Recovery Path Research Articles

Mixed methods study of help seekers and self-changers responding to an online recovery survey.

To compare self-changers (natural recovery) with help seekers on demographics, pre-recovery problem severity, and recovery beliefs and behaviors; and to augment these quantitative findings with information extracted from the qualitative stories of a subset of self-changers to explore themes in recovery paths as informed by a nascent natural recovery literature. Quantitative secondary analyses were conducted with persons who had responded to a US nationwide online survey called 'What Is Recovery' (WIR) and who reported a prior lifetime alcohol problem (n = 5495). Six men and six women (with longer-term recoveries) interviewed later were asked to tell their 'recovery story from the beginning up to now'. These were coded using a narrative approach. Compared with help seekers, self-changers were younger and never married: they did not differ on problem severity, gender, ethnicity or education. Self-changers identified with 'used to have a problem' more than in recovery/recovered, reported fewer years in that status, and reported more current, non-problematic substance use. A new concept of shadow help and shadow obstacles to help-seeking emerged from the qualitative analysis. Though self-changers believed that they had overcome their alcohol problem on their own, change actually occurred within a social context that allowed access to information, normative expectations, relationships, and other opportunities that provided important resources for change. Findings imply that the concept of help-seeking needs to be re-conceptualized to include the informal help we found in this study.

How long is a transurethral catheter necessary in patients undergoing thoracotomy and receiving thoracic epidural analgesia? Literature review.

DESPITE THE AGING POPULATION and new lung cancer cases being on the rise, clinicians are forced to be more efficient and more productive without additional resources. Fast-track pathways have been described showing outstanding results, such as a faster recovery process and shorter length of hospital stay, but mainly for abdominal 1 Gravante G. Elmussareh M. Enhanced recovery for colorectal surgery: Practical hints, results and future challenges. World J Gastrointest Surg. 2012; 4: 190-198 Crossref PubMed Google Scholar , 2 Carli F. Charlebois P. Baldini G. et al. An integrated multidisciplinary approach to implementation of a fast-track program for laparoscopic colorectal surgery. Can J Anaesth. 2009; 56: 837-842 Crossref PubMed Scopus (71) Google Scholar and orthopedic 3 Kehlet H. Thienpont E. Fast-track knee arthroplasty—Status and future challenges. Knee. 2013; 20: S29-S33 Abstract Full Text PDF PubMed Scopus (93) Google Scholar surgeries. Although enhanced recovery paths might seem to be an excellent option to solve this problem, there is a scarcity of trials in thoracic surgery in general on this subject. 4 Jones N.L. Edmonds L. Ghosh S. et al. A review of enhanced recovery for thoracic anaesthesia and surgery. Anaesthesia. 2013; 68: 179-189 Crossref PubMed Scopus (72) Google Scholar Therefore, it is essential to implement recovery pathway programs for patients undergoing thoracic surgery. Thoracic epidural analgesia (TEA) is the gold standard to relieve pain after thoracotomy because of its association with severe pain. 5 Ochroch E.A. Gottschalk A. Augosutides J. et al. Long-term pain and activity during recovery from major thoracotomy using thoracic epidural analgesia. Anesthesiology. 2002; 97: 1234-1244 Crossref PubMed Scopus (150) Google Scholar Thus, a crucial point to implement a fast-track pathway in thoracic surgery is to offer TEA. It reduces significantly the incidence of postoperative morbidity compared with other types of analgesia. 6 Ng A. Swanevelder J. Pain relief after thoracotomy: Is epidural analgesia the optimal technique?. Br J Anaesth. 2007; 98: 159-162 Crossref PubMed Scopus (40) Google Scholar In contrast, TEA encompasses important side effects. Postoperative urinary retention (POUR) is one of the most frequent, with an average incidence of 26%. 7 Baldini G. Bagry H. Aprikian A. et al. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology. 2009; 110: 1139-1157 Crossref PubMed Scopus (404) Google Scholar To avoid this complication, it is a common practice to place a transurethral catheter, as long as the epidural is in situ and functioning well. 8 Zaouter C. Kaneva P. Carli F. Less urinary tract infection by earlier removal of bladder catheter in surgical patients receiving thoracic epidural analgesia. Reg Anesth Pain Med. 2009; 34: 542-548 Crossref PubMed Scopus (111) Google Scholar , 9 Ladak S.S. Katznelson R. Muscat M. et al. Incidence of urinary retention in patients with thoracic patient-controlled epidural analgesia (TPCEA) undergoing thoracotomy. Pain Manag Nurs. 2009; 10: 94-98 Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar Nevertheless, a urinary bladder catheter impedes early ambulation and can lead to urinary tract infection (UTI), which increases patients’ hospital length of stay and governmental costs.

Cost‐aware execution of transactional web services using labelled transition systems

Recently web service composition has become a very cost-effective way to develop business applications. However, owing to the unreliable nature of web services, providing the transactional support in execution of a service composition is an important design requirement. To guarantee the transactional execution of service compositions, a fault-handling routine has to be started once a service failure occurs in order to undo the effect of previously completed services by calling their corresponding compensation operations. Currently this fault-handling mechanism is implemented by means of low-level programming constructs such as exception-handling mechanism in languages such as WS-BPEL. However, since the logic of handling service failures might become very complex in some applications, this concern should be separated from the normal flow of the composition workflow based on the separation of concerns principle. To achieve this, in this study we have proposed an orchestration pattern for building a transactional service composition in which the failure-recovery logic is imposed on the composition workflow by a Labelled Transition System (LTS) as a separate module. It is assumed that each service within the composition is associated with two known transactional properties: (i) a rollback cost that indicates the cost of undoing (compensating) the service and (ii) a failure probability. The transactional logic of the service composition is also specified using the rollback dependencies represented in a rollback graph. An LTS then is generated to schedule the execution of services within the composition based on the composition transactional logic and properties such that upon a service failure, a recovery path with the lowest cost is followed.

Yield-Aware Pareto Front Extraction for Discrete Hierarchical Optimization of Analog Circuits

This paper presents an efficient method for extracting a yield-aware Pareto front between two competing metrics of an analog circuit block, with the purpose of performing hierarchical, system-level optimization using the component-level Pareto fronts as meta-models. The proposed method consists of three steps: finding a set of Pareto-optimal design points by tracing them on a discrete grid, estimating the yield distribution of each optimal design point using a control-variate technique, and constructing a yield-aware Pareto front by interpolation. The proposed algorithm is demonstrated on a problem of finding the optimal power allocation among the components composing a clock recovery path to minimize the final clock jitter. The algorithm can estimate the Pareto front of each circuit block within a 2% error, expressing the minimum achievable jitter with 99% yield for different power budgets, while requiring only 600 ~ 1100 Monte-Carlo simulation samples in total.

Stages of recovery in early psychosis: Associations with symptoms, function, and narrative development.

This study sought to explore the links between recovery stages, symptoms, function, and narrative development among individuals with a recent onset of psychosis. A qualitative longitudinal study was conducted including quantitative data at baseline. Forty-seven participants were administered the Indiana Psychiatric Illness Interview three times over 9 months and content analysis was performed. Participants also completed the Social Functioning Scale, the Brief Psychiatric Rating Scale--Expanded, the California Verbal Learning Test, and the Trailing Making Test at baseline. Descriptive discriminant analysis was performed. Results suggested that participants were mostly in the first two stages of recovery (moratorium, awareness) and that being in the awareness, rather than moratorium, stage was associated, to a different extent, with richer narrative development, better levels of psychosocial function, less negative and positive symptoms, and more years of education. Furthermore, recovery appeared to be a stable process over the assessment period. Recovery is a complex concept including objective and subjective aspects. In the recovery path of persons recently diagnosed with psychosis, social engagement, narrative development, and occupational functioning seem to be particularly important aspects. This study is a first step, and future research is needed with larger and more diverse participant pools, and assessments conducted over longer periods of time. As greater level of social engagement was the most robust predictor of membership in the awareness versus moratorium stage, treatment of early psychosis should include interventions targeting social relations and social skills. As greater narrative development was the second most robust predictor, enhancing it via psychotherapy could be a pertinent clinical goal.

Leaching for recovery of copper from municipal solid waste incineration fly ash: influence of ash properties and metal speciation.

Recovery of metals occurring in significant amounts in municipal solid waste incineration fly ash, such as copper, could offer several advantages: a decreased amount of potentially mobile metal compounds going to landfill, saving of natural resources and a monetary value. A combination of leaching and solvent extraction may constitute a feasible recovery path for metals from municipal solid waste incineration fly ash. However, it has been shown that the initial dissolution and leaching is a limiting step in such a recovery process. The work described in this article was focused on elucidating physical and chemical differences between two ash samples with the aim of explaining the differences in copper release from these samples in two leaching methods. The results showed that the chemical speciation is an important factor affecting the release of copper. The occurrence of copper as phosphate or silicate will hinder leaching, while sulphate and chloride will facilitate leaching.

AOLSR: hybrid ad hoc routing protocol based on a modified Dijkstra's algorithm

Mobile ad hoc networks (MANETs) are highly vulnerable to both link and node failures due to nodal mobility. The routing resilience against link and/or node failures needs to be enhanced to avoid the degradation of network performance. This can be achieved by multipath routing which uses multiple alternative paths to route the messages via multiple disjoint paths and result in increased bandwidth, fault-tolerance, and security. An optimized link state routing (OLSR) protocol is a proactive routing protocol. An advanced OLSR (AOLSR) protocol is proposed based on a modified Dijkstra's algorithm which enables routing in multiple paths of dense and sparse ne0074work topologies. The routing is based on the energy of nodes and links (implied from the lifetime) and the mobility of the nodes. It is a hybrid ad hoc routing protocol because it combines the proactive and reactive features. It is another form of source routing protocol which allows a sender of a data packet to partially or completely reveal the route the packets take through the network. Two cost functions are introduced to build link-disjoint or node-disjoint paths. Secondary functions, namely path recovery and loop discovery process are involved to manage the topology changes of the network. AOLSR protocol is analyzed and compared with the existing MANET routing protocols namely, dynamic source routing (DSR) and OLSR. Its performance is observed to be satisfactory in terms of average end-to-end delay, packet delivery ratio (PDR), average time in first-in-first-out (FIFO) queue, and throughput.

Successfully breaking a 20-year cycle of hospitalizations with recovery-oriented cognitive therapy for schizophrenia.

Individuals with severe and persistent schizophrenia can present challenges (e.g., difficulties sustaining motivation and conducting information processing tasks) to the implementation of recovery-oriented care. We present a successful application of recovery-oriented cognitive therapy (CT-R), a fusion of the spirit and principles of the recovery movement with the evidence base and know-how of cognitive therapy, that helped an individual with schizophrenia move along her recovery path by overcoming specific obstacles, including a 20-year cycle of hospitalizations (five per year), daily phone calls to local authorities, threatening and berating "voices," the belief that she would be killed at any moment, and social isolation. Building on strengths, treatment included collaboratively identifying meaningful personal goals that were broken down into successfully accomplishable tasks (e.g., making coffee) that disconfirmed negative beliefs and replaced the phone calling. At the end of treatment and at a 6-month follow-up, the phone calls had ceased, psychosocial functioning and neurocognitive performance had increased, and avolition and positive symptoms had decreased. She was not hospitalized once in 24 months. Results suggest that individuals with schizophrenia have untapped potential for recovery that can be mobilized through individualized, goal-focused psychosocial interventions.

Information resilience: source recovery in an information-centric network

Recent years have witnessed explosive growth in traffic demands combined with evolving content characteristics and dissemination patterns. This growth has resulted in an increasing demand for information identification as well as information-based communication functions that can meet this evolution. Consequently, information-centric networking envisions a shift in the future Internet communication paradigm from relying on the notion of an end node toward making information itself the primary object. This is realized by adopting information as the primary identifier of a user's demand. With this new concept in networking, new (information- focused) solutions can be developed to conventional problems found in IP networks, such as resilient content delivery. In this article we introduce a novel resiliency solution that goes beyond the scope of path recovery to tackle source failure scenarios in order to achieve the more general form of information resilience. We show that by utilizing the knowledge of information, offered by a publish/subscribe information-centric networking model, multiple publishers of a single information item can be natively identified, thereby allowing for recovery of the delivery process using alternative publishers should a publisher fail.

A flexible black-start network partitioning strategy considering subsystem recovery time balance

Summary When black out occurs, the whole power grid is divided into several subsystems to increase the efficiency and shorten the duration of power system restoration by using parallel restoration strategy. Therefore, reasonable network partitioning in black start phase after large-scale power failures is important in both theory and practice. In this paper, a flexible black start network partitioning strategy considering the subsystem recovery time balance is proposed. Based on the rules of zone division and analyzing initial black start partitioning model of subsystem shortest recovery path, subsystem recovery time balance index is defined to represent disparity of every subsystem's restoration process. Meanwhile, a flexible factor of total recovery time is introduced as part of objective function with the time balance index, aiming at reducing waiting time of the synchronization operation and strengthens efficiency of black start at the cost of the least total time increment. The classic Dijkstra algorithm and improved genetic algorithm are employed to obtain the optimal restoration plan in the paper. Case study on IEEE 118-bus test system shows the validity of the methodology proposed. Copyright © 2014 John Wiley & Sons, Ltd.

Development of Residential Fuel Cell System of Panasonic and Approaches to Enhance Durability

Panasonic has been developing residential fuel cells (micro CHP) since 1999 and launched the world's first system, the ENE-FARM, in May 2009 in Japan. Panasonic has now shipped a total of approx. 21,000 units throughout Japan as of the end of December 2012. Fig.1 shows the state-of-the-art model of the ENE-FARM which was launched in April 2013. Several points are improved from the previous model. First of all, the model achieved world’s highest overall efficiency 95 %(LHV) by reviewing the heat insulation of the heat recovery path and improved the heat recovery efficiency (Fig.2). Secondly, the price dropped approx. 25% by reducing 20% system components, 50% noble metal in the selective oxidation catalyst in fuel processor, and 50% platinum catalyst in stack. And finally, the durability enhanced by 20% from the previous model by improving the durability of the electrolyte membrane in the MEAs . MEAs are one of the most important components of the ENE-FARM in terms of cost, performance and durability. We have developed many core technologies such as high durability membrane, high activity catalyst, and low cost base material-less GDL. Among these materials, we consider that durability improvement of membrane is essential and further elucidation of its degradation mechanism is necessary. Although there have been many approaches to enhance the chemical stability [1] of membrane, mechanical stability haven’t discussed enough. However, in our previous study, long-term operation including start-up and shut down results in serious mechanical degradation. Hence, it is important to design membrane not only from chemical but mechanical aspects. In this study, we focused on mechanical degradation mechanism of membrane. It was also discussed about mechanical property to enhance membrane durability with keeping performance and cost. Membranes which consist of different mechanical strength and dimensional change were prepared. After fabricating MEAs in each membrane, acceleration experiment of mechanical degradation was conducted. The experiment is a cycle test that comprises OCV, potential cycle and wet and drying cycle. Each cycle was conducted in a short time to accelerate the degradation. After 5000 times cycle, stress-strain curves of each membrane were measured by tensile tester to investigate mechanical property. The results showed that membranes of low tensile strength and high dimensional change were degraded more than those of high strength and low dimensional change. It indicates that to reduce mechanical stress attributes to the dimensional change and to enhance mechanical strength to sustain mechanical stress result in high mechanical durability. By optimizing membrane strength and dimensional change, mechanical durability enhanced without any performance loss and increase in cost. It is also suggested that membrane which has higher mechanical durability tends to show higher chemical durability. Fig.3 shows the actual operation of the ENE-FARM and dissolved material elution from the membrane in the previous and current model. Due to the improvement of membrane, the amount of dissolved material elution reduced by approx. 20% and 60000hrs operation guarantee has achieved. Further progress for next generation ENE-FARM will be shown on the presentation. Acknowledgements This project has been supported by the fund from New Energy and Industrial Technology Development Organizations (NEDO), in Japan References [1] W. Delanay et al., ECS Trans., 11 (2007) 1093

The use of control information in dependency formation: An eye-tracking study

Abstract Recent research has shown much evidence that sentence comprehension can be extremely predictive. However, we currently know little about the limits of predictive processing. In the two eye-tracking experiments, we examined whether predictive information in dependency formation is inevitably given priority over a well-known structural preference in syntactic ambiguity resolution. Experiment 1 used sentences including control nouns like order (e.g. After Andrew’s order to wash the kids came over to the house ). If predictive dependency information is given priority over disambiguation preferences, then readers could immediately interpret the kids as the ones who have been ordered to wash, thus avoiding the garden path at the main verb came. However, garden path effects were found irrespective of control information, although the garden path difficulty was reduced when the lexical control information highlighted the globally correct analysis (as in the above example), relative to when it did not. Experiment 2 replicated these results with adjunct control , where the relevant dependency is obligatory (e.g. After refusing to wash the kids came over to the house ). Again, control information did not influence initial disambiguation, but did affect the difficulty of garden path recovery. Overall, the results suggest that there are limitations on the influence of predictive dependency formation on on-line structural disambiguation.

Shoulder pain and cycle to cycle kinematic spatial variability during recovery phase in manual wheelchair users: a pilot investigation.

Wheelchair propulsion plays a significant role in the development of shoulder pain in manual wheelchair users (MWU). However wheelchair propulsion metrics related to shoulder pain are not clearly understood. This investigation examined intra-individual kinematic spatial variability during semi-circular wheelchair propulsion as a function of shoulder pain in MWU. Data from 10 experienced adult MWU with spinal cord injury (5 with shoulder pain; 5 without shoulder pain) were analyzed in this study. Participants propelled their own wheelchairs on a dynamometer at 3 distinct speeds (self-selected, 0.7 m/s, 1.1 m/s) for 3 minutes at each speed. Motion capture data of the upper limbs were recorded. Intra-individual kinematic spatial variability of the steady state wrist motion during the recovery phase was determined using principal component analysis (PCA). The kinematic spatial variability was calculated at every 10% intervals (i.e at 11 interval points, from 0% to 100%) along the wrist recovery path.ResultsOverall, spatial variability was found to be highest at the start and end of the recovery phase and lowest during the middle of the recovery path. Individuals with shoulder pain displayed significantly higher kinematic spatial variability than individuals without shoulder pain at the start (at 10% interval) of the recovery phase (p<.004).ConclusionsAnalysis of intra-individual kinematic spatial variability during the recovery phase of manual wheelchair propulsion distinguished between those with and without shoulder pain. Variability analysis of wheelchair propulsion may offer a new approach to monitor the development and rehabilitation of shoulder pain.

Pre-configured polyhedron based protection against multi-link failures in optical mesh networks

This paper focuses on random multi-link failures protection in optical mesh networks, instead of single, the dual or sequential failures of previous studies. Spare resource efficiency and failure robustness are major concerns in link protection strategy designing and a k-regular and k-edge connected structure is proved to be one of the optimal solutions for link protection network. Based on this, a novel pre-configured polyhedron based protection structure is proposed, and it could provide protection for both simultaneous and sequential random link failures with improved spare resource efficiency. Its performance is evaluated in terms of spare resource consumption, recovery rate and average recovery path length, as well as compared with ring based and subgraph protection under probabilistic link failure scenarios. Results show the proposed novel link protection approach has better performance than previous works.

ANALYSING CRITICAL INFRASTRUCTURE FAILURE WITH A RESILIENCE INOPERABILITY INPUT–OUTPUT MODEL

Over the past few years much effort has been made in modelling economic losses resulting from critical infrastructure failure. It has appeared that including resilience measures in the modelling approach, which may mute the losses considerably, is a challenging task. At the same time it is necessary because it prevents the modeller from generating overestimates. This study presents two directions to improve the modelling of (economic) resilience for which the state-of-the art with respect to dynamic inoperability input–output modelling is taken as a starting point. Firstly, the new model allows for a different recovery path than the traditionally assumed ‘concave up decreasing curve’ describes for a disrupted infrastructure or economic sector in the aftermath of a disaster. In this paper, we explain how the recovery path may depend on the type of disaster. Secondly, the model refines the aspect of ‘inventory’ as a resilience measure. Inventory is interpreted in a broad sense here: it can be any resilience measures which enable an infrastructure or economic sector to continue its supply despite being disrupted. The model is applied to both a simple two-sector illustrative example and a severe winter storm scenario in Europe using economic data from the World Input–Output Database to show its practical usefulness.

Marketing Destination Zimbabwe During and Post the 2000-2008 Political and Economic Crises

Consequences of political and economic crises on tourist destinations are profound and inescapable. This paper discusses the 2000-2008 political and economic crisis issue in Zimbabwe in relation to the tourism industry. The 2000-2008 political and economic environment was characterised by political stand- off among the three major political parties, heightened negative publicity, shortages of basic commodities, hyperinflation and isolation of Zimbabwe by the international community. During the height of this crisis, international visitors declined sharply and hotels reported a one digit occupancy figure triggering a tourism crisis. This paper has some significance, as the tourism industry was greatly affected by the political and economic instability. Yet the overall marketing and promotional strategies adopted by stakeholders during and post the crisis to put the tourism industry on the recovery path have been rather minimal. The study used secondary sources of data and netnography to collect data. The article argues that tourist destinations that are prone to political and economic instabilities should be pro-active and device novel marketing strategies to reassure prospective tourists of the safety of the destination. The study revealed that destination Zimbabwe re-engaged with the western markets, courted the Asian market, bid to host high profile events and sought destination endorsement as a cocktail of practical marketing strategies to revive the tourism sector. Recommendations include collaborative marketing campaigns fronted by political leaders, activation of tourism police service and partnering with embassies to ensure visitor`s safety. Future research is suggested at micro level and industry sub-sector level like hotels and tour operators on how they individually market their products during a crisis period.

Trade Credit In Zimbabwe’s Economic Recovery

The aim of this study is to investigate factors influencing the use of trade credit by Zimbabwean manufacturing firms. Zimbabwe’s economy is on a recovery path after the decade-long political, social and economic crises. The recovery of the Zimbabwean economy has been largely hampered by a number of factors; chief among them, poor liquidity and difficulties in accessing working capital finance. The study is based on secondary data of 48 firms listed on the Zimbabwe Stock Exchange. The study found that firm size, investments in current assets and access to external funds influence the use of trade credit among these firms. DOI: 10.5901/mjss.2014.v5n2p431

Coil-Coil Under Load: Stability of Essential Machine Component

A molecular machine like myosin needs to work in cycles and resists the possibility of an overload. A critical component of myosin is the coiled-coli structure of two amphipathic alpha helices that helps transmit load and are found in a wide range of motor and structural proteins. What are the mechanical benefits of the coiled-coil structure and the specific sequence design found in the myosin protein? In this talk I will discuss a “load release valve” that is naturally designed into the coiled-coil sequence and structure. The valve responds to external load and undergoes significant conformational transition to reduce load levels and strain ensuring that a recovery path (and closure of the valve when appropriate) is simple, reliable and remarkably fast.

LED path recovery in a moving sensor

Existing Visible Light Communication (VLC) methods can recover each LED's on-off status only after its projection location is identified on each image. Identifying the LED projection is challenging because: 1) Clutter and noise corrupt the measurements; 2) The LED status will be “off” in some frames; 3) The predicted projection location sequence depends on the estimated vehicle state trajectory, which is uncertain. This article presents a new method determining the q most probable data and LED position sequences simultaneously, using Bayesian multiple hypothesis tracking (MHT) techniques by maximizing posterior probabilities. This article focuses on the VLC data and LED position sequence extraction, that includes vehicle state estimation. The MHT based algorithm is demonstrated by the simulation results.

Path Reecovery in 6LoWPAN Routing Protocol

6LoWPAN has become a new technology to provide the Internet connectivity to the traditional wireless sensor network (WSN). In order to route the delivered packet from originator to destination nodes, the simplified Ad-hoc On- Demand Distance Vector (AODV) routing protocol for 6LoWPAN with 6LoWPAN Ad-Hoc On-Demand Distance Vector Routing (LOAD) has been introduced. However, the conceptual LOAD routing protocol has yet proposed any path recovery mechanism in 6LoWPAN. In this paper, an originator recognition (OR) path recovery mechanism is proposed for the 6LoWPAN LOAD-based routing protocol. In this proposed mechanism, the participated nodes will memorize the originator address attached within data packet during the data transmission. When a link break happens on destination path, the LOAD protocol message will be amended by inserting an identity key, which is a memorial of originator address, in the generated route error (RERR) message before transmitted towards the originator for the failure notification. This identity key is then used by the originator to initialize path recovery in order to retransmit the failed data packet to the unreachable destination node. Instead of using MAC address in the LOAD routing protocol, IP address is used in the proposed Originator Recognition (OR) path recovery mechanism (OR-LOAD) routing protocol which is designed for the global routing. The proposed OR-LOAD routing protocol has been examined under noisy 6LoWPAN environment in Qualnet simulator. Its performance is then evaluated and compared to AODV routing protocol in terms of packet delivery ratio and average energy consumption. The simulation results show that the proposed OR-LOAD outperforms AODV with packet delivery ratio of 19.4%, and with comparable average energy consumption in both routing protocols.