The time has come for the constitution of the Association of Southeast Asian Nations （ASEAN） economic community and many facts have been analyzed regarding this topic. This paper presents the results of the statisti...The time has come for the constitution of the Association of Southeast Asian Nations （ASEAN） economic community and many facts have been analyzed regarding this topic. This paper presents the results of the statistical analysis applied to several economic parameters which firstly show how their integration pattern adjusts with a considerable good fitting to the optimum currency area model and to its extended version by Behrens; and secondly how the 10 members of this group are moving at relatively same speed in spite of their differences, that are also inferred for ranging.展开更多
OBJECTIVE: United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides primary health care services including care for diabetes and hypertension, with limited resources under diffic...OBJECTIVE: United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides primary health care services including care for diabetes and hypertension, with limited resources under difficult circumstances in Gaza, West Bank, Jordan, Lebanon and Syria. A total of 114,911 people with diabetes were registered with UNRWA health centres in 2011. The aim of this cross-sectional observational study was to assess the quality of diabetes care in the UNRWA primary health care centres. METHOD: The study population consisted of 1600 people with diabetes attending the 32 largest UNRWA health centres and treated there for at least one year. Between April and Sept. 2012 data from medical records, including results of clinical examinations and laboratory tests performed during the last one year, current management including self-care education and evidence of diabetes complications were collected and recorded in a previously validated data collection form (DCF). Patients were interviewed and clinically examined on the day of the audit and blood collected for HbA1c testing which was done at a central lab using High-performance liquid chromatography (HPLC) method (HLC®-723G8 Tosoh Corporation, Japan). Data was transferred from paper records into a computer and analysed with Epi-info 2000. RESULTS: Type 1 diabetes was present in 4.3% and type 2 diabetes in 95.7%. Co-morbid hypertension was present in 68.5%;90.3% were either obese (64.0%) or overweight (26.3%). Clinical management of diabetes was largely in line with UNRWA’s technical instructions (TI) for diabetes. Records for 2 hour postprandial glucose (2 h PPG), serum cholesterol, serum creatinine, and urine protein analysis were available in 94.7%, 96.4%, 91.4% and 87.5%, cases, respectively. Records of annual fundoscopic eye examination were available in 47.3% cases but foot examinations were less well documented. Most patients (95.6%) were on anti-diabetic drugs—68.2% oral anti diabetic drugs (OAD) only, 14.4% combination of OAD and insulin, and 12.9% insulin only. While 44.8% patients had 2 h PPG ≤ 180 mg/dl, only 28.2% had HbA1c ≤ 7%;55.5% and 28.2% had BP ≤ 140/90 and ≤130/80 mm of Hg respectively. Serum cholesterol ≥ 200 mg/dl, serum creatinine ≥ 1.2 mg/dl and macro albuminuria were noted in 39.8%, 6.4% and 10.3% cases respectively. Peripheral neuropathy (52.6%), foot infections (17%), diabetic retinopathy (11%) and myocardial infarction (9.6%) were the most common long term complications. One or more episodes of hypoglycaemia were reported by 25% cases in total and in 48% of those using insulin. 17.7% and 22.6% cases received no or ≥4 self-care education sessions respectively. CONCLUSION: The study confirmed that UNRWA doctors and nurses follow TI for diabetes and hypertension fairly well. Financial constraints and the consequent effects on UNRWA TI and policies related to diabetes care were important constraints. Key challenges identified were: reliance on 2 h PPG to measure control;non-availability of routine HbA1c testing, self-monitoring of blood glucose (SMBG) and statins within the UNRWA system;and high levels of obesity in the community. Addressing these will further strengthen UNRWA health system’s efforts of providing services for diabetes and hypertension at the primary care level. Given that most developing countries either have no or only rudimentary services for diabetes and hypertension at the primary care level, UNRWA’s efforts can serve as an inspiration to others.展开更多
An analysis of the monetary synchronization of the Union of South American Nations （UNASUR） for the decade 2004 through 2013 has been conducted using the optimum currency area （OCA） theories in order to evaluate t...An analysis of the monetary synchronization of the Union of South American Nations （UNASUR） for the decade 2004 through 2013 has been conducted using the optimum currency area （OCA） theories in order to evaluate the economic integration. By applying Bayoumi and Eichengreen＇s equation, it was found that with a decent adjustment, a high percentage of countries show a tendency to harmonize their currencies in function of the four independent variables： output disturbances, the dissimilarity in exports composition, the trade linkages, and the size of the economies. To extend the model, mobility of labor and level of the integration in good＇s market were added by modifying Behrens＇ proposal, founding that the six variables are indeed related to the exchange rate harmonization at different significant levels, with a considerable moderate fitting. Additionally an analysis of variance （ANOVA） has been considered in order to study the following economic indicators： gross domestic product （GDP）, population, GDP per capita, exports to group vs. total exports, unemployment, and inflation rates so as to visualize the economic asymmetries of the Union, for the same period. Differences were inferred for all of them but not for their annual speed of change. The least significant differences （LSD） provide further results and Duncan＇s multiple range tests lead to defining groups of countries with similar characteristics.展开更多
In this presentation,we have shown the methodology for the structural assessment of bridges that belong to the inventory of cultural heritage.Due to the significant number of“sub-standard”bridges,it is impossible fo...In this presentation,we have shown the methodology for the structural assessment of bridges that belong to the inventory of cultural heritage.Due to the significant number of“sub-standard”bridges,it is impossible for interventions in these bridges to be simultaneous and immediate,so certain criteria and priorities must be established in the ways of interventions for their rehabilitation.Bridges that are most at risk and need to be rehabilitated as soon as possible should be determined,and bridges that can be rehabilitated at a later stage should be identified.The prioritization scheme should include a number of aspects beyond the“pure engineering”ones.Main in this process are:seismicity of the area and the probability of the seismic event,vulnerability of the structure.Different structural systems may be considered to be more vulnerable in the event of an earthquake than others,and therefore may need attention as soon as possible.To make this preliminary assessment,we used the methodology of the US Highway Federation,then we proceed with the in-depth assessment of the carrying capacity using the well-known“time history”or“push over”methods,according to the specific case.As an example for the application of this methodology,we have taken the Dragoti Bridge,a category II cultural monument,the bridge with the largest span of light in Albania of 108 m.展开更多
In this presentation,we are showing the application of methods for assessing the structural capacity of existing reinforced concrete bridges,constructed before the application of European Norms.The safety check presen...In this presentation,we are showing the application of methods for assessing the structural capacity of existing reinforced concrete bridges,constructed before the application of European Norms.The safety check presented in the various guidelines includes a structural non-linear analysis,followed by checking especially the deformations and resistance of all piers.In most cases,the superstructure is not significantly involved in the seismic response of the structure,then continues with the controls of the substructure(piles and facades)and the foundations,as well as with the systems of the connections of the structure and those of the interconnection between the structural elements.The structural model reflects the real conditions of the structure,the structural model must contain all the relevant degrees of freedom,characterizing the dynamic response of the structure,the inertia characteristics i.e.the stiffness of the structure,and the superstructure connections.For the case of non-linear analysis,the structural model must be able to follow the development of stresses and deformations of the structure beyond the elastic phase caused by the formation of an increasing number of plastic zones.展开更多
文摘The time has come for the constitution of the Association of Southeast Asian Nations （ASEAN） economic community and many facts have been analyzed regarding this topic. This paper presents the results of the statistical analysis applied to several economic parameters which firstly show how their integration pattern adjusts with a considerable good fitting to the optimum currency area model and to its extended version by Behrens; and secondly how the 10 members of this group are moving at relatively same speed in spite of their differences, that are also inferred for ranging.
文摘OBJECTIVE: United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides primary health care services including care for diabetes and hypertension, with limited resources under difficult circumstances in Gaza, West Bank, Jordan, Lebanon and Syria. A total of 114,911 people with diabetes were registered with UNRWA health centres in 2011. The aim of this cross-sectional observational study was to assess the quality of diabetes care in the UNRWA primary health care centres. METHOD: The study population consisted of 1600 people with diabetes attending the 32 largest UNRWA health centres and treated there for at least one year. Between April and Sept. 2012 data from medical records, including results of clinical examinations and laboratory tests performed during the last one year, current management including self-care education and evidence of diabetes complications were collected and recorded in a previously validated data collection form (DCF). Patients were interviewed and clinically examined on the day of the audit and blood collected for HbA1c testing which was done at a central lab using High-performance liquid chromatography (HPLC) method (HLC®-723G8 Tosoh Corporation, Japan). Data was transferred from paper records into a computer and analysed with Epi-info 2000. RESULTS: Type 1 diabetes was present in 4.3% and type 2 diabetes in 95.7%. Co-morbid hypertension was present in 68.5%;90.3% were either obese (64.0%) or overweight (26.3%). Clinical management of diabetes was largely in line with UNRWA’s technical instructions (TI) for diabetes. Records for 2 hour postprandial glucose (2 h PPG), serum cholesterol, serum creatinine, and urine protein analysis were available in 94.7%, 96.4%, 91.4% and 87.5%, cases, respectively. Records of annual fundoscopic eye examination were available in 47.3% cases but foot examinations were less well documented. Most patients (95.6%) were on anti-diabetic drugs—68.2% oral anti diabetic drugs (OAD) only, 14.4% combination of OAD and insulin, and 12.9% insulin only. While 44.8% patients had 2 h PPG ≤ 180 mg/dl, only 28.2% had HbA1c ≤ 7%;55.5% and 28.2% had BP ≤ 140/90 and ≤130/80 mm of Hg respectively. Serum cholesterol ≥ 200 mg/dl, serum creatinine ≥ 1.2 mg/dl and macro albuminuria were noted in 39.8%, 6.4% and 10.3% cases respectively. Peripheral neuropathy (52.6%), foot infections (17%), diabetic retinopathy (11%) and myocardial infarction (9.6%) were the most common long term complications. One or more episodes of hypoglycaemia were reported by 25% cases in total and in 48% of those using insulin. 17.7% and 22.6% cases received no or ≥4 self-care education sessions respectively. CONCLUSION: The study confirmed that UNRWA doctors and nurses follow TI for diabetes and hypertension fairly well. Financial constraints and the consequent effects on UNRWA TI and policies related to diabetes care were important constraints. Key challenges identified were: reliance on 2 h PPG to measure control;non-availability of routine HbA1c testing, self-monitoring of blood glucose (SMBG) and statins within the UNRWA system;and high levels of obesity in the community. Addressing these will further strengthen UNRWA health system’s efforts of providing services for diabetes and hypertension at the primary care level. Given that most developing countries either have no or only rudimentary services for diabetes and hypertension at the primary care level, UNRWA’s efforts can serve as an inspiration to others.
文摘An analysis of the monetary synchronization of the Union of South American Nations （UNASUR） for the decade 2004 through 2013 has been conducted using the optimum currency area （OCA） theories in order to evaluate the economic integration. By applying Bayoumi and Eichengreen＇s equation, it was found that with a decent adjustment, a high percentage of countries show a tendency to harmonize their currencies in function of the four independent variables： output disturbances, the dissimilarity in exports composition, the trade linkages, and the size of the economies. To extend the model, mobility of labor and level of the integration in good＇s market were added by modifying Behrens＇ proposal, founding that the six variables are indeed related to the exchange rate harmonization at different significant levels, with a considerable moderate fitting. Additionally an analysis of variance （ANOVA） has been considered in order to study the following economic indicators： gross domestic product （GDP）, population, GDP per capita, exports to group vs. total exports, unemployment, and inflation rates so as to visualize the economic asymmetries of the Union, for the same period. Differences were inferred for all of them but not for their annual speed of change. The least significant differences （LSD） provide further results and Duncan＇s multiple range tests lead to defining groups of countries with similar characteristics.
文摘In this presentation,we have shown the methodology for the structural assessment of bridges that belong to the inventory of cultural heritage.Due to the significant number of“sub-standard”bridges,it is impossible for interventions in these bridges to be simultaneous and immediate,so certain criteria and priorities must be established in the ways of interventions for their rehabilitation.Bridges that are most at risk and need to be rehabilitated as soon as possible should be determined,and bridges that can be rehabilitated at a later stage should be identified.The prioritization scheme should include a number of aspects beyond the“pure engineering”ones.Main in this process are:seismicity of the area and the probability of the seismic event,vulnerability of the structure.Different structural systems may be considered to be more vulnerable in the event of an earthquake than others,and therefore may need attention as soon as possible.To make this preliminary assessment,we used the methodology of the US Highway Federation,then we proceed with the in-depth assessment of the carrying capacity using the well-known“time history”or“push over”methods,according to the specific case.As an example for the application of this methodology,we have taken the Dragoti Bridge,a category II cultural monument,the bridge with the largest span of light in Albania of 108 m.
文摘In this presentation,we are showing the application of methods for assessing the structural capacity of existing reinforced concrete bridges,constructed before the application of European Norms.The safety check presented in the various guidelines includes a structural non-linear analysis,followed by checking especially the deformations and resistance of all piers.In most cases,the superstructure is not significantly involved in the seismic response of the structure,then continues with the controls of the substructure(piles and facades)and the foundations,as well as with the systems of the connections of the structure and those of the interconnection between the structural elements.The structural model reflects the real conditions of the structure,the structural model must contain all the relevant degrees of freedom,characterizing the dynamic response of the structure,the inertia characteristics i.e.the stiffness of the structure,and the superstructure connections.For the case of non-linear analysis,the structural model must be able to follow the development of stresses and deformations of the structure beyond the elastic phase caused by the formation of an increasing number of plastic zones.
