies into practice in Malaysian Primary Care

Population ageing is poised to become a major challenge to the health system as Malaysia progresses to becoming a developed nation by 2020. This article aims to review the various ageing policy frameworks available globally; compare aged care policies and health services in Malaysia with Australia; and discuss various issues and challenges in translating these policies into practice in the Malaysian primary care system. Fundamental solutions identified to bridge the gap include restructuring of the health care system, development of comprehensive benefit packages for older people under the national health financing scheme, training of the primary care workforce, effective use of electronic medical records and clinical guidelines; and empowering older people and their caregivers with knowledge, skills and positive attitudes to ageing and self care. Ultimately, family medicine specialists must become the agents for change to lead multidisciplinary teams and work with various agencies to ensure that better coordination, continuity and quality of care are eventually delivered to older patients across time and settings

Waste Water Force Main Pipe Construction Alternatives to Protect Existing Foundations in the City of Chandler: Case Study

To provide additional wastewater capacity and redundancy in South Chandler, Arizona, a new 28” High Density Polyethylene (HDPE) force main was installed from the upsized Kyrene Lift Station three miles east to tie into an existing 66” transmission sewer line. The force main was installed under the State Route Loop 202 (SR 202L) freeway through existing 48” steel casings constructed ten years prior. Additionally, the force main was constructed through a narrow Arizona Department of Transportation (ADOT) corridor, which required clearance from existing utilities, including overhead 69 kV power poles. Two locations required innovative solutions to both access the existing sleeves and cross the transmission power pole foundations: 1) crossing of the 69 kV power pole required detailed slope stability analysis and location specific trench backfilling; and 2) access to the existing 48” was within 15 feet of an existing ADOT sound wall. Various alternatives for access were analyzed in this paper including temporary shoring, sheet pile installation, and full wall replacement and reconstructing on drilled shafts. Based on the objectives above, the existing power pole does not have sufficient embedment for maximum design loads but is stable with reduced load factors and lower operation wind forces. Also, for construction issue with the existing ADOT sound wall, the temporary shoring and sheet piles used due to the geotechnical conditions and construction costs

Depression among secondary school students: a comparison between urban and rural populations

Introduction: Childhood depression is a debilitating psychiatric illness and has frequently been under-diagnosed. It is crucial to identify the condition early, as undetected cases may lead to detrimental psychosocial consequences in adulthood. Objective: The prevalence of depression among school children in Selangor and to compare it between urban and rural schools. Also to identify factors associated with depression in secondary school children. Method: 2 urban and 3 rural secondary schools were selected by 2-staged stratified random sampling to represent the population of secondary school children in the state of Selangor, Malaysia. A total of 2,048 school children were enrolled and the level of depression was measured by a self-rated scale, the Children’s Depression Inventory. Results: This study found that the prevalence of possible depressive students in Selangor was 10.3%. There was no difference in the prevalence of depression between rural and urban population. Factors associated with depression were being female, Chinese, parents with low educational level, and high number of siblings, smoking and alcohol abuse. Depression contributed significantly to suicidal tendencies. Conclusions: A sizable proportion of the secondary school children in this population potentially suffer from depression. Psychological interventions are needed to ease this psychological burden and ensure their well being. Key words: Depression, secondary school students, factors associated

Pilot study on depression among secondary school students in Selangor

A cross sectional descriptive study of 2048 subjects was conducted to determine the prevalence of depression and factors influencing depression among students in secondary school from urban and rural areas in the state of Selangor. Malaysia. The children's depression inventory (COl) developed by Maria Kovacs was used in this study. Students who participated in this study come from two urban schools and three rural schools. It was found that in the yield for scores for five factors were 9.2% have negative mood. 5% have interpersonal problems. 8.3% have ineffectiveness. 9.8% have anhedonia and 10.6% have negative self esteem. Following the interpretive guidelines for the T-scores. it was found that 10.3% of the students were much above average in the depression scale. This study also found that: 1% of students were smoking. 1.6% of students were gum sniffling. 0.9% took drugs. 4.1 % took alcohol and 9.9% took things from other people. Females were more depressed than males. The Chinese students were more depressed compared to Indian students. Students whose parents had no formal education or had only primary education were more depressed than students whose parents had secondary. college or university education. Depression increased with increasing number of siblings. Depression contributed to the habit of drug abuse. gum sniffing and stealing but not to smoking and alcohol abuse. Suicidal tendencies were more likely among the depressed students. It is imperative that not only caregivers but also teachers have to be equipped with the knowledge. attitude and skills to assist secondary school children cope with their emotions. handle conflicts and manage stress early so that a more productive society will develop in the future

A Randomised Controlled Trial of Two Infusion Rates to Decrease Reactions to Antivenom

Background: Snake envenoming is a major clinical problem in Sri Lanka, with an estimated 40,000 bites annually. Antivenom is only available from India and there is a high rate of systemic hypersensitivity reactions. This study aimed to investigate whether the rate of infusion of antivenom reduced the frequency of severe systemic hypersensitivity reactions. Methods and findings: This was a randomized comparison trial of two infusion rates of antivenom for treatment of non-pregnant adult patients (>14 y) with snake envenoming in Sri Lanka. Snake identification was by patient or hospital examination of dead snakes when available and confirmed by enzyme-immunoassay for Russell’s viper envenoming. Patients were blindly allocated in a 11 randomisation schedule to receive antivenom either as a 20 minute infusion (rapid) or a two hour infusion (slow). The primary outcome was the proportion with severe systemic hypersensitivity reactions (grade 3 by Brown grading system) within 4 hours of commencement of antivenom. Secondary outcomes included the proportion with mild/moderate hypersensitivity reactions and repeat antivenom doses. Of 1004 patients with suspected snakebites, 247 patients received antivenom. 49 patients were excluded or not recruited leaving 104 patients allocated to the rapid antivenom infusion and 94 to the slow antivenom infusion. The median actual duration of antivenom infusion in the rapid group was 20 min (Interquartile range[IQR]:20–25 min) versus 120 min (IQR:75–120 min) in the slow group. There was no difference in severe systemic hypersensitivity reactions between those given rapid and slow infusions (32% vs. 35%; difference 3%; 95%CI:−10% to +17%;p = 0.65). The frequency of mild/moderate reactions was also similar. Similar numbers of patients in each arm received further doses of antivenom (30/104 vs. 23/94). Conclusions: A slower infusion rate would not reduce the rate of severe systemic hypersensitivity reactions from current high rates. More effort should be put into developing better quality antivenoms

Phase Diagram for the Winfree Model of Coupled Nonlinear Oscillators

In 1967 Winfree proposed a mean-field model for the spontaneous synchronization of chorusing crickets, flashing fireflies, circadian pacemaker cells, or other large populations of biological oscillators. Here we give the first bifurcation analysis of the model, for a tractable special case. The system displays rich collective dynamics as a function of the coupling strength and the spread of natural frequencies. Besides incoherence, frequency locking, and oscillator death, there exist novel hybrid solutions that combine two or more of these states. We present the phase diagram and derive several of the stability boundaries analytically.Comment: 4 pages, 4 figure