Technical Judgment Research Articles

Maintenance Tasks for 20 Kv Medium-Voltage Switchgear Based on Technical Judgment Experience and Manufacturer

A 20 kV medium-voltage switchgear is an important equipment in the electricity system that distributes electricity generated by the 20 kV electric power generator to electricity users. Calor Emag, Merlin Gerin, Alsthom, Fuji, AEG, Schneider, Meidensha, Goldstar, Modalek, Areva, and Siemens are among the companies that make products. This study describes a method for maintaining 20 kV medium-voltage switchgear, an essential equipment in the electricity system. In less technical terms, the failure rate is high at the beginning of an asset's life, which follows the curve of the bathtub. However, the failure rate quickly declines as we identify and discard defective components and eliminate early sources of potential failures, such as installation errors. This study introduces a novel approach by examining the relationship between maintenance tasks, which are based on technical judgment and experiences, and the maintenance tasks provided by the manufacturer for 20 kV medium voltage switchgear. The goal is to develop and deliver the most effective maintenance method for 20 kV medium voltage switchgear, to prevent malfunctions or even catastrophic explosions, while maintaining the lowest possible maintenance costs. Total use of labor over 2 years (24 months) for daily, monthly, 3 monthly, and 2 yearly is 3554-man hours (MH). It provides a comprehensive approach to preventing malfunctions and explosions, resulting in optimal maintenance costs and performance.

Geospatial-based decision support system for prioritizing road segments for maintenance and rehabilitation

Given the growing demand for moving goods and people and the escalating number of vehicles on highways, issues related to road safety have become common concerns. Additionally, the aging of the road infrastructure and the intensification of climatic change effects reinforce the problem of road pavement serviceability. However, accessing funds for road maintenance and having the autonomy for pure technical decisions remain significant challenges for transport authorities. Thus, this paper addresses developing a geospatial-based systematic process for prioritizing highway segment candidates for maintenance and rehabilitation. The investigation was designed to facilitate the decision-making process for the state transportation authority to allocate funds over the 20.315 km of major highways in Minas Gerais, Brazil. The method consisted of ranking the highway segments regarding the geographic context to which each segment belongs, as well as the operational characteristics of the highways. The approach meets the United Nations Sustainable Development Goals by considering socio-economic and demographic perspectives along with other traditional engineering characteristics such as the available transport infrastructure, the traffic volume, the highway capacity, the pavement serviceability and the potential for deterioration, the condition of the surface drainage, and weather-related data. Transportation practitioners with expertise in pavement maintenance and rehabilitation and transportation managers contributed to the development by weighting the factors according to the best possible technical judgment regarding prioritizing funds. The GIS-oriented Delphi framework resulted in a priority index. The index allowed the elaboration of a ranking of priorities, which is vital information regarding public policies and the transparent use of public money for road maintenance and rehabilitation within the State of Minas Gerais. The model is robust and outputs geoinformation and tabular data to feed the decision-making process in an organized and transparent manner. Therefore, the core methodology can be easily transferable to other jurisdictions.

Flexible wearable intelligent sensing system for wheelchair sports monitoring

The application of wearable intelligent systems toward human-computer interaction has received widespread attention. It is still desirable to conveniently promote health and monitor sports skills for disabled people. Here, a wireless intelligent sensing system (WISS) has been developed, which includes two ports of wearable flexible triboelectric nanogenerator (WF-TENG) sensing and an upper computer digital signal receiving intelligent processing. The WF-TENG sensing port is connected by the WF-TENG sensor and flexible printed circuit (FPC). Due to its flexibility, the WF-TENG sensing port can be freely adhered on the surface of human skin. The WISS can be applied to entertainment reaction training based on human-computer interaction, and to the technical judgment and analysis on wheelchair curling sport. This work provides new application opportunities for wearable devices in the fields of sports skills monitoring, sports assistive devices and health promotion for disabled people.

개발행위허가에 관한 항고소송에서 사법심사와 증명책임

The burden of proof is a matter of which of the parties to the lawsuit is to be disadvantaged if the court cannot obtain certainty about the existence of essential facts in the final stage of the lawsuit. Furthermore, the burden of proof becomes the standard of action for the court and the parties throughout the entire process of litigation, and becomes an indicator of litigation command by the court and a goal of proof activities for the parties.
 Recently, the Supreme Court did Judgement that the broad deference should given to the legal requirement of environmental impact having prospective character and that the complainant should the burden of proof for the abuse of discretion. In environmental litigation, it is difficult to prove the causal relationship of environmental pollution, and protection is not sufficient with follow-up measures for environmental damage. In consideration of such points, it is persuasive to first respect the administrative judgment on environmental damage, and to judge that the decision is illegal only when it is unreasonable. However, when the burden of proof is heavy on one party, the possibility of remedies may be excessively limited.
 In the refusal of beneficial administrative acts corresponding to permits such as development permits, it is necessary to fairly distribute the burden of proof by considering the specificity of the appeal suit, the difficulty of proof, and the probability of factual existence.
 On the premise of the distinction between discretion and margin of judgment, the determination of whether or not the standards for permitting development activities are satisfied is a matter of judgment of a certain indeterminate concept among the action requirements.
 It is appropriate for the administrative agency to bear the burden of proof in cases where the margin for judgment is recognized as an area of professional and technical judgment. However, the planning act aspects of development permission should be considered. In terms of procedural legal control of planning discretion, the object of proof should be limited to the logical and technical validity of the judgment process or judgment method of disapproval decision.

Compiling method of automobile fault diagnosis information

Automobile fault diagnosis is the most technical content in automobile maintenance. The speed, accuracy and convenience of diagnosis directly affect the maintenance efficiency. Automobile fault diagnosis information is an important reference for finding and solving automobile faults. High quality information is the key to improve technical personnel's judgment and solving faults. In this paper, the methods and examples of fault diagnosis information compilation are given to guide the technical data writers to compile effective fault diagnosis information for automobiles.

Gradual Goals of Energy Transformation and Upgrading in China’s Power Industry Considering Production Profiles

As the largest processing sector of primary energy, the transformation and upgrading of the power sector is undoubtedly an effective way to alleviate the situation of energy and environment. This article studies the gradual goals of the transformation and upgrading of China’s power industry, where the conditions of technical judgment, specific profile, and moderate agenda are incorporated. The empirical analysis of China’s provincial power sectors based on the constructed models came to the following results. First, it is of great importance to consider the profile of each region’s power sector in setting energy-saving and emission reduction targets. The analysis of variance demonstrates significant differences in the reference points of inputs and outputs under the 1% confidence level. Second, regardless of the specific quantity, the strongly consistent trends of the short- and long-term targets demonstrated the feasibility and effectiveness of the gradual goals. Finally, realizing the potential of energy-saving and emission reduction needs a gradual pathway instead of accomplishing in one stroke. The targets of this study, which are attainable for the power sector and still represent a best practice, could serve as transitional benchmarks in power supply and emission reduction. To further achieve carbon neutrality, the management strategy to coordinate power supply and renewable energy accommodation needs to be transformed.

РАЦИОНАЛЬНАЯ СТРУКТУРА УПРАВЛЕНИЯ ЭКОНОМИКОЙ ПРИРОДОПОЛЬЗОВАНИЯ

The article is devoted to the development of the methodology of rational management of the economics of environmental management. The importance of this study stems from the need to establish principles and strategies for sound economic management to promote economic development, sustainable resource use, reduce environmental problems and support human livelihoods. This article highlights the latest developments in the field of economic development management strategies for environmental management. Regulatory forecasts are proposed to rationalize management in accordance with the strategic goals and the achievement of established measures for the development of the environmental economy, which allows to ensure the country's competitiveness. Theoretical approaches and practical recommendations for the formation of the structure of rational management of the economy of natural resource use have been developed. The article reflects the current research results in the field of development of the methodology of rational management of the economics of environmental management. The features of environmental management are revealed and their assessment is proposed, where the functional purpose of rationalization, the purpose and the direction of the results are highlighted as classification signs. The practical experience of the level of achievement of planned values of indicators of environmental state subprograms in the Russian Federation is analyzed. The advantages of rational management of nature management economics are shown. The key elements of this article can be used as theories and strategies for justifying, selecting and implementing economic and economic projects, integrating environmental protection measures, mitigating environmental impacts, mitigating the effects of climate change and managing climate change. The conclusions drawn are based on an assessment of good or bad governance and technical judgment.

Prehospital Providers’ Perspectives about Online Medical Direction in Emergency End-of-Life Decision-Making

Background: End-of-life treatment decisions present special challenges for prehospital emergency providers. Paramedics regularly make value-laden choices that transcend technical judgment and professional skill, affecting the type of care, how and to whom it is provided. Changes in prehospital emergency care over the last decade have created new moral challenges for prehospital emergency providers; these changes have also accentuated the need for paramedics to make rapid and reasoned ethical judgments. Objective: The purpose of the study was to explore the decision-making process that occurs when prehospital emergency teams respond to an end-of-life call with a focus on how state authorized documents such as a Non-Hospital Do Not Resuscitate (NHDNR) or Medical/Physician’s Orders for Life-Sustaining Treatment (MOLST/POLST) or lack thereof inform decision-making. This paper presents the specific circumstances that informed the need for intervention from Online Medical Direction (OLMD) framed in the perspectives and words of the prehospital providers seeking that assistance. Methods: This study involved in-depth in-person interviews with 50 providers to elicit participants’ experiences in their own words using a semi-structured interview instrument. Interviews were audio recorded and transcribed with permission. Results: Five themes emerged that illuminated how and when OLMD was involved in emergency end-of-life decisions: Termination of Resuscitation (TOR); Family Revoked DNR; Missing Documents; No Documents and No CPR; and Unusual Situations. Participants illustrated how the decision to terminate efforts was best-supported when it was made by collaboration between the on-scene provider and OLMD. Participants described ethical dilemmas when families asked them to initiate CPR in the presence of DNR orders and cognitive dissonance when CPR has been initiated but a valid DNR/MOLST is subsequently located. Conclusions: The study findings demonstrate the invaluable contribution of OLMD for complex end-of-life care decisions by prehospital providers, especially when there are difficult legal, ethical, and logistical questions. OLMD provides far more than technical support.

The Logic and Legitimacy of Bank Supervision: The Case of the Bank Holiday of 1933

The U.S. banking holiday of March 1933 was a pivotal event in twentieth-century political and economic history. After closing the nation's banks for nine days, the administration of newly inaugurated president Franklin D. Roosevelt restarted the banking system as the first step toward national recovery from the global Great Depression. In the conventional narrative, the holiday succeeded because Roosevelt used his political talents to restore public confidence in the nation's banks. However, such accounts say virtually nothing about what happened during the holiday itself. We reinterpret the banking crises of the 1930s and the 1933 holiday through the lens of bank supervision, the continuous oversight of commercial banks by government officials. Through the 1930s banking crises, federal supervisors identified troubled banks but could not act to close them. Roosevelt empowered supervisors to act decisively during the holiday. By closing some banks, supervisors made credible Roosevelt's claims that banks that reopened were sound. Thus, the union of FDR's political skills with the technical judgment of bank supervisors was the key to solving the banking crisis. Neither could stand alone, and both together were the vital precondition for further economic reforms—including devaluing the dollar—and, with them, Roosevelt's New Deal.

Probabilistic Assessment of Damage from Same Shock Response Spectra due to Variations in Damping

Interpretation of field data from shock tests and subsequent assessment of product safety margins via laboratory testing are based on the shock response spectra (SRS). The SRS capture how a single degree of freedom (SDOF) structure responds to the shock at differing frequencies and, therefore, no longer contain the duration or other temporal parameters pertaining to the shock. A single duration can often be included in the technical specification or in the recreation of acceleration vs. time history from the specified SRS; however, there is little basis for that beyond technical judgment. The loss of such temporal information can result in the recreated SRS being the same while its effect on a system or component can be different. This paper attempts to quantify this deficiency as well as propose a simple method of capturing damping from shock waves that can allow the original waveform to be more accurately reconstructed from the SRS. In this study the decay rate associated with various frequencies that comprise the overall shock was varied. This variation in the decay rate leads to a variation in the acceleration vs. time history, which can be correlated to a “Damage Index” that captures the fatigue damage imparted to the object under shock. Several waveforms that have the same SRS but varying rates of decay for either high- or low-frequency components of the shock were investigated. The resulting variation in stress cycles and Damage Index is discussed in the context of the lognormal distribution of fatigue failure data. It is proposed that, along with the SRS, the decay rate is also captured to minimize the discrepancy between field data and representative laboratory tests.

Determination and Analysis of Film Reject Rate at Eight Selected Governmental Diagnostic X-Ray Facilities in Tigray Region, Northern Ethiopian.

Background:In radiography examination, it is common to encounter patients undergoing repeated X-ray exposure after the rejection of a film image due to poor image quality. This subjects the patients to unnecessary radiation exposure and extra cost for the facility. This fact has required to investigate the causes of film rejection in common X-ray examinations.Aims:This study aims to obtain images, which are adequate for the clinical diagnostic purpose with minimum radiation dose to the patient in X-ray radiographic examination using film rejects analysis.Methods:A prospective, crosssectional study design was carried out for 3 months. The film rejection rate data were collected using standardized checklist as recommended by the National Radiation Protection Authority and International Atomic Energy Agency. Daily recordings were compiled by frontline radiographers and senior physicians.Statistical Analysis Used:Data were analyzed descriptively using SPSS of version 23 software.Results:Overall rejection rate was 319 (10.02%) in 3183 X-ray exposures. The rejection rates by hospitals are 33.7% in Adwa, 13% in Aksum, 9.6% in Suhul, 9.2% in AbiAdi, 7.7% in Humera, 7% in Wukro, 4.3% in Lemlem Karl, and 2.9% in Alamata General Hospitals.Conclusions:Rejected films were found to have been caused by numerous factors including incorrect exposure, poor technical judgment, patient motion, and improper film processing. Hence, strategies need to be developed within medical imaging departments to improve the situation.

Los edificios de apartamentos del Movimiento Moderno en Camagüey: Un valioso patrimonio a conservar desde los proyectos y con la participación social

Camaguey’s historic urban center, declared a World Heritage site in 2008, possesses a considerable number of Modern Movement buildings constructed in the decade of the 1950s, which have undergone modifications to fulfill the new needs of their residents. Regretfully, most of these transformations have not received the necessary technical advice or participation of citizens to ensure that both the population s requirements are met and the city s valuable heritage is protected. Faced with this problem, research projects that coordinate the participation of researcher-academics, professionals and students, are an effective way to achieve successful solutions. Through a historical-architectural property analysis, a detailed diagnostic assessment and the technical judgment of professionals, as well as the incorporation of the resident population via the surveys carried out, this paper addresses mechanisms to ensure an attitude of respect for, and appreciation and awareness of the spatial and environmental conditions that provide solutions for these properties, which are aimed at providing social welfare to those who live there and at the same time should be preserved to bequeath to society.

Will Ebola change the game? Ten essential reforms before the next pandemic. The report of the Harvard-LSHTM Independent Panel on the Global Response to Ebola

© 2015 Elsevier Ltd. The west African Ebola epidemic that began in 2013 exposed deep inadequacies in the national and international institutions responsible for protecting the public from the far-reaching human, social, economic, and political consequences of infectious disease outbreaks. The Ebola epidemic raised a crucial question: what reforms are needed to mend the fragile global system for outbreak prevention and response, rebuild confidence, and prevent future disasters? To address this question, the Harvard Global Health Institute and the London School of Hygiene & Tropical Medicine jointly launched the Independent Panel on the Global Response to Ebola. Panel members from academia, think tanks, and civil society have collectively reviewed the worldwide response to the Ebola outbreak. After difficult and lengthy deliberation, we concluded that major reforms are both warranted and feasible. The Panel's conclusions off er a roadmap of ten interrelated recommendations across four thematic areas: 1 Preventing major disease outbreaks All countries need a minimum level of core capacity to detect, report, and respond rapidly to outbreaks. The shortage of such capacities in Guinea, Liberia, and Sierra Leone enabled Ebola to develop into a national, and worldwide, crisis. Recommendation 1: The global community must agree on a clear strategy to ensure that governments invest domestically in building such capacities and mobilise adequate external support to supplement eff orts in poorer countries. This plan must be supported by a transparent central system for tracking and monitoring the results of these resource flows. Additionally, all governments must agree to regular, independent, external assessment of their core capacities. Recommendation 2: WHO should promote early reporting of outbreaks by commending countries that rapidly and publicly share information, while publishing lists of countries that delay reporting. Funders should create economic incentives for early reporting by committing to disburse emergency funds rapidly to assist countries when outbreaks strike and compensating for economic losses that might result. Additionally, WHO must confront governments that implement trade and travel restrictions without scientific justification, while developing industry-wide cooperation frameworks to ensure private firms such as airlines and shipping companies continue to provide crucial services during emergencies. 2 Responding to major disease outbreaks When preventive measures do not succeed, outbreaks can cross borders and surpass national capacities. Ebola exposed WHO as unable to meet its responsibility for responding to such situations and alerting the global community. Recommendation 3: A dedicated centre for outbreak response with strong technical capacity, a protected budget, and clear lines of accountability should be created at WHO, governed by a separate Board. Recommendation 4: A transparent and politically protected WHO Standing Emergency Committee should be delegated with the responsibility for declaring public health emergencies. Recommendation 5: An independent UN Accountability Commission should be created to do systemwide assessments of worldwide responses to major disease outbreaks. 3 Research: production and sharing of data, knowledge, and technology Rapid knowledge production and dissemination are essential for outbreak prevention and response, but reliable systems for sharing epidemiological, genomic, and clinical data were not established during the Ebola outbreak. Recommendation 6: Governments, the scientific research community, industry, and non-governmental organisations must begin to develop a framework of norms and rules operating both during and between outbreaks to enable and accelerate research, govern the conduct of research, and ensure access to the benefits of research. Recommendation 7: Additionally, research funders should establish a worldwide research and development financing facility for outbreak-relevant drugs, vaccines, diagnostics, and non-pharmaceutical supplies (such as personal protective equipment) when commercial incentives are not appropriate.

El sistema de evaluación de la actividad investigadora de profesores universitarios

Originariamente la jurisprudencia entendió que la discrecionalidad técnica ejercida por órganos administrativos especializados no era susceptible de control jurídico debido a que dichos órganos asesores se limitarían a constatar las cualidades o datos que han de realizarse mediante valoraciones guiadas por los parámetros o criterios que son propios de un saber especializado no jurídico. No obstante, sí serían susceptibles de control jurídico todos aquellos elementos reglados de dichos procesos. En particular, en el caso de la valoración de la actividad investigadora de los profesores universitarios que realiza la Comisión Nacional de Evaluación de la Actividad Investigadora (CNEAI), la jurisprudencia ha establecido los límites de dicha discrecionalidad mediante la necesidad de motivar el juicio técnico, aun cuando la CNEAI se ampare en los comités de expertos. Es un caso interesante que nos sirve para explicar los límites de la discrecionalidad técnica en la actuación administrativa.

Disaggregating ethnoracial disparities in physician trust

Past research yields mixed evidence regarding whether ethnoracial minorities trust physicians less than Whites. Using the 2002 and 2006 General Social Surveys, variegated ethnoracial differences in trust in physicians are identified by disaggregating a multidimensional physician trust scale. Compared to Whites, Blacks are less likely to trust the technical judgment and interpersonal competence of doctors. Latinos are less likely than Whites to trust the fiduciary ethic, technical judgment, and interpersonal competence of doctors. Black–Latino differences in physician trust are a function of ethnoracial differences in parental nativity. The ways ethnoracial hierarchies are inscribed into power-imbalanced clinical exchanges are discussed.

Can a Literary Approach to Matters of Legal Concern Offer a Fairer Hearing than that Typically Offered by the Law?

From Professor Watt’s introduction: It is a wonderfully clear account of the claims that may be made for law and literature and will serve as a fine introduction to readers who are coming to the subject for the first time. It also explains some significant recent developments in the Australian jurisdiction which were new to the editors of this journal and may be new to many readers. One recent development of particular relevance to the theme of this journal, and this issue and part in particular, is the case of the judge who sought to supplement the shortcomings of a technical judgment by appending something approaching a full narrative account. The effort is reminiscent of narrative verdicts in coroners’ courts in the UK, but the attempt to give a voice to the voiceless is even more overt in the Australian example. The Australian case deserves close and sustained scrutiny, and judging from the quality of Sean Mulcahy’s excellent introduction to the matter, he may well be the person to provide it.

Resilience metrics for cyber systems

As federal agencies and businesses rely more on cyber infrastructure, they are increasingly vulnerable to cyber attacks that can cause damages disproportionate to the sophistication and cost to launch the attack. In response, regulatory authorities call for focusing attention on enhancing infrastructure resilience. For example, in the USA, President Obama issued an Executive Order and policy directives focusing on improving the resilience and security of cyber infrastructure to a wide range of cyber threats. Despite the national and international importance, resilience metrics to inform management decisions are still in the early stages of development. We apply the resilience matrix framework developed by Linkov et al. (Environ Sci Technol 47:10108–10110, 2013) to develop and organize effective resilience metrics for cyber systems. These metrics link national policy goals to specific system measures, such that resource allocation decisions can be translated into actionable interventions and investments. In this paper, a number of metrics have been identified and assessed using quantitative and qualitative measures found in the literature. We have proposed a generic approach and could integrate actual data, technical judgment, and literature-based measures to assess system resilience across physical, information, cognitive, and social domains.

OS1420 ニッケル基合金のBWR環境中疲労き裂進展速度線図の検討 : 第1報, Paris則形式によるき裂進展速度式の検討

When the flaws are detected m nuclear components by in-service inspection, structural integrity assessment is one of the most important procedures to assume the safety and reliability of nuclear power plants. Fatigue crack growth analysis should be performed for the technical judgment on continuous operation based on the Rules on Fitness-for-Service for Nuclear Power Plants of the Japan Society of Mechanical Engineers Code (JSME FFS Code) when the cyclic loading would be assumed. However, fatigue crack growth analysis for BWR components consisted of Ni-base alloy is currently impossible since the fatigue crack growth rate curve for Ni-base alloy in BWR water environment is not prepared yet in the JSME FFS Code. In this study, fatigue crack growth tests in BWR water environment were performed for Ni-base alloy. And fatigue crack growth rate curve in Paris law format was evaluated. As a result, fatigue crack growth rate curve for weld metal and heat affected zone (HAZ) was formulated, respectively. And the values of ΔK_<th> for less than 1s of rise time were determined.

Proposal of Fatigue Crack Growth Rate Curve in Air for Nickel-Base Alloys Used in BWR

When the defects are detected in the nuclear components in Japan, structural integrity assessment should be performed for the technical judgment on continuous service based on the Rules on Fitness-for-Service for Nuclear Power Plants of the Japan Society of Mechanical Engineers Code (JSME FFS Code). Fatigue crack growth analysis is required when the cyclic loading would be applied for the components. Recently, fatigue crack growth rate curve in air environment for Nickel-base alloys weld metal used in BWR was proposed by the authors and it was adopted as a code case of JSME FFS Code to evaluate the embedded flaw. In this study, fatigue crack growth behavior for heat-affected zone (HAZ) of Nickel-base alloys in air was investigated. And a unified fatigue crack growth rate curve in air for HAZ and weld metal of Nickel-base alloys used in BWR was evaluated. As a result, it was found that the curve for weld metal could be applied as a curve for both HAZ and weld metal since moderately conservative assessment of fatigue crack growth rate of HAZ is possible by the curve for weld metal in the Paris region. And the threshold value of stress intensity factor range (ΔKth) is determined to 3.0 MPa√m based on the fatigue crack growth rate of HAZ.

X-ray film reject rate analysis at eight selected government hospitals in Addis Ababa, Ethiopia, 2010

Abstract Background: Improper practices in radiography that lead to possible repeating of procedures predispose patients for additional cost, more waiting time, and excess dose of ionizing radiation, leading to various dose dependent and dose independent health problems including cancer. In the face of such problems and the scarcity of resources, improving the quality and efficiency of radiology services is imperative. Objective: The purpose of this research was to identify the main causes of film faults as well as the pattern and magnitude of film rejection. Methods: Using a prospective cross-sectional hospital based approach; eight public hospitals were selected in Addis Ababa through convenience sampling. Adult and pediatrics radiographs with film faults were reviewed using a standardized checklist of common causes of reject. The collected data were then entered into a database for analysis using descriptive statistics. Results: Reject rate was calculated in eight governmental hospitals across all plain film examinations. The overall reject rate was 374 (3.1 %) in 12,165 x-ray exposures. Total reject rate by hospital showed 10.5% for Zewditu and 1.53% and 1.87% for Tikur Anbessa Specialized Hospital (TASH) and the Police Hospital, respectively. Conclusions: Rejected films were found to have been caused by numerous factors including poor technical judgment, patient motion, and poor supervision of staff. Hence, strategies need to be developed within medical imaging departments to improve the situation. [Ethiop. J. Health Dev. 2012;26(1):54-59]