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Kebutuhan obat non resep dokter dan keperluan medis menjadi salah satu kebutuhan yang sangat penting untuk dipenuhi dengan mudah,cepat, tepat, dan aman bagi masyarakat saat ini, beragamnya pilihan obat yang dijual mengharuskan masyarakat mampu memilih dengan cermat dan tepat dalam membeli obat sesuai dengan kebutuhan penyakit yang dialami,informasi tentang kandungan, aturan pakai dan efek samping dari obat juga sangat penting untuk diketahui masyarakat guna memaksimalkan maanfaat dari obat yang dikonsumsi. Sistem penjualan obat yang tersedia saat ini adalah dengan penjualan langsung di apotek, toko kelontong dan secara daring yang memiliki keterbatasan dalam sebaran ketersedian toko dan waktu pelayanan yang terbatas. Penelitian ini bertujuan untuk memberikan alternatif sistem penjualan obat non resep dokter dan keperluan medis dengan memanfaatkan perkembangan teknologi vending machine (VM) menggunakan finite state automata (FSA model Non-deterministic Finite Automata (NFA)). Dengan kelebihan penjualan menggunakan VM yang dapat diletakan dimana saja dan dapat beroperasi kapan saja membuat penjualan dengan sistem ini dapat tersedia kapanpun dan dimanapun untuk memenuhi kebutuhan obat dan keperluan medis bagi masyarakat yang mendesak dengan mudah,cepat, tepat, dan aman. Metode yang diterapkan dalam Penerapan FSA pada VM Penjual Obat Non Resep Dokter dan Keperluan Medis ini antara lain Finite State Automata VM Obat Non Resep Dokter dan Keperluan Medis, Perancangan Sistem VM Obat Non Resep Dokter dan Keperluan Medis,dan Desain VM Obat Non Resep Dokter dan Keperluan Medis. Berdasarkan perancangan FSA VM diatas, dihasilkan VM Penjual Obat Non Resep Dokter dan Keperluan Medis yang dapat diletakan dimana saja dan tersedia kapan saja, sehingga dapat disimpulkan penggunaan finite state automata (FSA) model Non-deterministic Finite Automata (NFA) dapat dimanfaatkan dalam pembuatan VM Penjual Obat Non Resep Dokter dan Keperluan Medis dengan menyediakan menu pilihan metode pembayaran tunai dan non tunai, kebutuhan akan obat dan keperluan medis yang mendesak bagi masyarakat dapat terpenuhi dengan mudah, cepat, tepat dan aman.

Both polymer injection time and injection rate play an important role in the development of an offshore reservoir with a limited service life of the platform. To quantitatively and qualitatively investigate the influence of the formation packing sequence, injection rate, polymer injection timing, and their interaction on the performance of polymer flooding, a numerical reservoir model is simulated in this study based on the properties of offshore reservoir LD in China. Also, the polymer flooding experimental scheme is designed according to the response surface method and single-factor analysis method. Based on numerical simulation and statistical analysis, a regression model is established to predict the incremental oil recovery factor of polymer flooding. The analysis of variance (ANOVA) shows that the regression model fits well with the experimental data. The three factors' influence capacities on the increased oil recovery factor from large to small are the injection rate, formation rhythm, and injection timing. From the analysis, it is also found that the improved polymer flooding performance can be achieved under an injection rate of 0.07-0.09 PV/a and an injection timing of 30% water cut for positive rhythm formation.

Online ride-hailing has gradually become a popular travel choice worldwide, while it also brought policy challenges to balance the traditional taxi industry and online ride-hailing services. Understanding the operation patterns of urban online ride-hailing services is essential for government policy-making. However, insufficient attention has been paid to the operating characteristics of online ride-hailing vehicles due to limited empirical data. This paper proposes a cluster analysis framework for the identification of different operation patterns of urban online ride-hailing. The customer order and GPS data of online ride-hailing vehicles and traditional taxis in Xiamen, China is used in this study. The k-means++ clustering algorithm is used based on the proposed intensity and stability indices of ride-hailing vehicle operating characteristics. The results show that there are three types of online ride-hailing operation patterns, namely full-time (which accounts for 52.801%), part-time (29.502%), and occasional (17.697%). The operation pattern of full-time ride-hailing vehicles is similar to that of traditional taxis, but with lower intensity and stability due to a reduced workload and flexible time schedule. Part-time ride-hailing vehicles are operated unsteadily and irregularly in the drivers’ spare time, and the working time periods are mainly concentrated in the morning and evening peak hours. Occasional ride-hailing vehicles provide very limited service. Finally, several policy suggestions for online ride-hailing from the perspective of government management, e.g., the number of licenses and operation places and time periods, are proposed based on the results.

One common issue when implementing wearable strain sensors for health-monitoring is the limited service time when they are inevitably subjected to mechanical operation in practical applications. Th...

The goal of this study is to investigate a developmental process of consumer skepticism about quick service restaurants (QSRs, also known as fast food or limited service restaurants)’ corporate soc...

Hydride beds containing LaNi4.25Al0.75 (LANA.75) are used to store significant quantities of tritium. These hydride beds have a limited service life due to radiolytic decay of tritium to 3He within...

Purpose Tipping within the foodservice industry has traditionally been reserved for full-service restaurants. However, there is a growing trend of tip requests at limited-service restaurants, where tipping occurs prior to consuming the product. This research aims to examine the effect of a point-of-sale tip request at limited-service restaurants on return intentions via customer irritation. It also aims to analyze the moderating effects of check amount and perceived deservingness. Design/methodology/approach Four online scenario-based experiments were conducted to test the hypotheses. Participants were recruited from MTurk for all experiments (NStudy 1 = 152; NStudy 2 = 296; NStudy 3 = 206; NStudy 4 = 134). Findings Studies 1 and 2 suggested a negative impact of presenting a tip request on return intentions, with customer irritation as the underlying mechanism. Study 3 found the indirect effect was significant only when the check amount was low. Study 4 found that perceived deservingness of a tip also moderated this effect; the indirect effect was significant only when customers felt the employee did not deserve a tip. The effect was attenuated when customers felt the employee deserved a tip. Originality/value This paper contributes to the underexplored area of tipping behavior in the limited-service context. The findings contrast extant research on voluntary tipping at full-service restaurants, thus advancing theory by suggesting the consequences of tip requests are contextual and providing practical insights to limited-service establishments contemplating whether to begin requesting tips.

Women living in rural Australia who are labelled as depressed, by either themselves or professionals, contend with spatial injustices of limited service provision that converge with the dominant constructions of mental health and knowledge authorisation. Informed by a feminist social constructionist standpoint, semi-structured interviews were conducted with 27 women living in rural New South Wales in Australia. This paper explores how rural women navigate experiences labelled as depression. The women’s stories conveyed an overwhelming sense of loss, abuse and betrayal, and the pathologisation of their experiences of structural violence and oppression is of significant concern. Yet, the women also showed agency by using to their best benefit multiple and often divergent explanations for their experiences of depression. While many accepted the diagnosis of their symptoms, most resisted a sole pathological cause and actively created individually meaningful narratives of their depression experiences. The language of ‘depression’ provided a passport for some, allowing access to formal supports that would have otherwise been unavailable or highly stigmatised. Rurality and the associated structural disadvantage, particularly in regard to service provision, was only marginally present in the women’s stories. The alternative narratives of healing uncovered challenge the centrality of formal service delivery to the wellbeing of a community. Further, while the pathologisation of structural oppression must be resisted, the women’s stories demonstrate the importance of not invisibilising the agency they demonstrate in this difficult and contested space.

In this study, the five-in-one community mass prevention and mass treatment group established in Wuhan to curb novel coronavirus outbreak in 2019 to 2020 is introduced. Various public health propaganda methods are used, including community loudspeakers and community bulletin boards. In the meantime, WeChat platform account named “Wuhan neighborhood on WeChat” is registered and opened, and a Group Chat on WeChat is created for grid management. A diversity of on-line and off-line countermeasures against the novel coronavirus outbreak are implemented via the WeChat platform: three-early measures (early discovery, early reporting, and early treatment), centralized management, community-based reporting, hierarchical diagnosis, and treatment system, isolation of mild patients at designated facilities, diagnosis and treatment appointment system for patients with fever, patient transferral in special vehicles, terminal disinfection at homes, psychological support and daily caring plan for special populations. This WeChat platform allows for an all-region, all-around, all-time and entire population-coverage control of novel coronavirus outbreak, with the extension and strengthening of health propaganda, guidance for seeking medical assistance, mass prevention and mass treatment, and health self-management among the community residents. Great effect has been achieved in novel coronavirus control so far. The five-in-one community management mode of Wuhan plus “Wuhan neighborhood on WeChat” plays an important role in relieving the shortage of health service resources and resolving the problem of limited service scope of professional medical staff in Wuhan, and ultimately contributes to the overall novel coronavirus control.

Transients, such as tourists or business travelers, often fly into large cities and subsequently have to rely on public transportation for movement within the city. It is difficult to observe transient behavior in the event of a disaster through traditional survey methods. Thus, transient behavior has not been understood as well as resident behavior, which presents a challenge to emergency management. This study used taxi trip records that are passively collected year-round in New York City (NYC) to observe transient behavior during Hurricane Sandy (2012). The linkage between transients and taxi trips was built upon the fact that many transients choose hotels as accommodation and depend on taxis during their travel in NYC. This study extracted and analyzed taxi trips originating from hotels shortly before and after the hurricane landfall, which cover transient outbound activities in a week. In the pre-landfall period, it was found that transients who evacuated out of Manhattan were more likely to leave hotels about 18–24 h before hurricane landfall; and those who stayed made more shopping trips within Manhattan. In the post-landfall period, transients were more likely to relocate on the second day after hurricane landfall; some transients headed to local airports once limited service was resumed. This is believed to be the first study to use passively collected data to observe transient travel behavior in the event of a hurricane as well as on normal days.

The intent of this study was to assess the caloric and sodium contents in Children’s meal provided by forty selected limited service and casual dining restaurants. Meals from casual dining ...

Given the increasing value of lifelong learning, self-directed learning (SDL) has become increasingly relevant over time. In rural areas with limited service resources, the main approach to NEET-youth depicts them more as young people in need, and less as people with the potential for self-development and participation in lifelong learning. The growing importance of people’s return to education, flexible learning paths, and the need for quick adaptation and re-training in a rapidly changing society emphasizes the need to design service models for NEET-youth. This is in order to support their SDL skills, and indicate the service providers’ role throughout the process. The empirical study in Estonia was grounded on the Double Diamond service design method using quantitative data on the respondents’ readiness for SDL, and also qualitative data from service providers about their roles and the affordances of their services in supporting SDL skills. The model was tested with rural NEET-youth.

In recent years, the amount of spent lithium-ion batteries (LIBs) increase sharply due to the promotion of new energy vehicles and the limited service life. Recycling of spent LIBs has attracted much attention because of the serious environmental pollution and high economic value. Although some established techniques have been presented in spent LIBs recycling process, but most of them focus on cathode material recycling due to its high economic value. Therefore, preparation of high purity cathode material by a proper pretreating technology is an important procedure. In this paper, the technologies used in the pretreating process of spent LIBs are summarized systematically from three main points of discharging procedure, liberation, and separation. The collaborative application of multi-technologies is the key to realize efficient pretreating process, which can lay the foundation for the subsequent metallurgical process. In addition, an alternative pretreating flowchart of spent LIBs is proposed based on the multi-process collaboration. Pretreating procedures in this process are mainly based on the physical property difference, and they include "Discharging-Shredding-Crushing-Sieving-Separation".

In Africa, accessibility to drinking water is major problem for rural population. This study analyzes accessibility to the drinking water source in two villages in Burkina Faso. Data were obtained from household’s surveys. In total, 221 households have been surveyed. Data analysis method is based on water accessibility of World Health Organization & United Nations Children Fund (2017) and Howard & Bartram (2003) approach. Results show that in Toessin village, more than half of the households have improved service or intermediate access to wells, whereas a small percentage have access to boreholes. Slightly over half of the households have a low service or a minimal access for the same quantities of water and sources. No household falls under the limited service state or does not have access to wells, whereas small number of the families do not have access to boreholes. In the Bonogo village, nearly one third of households have improved service or intermediate access to boreholes and a very small number of household have intermediate access to wells. The majority of the Bonogo household’s access to boreholes fall under the basic service or a minimal access category, whereas accessibility to wells under the same category constitute slightly over half of the household. However, only a very small number of household in Bonogo have a limited service or do not have access at boreholes and wells. Overall, in terms of accessibility to drinking water sources, the majority of households in Toessin falls under the improved service or intermediate/minimal access for wells, whilst in Bonogo, most households fall under the basic service or minimal access to boreholes. It is necessary to dig new boreholes in Toessin in order to improve access to the drinking water. Keywords: accessibility, boreholes, Burkina Faso, drinking water, households, traditional wells

To examine the correct application of the $0.01/ounce Cook County, Illinois, Sweetened Beverage Tax on sugar-sweetened and artificially sweetened beverages, a total of 111 beverage products were purchased from 28 food stores in September and November 2017. Purchases were categorized by taxable (sugar-sweetened and artificially sweetened soda and juice drinks) and nontaxable (100% fruit juice and sparkling water) beverage type, store type (limited service vs supermarket/grocery), and area median household income (lower vs higher). Two-sample tests of proportions were conducted to compare correctly taxed purchases. The tax was correctly applied in 91.0% of cases. Correct tax application was found in 87.8% of taxable beverage purchases versus 97.3% of nontaxable beverage purchases (P = .10), 71.4% of juice drink purchases versus 95.6% of nonjuice drink purchases (P < .001), and 85.5% of limited service store purchases versus 100% of supermarket/grocery purchases (P = .01). No significant differences were found by area income.

This paper studies the Ethernet passive optical network (EPON) with limited service. The transmission window (TW) is limited in this system to guarantee a bounded delay experienced by disciplined users and to constrain malicious users from monopolizing the transmission channel. Thus, selecting an appropriate TW size is critical to the performance of EPON with limited service discipline. In this paper, we develop an M/G/1 queuing model with vacation times and limited-service discipline to investigate the impact of TW size on packet delay. A distinguishing feature of this model is that there are two queues in the buffer of each optical network unit (ONU): one queue is inside the gate and the other one is outside the gate, from which we derive the generalized formula of mean waiting time. Furthermore, based on the service-level agreements of users and the Chernoff bound of queue length, we provide a simple rule to determine an optimum TW size for limited-service EPONs. The analytic results reported in this paper are all verified by simulations.

As an emerging kinetic damage weapon system, railgun has attracted much attention due to its remarkable advantages such as high initial speed, high kinetic energy, high shooting speed, high emission density, low cost, and antijamming. However, there are currently degradations of electromagnetic railgun launch performance and reliability, the limited service life as well, resulting from rail damage such as the transition erosion and grooving damage. Based on 24 consecutive shots, this paper presents the statistical analysis of B-dot probe data, aiming to show the working stability and reliability of the electromagnetic rail launch system when consecutive firing. On the basis of current data and B-dot probe data, the speed-displacement curve was obtained by simulation, through which it is easy to get the movement state of the armature in the launch track. Finally, by checking the disassembly of the launch rail, this paper analyses the damage states of launching rail after the 24 consecutive launch experiments. Through the above three aspects of research and analysis, this paper could be the reference for the further research and analysis on the performance and lifetime of railgun.

Recent research on limited service brokerage finds positive broker intermediation effects evidenced by price increases ranging from 2% to 6%. Time-on-market effects of limited service contracts ran...

Unmanned aerial vehicles (UAVs) or drones are increasingly proposed for medical uses due to their potential to transport medical supplies quickly and efficiently. A prototype medical drone that is equipped with an on-board automated external defibrillator (AED) was announced recently to significantly reduce the time it takes for an AED to arrive to a patient's side. As drones are battery-operated and have limited service range, a network of medical drones is required to adequately provide service to a large area. This paper developed a new spatial optimization model, the backup coverage location problem with complementary coverage (BCLP-CC), to aid in the deployment of a network of AED enabled medical drones. By explicitly integrating backup coverage and continuously distributed demand, the BCLP-CC can optimally place drones and the corresponding launch sites while significantly improving backup coverage with minimal loss of primary coverage. Our results show that 90.4% of historical out-of-hospital cardiac arrests in Salt Lake County can be responded to within 1 min by using 71 drones and 68 launch sites. In addition, 58.9% of incidents can be served by two or more drones, a significant improvement over existing models. This study shows that drones could significantly reduce life-saving equipment travel times for victims of cardiac arrest by appropriately siting them, which will motivate further research in using UAVs or drones for emergency medical purpose.

The Savannah River Tritium Enterprise (SRTE) has used hydride beds to store and process hydrogen isotopes for over two decades. New beds are being designed to use a hydride material – LaNi4.15Al0.85 (LANA.85) – that has a lower plateau pressure than the material previously employed. LANA.85 is expected to have a limited service life due to radiolytic decay of tritium to He-3 within the metal matrix, which will result in degradation of hydride performance. Tritium aging was initiated on a LANA.85 metal hydride sample to look for changes in desorption isotherm performance which occur with aging. Desorption isotherms were collected at 120°C, and 160°C annually. A lower temperature isotherm was collected at 100°C after 2 years of aging. A single absorption isotherm was collected each year at 120°C. After testing, each sample was reloaded with tritium for quiescent aging until the following year. Samples were stored in the beta phase.Results collected on the virgin material and annually for 2 years of ...

Wood is still one of the most used construction materials due to its abundancy, strength-to-weight ratio, production costs, and environmental benefits. However, as wood is biodegradable, it has a limited service life. Wood products in ground contact have to be treated with Cu-based wood preservatives owing to the favorable conditions for wood decay, e.g., soft rot fungi. However, a range of wood destroying fungi have developed resistance mechanisms against Cu-based wood preservatives formulations. Screening of a Trichoderma strain with a highly antagonistic potential against wood destroying basidiomycetes maybe promising sustainable integrated wood protection strategy in combination with chromium-free wood preservatives.

This paper deals with the finite-buffer single server vacation queues with batch Markovian arrival process (BMAP). The server follows gated-limited service discipline, i.e., the server can serve a maximum of L customers out of those that are waiting at the start of the busy period or all the waiting customers, whichever is minimum. It has been assumed that the server can take only one vacation, i.e., if no customers are found at the end of a vacation, the server remains idle until a batch of customers arrives. The service time and vacation time distributions are considered to possess rational Laplace–Stieltjes transform. The queue-length distribution at post-departure, arbitrary, and pre-arrival epochs has been obtained. Various performance measures like mean queue-length, mean waiting time of an arbitrary customer, and mean length of busy and idle periods have been derived for this model. Numerical results have been presented based on the analysis done.

This paper investigates how increases in concentration can be interrupted or reversed by changes in how firms compete on quality. We examine the U.S. hotel industry during the past half century. We document that starting in the early 1980s, quality competition came more in the form of costs that vary with hotel size, and less in the form of costs that are fixed with hotel size, particularly for business travelers. We then show that, consistent with Sutton (1991), industry structure has evolved differently since then in areas that are business travel versus personal travel destinations. Demand increases have been associated with more, but smaller, hotels in business travel destinations. In contrast, the growth in the number of hotels is much smaller, and the growth in average hotel size is much greater, in personal travel destinations. We provide evidence that this change reflects the emergence of two new classes of hotels – limited service and all-suites hotels – that did not exist before the early 1980s. These entrants – many of which had high quality rooms but which had limited out-of-room amenities – had a narrower competitive impact on other hotels than did the entrants of the 1960s and 1970s, which competed more on out-of-the-room amenities, and this led the industry structure to evolve differently.

Generally, methods of authentication and identification utilized in asserting users' credentials directly affect security of offered services. In a federated environment, service owners must trust external credentials and make access control decisions based on Assurance Information received from remote Identity Providers (IdPs). Communities (e.g. NIST, IETF and etc.) have tried to provide a coherent and justifiable architecture in order to evaluate Assurance Information and define Assurance Levels (AL). Expensive deployment, limited service owners' authority to define their own requirements and lack of compatibility between heterogeneous existing standards can be considered as some of the unsolved concerns that hinder developers to openly accept published works. By assessing the advantages and disadvantages of well-known models, a comprehensive, flexible and compatible solution is proposed to value and deploy assurance levels through a central entity called Proxy.

We examined adolescent application usage related to smartphone addiction and also explored mediation strategies used to prevent their addiction. Participants were 3,000 adolescents in grades 7 to 12 who completed an online survey. According to the findings, frequent use of social networking site applications (apps), game apps, and video apps tended to exacerbate adolescents' addiction to smartphones. Mediation strategies negatively related to smartphone addiction were active parental mediation for young adolescent girls, technical restrictions for young adolescent boys, and limited service plans for both these groups. Parental restriction tended to increase the likelihood of smartphone addiction. Addiction prevention programs being implemented in schools did not have any impact in preventing addiction. Overall, our findings suggest that the effects of mediation strategies are weak and these effects are limited to young adolescents.

Buildings, structures and systems of large scale and high value (e.g. conventional and nuclear power plants, etc.) are designed for a certain, limited service lifetime. If the standards and guidelines of the time are taken into account during the design process, the resulting structures will operate safely in most cases. However, in the course of technical history there were examples of unusual, catastrophic failures of structures, even resulting in human casualties. Although the concept of Structural Integrity first appeared in industrial applications only two-three decades ago, its pertinence has been growing higher ever since. Four nuclear power generation units have been constructed in Hungary, more than 30 years ago. In every unit, VVER-440 V213 type light-water cooled, light-water moderated, pressurized water reactors are in operation. Since the mid-1980s, Pressurized Thermal Shock (PTS) analyses of Reactor Pressure Vessels (RPV) have been conducted in Hungary, where the concept of structural integrity was the basis of research and development. In the first part of the paper, a short historic overview is given, where the origins of the Structural Integrity concept are presented, and the beginnings of Structural Integrity in Hungary are summarized. In the second part, a new conceptual model of Structural Integrity is introduced. In the third part, a brief description of the VVER-440 V213 type RPV and its surrounding primary system is presented. In the fourth part, a conceptual model developed for PTS Structural Integrity Analyses is explained.

Objectives Children in rural areas have difficulty accessing the same services as their urban peers, which is a particular challenge in large countries such as the U.S. and Canada. Despite known problems providing services in rural areas, there is limited research investigating services for children with hearing loss living in rural areas. This scoping review examines the accessibility of services for children with hearing loss in rural U.S. and Canada. Methods The search strategy included four databases and gray literature from 2008-2018. Eight government documents and 16 articles met the inclusion criteria and the main findings in the literature were themed. Results Children with hearing loss, experienced difficulties accessing specialized services which influenced the timing of diagnosis of hearing loss, receiving hearing technology and accessing ongoing support. Families in rural areas also had access to less information about hearing loss than urban families. Managing funding and health insurance was also a challenge for families in rural areas. Conclusion The limited research in this area indicates that children with hearing loss in rural areas can experience barriers when accessing the same services as their urban peers. Limited service provision can negatively influence outcomes for children with hearing loss. Alternate service delivery such as teleintervention and visiting specialists can improve service provision in rural areas. Comprehensive research of the experience of children with hearing loss across states, provinces and territories would guide improvements to services for children with hearing loss in rural areas of the U.S. and Canada.

BACKGROUND: The United States Department of Agriculture’s Supplemental Nutrition Assistance Program (SNAP) is the country’s largest nutrition assistance program for low-income populations. While SNAP has been shown to reduce food insecurity, research on the diet quality of program participants is inconsistent. OBJECTIVE: This study examined if the community food environment is a potential moderator of the association between SNAP participation and eating behaviors. DESIGN: This cross-sectional study utilized participant data from a telephone survey of 2,211 households in four cities in New Jersey. Data were collected from two cross-sectional panels from 2009–10 and 2014. Food outlet data were purchased from commercial sources and classified as supermarkets, small grocery stores, convenience stores, or limited service restaurants. PARTICIPANTS/SETTING: Analysis is limited to 983 respondents (588 SNAP participants) with household incomes below 130% of the Federal Poverty Level. MAIN OUTCOME MEASURES: Eating behaviors assessed as frequency of consum ption of fruit, vegetables, salad, and sugar sweetened beverages (SSB). STATISTICAL ANALYSIS PERFORMED: Interaction and stratified analyses using gamma regression determined the differences in the association between SNAP participation and eating behaviors by the presence or absence of food outlets adjusted for covariates. RESULTS: SNAP participation was associated with a higher frequency of consuming SSB (p

Decommissioned aircraft are a source of high quality components and materials. Some of these engine and landing gear components have a limited service life and must be replaced after a defined number of revolutions, operating hours and landings in aircraft maintenance hangars. Before the materials can be introduced into the secondary raw material cycle, the components must be rendered unusable through a documented process. The reason for this process is to prevent suspected unapproved parts and inferior imitations (bogus parts) from appearing on the world market. The materials in question accumulate continuously at aircraft maintenance hangars, so their documented dismantling and ultimate recycling can be scheduled.

This article aims to describe the discretion and dilemma faced by street-level bureaucrats (SLBs) in the implementation of dottorotta home care programs in Makassar City, Indonesia. This study used a qualitative descriptive approach with data collection techniques in-depth interviews, observation, and analysis of documents relevant to the research. The results showed that in implementing the dottorotta home care program, SLBs were often faced with scarcity of resources, both human and financial, and limited service time. To deal with the scarcity of these resources, SLBs use their discretionary authority, but in reality they are often faced with ethical dilemmas and psychological dilemmas. In this situation, SLBs use their experience and expertise so that the decisions taken do not harm the organization and the community it serves.

Perceptions of service needs and barriers to care among caregivers of individuals with Parkinson's disease have not been well explored. The purpose of this study was to assess caregiver perceptions of their own and patients' medical and supportive service needs. An online and paper survey was disseminated to a sample of caregivers (n = 66) of individuals with Parkinson's disease. Although caregivers reported positive quality of life and adjustment to caregiving, nearly half of the sample endorsed feeling stressed about caregiving. Caregivers reported that services for symptom management, coping with changes in lifestyle, future planning, relationships, and cognition, and wellness strategies were most needed. Reported barriers to patients accessing care included limited service availability and a lack of insurance coverage for services. These findings suggest a need to improve access to services for patients and increased efforts to promote caregiver wellness at movement disorder specialty clinics.

Food away from home (FAFH) has become increasingly integral to the American diet. In 2010, the share of Americans’ food budget for FAFH—reaching 50 percent (up from 41 percent in 1984)—surpassed the share for food at home (FAH) for the first time. Likewise, Americans’ share of energy intake from FAFH rose from 17 percent in 1977-78 to 34 percent in 2011-12, with differences in growth across types of FAFH (e.g., full- and quick-service restaurant foods, school meals, etc.). Along with the demand for FAFH, availability of FAFH has also increased, with much of the growth in recent years attributable to quick-service restaurants. The growing presence of FAFH in Americans’ diets reflects changes in consumer demand and producer behavior and affects the health and nutrition of individuals over time. This report takes a comprehensive look at the role of FAFH in American diets, exploring nutritional composition of FAFH and key Federal programs that may influence FAFH. The report also discusses how FAFH choices and availability relate to diet quality, income, age, and other socioeconomic factors.

A case study of Brisbane, the capital city of Queensland, Australia, explored how explicit measures of transit quality of service (e.g., service frequency, service span, and travel time ratio) and implicit environmental predictors (e.g., topographic grade factor) influenced bus ridership. The primary hypothesis tested was that bus ridership was higher in suburbs with high transit quality of service than in suburbs with limited service quality. Multiple linear regression, used to identify a strong positive relationship between route intensity (bus-km/h-km2) and bus ridership, indicated that both increased service frequency and spatial route density corresponded to higher bus ridership. Additionally, the travel time ratio (i.e., the ratio of in-vehicle transit travel time to in-vehicle automobile travel time) had a significant negative association with suburban ridership: transit use declined as travel time ratio increased. In contrast, topographic grade and service span did not significantly affect suburban bus ridership. The study findings enhance the fundamental understanding of traveler behavior, which is informative to urban transportation policy, planning, and provision.

Low-cost unmanned aircraft that use affordable manufacturing and have limited service life can enable mission concepts in which there is a higher tolerance for aircraft loss, or attrition. Because of their higher risk tolerance, these low-cost attritable aircraft could also integrate emerging technology which may have previously been considered too risky for integration into expensive and long life aircraft. Light-weight multifunctional structural composites have the potential to integrate additional functions and enable mission agility without significantly adding weight or reducing payload capacity. However, design and development of these material systems are often difficult because of the traditional “building block” development approach used for traditional composites, the large option space available for structural and functional properties, and the potential complexity of the multiscale and multiphysics coupling. To realize integrated functionality, new multi-scales and multi-physical experimental mechanical characterization techniques should be merged with maturing integrated materials models. We discuss this need using examples of a reconfigurable liquid metal Structurally Embedded Vascular Antenna (SEVA), a plasmonic nanoparticle based method for measuring internal temperature gradients, and embedded micro-cantilever carbon-nanotube based sensors. The latter of these is also used to discuss the potential to accelerate development of multifunctional structural concepts by provide air flow measurement and structural feedback during testing of complex structures. This could, in turn, eliminate some testing of intermediate elements in the slow and expensive traditional “building block” approach.

Annually, many operations for repeat prosthetic reconstruction of the pulmonary artery valve are performed due to dysfunction after primary correction of both congenital and acquired heart defects. Open operations with artificial circulation are associated with a high surgical risk. Transcatheter implantation is a new and progressive technique of heart valve replacement. Until recently, implantation of only a biological graft in the position of a pulmonary artery valve was possible, but a limited service life and high risk of the development of infective endocarditis stimulate search for new solutions of this problem. In the he present work we describe cases concerning placement of the first Russian-made valve-containing stent in the position of the pulmonary artery, with the stent's closing mechanism made of polytetrafluoroethylene thus giving ground to count on more favourable results.Ежегодно выполняется множество операций по репротезированию клапана легочной артерии, связанной с дисфункцией после первичной коррекции как врожденных, так и приобретенных пороков сердца. Открытые операции с использованием искусственного кровообращения ассоциированы с большим хирургическим риском. Транскатетерная имплантация является новой и прогрессивной методикой замены клапанов сердца. До недавнего времени в позиции клапана легочной артерии была возможна имплантация только биологического протеза, но ограниченный срок службы и высокий риск развития инфекционного эндокардита стимулируют поиск новых решений данной проблемы. В настоящей работе представлено описание случаев установки первого российского клапансодержащего стента в позицию легочной артерии, запирательный механизм которого выполнен из политетрафторэтилена, что дает основание рассчитывать на более благоприятные результаты.

Periodic maintenance inevitably leads to 'over-maintenance' or 'non-timely maintenance' of equipment or systems. To improve reliability and reduce maintenance cost, this paper presents a dynamic maintenance cycle optimisation model for multi-component systems. In this paper, the influence of different maintenance intervals on system reliability and total maintenance cost is determined under the conditions that the system has a limited service time and the components are not fully maintained. The model uses the optimisation of system maintenance cost as the objective function to determine the optimal preventive maintenance times and maintenance intervals under the constraint of the lowest reliability of the system. The simulation results of the final example verify that the proposed method can significantly improve the maintenance cost, system reliability, and reliability fluctuation stability. And it can be used to guide subway maintenance cycle optimisation.

PURPOSE: This study sought to document current refractive services in the northern and central regions of Ghana as a first step toward evidence-based planning of refractive services. METHODS: A descriptive cross-sectional survey was carried out in health facilities in the northern and central regions of Ghana, which provided eye-care services. A semi-structured questionnaire was administered to gather information on each facility type, human resources providing refractive services, assessment of refraction and spectacle dispensing output and provider barriers to the services. RESULTS: Current outputs of refraction in the northern and central regions were 0.5 and 1.2 per cent of the estimated refractive needs, respectively. Spectacle dispensing services were below the outputs of refraction. Lack of equipment (36.8 per cent) and cost of providing spectacles frames (31.6 per cent), were identified as the main barriers to providing refractive services. CONCLUSION: The provision of refractive services in the study regions was inadequate. Lack of infrastructure and inadequate human resource were the major reasons for the limited service provision. This should be considered for planning refractive services in the study regions and Ghana as a whole.