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Sample records for cooperatively control adherence

  1. Adherence to Cooperative Principles among Agricultural ...

    African Journals Online (AJOL)

    User

    Data on group characteristics, level of awareness, adherence and ... enhance small scale farmers' access to credit, Oruonye and Musa (2012) ... According to FAO (2012) cooperatives play important roles in overcoming barriers ... collective bargaining power in input and output markets; and ..... Members' dishonest attitude.

  2. 7 CFR 1484.34 - Must Cooperators adhere to specific standards of ethical conduct?

    Science.gov (United States)

    2010-01-01

    ... Cooperators adhere to specific standards of ethical conduct? (a) A Cooperator shall conduct its business in... funds to promote private self interests or conduct private business, except as members of sales teams... advertising. Deceptive or misleading promotions may result in cancellation or termination of a project...

  3. Evaluation of factors affecting adherence to asthma controller ...

    African Journals Online (AJOL)

    Background: Adherence to controller therapy in asthma is a major concern during the management of the disease. ... The adherence to asthma treatment was rated using Morisky Medication Adherence Scale. A ..... in an outpatient setting.

  4. Evaluation of factors affecting adherence to asthma controller ...

    African Journals Online (AJOL)

    Evaluation of factors affecting adherence to asthma controller therapy in chest clinics in a sub-Saharan African setting: a cross-sectional study. ... Background: Adherence to controller therapy in asthma is a major concern during the management of the disease. Objective: To determine the adherence rate and identify the ...

  5. Recent developments in cooperative control and optimization

    CERN Document Server

    Murphey, Robert; Pardalos, Panos

    2004-01-01

    Over the past several years, cooperative control and optimization has un­ questionably been established as one of the most important areas of research in the military sciences. Even so, cooperative control and optimization tran­ scends the military in its scope -having become quite relevant to a broad class of systems with many exciting, commercial, applications. One reason for all the excitement is that research has been so incredibly diverse -spanning many scientific and engineering disciplines. This latest volume in the Cooperative Systems book series clearly illustrates this trend towards diversity and creative thought. And no wonder, cooperative systems are among the hardest systems control science has endeavored to study, hence creative approaches to model­ ing, analysis, and synthesis are a must! The definition of cooperation itself is a slippery issue. As you will see in this and previous volumes, cooperation has been cast into many different roles and therefore has assumed many diverse meanings. P...

  6. Guidelines Adherence and Hypertension Control in an Outpatient ...

    African Journals Online (AJOL)

    Purpose: To evaluate doctors' adherence to Malaysian Clinical Practice Guideline (CPG) 2008 in established hypertensive patients with cardiovascular diseases and factors associated with guideline adherence and hypertension control in Pulau Pinang Hospital, Malaysia. Methods: Prescriptions written by 13 doctors for ...

  7. Co-operatives and Normative Control

    DEFF Research Database (Denmark)

    Bregn, Kirsten; Jagd, Søren

    1992-01-01

    This paper explores the conditions for applying normative control in co-operatives. For normative control to be effective two conditions are found particularly important: Individuals must be morally involved and the organization must have a system of making it possible to link common norms...... and individual action. If these conditions are not fulfilled, as may be the case in many co-operatives, normative control cannot be expected to work. The problems of normative control in co-operatives may then not be caused by the use of normative control as such, but may instead be a problem of securing...

  8. Internal Control Good Cooperative Governance And Performance

    Directory of Open Access Journals (Sweden)

    Andry Arifian Rachman

    2017-11-01

    Full Text Available This study aims to examine the influence of internal control and good cooperative governance partially and simultaneously to the performance of cooperatives in West Java Province. The research method used in this research is descriptive and verification. The sample in this research is 22 boards as manager of cooperative in West Java Province. The data used in the research is the primary data through questionnaire collection. Validity and reliability testing is performed before hypothesis testing. This research uses multiple regression analysis technique. Based on hypothesis testing obtained 1 internal control has no significant effect on performance 2 good cooperative governance has a significant effect on performance and 3 internal control and good cooperative governance have a significant effect on performance.

  9. Guidelines Adherence and Hypertension Control in an Outpatient ...

    African Journals Online (AJOL)

    All rights reserved. Available online at http://www.tjpr.org ... adherence and hypertension control in Pulau Pinang Hospital, Malaysia. Methods: ... Despite the positive impact of guidelines' ..... Size in Information Technology, Learning, and.

  10. Fault tolerancy in cooperative adaptive cruise control

    NARCIS (Netherlands)

    Nunen, E. van; Ploeg, J.; Medina, A.M.; Nijmeijer, H.

    2013-01-01

    Future mobility requires sound solutions in the field of fault tolerance in real-time applications amongst which Cooperative Adaptive Cruise Control (CACC). This control system cannot rely on the driver as a backup and is constantly active and therefore more prominent to the occurrences of faults

  11. Agent control of cooperating satellites

    OpenAIRE

    Lincoln, N.K.; Veres, S.M.; Dennis, Louise; Fisher, Michael; Lisitsa, Alexei

    2011-01-01

    A novel, hybrid, agent architecture for (small)swarms of satellites has been developed. The software architecture for each satellite comprises ahigh-level rational agent linked to a low-level control system. The rational agent forms dynamicgoals, decides how to tackle them and passes theactual implementation of these plans to the control layer. The rational agent also has access to aMatLabmodel of the satellite dynamics, thus allowing it to carry out selective hypothetical reasoningabout pote...

  12. Cooperative Control of Multiple Unmanned Autonomous Vehicles

    Science.gov (United States)

    2005-06-03

    I I Final Report 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS Cooperative Control of Multiple Unmanned Autonomous Vehicles F49620-01-1-0337 6. AUTHOR(S... Autonomous Vehicles Final Report Kendall E. Nygard Department of Computer Science and Operations Research North Dakota State University Fargo, ND 58105-5164

  13. Graceful degradation of cooperative adaptive cruise control

    NARCIS (Netherlands)

    Ploeg, J.; Semsar-Kazerooni, E.; Lijster, G.; Wouw, N. van de; Nijmeijer, H.

    2015-01-01

    Cooperative adaptive cruise control (CACC) employs wireless intervehicle communication, in addition to onboard sensors, to obtain string-stable vehicle-following behavior at small intervehicle distances. As a consequence, however, CACC is vulnerable to communication impairments such as latency and

  14. Thermonuclear controlled fusion: international cooperation

    International Nuclear Information System (INIS)

    Conscience, J.-F.

    2001-01-01

    This report summarizes the current worldwide status of research in the field of thermonuclear controlled fusion as well as the international research programme planed for the next decades. The two main projects will be the ITER facility (International Thermonuclear Experimental Reactor) that should produce 10 times more energy than the energy injected, and the IFMIF (International Fusion Materials Irradiation Facility) designed to study the reactions of materials under intense neutron fluxes. The future of the pioneering JET facility (Joint European Torus) is also discussed. The engagement of the various countries (USA, Japan, Germany, Russian Federation and Canada) and international organisations (EURATOM and IEA) in terms of investment and research is described. Switzerland is involved in this program through an agreement with EURATOM and is mainly dedicated to experimental studies with the TCV machine in Lausanne and numerical studies of plasma configurations. It will participate to the development of the microwave plasma heating system for the ITER machine

  15. Internal control in non - agricultural cooperatives

    Directory of Open Access Journals (Sweden)

    Yolanda García Castro

    2014-12-01

    Full Text Available The process of formation of non-agricultural cooperatives in Cuba, has been a step forward for the Cuban economy, provide primary care represents economic sustainability for the country. A necessary tool for achieving quality in the provision of services and products, it represents the audit process. In this sense the present work was aimed in the Council of the Provincial Administration, in order to strengthen the functioning of non-agricultural cooperatives. Theoretical and empirical methods, techniques, surveys and interviews with leaders and workers, aimed to assess the knowledge, applications for the creation of cooperatives, processing, approval, establishment and operation, based on guidelines established in internal control were applied; and descriptive statistics for processing information, which identified the important work that developed the organization, which was able to promote the operation of non-agricultural cooperatives, as well as the tools necessary for the production of income and consequently improve the quality of services. The diagnosis made it possible to identify the point in the process, so disruption to the operation. Undoubtedly, every experiment needs time to mature and gain experience, besides confirming Waste Disposal workers cooperatives and agencies to jump-start this process. Improvement measures were implemented in order to increase the economic efficiency of each process, in response to various guidelines of Economic and Social Policy of the Party and the Revolution, adopted at the Sixth Party Congress and Conference Objectives.

  16. Cooperative adaptive cruise control : tradeoffs between control and network specifications

    NARCIS (Netherlands)

    Oncu, S.; Wouw, van de N.; Nijmeijer, H.

    2011-01-01

    In this study, we consider a Cooperative Adaptive Cruise Control (CACC) system which regulates inter-vehicle distances in a vehicle string. Improved performance can be achieved by utilizing information exchange between vehicles through wireless communication besides local sensor measurements.

  17. Association of adherence to epilepsy quality standards with seizure control.

    Science.gov (United States)

    Moura, Lidia M V R; Mendez, Diego Yacaman; Jesus, Jonathan De; Andrade, Rogger A; Weissman, Joel S; Vickrey, Barbara G; Hoch, Daniel B

    2015-11-01

    We assessed the relationship between adherence to epilepsy quality measures (EQM) and seizure control over 2-3 years in a retrospective cohort study. 6150 patients were identified at two large academic medical centers with a primary or secondary diagnosis of epilepsy, were 18-85 years old and seen in outpatient general neurology or epilepsy units between June 2011 and May 2014. Patients were included if: their initial visit was between June 2011 and June 2012, treatment was with ≥1 anti-seizure drug, there was ≥1 visit per year during the timeframe, and seizure frequency was documented at initial and final visits, yielding 162 patients/1055 visits from which socio-demographic, clinical and care quality data were abstracted. Quality care was assessed as (1) percent adherence to up to 8 eligible EQM, and (2) defect-free care (DFC: adherence to all eligible EQM). Seizure control (SC) was defined as ≥50% reduction in average seizures/month between initial and final visits. Chi-square and t-test compared care quality with seizure control. Logistic regression was used to assess the relationships between SC, quality of care and subspecialist involvement. Care quality, reflected by documentation of seizure frequency, addressing therapeutic interventions, and referral to a comprehensive epilepsy center, all exceeded 80% adherence. Care quality as reflected by documentation of seizure type, etiology or syndrome; assessment of side effects, counseling about epilepsy safety and women's issues, and screening for psychiatric disorders ranged from 40 to 57%. Mean EQM adherence across all applicable measures was associated with greater seizure control (p=0.0098). DFC was low (=8%) and did not covary with seizure control (p=0.55). The SC and non-SC groups only differed on epilepsy etiology (p=0.04). Exploratory analysis showed that mean quality scores are associated with seizure control (OR=4.9 [1.3-18.5], p=0.017) while controlling for the effect of subspecialty involvement

  18. Distributed cooperative control of AC microgrids

    Science.gov (United States)

    Bidram, Ali

    In this dissertation, the comprehensive secondary control of electric power microgrids is of concern. Microgrid technical challenges are mainly realized through the hierarchical control structure, including primary, secondary, and tertiary control levels. Primary control level is locally implemented at each distributed generator (DG), while the secondary and tertiary control levels are conventionally implemented through a centralized control structure. The centralized structure requires a central controller which increases the reliability concerns by posing the single point of failure. In this dissertation, the distributed control structure using the distributed cooperative control of multi-agent systems is exploited to increase the secondary control reliability. The secondary control objectives are microgrid voltage and frequency, and distributed generators (DGs) active and reactive powers. Fully distributed control protocols are implemented through distributed communication networks. In the distributed control structure, each DG only requires its own information and the information of its neighbors on the communication network. The distributed structure obviates the requirements for a central controller and complex communication network which, in turn, improves the system reliability. Since the DG dynamics are nonlinear and non-identical, input-output feedback linearization is used to transform the nonlinear dynamics of DGs to linear dynamics. Proposed control frameworks cover the control of microgrids containing inverter-based DGs. Typical microgrid test systems are used to verify the effectiveness of the proposed control protocols.

  19. Adherence therapy improves medication adherence and quality of life in people with Parkinson's disease: a randomised controlled trial.

    Science.gov (United States)

    Daley, D J; Deane, K H O; Gray, R J; Clark, A B; Pfeil, M; Sabanathan, K; Worth, P F; Myint, P K

    2014-08-01

    Many factors are associated with medication non-adherence in Parkinson's disease (PD), including complex treatment regimens, mood disorders and impaired cognition. However, interventions to improve adherence which acknowledge such factors are lacking. A phase II randomised controlled trial was conducted investigating whether Adherence Therapy (AT) improves medication adherence and quality of life (QoL) compared with routine care (RC) in PD. Eligible PD patients and their spouse/carers were randomised to intervention (RC plus AT) or control (RC alone). Primary outcomes were change in adherence (Morisky Medication Adherence Scale) and QoL (Parkinson's Disease Questionnaire-39) from baseline to week-12 follow up. Secondary outcomes were MDS-UPDRS (part I, II, IV), Beliefs about Medication Questionnaire (BMQ), EuroQol (EQ-5D) and the Caregiving Distress Scale. Blinded data were analysed using logistic and linear regression models based on the intention-to-treat principle. Seventy-six patients and 46 spouse/carers completed the study (intervention: n = 38 patients, n = 24 spouse/carers). At week-12 AT significantly improved adherence compared with RC (OR 8.2; 95% CI: 2.8, 24.3). Numbers needed to treat (NNT) were 2.2 (CI: 1.6, 3.9). Compared with RC, AT significantly improved PDQ-39 (-9.0 CI: -12.2, -5.8), BMQ general harm (-1.0 CI: -1.9, -0.2) and MDS-UPDRS part II (-4.8 CI: -8.1, -1.4). No significant interaction was observed between the presence of a spouse/carer and the effect of AT. Adherence Therapy improved self-reported adherence and QoL in a PD sample. The small NNT suggests AT may be cost-effective. A larger pragmatic trial to test the efficacy and cost-effectiveness of AT by multiple therapists is required. © 2014 John Wiley & Sons Ltd.

  20. International pollution control: Cooperative versus noncooperative strategies

    International Nuclear Information System (INIS)

    Dockner, E.J.; Van Long, N.

    1993-01-01

    International pollution control involving two neighboring countries is modeled as a simple two-player dynamic game. Each country produces a good that is consumed by domestic households. Production of each consumption good results in emissions of pollutants. Households in each country derive utility from the consumption of the domestically produced good but incur costs through the total stock of pollution (stock externality). In this setting we characterize cooperative as well as noncooperative pollution control strategies of the governments of the two countries that maximize the discounted stream of net benefits of a representative consumer. It turns out that when the governments are restricted to use linear strategies noncooperative behavior results in overall losses for both countries. If, on the contrary, governments use nonlinear Markov-perfect strategies and the discount rate is small enough a Pareto-efficient steady-state pollution stock can be supported as a differentiable subgame-perfect equilibrium. Thus, the emergence of first-best solutions (cooperative outcomes) does not require any institutional arrangements (threats, retaliation, etc.) but can be brought about through the use of nonlinear Markov-perfect equilibrium strategies. 20 refs., 1 tab

  1. Cooperation and control in multiplayer social dilemmas

    Science.gov (United States)

    Hilbe, Christian; Wu, Bin; Traulsen, Arne; Nowak, Martin A.

    2014-01-01

    Direct reciprocity and conditional cooperation are important mechanisms to prevent free riding in social dilemmas. However, in large groups, these mechanisms may become ineffective because they require single individuals to have a substantial influence on their peers. However, the recent discovery of zero-determinant strategies in the iterated prisoner’s dilemma suggests that we may have underestimated the degree of control that a single player can exert. Here, we develop a theory for zero-determinant strategies for iterated multiplayer social dilemmas, with any number of involved players. We distinguish several particularly interesting subclasses of strategies: fair strategies ensure that the own payoff matches the average payoff of the group; extortionate strategies allow a player to perform above average; and generous strategies let a player perform below average. We use this theory to describe strategies that sustain cooperation, including generalized variants of Tit-for-Tat and Win-Stay Lose-Shift. Moreover, we explore two models that show how individuals can further enhance their strategic options by coordinating their play with others. Our results highlight the importance of individual control and coordination to succeed in large groups. PMID:25349400

  2. It's the adherence, stupid (that determines asthma control in preschool children)!

    Science.gov (United States)

    Klok, Ted; Kaptein, Adrian A; Duiverman, Eric J; Brand, Paul L

    2014-03-01

    Although guideline-based asthma care and adherence to inhaled corticosteroids are predictors of asthma control, the role of adherence in maintaining long-term asthma control is largely unknown. This study was designed to explore the relationship between adherence to inhaled corticosteroids and long-term asthma control in young children with asthma. In this observational study, 81 2-6-year-old asthmatic children, using inhaled corticosteroids, closely followed-up in a programme with extensive self-management training, were enrolled. Adherence was measured daily for 12 months using Smartinhaler (Nexus6 Ltd, Auckland, New Zealand) devices. Long-term asthma control was assessed by parents and physicians and included clinical assessment, an asthma control questionnaire and lung function measurement. We examined the association of adherence to asthma control, adjusting for seasonal influences and clinical characteristics. Median (interquartile range) adherence was 87% (70-94%), and 64 (79%) children had well-controlled asthma throughout follow-up. Adherence >80% was associated with better asthma control, and we found no important confounders of this association. Children with persistent mild symptoms had lower adherence rates (p=0.028). Guideline-based asthma care was associated with good asthma control in most children. Adherence to inhaled corticosteroids was an independent strong predictor of long-term asthma control, with highest levels of asthma control found in children with adherence >80% of doses prescribed.

  3. Intelligent control and cooperation for mobile robots

    Science.gov (United States)

    Stingu, Petru Emanuel

    The topic discussed in this work addresses the current research being conducted at the Automation & Robotics Research Institute in the areas of UAV quadrotor control and heterogenous multi-vehicle cooperation. Autonomy can be successfully achieved by a robot under the following conditions: the robot has to be able to acquire knowledge about the environment and itself, and it also has to be able to reason under uncertainty. The control system must react quickly to immediate challenges, but also has to slowly adapt and improve based on accumulated knowledge. The major contribution of this work is the transfer of the ADP algorithms from the purely theoretical environment to the complex real-world robotic platforms that work in real-time and in uncontrolled environments. Many solutions are adopted from those present in nature because they have been proven to be close to optimal in very different settings. For the control of a single platform, reinforcement learning algorithms are used to design suboptimal controllers for a class of complex systems that can be conceptually split in local loops with simpler dynamics and relatively weak coupling to the rest of the system. Optimality is enforced by having a global critic but the curse of dimensionality is avoided by using local actors and intelligent pre-processing of the information used for learning the optimal controllers. The system model is used for constructing the structure of the control system, but on top of that the adaptive neural networks that form the actors use the knowledge acquired during normal operation to get closer to optimal control. In real-world experiments, efficient learning is a strong requirement for success. This is accomplished by using an approximation of the system model to focus the learning for equivalent configurations of the state space. Due to the availability of only local data for training, neural networks with local activation functions are implemented. For the control of a formation

  4. Interventions to Improve Medication Adherence among Older Adults: Meta-Analysis of Adherence Outcomes among Randomized Controlled Trials

    Science.gov (United States)

    Conn, Vicki S.; Hafdahl, Adam R.; Cooper, Pamela S.; Ruppar, Todd M.; Mehr, David R.; Russell, Cynthia L.

    2009-01-01

    Purpose: This study investigated the effectiveness of interventions to improve medication adherence (MA) in older adults. Design and Methods: Meta-analysis was used to synthesize results of 33 published and unpublished randomized controlled trials. Random-effects models were used to estimate overall mean effect sizes (ESs) for MA, knowledge,…

  5. Treatment non-adherence among patients with poorly controlled ...

    African Journals Online (AJOL)

    2014-03-01

    Mar 1, 2014 ... Background: Poor adherence to prescribed therapy among patients with chronic diseases is a growing concern which un- dermines the ... consent was obtained from individual patient to signi- .... and SRMAS in binary categories of adherence versus ..... United Kingdom Prospective Diabetes Study Group.

  6. Financial incentives to improve adherence to antipsychotic maintenance medication in non-adherent patients: a cluster randomised controlled trial.

    Science.gov (United States)

    Priebe, Stefan; Bremner, Stephen A; Lauber, Christoph; Henderson, Catherine; Burns, Tom

    2016-09-01

    Poor adherence to long-term antipsychotic injectable (LAI) medication in patients with psychotic disorders is associated with a range of negative outcomes. No psychosocial intervention has been found to be consistently effective in improving adherence. To test whether or not offering financial incentives is effective and cost-effective in improving adherence and to explore patient and clinician experiences with such incentives. A cluster randomised controlled trial with economic and nested qualitative evaluation. The intervention period lasted for 12 months with 24 months' follow-up. The unit of randomisation was mental health teams in the community. Community teams in secondary mental health care. Patients with a diagnosis of schizophrenia, schizoaffective psychosis or bipolar illness, receiving ≤ 75% of their prescribed LAI medication. In total, 73 teams with 141 patients (intervention n = 78 and control n = 63) were included. Participants in the intervention group received £15 for each LAI medication. Patients in the control group received treatment as usual. adherence to LAI medication (the percentage of received out of those prescribed). percentage of patients with at least 95% adherence; clinical global improvement; subjective quality of life; satisfaction with medication; hospitalisation; adverse events; and costs. Qualitative evaluation: semistructured interviews with patients in the intervention group and their clinicians. outcome data were available for 131 patients. Baseline adherence was 69% in the intervention group and 67% in the control group. During the intervention period, adherence was significantly higher in the intervention group than in the control group (85% vs. 71%) [adjusted mean difference 11.5%, 95% confidence interval (CI) 3.9% to 19.0%; p = 0.003]. Secondary outcome: patients in the intervention group showed statistically significant improvement in adherence of at least 95% (adjusted odds ratio 8.21, 95% CI 2.00 to 33

  7. Behavioral measures to reduce non-adherence in renal transplant recipients: a prospective randomized controlled trial.

    Science.gov (United States)

    Garcia, Márcia Fátima Faraldo Martinez; Bravin, Ariane Moyses; Garcia, Paula Dalsoglio; Contti, Mariana Moraes; Nga, Hong Si; Takase, Henrique Mochida; de Andrade, Luis Gustavo Modelli

    2015-11-01

    Solid-organ transplant recipients present a high rate of non-adherence to drug treatment. Few interventional studies have included approaches aimed at increasing adherence. The objective of this study was to evaluate the impact of an educational and behavioral strategy on treatment adherence of kidney transplant recipients. In a randomized prospective study, incident renal transplant patients (n = 111) were divided into two groups: control group (received usual transplant patient education) and treatment group (usual transplant patient education plus ten additional weekly 30-min education/counseling sessions about immunosuppressive drugs and behavioral changes). Treatment adherence was assessed using ITAS adherence questionnaire after 3 months. Renal function at 3, 6, and 12 months, and the incidence of transplant rejection were evaluated. The non-adherence rates were 46.4 and 14.5 % in the control and treatment groups (p = 0.001), respectively. The relative risk for non-adherence was 2.59 times (CI 1.38-4.88) higher in the control group. Multivariate analysis demonstrated a 5.84 times (CI 1.8-18.8, p = 0.003) higher risk of non-adherence in the control group. There were no differences in renal function and rejection rates between groups. A behavioral and educational strategy addressing the patient's perceptions and knowledge about the anti-rejection drugs significantly improved the short-term adherence to immunosuppressive therapy.

  8. Mother, father, and adolescent self-control and adherence in adolescents with Type 1 diabetes.

    Science.gov (United States)

    Lansing, Amy Hughes; Crochiere, Rebecca; Cueto, Carrie; Wiebe, Deborah J; Berg, Cynthia A

    2017-06-01

    This study explored whether shared self-control across a family system, including adolescent, mother, and father self-control, as well as the interaction of mother and father self-control, was associated with ease of completing adherence tasks and the completion of adherence behaviors related to the Type 1 diabetes (T1D) regimen. One hundred thirty-seven adolescents (M = 13.48 years), mothers, and fathers completed a self-report measure of self-control, while adolescents also self-reported on ease of completing adherence tasks and the frequency with which they completed adherence tasks. Higher adolescent, mother, father, and the interaction of mother and father self-control were each associated with greater adolescent perceptions of ease of completing adherence tasks. Also, greater adolescent perception of ease of adherence mediated the association of higher adolescent, father, and the interaction of mother and father self-control on more frequent adherence behaviors. The results are consistent with the idea that family members may share the load of self-control within the family system. The results point to the importance of assessing and intervening within the entire family system to support improved quality of life and better adherence to the medical regimen in adolescents with Type 1 diabetes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  9. Evolution of cooperation in a hierarchical society with corruption control.

    Science.gov (United States)

    Huang, Feng; Chen, Xiaojie; Wang, Long

    2018-07-14

    Punishment is widely recognized as a potential promoter in sustaining or even enhancing public cooperation, but it meanwhile induces the problem of second-order free-riders. Particularly, recent evidence shows that costly punishment can be maintained if punishers may engage in corruption. However, how to reduce or eliminate incidents of corruption has been the enduring conundrum in human society. As power asymmetries are associated with hierarchies, we investigate how costly punishment affects the evolution of cooperation in the cases without and with corruption control. In the absence of corruption control, altruistic punishers are incapable of punishing corrupt punishers. Corrupt punishment maintains civilian cooperation but undermines the evolution of altruistic punishment. Otherwise, altruistic punishers can enforce symmetrical or asymmetrical punishment on both corrupt punishers and civilian defectors. In this case, both civilian cooperation and altruistic punishment can be promoted. And as an instrument of corruption control, the policy of asymmetrical punishment is more effective in fostering public cooperation and improving social welfare than symmetrical punishment. Moreover, no matter whether corruption control is considered or not, spiteful corruption that non-cooperative punishers penalize defectors is a more effective form for enhancing cooperation compared with bribery. Our work may thus offer an insight into the effects of corruption on public cooperation and the policy of anti-corruption. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Parameter tuning and cooperative control for automated guided vehicles

    NARCIS (Netherlands)

    Stouten, B.

    2005-01-01

    For several practical control engineering applications it is desirable that multiple systems can operate independently as well as in cooperation with each other. Especially when the transition between individual and cooperative behavior and vice versa can be carried out easily, this results in

  11. A joint network/control design for cooperative automatic driving

    NARCIS (Netherlands)

    Giordano, G.; Segata, Michele; Blanchini, Franco; Cigno, Renato Lo; Altintas, O.; Casetti, C.; Meireles, R.; Kirsch, N.; Lo Cigno, R.

    2017-01-01

    Cooperative automatic driving, or platooning, is a promising solution to improve traffic safety, while reducing congestion and pollution. The design of a control system for this application is a challenging, multi-disciplinary problem, as cooperation between vehicles is obtained through wireless

  12. Multi-agent cooperation for particle accelerator control

    CERN Document Server

    Skarek, Paul

    1996-01-01

    We present practical investigations in a real industrial controls environment for justifying theoretical DAI (Distributed Artificial Intelligence) results, and we discuss theoretical aspects of practical investigations for accelerator control and operation. A generalized hypothesis is introduced based on a unified view of control, monitoring, diagnosis, maintenance and repair tasks leading to a general method of cooperation for expert systems by exchanging hypotheses. This has been tested for task and result sharing cooperation scenarios. Generalized hypotheses also allow us to treat the repetitive diagnosis-recovery cycle as task sharing cooperation. Problems with such a loop or even recursive calls between the different agents are discussed.

  13. Cooperative control of a squad of mobile vehicles

    International Nuclear Information System (INIS)

    Lewis, C.; Feddema, J.; Klarer, P.

    1998-01-01

    Tasks such as the localization of chemical sources, demining, perimeter control, surveillance and search and rescue missions are usually performed by teams of people. At least conceptually, large groups of relatively cheap mobile vehicles outfitted with sensors should be able to automatically accomplish some of these tasks. Sandia National Labs is currently developing a swarm of semi-autonomous all terrain vehicles for remote cooperative sensing applications. This paper will describe the capabilities of this system and outline some of its possible applications. Cooperative control and sensing strategies will also be described. Eight Roving All Terrain Lunar Explorer Rovers (RATLERs) have been built at Sandia as a test platform for cooperative control and sensing applications. This paper will first describe the hardware capabilities of the RATLER system. Then it will describe the basic control algorithm for GPS based navigation and obstacle avoidance. A higher level cooperative control task will then be described

  14. Vehicle-to-infrastructure program cooperative adaptive cruise control.

    Science.gov (United States)

    2015-03-01

    This report documents the work completed by the Crash Avoidance Metrics Partners LLC (CAMP) Vehicle to Infrastructure (V2I) Consortium during the project titled Cooperative Adaptive Cruise Control (CACC). Participating companies in the V2I Cons...

  15. Automatic gain control of neural coupling during cooperative hand movements.

    Science.gov (United States)

    Thomas, F A; Dietz, V; Schrafl-Altermatt, M

    2018-04-13

    Cooperative hand movements (e.g. opening a bottle) are controlled by a task-specific neural coupling, reflected in EMG reflex responses contralateral to the stimulation site. In this study the contralateral reflex responses in forearm extensor muscles to ipsilateral ulnar nerve stimulation was analyzed at various resistance and velocities of cooperative hand movements. The size of contralateral reflex responses was closely related to the level of forearm muscle activation required to accomplish the various cooperative hand movement tasks. This indicates an automatic gain control of neural coupling that allows a rapid matching of corrective forces exerted at both sides of an object with the goal 'two hands one action'.

  16. Cooperative Control of Distributed Autonomous Vehicles in Adversarial Environments

    Science.gov (United States)

    2006-08-14

    COOPERATIVE CONTROL OF DISTRIBUTED AUTONOMOUS VEHICLES IN ADVERSARIAL ENVIRONMENTS Grant #F49620–01–1–0361 Final Report Jeff Shamma Department of...CONTRACT NUMBER F49620-01-1-0361 5b. GRANT NUMBER 4. TITLE AND SUBTITLE COOPERATIVE CONTROL OF DISTRIBUTED AUTONOMOUS VEHICLES IN...single dominant language or a distribution of languages. A relation to multivehicle systems is understanding how highly autonomous vehicles on extended

  17. Nonlinear Model Predictive Control for Cooperative Control and Estimation

    Science.gov (United States)

    Ru, Pengkai

    Recent advances in computational power have made it possible to do expensive online computations for control systems. It is becoming more realistic to perform computationally intensive optimization schemes online on systems that are not intrinsically stable and/or have very small time constants. Being one of the most important optimization based control approaches, model predictive control (MPC) has attracted a lot of interest from the research community due to its natural ability to incorporate constraints into its control formulation. Linear MPC has been well researched and its stability can be guaranteed in the majority of its application scenarios. However, one issue that still remains with linear MPC is that it completely ignores the system's inherent nonlinearities thus giving a sub-optimal solution. On the other hand, if achievable, nonlinear MPC, would naturally yield a globally optimal solution and take into account all the innate nonlinear characteristics. While an exact solution to a nonlinear MPC problem remains extremely computationally intensive, if not impossible, one might wonder if there is a middle ground between the two. We tried to strike a balance in this dissertation by employing a state representation technique, namely, the state dependent coefficient (SDC) representation. This new technique would render an improved performance in terms of optimality compared to linear MPC while still keeping the problem tractable. In fact, the computational power required is bounded only by a constant factor of the completely linearized MPC. The purpose of this research is to provide a theoretical framework for the design of a specific kind of nonlinear MPC controller and its extension into a general cooperative scheme. The controller is designed and implemented on quadcopter systems.

  18. Blood Pressure Treatment Adherence and Control after Participation in the ReHOT

    Directory of Open Access Journals (Sweden)

    Nathália Silva de Jesus

    Full Text Available Abstract Background: Lack of adherence to pharmacological treatment is one of the main causes of low control rates in hypertension. Objective: To verify treatment adherence and associated factors, as well as blood pressure (BP control in participants of the Resistant Hypertension Optimal Treatment (ReHOT clinical trial. Method: Cross-sectional study including all 109 patients who had completed the ReHOT for at least 6 months. We excluded those participants who failed to respond to the new recruitment after three phone contact attempts. We evaluated the BP control by ambulatory BP monitoring (ABPM; controlled levels: 24-hour systolic and diastolic BP < 130 x 80 mmHg and analyzed the patients' treatment adherence using the Morisky Medication Adherence Scale (MMAS questionnaire validated by Bloch, Melo, and Nogueira (2008. The statistical analysis was performed with the software IBM SPSS statistics 21.0. We tested the normality of the data distribution with kurtosis and skewness. The variables tested in the study are presented with descriptive statistics. Comparisons between treatment adherence and other variables were performed with Student's t test for independent variables and Pearson's chi-square or Fisher's exact test. To conduct analyses among patients considering adherence to treatment and BP control, we created four groups: G0, G1, G2, and G3. We considered a 5% significance level in all tests. Results: During the ReHOT, 80% of the patients had good BP control and treatment adherence. Of 96 patients reevaluated in the present study, only 52.1% had controlled hypertension when assessed by ABPM, while 31.3% were considered adherent by the MMAS. Regarding other ABPM measures, we observed an absence of a nocturnal dip in 64.6% of the patients and a white-coat effect and false BP control in 23% and 12.5%, respectively. Patients' education level showed a trend towards being a determinant factor associated with lack of adherence (p = 0

  19. Design of a nuclear reactor cooperative controller

    International Nuclear Information System (INIS)

    Alang-Rashid, N.K.; Heger, A.S.

    1991-01-01

    This paper describes the development of a fuzzy logic controller software package and explores the feasibility of its use in nuclear reactor operation. The controller complements reactor operator actions, and the operators can override the controller decisions. Techniques of providing learning capability to the controller are also being investigated to improve the reasoning and control skill of the controller. The fuzzy logic controller is implemented in C language and its overall structure is shown. The heart of the systems consists of a fuzzifier, a rule interpreter, and a defuzzifier. The controller is designed as a stand-alone package that can be interfaced to a simulated model of a nuclear reactor. Since no model is an accurate representation of the actual process being modeled, some tuning must be performed to use the controller in an actual reactor. This is accomplished using the learning feature of the controller

  20. Cooperative and Non-Cooperative Game Control Strategies of the Ship in Collision Situation

    Directory of Open Access Journals (Sweden)

    Jozef Lisowski

    2018-03-01

    Full Text Available The paper introduces the positional cooperative and non-cooperative game of a greater number of met ships for the description of the process considered as well as for the synthesis of optimal control strategies of the own ship in collision situation. The approximated mathematical model of differential game in the form of triple linear programming problem is used for the synthesis of safe ship trajectory as a multistage process decision. The considerations have been illustrated an example of program computer simulation to determine the safe ship trajectories in situation of passing a many of the ships encountered.

  1. Cooperative Frequency Control for Autonomous AC Microgrids

    DEFF Research Database (Denmark)

    Shafiee, Qobad; Quintero, Juan Carlos Vasquez; Guerrero, Josep M.

    2015-01-01

    Distributed secondary control strategies have been recently studied for frequency regulation in droop-based AC Microgrids. Unlike centralized secondary control, the distributed one might fail to provide frequency synchronization and proportional active power sharing simultaneously, due to having...... not require measuring the system frequency as compared to the other presented methods. An ac Microgrid with four sources is used to verify the performance of the proposed control methodology....

  2. Health locus of control: Its relationship with medication adherence and medication wastage.

    Science.gov (United States)

    West, Lorna Marie; Borg Theuma, Ruth; Cordina, Maria

    2017-12-09

    Non-adherence is a significant factor contributing to medication wastage. Whilst there is some evidence on the influence of patients' health locus of control in relation to adherence, there has been little inquiry into its relationship with mediation wastage. To determine the relationship between medication adherence and health locus of control as well as medication wastage and health locus of control in patients with chronic conditions. Outpatients having a diagnosis of asthma, cardiovascular conditions, or diabetes participated in a cross-sectional study employing a self-administered questionnaire. The questionnaire determined presence of unused medication (wastage), adherence using 'Tool for Adherence Behaviour Screening' (TABS), and health locus of control using 'Multidimensional Health Locus of Control' (MHLC) scale Form C. Logistic regression was performed to ascertain the effects of MHLC and demographics in relation to adherence and wastage. MHLC beliefs were divided into 8 types of health locus of control. One-Way ANOVA was used to assess differences between conditions and belief types. P-values ≤ .05 were considered significant. There were 330 patients recruited (58% male; age, mean±(SD): 61 ± 15 years; 110 asthma, 110 cardiovascular, 110 diabetes). In terms of health locus of control, females had higher 'doctors' beliefs (p = .054) and significantly lower 'other people' beliefs (p = control. 'Yea-sayers' had the least presence of unused medication, followed by 'pure internal' believers. 'Pure powerful others external' had the highest presence of unused medication. Healthcare professionals should take into account patients' health locus of control beliefs whilst conducting an intervention with patients; this can impact positively medication adherence and minimisation of medication wastage. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Automated Merging in a Cooperative Adaptive Cruise Control (CACC) System

    NARCIS (Netherlands)

    Klein Wolterink, W.; Heijenk, Geert; Karagiannis, Georgios

    2011-01-01

    Cooperative Adaptive Cruise Control (CACC) is a form of cruise control in which a vehicle maintains a constant headway to its preceding vehicle using radar and vehicle-to-vehicle (V2V) communication. Within the Connect & Drive1 project we have implemented and tested a prototype of such a system,

  4. Automated Merging in a Cooperative Adaptive Cruise Control (CACC) System

    NARCIS (Netherlands)

    Klein Wolterink, W.; Karagiannis, Georgios; Brogle, Marc; Masip Bruin, Xavier; Braun, Torsten; Heijenk, Gerhard J.

    Cooperative Adaptive Cruise Control (CACC) is a form of cruise control in which a vehicle maintains a constant headway to its preceding vehicle using radar and vehicle-to-vehicle (V2V) communication. Within the Connect & Drive1 project we have implemented and tested a prototype of such a system,

  5. Asthma medication adherence: the role of God and other health locus of control factors.

    Science.gov (United States)

    Ahmedani, Brian K; Peterson, Edward L; Wells, Karen E; Rand, Cynthia S; Williams, L Keoki

    2013-02-01

    Medication adherence is an important determinant of disease outcomes, yet medication use on average tends to be low among patients with chronic conditions, including asthma. Although several predictors of non-adherence have been assessed, more research is needed on patients' beliefs about God and how these relate to medication use. To examine the relationship between perceptions about "God's" role in health and other locus of control factors with inhaled corticosteroid (ICS) adherence among asthma patients. Participants were from a clinical trial to improve ICS adherence and were 5-56 years old, had a diagnosis of asthma, and were receiving ICS medication. Baseline adherence was estimated from electronic prescription and pharmacy fill records. Patients were considered to be adherent if ICS use was ≥80% of prescribed. A baseline survey with the Multidimensional Health Locus of Control scale was used to assess five sources (God, doctors, other people, chance, and internal). Medication adherence was low (36%). Patients' who had a stronger belief that God determined asthma control were less likely to be adherent (odds ratio [OR] 0.82, 95% confidence interval [CI] 0.70-0.96). This relationship was stronger among African American (OR 0.68, 95% CI0.47-0.99) compared to white patients (OR 0.89, 95% CI 0.75-1.04), and among adults (OR 0.81, 95% CI 0.69-0.96) compared to children (OR 0.84, 95% CI 0.58-1.22). Patients' belief in God's control of health appears to be a factor in asthma controller use, and therefore should be considered in physician-patient discussions concerning course of treatment. ClinicalTrials.gov: NCT00459368. Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  6. Caregiver's Health Locus of Control and Medication Adherence in Sickle Cell Disease.

    Science.gov (United States)

    Viswanathan, Kusum; Swaminathan, Neeraja; Viswanathan, Ramaswamy; Lakkaraja, Madhavi

    2015-03-01

    The authors would like to thank Dr. Morisky for giving us permission to use the Morisky Medication Adherence Scale To explore caregivers' Health Locus of Control's relationship to self-reported adherence to penicillin prophylaxis or hydroxyurea in children with sickle cell disease (SCD). A questionnaire-based study was conducted of caregivers of children with SCD who visited a comprehensive sickle cell center in an inner city hospital, who were either on penicillin prophylaxis or hydroxyurea or both. Multidimensional Health Locus of Control Scale (MHLC) and the Morisky Medication Adherence Scale (MMAS-8) questionnaires were used for the study. Caregivers of 43 children (27 on penicillin prophylaxis, 13 on hydroxyurea, and 3 on both) completed the MHLC and the MMAS-8. There was no significant difference in adherence between the penicillin and the hydroxyurea groups. The mean Powerful Others score of caregivers of the hydroxyurea only group (25.5+5.6) was higher than that of the penicillin only group (21.2+6.1, p=0.043). Regression analysis revealed an inverse relationship of Chance Locus of Control to adherence in the entire group (Beta = -0.306, R2=0.093, F[1,40]=4.12, p=0.049). Chance Locus of control may identify caregivers of children with SCD at risk for non-adherence to treatment. © 2015 National Medical Association. Published by Elsevier Inc. All rights reserved.

  7. Retailer adherence to Family Smoking Prevention and Tobacco Control Act, North Carolina, 2011.

    Science.gov (United States)

    Rose, Shyanika W; Myers, Allison E; D'Angelo, Heather; Ribisl, Kurt M

    2013-04-04

    The Family Smoking Prevention and Tobacco Control Act regulates the sales and marketing of tobacco products in the United States; poor adherence by tobacco retailers may reduce the effectiveness of the Act's provisions. The objectives of this study were 1) to assess whether and to which provisions retailers were adherent and 2) to examine differences in adherence by county, retailer neighborhood, and retailer characteristics. We conducted multivariate analysis of tobacco retailers' adherence to 12 point-of-sale provisions of the Tobacco Control Act in 3 North Carolina counties. We conducted observational audits of 324 retailers during 3 months in 2011 to assess adherence. We used logistic regression to assess associations between adherence to provisions and characteristics of each county, retailer neighborhood, and retailer. We found 15.7% of retailers did not adhere to at least 1 provision; 84.3% adhered to all provisions. The provisions most frequently violated were the ban on sales of cigarettes with modified-risk labels (eg, "light" cigarettes) (43 [13.3%] retailers nonadherent) and the ban on self-service for cigarettes and smokeless tobacco (6 [1.9%] retailers nonadherent). We found significant differences in rates of nonadherence by county and type of retailer. Pharmacies and drug stores were more than 3 times as likely as grocery stores to be nonadherent. Most tobacco retailers have implemented regulatory changes without enforcement by the US Food and Drug Administration. Monitoring rates of adherence by store type and locale (eg, county) may help retailers comply with point-of-sale provisions.

  8. A Pilot Randomized Controlled Trial to Promote Immunosuppressant Adherence in Adult Kidney Transplant Recipients.

    Science.gov (United States)

    Cukor, Daniel; Ver Halen, Nisha; Pencille, Melissa; Tedla, Fasika; Salifu, Moro

    2017-01-01

    Nonadherence to immunosuppressant medication is a prevalent practice among kidney transplant recipients and has been associated with increased risk for graft failure and economic burden. The aim of this pilot study was to test whether a culturally sensitive cognitive-behavioral adherence promotion program could significantly improve medication adherence to tacrolimus prescription as measured by telephone pill counts among kidney transplant recipients. Thirty-three adult transplant recipients were less than 98% adherent to tacrolimus prescription based on 3 telephone pill counts and were randomized either to the 2-session cognitive-behavioral adherence promotion program or to standard care. The curriculum was developed from an iterative process with transplant recipients into a 2-session group program that provided psychoeducation, addressed barriers to adherence, fostered motivation to improve adherence behavior, and discussed cultural messages on adherence behavior. The intervention group displayed significantly higher levels of adherence when compared to the control group (t = 2.2, p = 0.04) and. similarly, when the amount of change was compared between the groups, the intervention group showed more change than the control condition (F (22,1) = 12.005, p = 0.003). Tacrolimus trough concentration levels were used as a secondary measure of adherence and, while there were no significant between-group differences for mean trough concentration levels, the variability in the trough levels did significantly decrease over time indicating more consistent pill-taking behavior in the intervention group. There is preliminary support for the pilot program as a successful intervention in helping patients with their immunosuppressant medication. © 2016 S. Karger AG, Basel.

  9. Distributed Cooperative Secondary Control of Microgrids Using Feedback Linearization

    DEFF Research Database (Denmark)

    Bidram, Ali; Davoudi, Ali; Lewis, Frank

    2013-01-01

    This paper proposes a secondary voltage control of microgrids based on the distributed cooperative control of multi-agent systems. The proposed secondary control is fully distributed; each distributed generator (DG) only requires its own information and the information of some neighbors. The dist......This paper proposes a secondary voltage control of microgrids based on the distributed cooperative control of multi-agent systems. The proposed secondary control is fully distributed; each distributed generator (DG) only requires its own information and the information of some neighbors...... parameters can be tuned to obtain a desired response speed. The effectiveness of the proposed control methodology is verified by the simulation of a microgrid test system....

  10. ROLE OF COUNSELING ON MEDICAL ADHERENCE AND GLYCEMIC CONTROL IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Anoop Kumar

    2015-11-01

    Full Text Available BACKGROUND: Diabetes Mellitus (DM refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. It is the leading cause of of end stage renal disease, non-traumatic limb amputation and adult blindness. The studies have shown that complications of DM can be prevented by the proper control of blood glucose, which is dependent on the patient’s adherence to medication, life style modification, frequent monitoring of blood glucose etc. and can be influenced by proper education and counseling of the patient. The patients with DM should receive education about exercise, care of DM during illness and medications to lower plasma glucose1 . This study aims to assess the impact of patients counseling on the medication adherence in type 2DM. METHOD: This is a prospective randomized study that includes 100 patients with type 2 DM in the out-patient department of internal medicine in a tertiary care teaching hospital, north Kerala. After getting informed consent, they were kept in two groups by simple randomization technique and were assessed and followed at 4 weeks interval. Data related to the medication adherence was collected using Morisky Medication Adherence Scale questionnaire (MMAS-8. RESULTS: Out of 100 patients 33% were male and 67% female. Both baseline and 1st follow up showed a low adherence value (<6 both in control and intervention group. In the second follow up most of the patients in intervention group showed a moderate adherence (6-8, whereas control group did not show any improvement. CONCLUSION: It can be concluded that there is a stastically significant improvement in the adherence level after patient counseling and education. Knowledge about the disease and treatment has improved the patient’s adherence to medication.

  11. Shaping Societal Impact: between control and cooperation

    NARCIS (Netherlands)

    Messemaker, M.; Wolbers, J.J.; Treurniet, W.; Boersma, F.K.; Comes, T; Fiedrich, F; Fortier, S; Geldermann, J; Muller, T

    2013-01-01

    In our modern society, the impact of large-scale safety and security incidents can be large and diverse. Yet, this societal impact is makeable and controllable to a limited extent. At best, the effect of concrete response actions is that the direct damage is somewhat reduced and that the recovery is

  12. [Infection control team (ICT) in cooperation with microbiology laboratories].

    Science.gov (United States)

    Okazaki, Mitsuhiro

    2012-10-01

    Infection control as a medical safety measure is an important issue in all medical facilities. In order to tackle this measure, cooperation between the infection control team (ICT) and microbiological laboratory is indispensable. Multiple drug-resistant bacteria have shifted from Gram-positive bacteria to Gram-negative bacilli within the last ten years. There are also a variety of bacilli, complicating the examination method and test results further. Therefore, cooperation between the ICT and microbiological laboratory has become important to understand examination results and to use them. In order to maintain functional cooperation, explanatory and communicative ability between the microbiological laboratory and ICT is required every day. Such positive information exchange will develop into efficient and functional ICT activity.

  13. Controller adherence following hospital discharge in high risk children: A pilot randomized trial of text message reminders.

    Science.gov (United States)

    Kenyon, Chén C; Gruschow, Siobhan M; Quarshie, William O; Griffis, Heather; Leach, Michelle C; Zorc, Joseph J; Bryant-Stephens, Tyra C; Miller, Victoria A; Feudtner, Chris

    2018-02-13

    To assess the feasibility of a mobile health, inhaled corticosteroid (ICS) adherence reminder intervention and to characterize adherence trajectories immediately following severe asthma exacerbation in high-risk urban children with persistent asthma. Children aged 2-13 with persistent asthma were enrolled in this pilot randomized controlled trial during an asthma emergency department (ED) visit or hospitalization. Intervention arm participants received daily text message reminders for 30 days, and both arms received electronic sensors to measure ICS use. Primary outcomes were feasibility of sensor use and text message acceptability. Secondary outcomes included adherence to prescribed ICS regimen and 30-day adherence trajectories. Group-based trajectory modeling was used to examine adherence trajectories. Forty-one participants (mean age 5.9) were randomized to intervention (n = 21) or control (n = 20). Overall, 85% were Black, 88% had public insurance, and 51% of the caregivers had a high school education or less. Thirty-two participant families (78%) transmitted medication adherence data; of caregivers who completed the acceptability survey, 25 (96%) chose to receive daily reminders beyond that study interval. Secondary outcome analyses demonstrated similar average daily adherence between groups (intervention = 36%; control = 32%, P = 0.73). Three adherence trajectories were identified with none ever exceeding 80% adherence. Within a high-risk pediatric cohort, electronic monitoring of ICS use and adherence reminders delivered via text message were feasible for most participants, but there was no signal of effect. Adherence trajectories following severe exacerbation were suboptimal, demonstrating an important opportunity for asthma care improvement.

  14. Cooperative wireless network control based health and activity monitoring system.

    Science.gov (United States)

    Prakash, R; Ganesh, A Balaji; Girish, Siva V

    2016-10-01

    A real-time cooperative communication based wireless network is presented for monitoring health and activity of an end-user in their environment. The cooperative communication offers better energy consumption and also an opportunity to aware the current location of a user non-intrusively. The link between mobile sensor node and relay node is dynamically established by using Received Signal Strength Indicator (RSSI) and Link Quality Indicator (LQI) based on adaptive relay selection scheme. The study proposes a Linear Acceleration based Transmission Power Decision Control (LA-TPDC) algorithm to further enhance the energy efficiency of cooperative communication. Further, the occurrences of false alarms are carefully prevented by introducing three stages of sequential warning system. The real-time experiments are carried-out by using the nodes, namely mobile sensor node, relay nodes and a destination node which are indigenously developed by using a CC430 microcontroller integrated with an in-built transceiver at 868 MHz. The wireless node performance characteristics, such as energy consumption, Signal-Noise ratio (SNR), Bit Error Rate (BER), Packet Delivery Ratio (PDR) and transmission offset are evaluated for all the participated nodes. The experimental results observed that the proposed linear acceleration based transmission power decision control algorithm almost doubles the battery life time than energy efficient conventional cooperative communication.

  15. Adherence to two methods of education and metabolic control in ...

    African Journals Online (AJOL)

    BACKGROUND: Education in diabetes optimizes metabolic control, prevents acute and chronic complications, and improves quality of life. Our main objective was to evaluate if a better metabolic control is achieved in diabetic patients undergoing a program of intensive interactive care than in those with traditional care and ...

  16. Control of cooperative manipulators in holding deformable objects

    Science.gov (United States)

    Alkathiri, A. A.; Azlan, N. Z.

    2017-11-01

    This paper presents the implementation of a control system to control cooperative manipulators to hold deformable objects. The aim is to hold the deformable object without having information on the shape and stiffness of the deformable object beforehand. The prototype of a pair of manipulators has been designed and built to test the controller. A force sensor and a rotary encoder are used to give feedback to the controller, which controls the DC motor actuators accordingly. A position proportional-integral-derivative (PID) controller technique has been applied for one of the manipulators and a PID force control technique is applied to the other. Simulations and experimental tests have been conducted on models and the controller has been implemented on the real plant. Both simulation and test results prove that the implemented control technique has successfully provided the desired position and force to hold the deformable object with maximum experimental errors of 0.34mm and 50mN respectively.

  17. Cooperative Game for Fish Harvesting and Pollution Control

    KAUST Repository

    Dia, Ben Mansour

    2015-01-07

    We study fishery strategies in a shallow river subject to agricultural and industrial pollution. The flowing pollutants in the river are modeled by a nonlinear stochastic differential equation in a general manner. The logistic growth model for the fish population is modified to cover the pollution impact on the fish growth rate. A stochastic cooperative game is formulated to design strategies for preserving the fish population by controlling the pollution as well as the harvesting fish.

  18. Effectiveness of a medication-adherence tool : Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Hilbink, Mirrian; Lacroix, Joyca; Bremer-van der Heiden, Linda; van Halteren, Aart; Teichert, Martina; van Lieshout, Jan

    2016-01-01

    Background: Research shows that more than half of the people taking medication for a chronic condition are non-adherent. Nonadherence hinders disease control with a burden on patient quality of life and healthcare systems. We developed a tool that provides insight into nonadherence risks and

  19. Effectiveness of a medication-adherence tool: study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Hilbink-Smolders, M.; Lacroix, J.; Bremer-van der Heiden, L.; Halteren, A. van; Teichert, M.; Lieshout, J. van

    2016-01-01

    BACKGROUND: Research shows that more than half of the people taking medication for a chronic condition are non-adherent. Nonadherence hinders disease control with a burden on patient quality of life and healthcare systems. We developed a tool that provides insight into nonadherence risks and

  20. Educational interventions for knowledge on the disease, treatment adherence and control of diabetes mellitus.

    Science.gov (United States)

    Figueira, Ana Laura Galhardo; Boas, Lilian Cristiane Gomes Villas; Coelho, Anna Claudia Martins; Freitas, Maria Cristina Foss de; Pace, Ana Emilia

    2017-04-20

    to assess the effect of educational interventions for knowledge on the disease, medication treatment adherence and glycemic control of diabetes mellitus patients. evaluation research with "before and after" design, developed in a sample of 82 type 2 diabetes mellitus patients. To collect the data, the Brazilian version of the Diabetes Knowledge Scale (DKN-A), the Measure of Adherence to Treatments and the electronic system at the place of study were used. The data were collected before and after the end of the educational interventions. The educational activities were developed within 12 months, mediated by the Diabetes Conversation Maps, using the Cognitive Social Theory to conduct the interventions. the knowledge on the disease (pknowledge about diabetes mellitus, the medication treatment adherence and the glycated hemoglobin rates.

  1. Control and Protection Cooperation Strategy for Voltage Instability

    DEFF Research Database (Denmark)

    Liu, Zhou; Chen, Zhe; Sun, Haishun

    2012-01-01

    Most cascaded blackouts are caused by unexpected backup relay operations due to low voltage or overload state caused by post fault load restoration dynamics. If such state can be sensed and adjusted appropriately prior to those relay actions, system stability might be sustained. This paper proposed...... a control and protection cooperation strategy to prevent post fault voltage instability. The multi-agent technology is applied for the strategy implementation; the criteria based on wide area measured apparent impedances are defined to choose the control strategy, such as tap changer adjusting or load...

  2. Adherence rates to ferric citrate as compared to active control in patients with end stage kidney disease on dialysis.

    Science.gov (United States)

    Jalal, Diana; McFadden, Molly; Dwyer, Jamie P; Umanath, Kausik; Aguilar, Erwin; Yagil, Yoram; Greco, Barbara; Sika, Mohammed; Lewis, Julia B; Greene, Tom; Goral, Simin

    2017-04-01

    Oral phosphate binders are the main stay of treatment of hyperphosphatemia. Adherence rates to ferric citrate, a recently approved phosphate binder, are unknown. We conducted a post-hoc analysis to evaluate whether adherence rates were different for ferric citrate vs. active control in 412 subjects with end stage kidney disease (ESKD) who were randomized to ferric citrate vs. active control (sevelamer carbonate and/or calcium acetate). Adherence was defined as percent of actual number of pills taken to total number of pills prescribed. There were no significant differences in baseline characteristics including gender, race/ethnicity, and age between the ferric citrate and active control groups. Baseline phosphorus, calcium, and parathyroid hormone levels were similar. Mean (SD) adherence was 81.4% (17.4) and 81.7% (15.9) in the ferric citrate and active control groups, respectively (P = 0.88). Adherence remained similar between both groups after adjusting for gender, race/ethnicity, age, cardiovascular disease (CVD), and diabetic nephropathy (mean [95% CI]: 81.4% [78.2, 84.6] and 81.5% [77.7, 85.2] for ferric citrate and active control, respectively). Gender, race/ethnicity, age, and diagnosis of diabetic nephropathy did not influence adherence to the prescribed phosphate binder. Subjects with CVD had lower adherence rates to phosphate binder; this was significant only in the active control group. Adherence rates to the phosphate binder, ferric citrate, were similar to adherence rates to active control. Similar adherence rates to ferric citrate are notable since tolerance to active control was an entry criteria and the study was open label. Gender, race/ethnicity, nor age influenced adherence. © 2016 International Society for Hemodialysis.

  3. Impact of written information on control and adherence in type 2 diabetes.

    Science.gov (United States)

    Caetano, Inês Rosendo Carvalho E Silva; Santiago, Luiz Miguel; Marques, Margarida

    2018-02-01

    Diabetes therapeutic education and information by leaflets is important. This study aimed to understand the effectiveness of written information to diabetic patients, after six months, in the control of diabetes and medication adherence. Non-pharmacological clinical trial. Randomized sample of diabetic patients of 65 volunteer doctors, distributed among the five health regions in Portugal. At the first appointment, patients were randomized in four groups (three intervention with validated leaflets and one control), leaflet reading being reinforced at the follow-up appointments in a 6-months period. Variables collected: HbA1c, home blood glucose, weight, waist circumference, blood pressure, cigarettes smoked, physical activity level, adherence to medication, medication, height, diabetes progression, age, sex and educational background. Descriptive and inferential statistics. From the 709 patients recruited, 702 were studied in this 6-months period with no statistical differences in the baseline variables studied. After six months of intervention, the adherence to medication improved in the leaflet group (p=0.034). This was noticed in those under 65 years of age (p=0.027), with diabetes for ≤ 5 years (p=0.010), with educational background up to 4 years (p=0.030) and 9 years (p=0.006) and with HbA1c ≥ 7% at the beginning of the study. Interventions with leaflets handed in primary healthcare to people with diabetes type 2 can bring benefits in what concerns adherence to therapeutics, namely in younger people with a less studies.

  4. Communication interventions to improve adherence to infection control precautions: a randomised crossover trial.

    Science.gov (United States)

    Ong, Mei-Sing; Magrabi, Farah; Post, Jeffrey; Morris, Sarah; Westbrook, Johanna; Wobcke, Wayne; Calcroft, Ross; Coiera, Enrico

    2013-02-06

    Ineffective communication of infection control requirements during transitions of care is a potential cause of non-compliance with infection control precautions by healthcare personnel. In this study, interventions to enhance communication during inpatient transfers between wards and radiology were implemented, in the attempt to improve adherence to precautions during transfers. Two interventions were implemented, comprising (i) a pre-transfer checklist used by radiology porters to confirm a patient's infectious status; (ii) a coloured cue to highlight written infectious status information in the transfer form. The effectiveness of the interventions in promoting adherence to standard precautions by radiology porters when transporting infectious patients was evaluated using a randomised crossover trial at a teaching hospital in Australia. 300 transfers were observed over a period of 4 months. Compliance with infection control precautions in the intervention groups was significantly improved relative to the control group (p group was 38%. Applying the coloured cue resulted in a compliance rate of 73%. The pre-transfer checklist intervention achieved a comparable compliance rate of 71%. When both interventions were applied, a compliance rate of 74% was attained. Acceptability of the coloured cue was high, but adherence to the checklist was low (40%). Simple measures to enhance communication through the provision of a checklist and the use a coloured cue brought about significant improvement in compliance with infection control precautions by transport personnel during inpatient transfers. The study underscores the importance of effective communication in ensuring compliance with infection control precautions during transitions of care.

  5. Multi-robot motion control for cooperative observation

    International Nuclear Information System (INIS)

    Parker, L.E.

    1997-01-01

    An important issue that arises in the automation of many security, surveillance, and reconnaissance tasks is that of monitoring (or observing) the movements of targets navigating in a bounded area of interest. A key research issue in these problems is that of sensor placement--determining where sensors should be located to maintain the targets in view. In complex applications involving limited-range sensors, the use of multiple sensors dynamically moving over time is required. In this paper, the authors investigate the use of a cooperative team of autonomous sensor-based robots for the observation of multiple moving targets. They focus primarily on developing the distributed control strategies that allow the robot team to attempt to minimize the total time in which targets escape observation by some robot team member in the area of interest. This paper first formalizes the problem and discusses related work. The authors then present a distributed approximate approach to solving this problem that combines low-level multi-robot control with higher-level reasoning control based on the ALLIANCE formalism. They analyze the effectiveness of the approach by comparing it to 3 other feasible algorithms for cooperative control, showing the superiority of the approach for a large class of problems

  6. Cooperative motion control for multi-target observation

    International Nuclear Information System (INIS)

    Parker, L.E.

    1997-01-01

    An important issue that arises in the automation of many security, surveillance, and reconnaissance tasks is that of monitoring (or observing) the movements of targets navigating in a bounded area of interest. A key research issue in these problems is that of sensor placement--determining where sensors should be located to maintain the targets in view. In complex applications involving limited-range sensors, the use of multiple sensors dynamically moving over time is required. In this paper, the author investigates the use of a cooperative team of autonomous sensor-based robots for the observation of multiple moving targets. The focus is primarily on developing the distributed control strategies that allow the robot team to attempt to minimize the total time in which targets escape observation by some robot team member in the area of interest. This paper first formalizes the problem and discusses related work. The author then presents a distributed approximate approach to solving this problem that combines low-level multi-robot control with higher-level reasoning control based on the ALLIANCE formalism. The effectiveness of the approach is analyzed by comparing it to three other feasible algorithms for cooperative control, showing the superiority of the approach for a large class of problems

  7. Multi-robot motion control for cooperative observation

    Energy Technology Data Exchange (ETDEWEB)

    Parker, L.E. [Oak Ridge National Lab., TN (United States). Center for Engineering Systems Advanced Research

    1997-06-01

    An important issue that arises in the automation of many security, surveillance, and reconnaissance tasks is that of monitoring (or observing) the movements of targets navigating in a bounded area of interest. A key research issue in these problems is that of sensor placement--determining where sensors should be located to maintain the targets in view. In complex applications involving limited-range sensors, the use of multiple sensors dynamically moving over time is required. In this paper, the authors investigate the use of a cooperative team of autonomous sensor-based robots for the observation of multiple moving targets. They focus primarily on developing the distributed control strategies that allow the robot team to attempt to minimize the total time in which targets escape observation by some robot team member in the area of interest. This paper first formalizes the problem and discusses related work. The authors then present a distributed approximate approach to solving this problem that combines low-level multi-robot control with higher-level reasoning control based on the ALLIANCE formalism. They analyze the effectiveness of the approach by comparing it to 3 other feasible algorithms for cooperative control, showing the superiority of the approach for a large class of problems.

  8. Cooperative motion control for multi-target observation

    Energy Technology Data Exchange (ETDEWEB)

    Parker, L.E.

    1997-08-01

    An important issue that arises in the automation of many security, surveillance, and reconnaissance tasks is that of monitoring (or observing) the movements of targets navigating in a bounded area of interest. A key research issue in these problems is that of sensor placement--determining where sensors should be located to maintain the targets in view. In complex applications involving limited-range sensors, the use of multiple sensors dynamically moving over time is required. In this paper, the author investigates the use of a cooperative team of autonomous sensor-based robots for the observation of multiple moving targets. The focus is primarily on developing the distributed control strategies that allow the robot team to attempt to minimize the total time in which targets escape observation by some robot team member in the area of interest. This paper first formalizes the problem and discusses related work. The author then presents a distributed approximate approach to solving this problem that combines low-level multi-robot control with higher-level reasoning control based on the ALLIANCE formalism. The effectiveness of the approach is analyzed by comparing it to three other feasible algorithms for cooperative control, showing the superiority of the approach for a large class of problems.

  9. A note on cooperative versus non-cooperative strategies in international pollution control

    Energy Technology Data Exchange (ETDEWEB)

    Rubio, Santiago J.; Casino, Begona [Department of Economic Analysis, University of Valencia, Avda. de los Naranjos s/n, Edificio Departamental Oriental, 46022 Valencia (Spain)

    2002-06-01

    In this note, we evaluate the scope of Dockner and Long's [Journal of Environment Economics and Management 24 (1993) 13] conclusion on the efficiency of the non-cooperative outcome in a differential game of international pollution control. We also complete the study of the different equilibria the differential game can present. Our results show that their conclusion requires that the initial value of the stock of pollution be higher than the Pareto-efficient pollution stock so that the equilibrium path of emissions involves a decreasing stock of pollution. Our results also show that the application of the procedure proposed by Tsutsui and Mino [Journal of Economic Theory 52 (1990) 136] to construct a Markov-perfect equilibrium using non-linear strategies is problematic when the initial pollution stock is lower than the Pareto-efficient pollution stock.

  10. Cooperative photoinduced metastable phase control in strained manganite films

    Science.gov (United States)

    Zhang, Jingdi; Tan, Xuelian; Liu, Mengkun; Teitelbaum, S. W.; Post, K. W.; Jin, Feng; Nelson, K. A.; Basov, D. N.; Wu, Wenbin; Averitt, R. D.

    2016-09-01

    A major challenge in condensed-matter physics is active control of quantum phases. Dynamic control with pulsed electromagnetic fields can overcome energetic barriers, enabling access to transient or metastable states that are not thermally accessible. Here we demonstrate strain-engineered tuning of La2/3Ca1/3MnO3 into an emergent charge-ordered insulating phase with extreme photo-susceptibility, where even a single optical pulse can initiate a transition to a long-lived metastable hidden metallic phase. Comprehensive single-shot pulsed excitation measurements demonstrate that the transition is cooperative and ultrafast, requiring a critical absorbed photon density to activate local charge excitations that mediate magnetic-lattice coupling that, in turn, stabilize the metallic phase. These results reveal that strain engineering can tune emergent functionality towards proximal macroscopic states to enable dynamic ultrafast optical phase switching and control.

  11. Interventions to improve hemodialysis adherence: a systematic review of randomized-controlled trials.

    Science.gov (United States)

    Matteson, Michelle L; Russell, Cynthia

    2010-10-01

    Over 485,000 people in the United States have chronic kidney disease, a progressive kidney disease that may lead to hemodialysis. Hemodialysis involves a complex regimen of treatment, medication, fluid, and diet management. In 2005, over 312,000 patients were undergoing hemodialysis in the United States. Dialysis nonadherence rates range from 8.5% to 86%. Dialysis therapy treatment nonadherence, including treatment, medication, fluid, and diet nonadherence, significantly increases the risk of morbidity and mortality. The purpose of this paper is to systematically review randomized-controlled trial intervention studies designed to increase treatment, medication, fluid, and diet adherence in adult hemodialysis patients. A search of Cumulative Index of Nursing and Allied Health Literature (CINAHL) (1982 to May 2008), MEDLINE (1950 to May 2008), PsycINFO (1806 to May 2008), and all Evidence-Based Medicine (EBM) Reviews (Cochran DSR, ACP Journal Club, DARE, and CCTR) was conducted to identify randomized-controlled studies that tested the efficacy of interventions to improve adherence in adult hemodialysis patients. Eight randomized-controlled trials met criteria for inclusion. Six of the 8 studies found statistically significant improvement in adherence with the intervention. Of these 6 intervention studies, all studies had a cognitive component, with 3 studies utilizing cognitive/behavioral intervention strategies. Based on this systematic review, interventions utilizing a cognitive or cognitive/behavioral component appear to show the most promise for future study. © 2010 The Authors. Hemodialysis International © 2010 International Society for Hemodialysis.

  12. Asymmetric public goods game cooperation through pest control.

    Science.gov (United States)

    Reeves, T; Ohtsuki, H; Fukui, S

    2017-12-21

    Cooperation in a public goods game has been studied extensively to find the conditions for sustaining the commons, yet the effect of asymmetry between agents has been explored very little. Here we study a game theoretic model of cooperation for pest control among farmers. In our simple model, each farmer has a paddy of the same size arranged adjacently on a line. A pest outbreak occurs at an abandoned paddy at one end of the line, directly threatening the frontier farmer adjacent to it. Each farmer pays a cost of his or her choice to an agricultural collective, and the total sum held by the collective is used for pest control, with success probability increasing with the sum. Because the farmers' incentives depend on their distance from the pest outbreak, our model is an asymmetric public goods game. We derive each farmer's cost strategy at the Nash equilibrium. We find that asymmetry among farmers leads to a few unexpected outcomes. The individual costs at the equilibrium do not necessarily increase with how much the future is valued but rather show threshold behavior. Moreover, an increase in the number of farmers can sometimes paradoxically undermine pest prevention. A comparison with a symmetric public goods game model reveals that the farmer at the greatest risk pays a disproportionate amount of cost in the asymmetric game, making the use of agricultural lands less sustainable. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Cooperative control of multi-agent systems optimal and adaptive design approaches

    CERN Document Server

    Lewis, Frank L; Hengster-Movric, Kristian; Das, Abhijit

    2014-01-01

    Task complexity, communication constraints, flexibility and energy-saving concerns are all factors that may require a group of autonomous agents to work together in a cooperative manner. Applications involving such complications include mobile robots, wireless sensor networks, unmanned aerial vehicles (UAVs), spacecraft, and so on. In such networked multi-agent scenarios, the restrictions imposed by the communication graph topology can pose severe problems in the design of cooperative feedback control systems.  Cooperative control of multi-agent systems is a challenging topic for both control theorists and practitioners and has been the subject of significant recent research. Cooperative Control of Multi-Agent Systems extends optimal control and adaptive control design methods to multi-agent systems on communication graphs.  It develops Riccati design techniques for general linear dynamics for cooperative state feedback design, cooperative observer design, and cooperative dynamic output feedback design.  B...

  14. Self-efficacy beliefs, locus of control, religiosity and non-adherence to immunosuppressive medications in kidney transplant patients.

    Science.gov (United States)

    Silva, Andresa Nascimento; Moratelli, Lucas; Tavares, Paula Liziero; Marsicano, Elisa De Oliveira; Pinhati, Renata Romanholi; Colugnati, Fernando Antonio Basile; Lucchetti, Giancarlo; Sanders-Pinheiro, Helady

    2016-11-01

    Adherence to immunosuppressive medication is essential for favourable kidney transplant outcomes. The present study aims to investigate how self-efficacy beliefs, health locus of control and religiosity are associated with adherence to immunosuppressives in post kidney transplant recipients. This is a cross-sectional study with 88 recipients with more than 1 year after transplantation. Three methods were used to classify patients as adherent or non-adherent: Basel Assessment of Adherence Scale for Immunosuppressives - BAASIS, the collateral report and blood levels of immunosuppressive medications. Self-efficacy, health locus of control, and religiosity were evaluated applying General Perceived Self-Efficacy Scale, Multidimensional Health Locus of Control Scale and Duke University Religion Index, respectively. Non-adherence was modelled by uni- and multivariated analysis. Sixty-three percent of the patients were male, age 47.2 ± 12.9 years, and median post-transplant time 108.71 (49.0-266.0) months. We found 70.5% of patients were non-adherent through at least one method. Adherent patients presented higher self-efficacy scores (45.1 ± 4.9 vs 38.3 ± 8.6; P locus of control (OR 1.23, IC 1.04-1.45, P = 0.016) and lower intrinsic religiosity (OR 0.56, IC 0.38-0.84, P = 0.006). Our study showed that self-efficacy, chance locus of control, and intrinsic religiosity were associated with non-adherence to immunosuppressives. A broader perception of the kidney transplant patient´s integrality can help health professionals to design strategies to promote adherence in this population. © 2015 Asian Pacific Society of Nephrology.

  15. By passing microbial resistance: xylitol controls microorganisms growth by means of its anti-adherence property.

    Science.gov (United States)

    Ferreira, Aline S; Silva-Paes-Leme, Annelisa F; Raposo, Nádia R B; da Silva, Sílvio S

    2015-01-01

    Xylitol is an important polyalcohol suitable for use in odontological, medical and pharmaceutical products and as an additive in food. The first studies on the efficacy of xylitol in the control and treatment of infections started in the late 1970s and it is still applied for this purpose, with safety and very little contribution to resistance. Xylitol seems to act against microorganisms exerting an anti-adherence effect. Some research studies have demonstrated its action against Gram-positive and Gram-negative bacteria and yeasts. However, a clear explanation of how xylitol is effective has not been completely established yet. Some evidence shows that xylitol acts on gene expression, down-regulating the ones which are involved in the microorganisms' virulence, such as capsule formation. Another possible clarification is that xylitol blocks lectin-like receptors. The most important aspect is that, over time, xylitol bypasses microbial resistance and succeeds in controlling infection, either alone or combined with another compound. In this review, the effect of xylitol in inhibiting the growth of a different microorganism is described, focusing on studies in which such an anti-adherent property was highlighted. This is the first mini-review to describe xylitol as an anti-adherent compound and take into consideration how it exerts such action.

  16. One of the Major Problems in Tuberculosis Control: Adherence to Therapy

    Directory of Open Access Journals (Sweden)

    Belguzar Kara

    2009-02-01

    Full Text Available Abstract: Although tuberculosis (TB is a preventable and curable disease, approximately one third of the world’s population is infected with the TB bacillus. Tuberculosis is a major public health problem in especially developing countries. Nonadherence to TB therapy regimes is common, as treatment is difficult and requires long courses of multiple antibiotics. It is estimated that the rate of nonadherence to TB treatment ranges from 20 to 80%. Nonadherence to TB treatment is the most serious barrier in disease control because incomplete treatment may result in prolonged infectiousness, drug resistance, relapse and death. However, handling the factors affecting adherence to treatment for the patients may increase the efficiency of the treatment and help to reach better health outcomes. This article reviews evidence regarding adherence to TB treatment in patients and affecting factors and makes recommendations for health care professionals. [TAF Prev Med Bull 2009; 8(1.000: 75-82

  17. Human-FES cooperative control for wrist movement: a preliminary study

    Directory of Open Access Journals (Sweden)

    Kai Gui

    2016-07-01

    Full Text Available Functional electrical stimulation (FES sometimes applies to patients with partial paralysis, so human voluntary control and FES control both exist. Our study aims to build a cooperative controller to achieve human-FES cooperation. This cooperative controller is formed by a classical FES controller and an impedance controller. The FES controller consists of a back propagation (BP neural network-based feedforward controller and a PID-based feedback controller. The function of impedance controller is to convert volitional force/torque, which is estimated from a three-stage filter based on EMG, into additional angle. The additional angle can reduce the FES intensity in our cooperative controller, comparing to that in classical FES controller. Some assessment experiments are designed to test the performance of the cooperative controller.

  18. Cooperative research for human factors review of advanced control rooms

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Woon; Park, Jae Chang; Lee, Yong Hee; Oh, In Seok; Lee, Hyun Chul

    2000-12-01

    This project has been performed as cooperative research between KAERI and USNRC. Human factors issues related to soft controls, which is one of key features of advanced HSI, are identified in this project. The issues are analyzed for the evaluation approaches in either experimental or analytical ways. Also, issues requiring additional researches for the evaluation of advanced HSI are identified in the areas of advanced information systems design, computer-based procedure systems, soft controls, human systems interface and plant modernization process, and maintainability of digital systems. The issues are analyzed to discriminate the urgency of researches on it to high, medium, and low levels in consideration of advanced HSI development status in Korea, and some of the issues that can be handled by experimental researches are identified. Additionally, an experimental study is performed to compare operator's performance on human error detection in advanced control rooms vs. in conventional control rooms. It is found that advanced control rooms have several design characteristics hindering operator's error detection performance compared to conventional control rooms.

  19. Cooperative research for human factors review of advanced control rooms

    International Nuclear Information System (INIS)

    Lee, Jung Woon; Park, Jae Chang; Lee, Yong Hee; Oh, In Seok; Lee, Hyun Chul

    2000-12-01

    This project has been performed as cooperative research between KAERI and USNRC. Human factors issues related to soft controls, which is one of key features of advanced HSI, are identified in this project. The issues are analyzed for the evaluation approaches in either experimental or analytical ways. Also, issues requiring additional researches for the evaluation of advanced HSI are identified in the areas of advanced information systems design, computer-based procedure systems, soft controls, human systems interface and plant modernization process, and maintainability of digital systems. The issues are analyzed to discriminate the urgency of researches on it to high, medium, and low levels in consideration of advanced HSI development status in Korea, and some of the issues that can be handled by experimental researches are identified. Additionally, an experimental study is performed to compare operator's performance on human error detection in advanced control rooms vs. in conventional control rooms. It is found that advanced control rooms have several design characteristics hindering operator's error detection performance compared to conventional control rooms

  20. Improving adherence to Standard Precautions for the control of health care-associated infections.

    Science.gov (United States)

    Moralejo, Donna; El Dib, Regina; Prata, Rafaela A; Barretti, Pasqual; Corrêa, Ione

    2018-02-26

    'Standard Precautions' refers to a system of actions, such as using personal protective equipment or adhering to safe handling of needles, that healthcare workers take to reduce the spread of germs in healthcare settings such as hospitals and nursing homes. To assess the effectiveness of interventions that target healthcare workers to improve adherence to Standard Precautions in patient care. We searched CENTRAL, MEDLINE, Embase, CINAHL, LILACS, two other databases, and two trials registers. We applied no language restrictions. The date of the most recent search was 14 February 2017. We included randomised trials of individuals, cluster-randomised trials, non-randomised trials, controlled before-after studies, and interrupted time-series studies that evaluated any intervention to improve adherence to Standard Precautions by any healthcare worker with responsibility for patient care in any hospital, long-term care or community setting, or artificial setting, such as a classroom or a learning laboratory. Two review authors independently screened search results, extracted data from eligible trials, and assessed risk of bias for each included study, using standard methodological procedures expected by Cochrane. Because of substantial heterogeneity among interventions and outcome measures, meta-analysis was not warranted. We used the GRADE approach to assess certainty of evidence and have presented results narratively in 'Summary of findings' tables. We included eight studies with a total of 673 participants; three studies were conducted in Asia, two in Europe, two in North America, and one in Australia. Five studies were randomised trials, two were cluster-randomised trials, and one was a non-randomised trial. Three studies compared different educational approaches versus no education, one study compared education with visualisation of respiratory particle dispersion versus education alone, two studies compared education with additional infection control support versus

  1. Notification: Audit of EPA's Adherence to Policies, Procedures and Oversight Controls Pertaining to the Administrator’s Travel

    Science.gov (United States)

    Project #OA-FY17-0382, August 28, 2017. The EPA OIG plans to begin preliminary research on the EPA’s adherence to policies, procedures and oversight controls pertaining to the Administrator’s travel to Oklahoma.

  2. A cooperative control algorithm for camera based observational systems.

    Energy Technology Data Exchange (ETDEWEB)

    Young, Joseph G.

    2012-01-01

    Over the last several years, there has been considerable growth in camera based observation systems for a variety of safety, scientific, and recreational applications. In order to improve the effectiveness of these systems, we frequently desire the ability to increase the number of observed objects, but solving this problem is not as simple as adding more cameras. Quite often, there are economic or physical restrictions that prevent us from adding additional cameras to the system. As a result, we require methods that coordinate the tracking of objects between multiple cameras in an optimal way. In order to accomplish this goal, we present a new cooperative control algorithm for a camera based observational system. Specifically, we present a receding horizon control where we model the underlying optimal control problem as a mixed integer linear program. The benefit of this design is that we can coordinate the actions between each camera while simultaneously respecting its kinematics. In addition, we further improve the quality of our solution by coupling our algorithm with a Kalman filter. Through this integration, we not only add a predictive component to our control, but we use the uncertainty estimates provided by the filter to encourage the system to periodically observe any outliers in the observed area. This combined approach allows us to intelligently observe the entire region of interest in an effective and thorough manner.

  3. Implementation of a Novel Adherence Monitoring Strategy in a Phase III, Blinded, Placebo-Controlled, HIV-1 Prevention Clinical Trial.

    Science.gov (United States)

    Husnik, Marla J; Brown, Elizabeth R; Marzinke, Mark; Livant, Edward; Palanee-Phillips, Thesla; Hendrix, Craig W; Matovu Kiweewa, Flavia; Nair, Gonasagrie; Soto-Torres, Lydia E; Schwartz, Katie; Hillier, Sharon L; Baeten, Jared M

    2017-11-01

    Placebo-controlled HIV-1 prevention trials of pre-exposure prophylaxis (PrEP) have not generally used concurrent measurement of adherence because of the potential risk of unblinding. However, several pre-exposure prophylaxis trials for HIV-1 prevention among women failed to show effectiveness because of low product adherence. Evaluation of product adherence objectively during a study provides the opportunity for strengthening adherence activities at sites having low adherence. During MTN-020/ASPIRE, a phase III, placebo-controlled trial of the dapivirine intravaginal ring, we implemented an adherence monitoring system. Monitoring began in quarter 1 (Q1) 2013 and continued through the conclusion of the trial. Blood plasma was collected quarterly and tested for dapivirine concentrations while maintaining blinding among study team members involved in participant management. Dapivirine concentrations >95 pg/mL, reflecting >8 hours of continuous use, were assessed as signaling product use. Study leadership monitored results on a monthly basis and provided feedback to site investigators. Experiences were shared across sites to motivate staff and counsel participants to strive toward higher adherence levels. An upward trend in adherence was observed (P dapivirine >95 pg/mL increased from 63% in Q1 2013 to 84% by Q1 2015. Ongoing drug level testing as a marker of adherence in MTN-020/ASPIRE demonstrates the feasibility of real-time adherence monitoring while maintaining study blinding at the level of participants, sites, and study leadership. This approach is novel for large-scale effectiveness studies for HIV-1 prevention.

  4. Randomized controlled trial of a mobile phone intervention for improving adherence to naltrexone for alcohol use disorders.

    Directory of Open Access Journals (Sweden)

    Susan A Stoner

    Full Text Available Naltrexone is a front-line treatment for alcohol use disorders, but its efficacy is limited by poor medication adherence. This randomized controlled trial evaluated whether a mobile health intervention could improve naltrexone adherence.Treatment-seeking participants with an alcohol use disorder (N = 76 were randomized to intervention and control conditions. All participants received naltrexone (50 mg/day with a medication event monitoring system (MEMS and a prepaid smartphone, and received a daily text message querying medication side effects, alcohol use, and craving. Those in the intervention arm received additional medication reminders and adherence assessment via text message.The primary outcome, proportion of participants with adequate adherence (defined as ≥80% of prescribed doses taken through Week 8, did not differ between groups in intent-to-treat analyses (p = .34. Mean adherence at study midpoint (Week 4 was 83% in the intervention condition and 77% in the control condition (p = .35. Survival analysis found that the intervention group sustained adequate adherence significantly longer (M = 19 days [95% CI = 0.0-44.0] than those in the control group (M = 3 days [95% CI = 0.0-8.1] during the first month of treatment (p = .04. Medication adherence did not predict drinking outcomes.These results suggest that in the context of daily monitoring and assessment via cell phone, additional text message reminders do not further improve medication adherence. Although this initial trial does not provide support for the efficacy of text messaging to improve adherence to pharmacotherapy for alcohol use disorders, additional trials with larger samples and alternate designs are warranted.ClinicalTrials.gov: NCT01349985.

  5. 42 CFR 455.21 - Cooperation with State Medicaid fraud control units.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Cooperation with State Medicaid fraud control units... Detection and Investigation Program § 455.21 Cooperation with State Medicaid fraud control units. In a State with a Medicaid fraud control unit established and certified under subpart C of this part, (a) The...

  6. The effects of yoga on psychosocial variables and exercise adherence: a randomized, controlled pilot study.

    Science.gov (United States)

    Bryan, Stephanie; Pinto Zipp, Genevieve; Parasher, Raju

    2012-01-01

    Physical inactivity is a serious issue for the American public. Because of conditions that result from inactivity, individuals incur close to $1 trillion USD in health-care costs, and approximately 250 000 premature deaths occur per year. Researchers have linked engaging in yoga to improved overall fitness, including improved muscular strength, muscular endurance, flexibility, and balance. Researchers have not yet investigated the impact of yoga on exercise adherence. The research team assessed the effects of 10 weeks of yoga classes held twice a week on exercise adherence in previously sedentary adults. The research team designed a randomized controlled pilot trial. The team collected data from the intervention (yoga) and control groups at baseline, midpoint, and posttest (posttest 1) and also collected data pertaining to exercise adherence for the yoga group at 5 weeks posttest (posttest 2). The pilot took place in a yoga studio in central New Jersey in the United States. The pretesting occurred at the yoga studio for all participants. Midpoint testing and posttesting occurred at the studio for the yoga group and by mail for the control group. Participants were 27 adults (mean age 51 y) who had been physically inactive for a period of at least 6 months prior to the study. Interventions The intervention group (yoga group) received hour-long hatha yoga classes that met twice a week for 10 weeks. The control group did not participate in classes during the research study; however, they were offered complimentary post research classes. Outcome Measures The study's primary outcome measure was exercise adherence as measured by the 7-day Physical Activity Recall. The secondary measures included (1) exercise self-efficacy as measured by the Multidimensional Self-Efficacy for Exercise Scale, (2) general well-being as measured by the General Well-Being Schedule, (3) exercise-group cohesion as measured by the Group Environment Questionnaire (GEQ), (4) acute feeling response

  7. Lacunae in noncommunicable disease control program: Need to focus on adherence issues!

    Directory of Open Access Journals (Sweden)

    Tarundeep Singh

    2017-01-01

    Full Text Available Introduction: Chronic non communicable diseases in India have increased in magnitude with earlier onset and more likelihood of complications. Much emphasis is given to early diagnosis and timely treatment. Additionally, tertiary prevention through medication adherence is needed to limit disability and prevent early onset of complications. This study was aimed to assess the magnitude of medication and lifestyle adherence among elderly patients suffering from diabetes and hypertension in rural areas of Punjab. Methodology: This was a clinic based study in district Fatehgarh Sahib, Punjab. Patients were subjected to regular blood pressure and blood glucose monitoring. Thereafter they were offered free medications through weekly clinic held at Community Health Center, Bassi Pathana. Along with treatment, Public Health Nurse conducted counselling on diet and lifestyle. Frequency and process of taking medications was explained in local language and records duly maintained during visits. Results: Nearly 70% of study subjects were more than 50 years old. Males constituted 26% of the sample and 60% of subjects were illiterate. Large majority of study subjects did not consumed tobacco (98.08% or alcohol (89.42% in past thirty days. In-sufficient physical activity and poor compliance to diet was reported by 10.5% (Males: 7.4%, Females: 11.7% and 23.5% (Males: 31.5%, Females: 20.8% subjects. Nearly 46.15% of study subjects reported missing prescribed medications. Nearly 61.54% of study subjects were very sure that they will be able to take medicines as directed by physician. Conclusion: National Program for Control of Diabetes, Cardio-vascular Disease and Stroke relies on early diagnosis and treatment non- communicable diseases. However, with reported levels of adherence to medication and lifestyle interventions, there is an urgent need of exploring innovative ways to ensure compliance and improve treatment outcomes.

  8. Evolutionary Fuzzy Control and Navigation for Two Wheeled Robots Cooperatively Carrying an Object in Unknown Environments.

    Science.gov (United States)

    Juang, Chia-Feng; Lai, Min-Ge; Zeng, Wan-Ting

    2015-09-01

    This paper presents a method that allows two wheeled, mobile robots to navigate unknown environments while cooperatively carrying an object. In the navigation method, a leader robot and a follower robot cooperatively perform either obstacle boundary following (OBF) or target seeking (TS) to reach a destination. The two robots are controlled by fuzzy controllers (FC) whose rules are learned through an adaptive fusion of continuous ant colony optimization and particle swarm optimization (AF-CACPSO), which avoids the time-consuming task of manually designing the controllers. The AF-CACPSO-based evolutionary fuzzy control approach is first applied to the control of a single robot to perform OBF. The learning approach is then applied to achieve cooperative OBF with two robots, where an auxiliary FC designed with the AF-CACPSO is used to control the follower robot. For cooperative TS, a rule for coordination of the two robots is developed. To navigate cooperatively, a cooperative behavior supervisor is introduced to select between cooperative OBF and cooperative TS. The performance of the AF-CACPSO is verified through comparisons with various population-based optimization algorithms for the OBF learning problem. Simulations and experiments verify the effectiveness of the approach for cooperative navigation of two robots.

  9. A Robust Cooperated Control Method with Reinforcement Learning and Adaptive H∞ Control

    Science.gov (United States)

    Obayashi, Masanao; Uchiyama, Shogo; Kuremoto, Takashi; Kobayashi, Kunikazu

    This study proposes a robust cooperated control method combining reinforcement learning with robust control to control the system. A remarkable characteristic of the reinforcement learning is that it doesn't require model formula, however, it doesn't guarantee the stability of the system. On the other hand, robust control system guarantees stability and robustness, however, it requires model formula. We employ both the actor-critic method which is a kind of reinforcement learning with minimal amount of computation to control continuous valued actions and the traditional robust control, that is, H∞ control. The proposed system was compared method with the conventional control method, that is, the actor-critic only used, through the computer simulation of controlling the angle and the position of a crane system, and the simulation result showed the effectiveness of the proposed method.

  10. The patient education - Learning and Coping Strategies - improves adherence in cardiac rehabilitation (LC-REHAB): A randomised controlled trial.

    Science.gov (United States)

    Lynggaard, Vibeke; Nielsen, Claus Vinther; Zwisler, Ann-Dorthe; Taylor, Rod S; May, Ole

    2017-06-01

    Despite proven benefits of cardiac rehabilitation (CR), adherence to CR remains suboptimal. This trial aimed to assess the impact of the patient education 'Learning and Coping Strategies' (LC) on patient adherence to an eight-week CR program. 825 patients with ischaemic heart disease or heart failure were open label randomised to either the LC arm (LC plus CR) or the control arm (CR alone) across three hospital units in Denmark. Both arms received same amount of training and education hours. LC consisted of individual clarifying interviews, participation of experienced patients as co-educators, situational, reflective and inductive teaching. The control arm received structured deductive teaching. The primary outcomes were patient adherence to at least 75% of the exercise training or education sessions. We tested for subgroup effects on the primary outcomes using interaction terms. The primary outcomes were compared across arms using logistic regression. More patients in the LC arm adhered to at least 75% of the exercise training sessions than control (80% versus 73%, adjusted odds ratio (OR):1.48; 95% CI:1.07 to 2.05, P=0.018) and 75% of education sessions (79% versus 70%, adjusted OR:1.61, 1.17 to 2.22, P=0.003). Some evidence of larger effects of LC on adherence was seen for patients with heart failure, low education and household income. Addition of LC strategies improved adherence in rehabilitation both in terms of exercise training and education. Patients with heart failure, low levels of education and household income appear to benefit most from this adherence promoting intervention. www.clinicaltrials.gov identifier NCT01668394. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Vehicle handling and stability control by the cooperative control of 4WS and DYC

    Science.gov (United States)

    Shen, Huan; Tan, Yun-Sheng

    2017-07-01

    This paper proposes an integrated control system that cooperates with the four-wheel steering (4WS) and direct yaw moment control (DYC) to improve the vehicle handling and stability. The design works of the four-wheel steering and DYC control are based on sliding mode control. The integration control system produces the suitable 4WS angle and corrective yaw moment so that the vehicle tracks the desired yaw rate and sideslip angle. Considering the change of the vehicle longitudinal velocity that means the comfort of driving conditions, both the driving torque and braking torque are used to generate the corrective yaw moment. Simulation results show the effectiveness of the proposed control algorithm.

  12. Referral from primary care to a physical activity programme: establishing long-term adherence? A randomized controlled trial. Rationale and study design

    Directory of Open Access Journals (Sweden)

    Puig-Ribera Anna

    2009-01-01

    Full Text Available Abstract Background Declining physical activity is associated with a rising burden of global disease. There is little evidence about effective ways to increase adherence to physical activity. Therefore, interventions are needed that produce sustained increases in adherence to physical activity and are cost-effective. The purpose is to assess the effectiveness of a primary care physical activity intervention in increasing adherence to physical activity in the general population seen in primary care. Method and design Randomized controlled trial with systematic random sampling. A total of 424 subjects of both sexes will participate; all will be over the age of 18 with a low level of physical activity (according to the International Physical Activity Questionnaire, IPAQ, self-employed and from 9 Primary Healthcare Centres (PHC. They will volunteer to participate in a physical activity programme during 3 months (24 sessions; 2 sessions a week, 60 minutes per session. Participants from each PHC will be randomly allocated to an intervention (IG and control group (CG. The following parameters will be assessed pre and post intervention in both groups: (1 health-related quality of life (SF-12, (2 physical activity stage of change (Prochaska's stages of change, (3 level of physical activity (IPAQ-short version, (4 change in perception of health (vignettes from the Cooperative World Organization of National Colleges, Academies, and Academic Associations of Family Physicians, COOP/WONCA, (5 level of social support for the physical activity practice (Social Support for Physical Activity Scale, SSPAS, and (6 control based on analysis (HDL, LDL and glycated haemoglobin. Participants' frequency of visits to the PHC will be registered over the six months before and after the programme. There will be a follow up in a face to face interview three, six and twelve months after the programme, with the reduced version of IPAQ, SF-12, SSPAS, and Prochaska's stages

  13. A Pharmaceutical Care Program to Improve Adherence to Statin Therapy : A Randomized Controlled Trial

    NARCIS (Netherlands)

    Eussen, Simone R. B. M.; van der Elst, Menno E.; Klungel, Olaf H.; Rompelberg, Cathy J. M.; Garssen, Johan; Oosterveld, Marco H.; de Boer, Anthonius; de Gier, Johan J.; Bouvy, Marcel L.

    2010-01-01

    BACKGROUND: Despite the well-known beneficial effects of statins, many patients do not adhere to chronic medication regimens. OBJECTIVE: To implement and assess the effectiveness of a community pharmacy based pharmaceutical care program developed to improve patients' adherence to statin therapy.

  14. Disease related knowledge, medication adherence and glycaemic control among patients with type 2 diabetes mellitus in Pakistan.

    Science.gov (United States)

    Nazir, Saeed Ur Rashid; Hassali, Mohamed Azmi; Saleem, Fahad; Bashir, Sajid; Aljadhey, Hisham

    2016-04-01

    The purpose of this study was to investigate the association of diabetes-related knowledge and treatment adherence with glycaemic control among patients with type 2 diabetes mellitus (T2DM) in Pakistan. The study was designed as a questionnaire-based, cross-sectional analysis. T2DM patients attending a public outpatient clinic in Sargodha, Pakistan, were targeted for the study. In addition to the demographic information, the Urdu version of Michigan Diabetes Knowledge Test and Morisky Medication Adherence Scale was used for data collection. Patients' medical records were reviewed for glycated haemoglobin levels (HbA1c). Descriptive statistics were used to elaborate sociodemographic characteristics. The Spearman's Rho correlation was used to measure association of disease-related knowledge and treatment adherence with glycaemic control. SPSS V 20.0 was used for data analysis and ppatients were included in the study. The mean age (SD) of these patients was 50.77±9.671 years, 56.6% were males and 90% (n=353) of respondents were married. The mean (SD) duration of disease was 5.58 (4.09) years with median HbA1c of 9.00 (IQR=8.20-10.40). The median knowledge score was 8.0 (IQR=6.0-10.0), while the median adherence score was 4.7 (IQR=3.0-6.0). HbA1c had non-significant and weak negative association with diabetes-related knowledge (r=-0.036, p=0.404) and treatment adherence (r=-0.071, p=0.238). There was negative association reported between HbA1c, treatment adherence and diabetes-related knowledge. Greater efforts are clearly required to investigate other factors affecting glycaemic control among T2DM patients in Pakistan. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  15. Cooperative Planning, Uncertainty, and Managerial Control in Concurrent Design

    OpenAIRE

    Victoria L. Mitchell; Barrie R. Nault

    2007-01-01

    We examine whether cooperative planning and uncertainty affect the magnitude of rework in concurrent engineering projects with upstream and downstream operations, and explore the impact of such rework on project delays. Using survey data from a sample of 120 business process (BP) redesign and related information technology (IT) development projects in healthcare and telecommunications, our results indicate that upstream (BP) rework and downstream (IT) rework is mediated and mitigated by coope...

  16. Use of a goal setting intervention to increase adherence to low back pain rehabilitation: a randomized controlled trial.

    Science.gov (United States)

    Coppack, Russell J; Kristensen, Jakob; Karageorghis, Costas I

    2012-11-01

    To examine the effects of a goal setting intervention on self-efficacy, treatment efficacy, adherence and treatment outcome in patients undergoing low back pain rehabilitation. A mixed-model 2 (time) × 3 (group) randomized controlled trial. A residential rehabilitation centre for military personnel. UK military personnel volunteers (N = 48); mean age was 32.9 (SD 7.9) with a diagnosis of non-specific low back pain. Subjects were randomly assigned to either a goal setting experimental group (Exp, n = 16), therapist-led exercise therapy group (C1, n = 16) or non-therapist-led exercise therapy group (C2, n = 16). Treatment duration for all groups was three weeks. Self-efficacy, treatment efficacy and treatment outcome were recorded before and after the treatment period. Adherence was rated during regularly scheduled treatment sessions using the Sports Injury Rehabilitation Adherence Scale (SIRAS). The Biering-Sørensen test was used as the primary measure of treatment outcome. ANCOVA results showed that adherence scores were significantly higher in the experimental group (13.70 ± 1.58) compared with C2 (11.74 ± 1.35), (P goal setting to enhance adherence in clinical rehabilitation.

  17. Repackaged sodium valproate tablets--Meeting quality and adherence to ensure seizure control.

    Science.gov (United States)

    Redmayne, Nichola; Robertson, Sherryl; Kockler, Jutta; Llewelyn, Victoria; Haywood, Alison; Glass, Beverley

    2015-09-01

    Sodium valproate, which is commonly repacked to assist with adherence to ensure seizure control, is hygroscopic and therefore sensitive to moisture. The aim of this study was thus to determine the stability implications of removing the enteric coated tablets from their original packaging and repackaging into a Dose Administration Aid (DAA) with storage under various environmental conditions. Physicochemical stability of enteric coated sodium valproate tablets repackaged into a DAA and stored at controlled room temperature, accelerated and refrigerated conditions was evaluated for 28 days. A validated high performance liquid chromatography method was used for the quantitation of the drug content. Although the chemical stability (sodium valproate between 95 and 105% of labelled content) was maintained for 28 days for all storage conditions, for those tablets stored under accelerated conditions the integrity of the enteric coat was compromised after only 8 days. Repackaging of enteric coated sodium valproate should be undertaken with caution and be informed by storage climate. This is particularly relevant for those patients living in hot, humid environments where they should be advised to store their DAA in a refrigerator. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  18. Cooperative Remote Monitoring, Arms control and nonproliferation technologies: Fourth quarter 1995

    Energy Technology Data Exchange (ETDEWEB)

    Alonzo, G M [ed.

    1995-01-01

    The DOE`s Cooperative Remote Monitoring programs integrate elements from research and development and implementation to achieve DOE`s objectives in arms control and nonproliferation. The contents of this issue are: cooperative remote monitoring--trends in arms control and nonproliferation; Modular Integrated Monitoring System (MIMS); Authenticated Tracking and Monitoring Systems (ATMS); Tracking and Nuclear Materials by Wide-Area Nuclear Detection (WAND); Cooperative Monitoring Center; the International Remote Monitoring Project; international US and IAEA remote monitoring field trials; Project Dustcloud: monitoring the test stands in Iraq; bilateral remote monitoring: Kurchatov-Argonne-West Demonstration; INSENS Sensor System Project.

  19. Cooperative Control of Regenerative Braking and Antilock Braking for a Hybrid Electric Vehicle

    OpenAIRE

    Yin, Guodong; Jin, XianJian

    2013-01-01

    A new cooperative braking control strategy (CBCS) is proposed for a parallel hybrid electric vehicle (HEV) with both a regenerative braking system and an antilock braking system (ABS) to achieve improved braking performance and energy regeneration. The braking system of the vehicle is based on a new method of HEV braking torque distribution that makes the antilock braking system work together with the regenerative braking system harmoniously. In the cooperative braking control strategy, a sli...

  20. A randomized controlled trial comparing the effects of counseling and alarm device on HAART adherence and virologic outcomes.

    Directory of Open Access Journals (Sweden)

    Michael H Chung

    2011-03-01

    Full Text Available Behavioral interventions that promote adherence to antiretroviral medications may decrease HIV treatment failure. Antiretroviral treatment programs in sub-Saharan Africa confront increasing financial constraints to provide comprehensive HIV care, which include adherence interventions. This study compared the impact of counseling and use of an alarm device on adherence and biological outcomes in a resource-limited setting.A randomized controlled, factorial designed trial was conducted in Nairobi, Kenya. Antiretroviral-naïve individuals initiating free highly active antiretroviral therapy (HAART in the form of fixed-dose combination pills (d4T, 3TC, and nevirapine were randomized to one of four arms: counseling (three counseling sessions around HAART initiation, alarm (pocket electronic pill reminder carried for 6 months, counseling plus alarm, and neither counseling nor alarm. Participants were followed for 18 months after HAART initiation. Primary study endpoints included plasma HIV-1 RNA and CD4 count every 6 months, mortality, and adherence measured by monthly pill count. Between May 2006 and September 2008, 400 individuals were enrolled, 362 initiated HAART, and 310 completed follow-up. Participants who received counseling were 29% less likely to have monthly adherence <80% (hazard ratio [HR] = 0.71; 95% confidence interval [CI] 0.49-1.01; p = 0.055 and 59% less likely to experience viral failure (HIV-1 RNA ≥5,000 copies/ml (HR 0.41; 95% CI 0.21-0.81; p = 0.01 compared to those who received no counseling. There was no significant impact of using an alarm on poor adherence (HR 0.93; 95% CI 0.65-1.32; p = 0.7 or viral failure (HR 0.99; 95% CI 0.53-1.84; p = 1.0 compared to those who did not use an alarm. Neither counseling nor alarm was significantly associated with mortality or rate of immune reconstitution.Intensive early adherence counseling at HAART initiation resulted in sustained, significant impact on adherence and

  1. In patients with severe uncontrolled asthma, does knowledge of adherence and inhaler technique using electronic monitoring improve clinical decision making? A protocol for a randomised controlled trial.

    LENUS (Irish Health Repository)

    Mokoka, Matshediso C

    2017-06-15

    Many patients with asthma remain poorly controlled despite the use of inhaled corticosteroids and long-acting beta agonists. Poor control may arise from inadequate adherence, incorrect inhaler technique or because the condition is refractory. Without having an objective assessment of adherence, clinicians may inadvertently add extra medication instead of addressing adherence. This study aims to assess if incorporating objectively recorded adherence from the Inhaler Compliance Assessment (INCA) device and lung function into clinical decision making provides more cost-effective prescribing and improves outcomes.

  2. A 2-arm, randomized, controlled trial of a motivational interviewing-based intervention to improve adherence to antiretroviral therapy (ART) among patients failing or initiating ART.

    Science.gov (United States)

    Golin, Carol E; Earp, Joanne; Tien, Hsiao-Chuan; Stewart, Paul; Porter, Carol; Howie, Lynn

    2006-05-01

    Motivational interviewing (MI) is a counseling technique that has been used effectively to change a number of health-related behaviors. We sought to assess the impact on patients' antiretroviral therapy (ART) adherence of a multicomponent, MI-based ART adherence intervention compared with that of an HIV informational control program. Two-arm, randomized, controlled trial. One hundred forty adult HIV-infected patients attending a large, academic center infectious diseases clinic who were either failing or newly initiating an ART regimen. STUDY ENDPOINTS: (1) Mean adherence level (% of prescribed doses take in the prior month) at the week 12 visit, (2) change in mean adherence, (3) percentage of patients achieving >95% adherence in the third 4-week block, and (4) change in viral load. The MI group's mean adherence improved by 4.5% compared with a decrease in the control group's adherence by 3.83% (P = 0.10). In the treatment group, 29% achieved >95% adherence compared with only 17% in the control group (P = 0.13). When we controlled for ethnicity, the intervention group had 2.75 times higher odds of achieving more than 95% adherence than did the controls (P = 0.045; 95% confidence interval: 1.023, 7.398). Although a number of mediating variables (beliefs about ART, coping style, social support, and goals set) had statistically significant changes in the expected direction in the MI group compared with controls, in the intent-to-treat analysis, the mean adherence at study exit for the intervention group was 76% (SD = 27%) and 71% (SD = 27%) for the control group (P = 0.62). Although not definitive, this study provides some evidence that MI offers an effective approach to improving adherence. Future studies able to build MI into the intervention for longer than 3 months may have a greater impact.

  3. The efficacy of a brief motivational enhancement education program on CPAP adherence in OSA: a randomized controlled trial.

    Science.gov (United States)

    Lai, Agnes Y K; Fong, Daniel Y T; Lam, Jamie C M; Weaver, Terri E; Ip, Mary S M

    2014-09-01

    Poor adherence to CPAP treatment in OSA adversely affects the effectiveness of this therapy. This randomized controlled trial (RCT) examined the efficacy of a brief motivational enhancement education program in improving adherence to CPAP treatment in subjects with OSA. Subjects with newly diagnosed OSA were recruited into this RCT. The control group received usual advice on the importance of CPAP therapy and its care. The intervention group received usual care plus a brief motivational enhancement education program directed at enhancing the subjects' knowledge, motivation, and self-efficacy to use CPAP through the use of a 25-min video, a 20-min patient-centered interview, and a 10-min telephone follow-up. Self-reported daytime sleepiness adherence-related cognitions and quality of life were assessed at 1 month and 3 months. CPAP usage data were downloaded at the completion of this 3-month study. One hundred subjects with OSA (mean ± SD, age 52 ± 10 years; Epworth Sleepiness Scales [ESS], 9 ± 5; median [interquartile range] apnea-hypopnea index, 29 [20, 53] events/h) prescribed CPAP treatment were recruited. The intervention group had better CPAP use (higher daily CPAP usage by 2 h/d [Cohen d = 1.33, P motivational enhancement education in addition to usual care were more likely to show better adherence to CPAP treatment, with greater improvements in treatment self-efficacy and daytime sleepiness. ClinicalTrials.gov; No.: NCT01173406; URL: www.clinicaltrials.gov.

  4. The impact of knowledge and attitudes on adherence to tuberculosis treatment: a case-control study in a Moroccan region

    Science.gov (United States)

    Tachfouti, Nabil; Slama, Katia; Berraho, Mohammed; Nejjari, Chakib

    2012-01-01

    Background Although tuberculosis (TB) care is provided free of charge in Morocco, a high number of patients voluntarily interrupt their treatment before the end. Treatment Default is a major obstacle in the fight against the disease. The purpose of this study was to describe the impact of knowledge and attitudes toward TB on treatment adherence. Methods Case-control study of 290 TB patients (85 defaulters and 205 controls). A defaulter was defined as a TB patient who interrupted treatment for two months or longer. Socio-demographic measurements, knowledge and attitude were collected by face to face anonymous questionnaire. Khi-square test was conducted to examine differences in TB attitudes and knowledge according to treatment adherence. Results The mean age of participants was 31.7 ± 12.0 years. Monthly income was under 2000 MAD (180 €) for 82% of them. Over sixty four percent were illiterate or had a basic educational level. Microbial cause was known by 17.2% respondents; 20.5% among adherent patients versus 9.4% (p=0.02). The fact that the disease is curable was more known by adherent patients: 99.0% versus 88.2% (p education into current TB case management. PMID:22937192

  5. A Study on the cooperation policy in multilateral nuclear control regimes and the advancing of national export control system

    International Nuclear Information System (INIS)

    Lee, Byung Wook; Oh, K. B.; Yang, M. H.; Lee, H. M.; Lee, K. S.; Ko, H. S.; Ryu, J. S.; Kim, J. S.

    2004-08-01

    This study carried out the analysis of trends of the multilateral nuclear control in four aspects. First, this study analyzes the past trends of the international nuclear non-proliferation regime, which includes the NPT, the IAEA safeguards system, the international nuclear export control regime and the physical protection of nuclear materials. Second, this study establishes the multilateral cooperation strategies for the effective cooperation in the process of strengthening the nuclear control regimes. Third, this study reviews the major agenda of nuclear control regimes and establishes national positions on each agenda. Fourth, this study also analyzes outstanding issues in nuclear control regimes and derives some factors to reflect national nuclear control system

  6. Automatic Access Control Based on Face and Hand Biometrics in A Non-Cooperative Context

    DEFF Research Database (Denmark)

    Jahromi, Mohammad Naser Sabet; Bonderup, Morten Bojesen; Nasrollahi, Kamal

    2018-01-01

    Automatic access control systems (ACS) based on the human biometrics or physical tokens are widely employed in public and private areas. Yet these systems, in their conventional forms, are restricted to active interaction from the users. In scenarios where users are not cooperating with the system......, these systems are challenged. Failure in cooperation with the biometric systems might be intentional or because the users are incapable of handling the interaction procedure with the biometric system or simply forget to cooperate with it, due to for example, illness like dementia. This work introduces...

  7. Multi-Vehicle Cooperative Control Research at the NASA Armstrong Flight Research Center, 2000-2014

    Science.gov (United States)

    Hanson, Curt

    2014-01-01

    A brief introductory overview of multi-vehicle cooperative control research conducted at the NASA Armstrong Flight Research Center from 2000 - 2014. Both flight research projects and paper studies are included. Since 2000, AFRC has been almost continuously pursuing research in the areas of formation flight for drag reduction and automated cooperative trajectories. An overview of results is given, including flight experiments done on the FA-18 and with the C-17. Other multi-vehicle cooperative research is discussed, including small UAV swarming projects and automated aerial refueling.

  8. Hierarchical Control Strategy for the Cooperative Braking System of Electric Vehicle

    OpenAIRE

    Peng, Jiankun; He, Hongwen; Liu, Wei; Guo, Hongqiang

    2015-01-01

    This paper provides a hierarchical control strategy for cooperative braking system of an electric vehicle with separated driven axles. Two layers are defined: the top layer is used to optimize the braking stability based on two sliding mode control strategies, namely, the interaxle control mode and signal-axle control strategies; the interaxle control strategy generates the ideal braking force distribution in general braking condition, and the single-axle control strategy can ensure braking s...

  9. Towards a generic lateral control concept for cooperative automated driving : theoretical and experimental evaluation

    NARCIS (Netherlands)

    Schmeitz, A.J.C.; Zegers, J.; Ploeg, J.; Alirezaei, M.

    2017-01-01

    Lateral vehicle control is an essential part for many automated and cooperative driving applications. Lane keeping and vehicle following are typical modes of such control system. The aim of this paper is to develop a generic lateral controller that can handle these different modes. Based on the

  10. Internal and external force-based impedance control for cooperative manipulation

    NARCIS (Netherlands)

    Heck, D.J.F.; Kostic, D.; Denasi, A.; Nijmeijer, H.

    2013-01-01

    An asymptotically stable cascaded control algorithm is proposed for cooperative manipulation of a common object. This algorithm controls motion and internal forces of the object, as well as the contact forces between the object and environment. The motion of each manipulator is controlled using an

  11. An interprovincial cooperative game model for air pollution control in China.

    Science.gov (United States)

    Xue, Jian; Zhao, Laijun; Fan, Longzhen; Qian, Ying

    2015-07-01

    The noncooperative air pollution reduction model (NCRM) that is currently adopted in China to manage air pollution reduction of each individual province has inherent drawbacks. In this paper, we propose a cooperative air pollution reduction game model (CRM) that consists of two parts: (1) an optimization model that calculates the optimal pollution reduction quantity for each participating province to meet the joint pollution reduction goal; and (2) a model that distribute the economic benefit of the cooperation (i.e., pollution reduction cost saving) among the provinces in the cooperation based on the Shapley value method. We applied the CRM to the case of SO2 reduction in the Beijing-Tianjin-Hebei region in China. The results, based on the data from 2003-2009, show that cooperation helps lower the overall SO2 pollution reduction cost from 4.58% to 11.29%. Distributed across the participating provinces, such a cost saving from interprovincial cooperation brings significant benefits to each local government and stimulates them for further cooperation in pollution reduction. Finally, sensitivity analysis is performed using the year 2009 data to test the parameters' effects on the pollution reduction cost savings. China is increasingly facing unprecedented pressure for immediate air pollution control. The current air pollution reduction policy does not allow cooperation and is less efficient. In this paper we developed a cooperative air pollution reduction game model that consists of two parts: (1) an optimization model that calculates the optimal pollution reduction quantity for each participating province to meet the joint pollution reduction goal; and (2) a model that distributes the cooperation gains (i.e., cost reduction) among the provinces in the cooperation based on the Shapley value method. The empirical case shows that such a model can help improve efficiency in air pollution reduction. The result of the model can serve as a reference for Chinese government

  12. Drug adherence in treatment resistant and in controlled hypertension-Results from the Swedish Primary Care Cardiovascular Database (SPCCD).

    Science.gov (United States)

    Holmqvist, Lina; Boström, Kristina Bengtsson; Kahan, Thomas; Schiöler, Linus; Qvarnström, Miriam; Wettermark, Björn; Hjerpe, Per; Hasselström, Jan; Manhem, Karin

    2018-03-01

    To assess drug adherence in patients treated with ≥3 antihypertensive drug classes, with both controlled and uncontrolled blood pressure and describe associated factors for nonadherence. Patients with hypertension, without cardiovascular comorbidity, aged >30 years treated with ≥3 antihypertensive drug classes were followed for 2 years. Both patients with treatment resistant hypertension (TRH) and patients with controlled hypertension were included. Clinical data were derived from a primary care database. Pharmacy refill data from the Swedish Prescribed drug registry was used to calculate proportion of days covered (PDC). Patients with a PDC level ≥ 80% were included. We found 5846 patients treated ≥3 antihypertensive drug classes, 3508 with TRH (blood pressure ≥ 140/90), and 2338 with controlled blood pressure (drug therapy had similar decline in adherence over time regardless of initial blood pressure control. Diabetes was associated with better adherence, which may imply that the structured caregiving of these patients enhances antihypertensive drug treatment. Copyright © 2018 John Wiley & Sons, Ltd.

  13. State of South Carolina Cooperative Aquatic Plant Control Program.

    Science.gov (United States)

    1980-11-01

    of a diquat and copper sulfate pentahydrate herbicide combination for hydrilla control was carried out by Yeo et. al. (1974). The copper was applied at...effective combination to control egeria and hydrilla (Gangstad, 1976). A diquat- copper sulfate combination is more effective in controlling hydrilla than the... copper resulting from the use of algacides or herbicides basic copper carbonate (malachite), copper sulfate , and copper tri- ethanolamine to control

  14. The OPTIMIZE trial: Rationale and design of a randomized controlled trial of motivational enhancement therapy to improve adherence to statin medication.

    Science.gov (United States)

    Rash, Joshua A; Lavoie, Kim L; Sigal, Ronald J; Campbell, David J T; Manns, Braden J; Tonelli, Marcello; Campbell, Tavis S

    2016-07-01

    Statins are a class of medications that are particularly effective for lowering cholesterol and reducing cardiovascular morbidity and mortality. Despite a range of benefits, non-adherence to statin medication is prevalent with 50% to 75% of patients failing to adhere to treatment within the first 2-years. A previous review on interventions to improve adherence to cholesterol lowering medication concluded that rigorous trials were needed with emphasis on the patient's perspective and shared decision making. Motivational interviewing (MInt) is a promising patient-centered approach for improving adherence in patients with chronic diseases. This manuscript describes the rational and design of a randomized controlled trial (RCT) testing the efficacy of MInt in improving adherence to statin medication. Patients filling their first statin prescription will be recruited to complete a 6-month observation run-in period (phase-1) after which medication possession ratio (MPR) will be assessed. Patients meeting criteria for non-adherence (MPR≤60%) will be invited to participate in the trial. 336 non-adherent new statin users will undergo a fasting lipid panel, complete baseline questionnaires, and be randomly allocated to receive four sessions of adherence education delivered using MInt (EdMInt) or to an education control (EC) delivered at 3-month intervals. Final assessments will occur 12-months after the first EdMInt or EC session. The primary outcome is change in MPR adherence to statin medication from baseline to 12-months. Secondary outcomes include within-patient change in self-reported medication adherence, stage of change and self-efficacy for medication adherence, motivation to adhere to statin medication, and lipid profile. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Medication adherence and blood pressure control amongst adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria

    Science.gov (United States)

    Ofoedu, John N.; Njoku, Patrick U.; Amadi, Agwu N.; Godswill-Uko, Ezinne U.

    2013-01-01

    Abstract Background As the case detection rates of hypertension increase in adult Nigerians, achieving target blood pressure (BP) control has become an important management challenge. Objectives To describe medication adherence and BP control amongst adult Nigerians with primary hypertension attending a primary care clinic of a tertiary hospital in a resource-poor environment in Eastern Nigeria. Methods A cross-sectional study was carried out in 140 adult patients with primary hypertension who have been on treatment for at least 6 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have achieved goal BP control if the BP was < 140 per 90 mmHg. Adherence was assessed in the previous 30 days using a pretested researcher-administered questionnaire on 30 days of self-reported therapy. Adherence was graded using an ordinal scoring system of 0–4; an adherent patient was one who scored 4 points in the previous 30 days. Reasons for non-adherence were documented. Results Adherence to medication and BP control rates were 42.9% and 35.0% respectively. BP control was significantly associated with medication adherence (p = 0.03), antihypertensive medication duration ≥3 years (p = 0.042), and taking ≥ one form of antihypertensive medication (p = 0.04). BP at the recruitment visit was significantly higher than at the end of the study (p = 0.036). The most common reason for non-adherence was forgetfulness (p = 0.046). Conclusions The rate of BP control amongst the study population was low, which may be connected with low medication adherence. This study urges consideration of factors relating to adherence alongside other factors driving goal BP control.

  16. Medication adherence and blood pressure control amongst adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria

    Directory of Open Access Journals (Sweden)

    Gabriel UP. Iloh

    2013-02-01

    Full Text Available Background: As the case detection rates of hypertension increase in adult Nigerians, achieving target blood pressure (BP control has become an important management challenge.Objectives: To describe medication adherence and BP control amongst adult Nigerians with primary hypertension attending a primary care clinic of a tertiary hospital in a resource-poor environment in Eastern Nigeria.Methods: A cross-sectional study was carried out in 140 adult patients with primary hypertension who have been on treatment for at least 6 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have achieved goal BP control if the BP was < 140 per 90 mmHg. Adherence was assessed in the previous 30 days using a pretested researcher-administered questionnaire on 30 days of self-reported therapy. Adherence was graded using an ordinal scoring system of 0–4; an adherent patient was one who scored 4 points in the previous 30 days. Reasons for non-adherence were documented.Results: Adherence to medication and BP control rates were 42.9% and 35.0% respectively. BP control was significantly associated with medication adherence (p = 0.03, antihypertensive medication duration ≥3 years (p = 0.042, and taking ≥ one form of antihypertensive medication (p = 0.04. BP at the recruitment visit was significantly higher than at the end of the study (p = 0.036. The most common reason for non-adherence was forgetfulness (p = 0.046. Conclusion: The rate of BP control amongst the study population was low, which may be connected with low medication adherence. This study urges consideration of factors relating to adherence alongside other factors driving goal BP control.

  17. A Combined Cooperative Braking Model with a Predictive Control Strategy in an Electric Vehicle

    Directory of Open Access Journals (Sweden)

    Hongqiang Guo

    2013-12-01

    Full Text Available Cooperative braking with regenerative braking and mechanical braking plays an important role in electric vehicles for energy-saving control. Based on the parallel and the series cooperative braking models, a combined model with a predictive control strategy to get a better cooperative braking performance is presented. The balance problem between the maximum regenerative energy recovery efficiency and the optimum braking stability is solved through an off-line process optimization stream with the collaborative optimization algorithm (CO. To carry out the process optimization stream, the optimal Latin hypercube design (Opt LHD is presented to discrete the continuous design space. To solve the poor real-time problem of the optimization, a high-precision predictive model based on the off-line optimization data of the combined model is built, and a predictive control strategy is proposed and verified through simulation. The simulation results demonstrate that the predictive control strategy and the combined model are reasonable and effective.

  18. Cooperative wind turbine control for maximizing wind farm power using sequential convex programming

    International Nuclear Information System (INIS)

    Park, Jinkyoo; Law, Kincho H.

    2015-01-01

    Highlights: • The continuous wake model describes well the wake profile behind a wind turbine. • The wind farm power function describes well the power production of a wind farm. • Cooperative control increases the wind farm power efficiency by 7.3% in average. • SCP can be employed to efficiently optimize the control actions of wind turbines. - Abstract: This paper describes the use of a cooperative wind farm control approach to improve the power production of a wind farm. The power production by a downstream wind turbine can decrease significantly due to reduced wind speed caused by the upstream wind turbines, thereby lowering the overall wind farm power production efficiency. In spite of the interactions among the wind turbines, the conventional (greedy) wind turbine control strategy tries to maximize the power of each individual wind turbine by controlling its yaw angle, its blade pitch angle and its generator torque. To maximize the overall wind farm power production while taking the wake interference into account, this study employs a cooperative control strategy. We first derive the wind farm power as a differentiable function of the control actions for the wind turbines in a wind farm. The wind farm power function is then maximized using sequential convex programming (SCP) to determine the optimum coordinated control actions for the wind turbines. Using an example wind farm site and available wind data, we show how the cooperative control strategy improves the power production of the wind farm

  19. Mobile phones to support adherence to antiretroviral therapy: what would it cost the Indian National AIDS Control Programme?

    Science.gov (United States)

    Rodrigues, Rashmi; Bogg, Lennart; Shet, Anita; Kumar, Dodderi Sunil; De Costa, Ayesha

    2014-01-01

    Adherence to antiretroviral treatment (ART) is critical to maintaining health and good clinical outcomes in people living with HIV/AIDS. To address poor treatment adherence, low-cost interventions using mobile communication technology are being studied. While there are some studies that show an effect of mobile phone reminders on adherence to ART, none has reported on the costs of such reminders for national AIDS programmes. This paper aims to study the costs of mobile phone reminder strategies (mHealth interventions) to support adherence in the context of India's National AIDS Control Program (NACP). The study was undertaken at two tertiary level teaching hospitals that implement the NACP in Karnataka state, South India. Costs for a mobile phone reminder application to support adherence, implemented at these sites (i.e. weekly calls, messages or both) were studied. Costs were collected based on the concept of avoidable costs specific to the application. The costs that were assessed were one-time costs and recurrent costs that included fixed and variable costs. A sequential procedure for costing was used. Costs were calculated at national-programme level, individual ART-centre level and individual patient level from the NACP's perspective. The assessed costs were pooled to obtain an annual cost per patient. The type of application, number of ART centres and number of patients on ART were varied in a sensitivity analysis of costs. The Indian NACP would incur a cost of between 79 and 110 INR (USD 1.27-1.77) per patient per year, based on the type of reminder, the number of patients on ART and the number of functioning ART centres. The total programme costs for a scale-up of the mHealth intervention to reach the one million patients expected to be on treatment by 2017 is estimated to be 0.36% of the total five-year national-programme budget. The cost of the mHealth intervention for ART-adherence support in the context of the Indian NACP is low and is facilitated by

  20. Robust model predictive cooperative adaptive cruise control subject to V2V impairments

    NARCIS (Netherlands)

    Van Nunen, Ellen; Verhaegh, Jan; Silvas, Emilia; Semsar-Kazerooni, Elham; Van De Wouw, Nathan

    2018-01-01

    To improve traffic throughput, Cooperative Adaptive Cruise Control (CACC) has been proposed as a solution. The usage of Vehicle-to-Vehicle (V2V) communication enables short following distances, thereby increasing road capacity and fuel reduction (especially for trucks). Control designs for CACC use

  1. Distributed Cooperative Control of Nonlinear and Non-identical Multi-agent Systems

    DEFF Research Database (Denmark)

    Bidram, Ali; Lewis, Frank; Davoudi, Ali

    2013-01-01

    This paper exploits input-output feedback linearization technique to implement distributed cooperative control of multi-agent systems with nonlinear and non-identical dynamics. Feedback linearization transforms the synchronization problem for a nonlinear and heterogeneous multi-agent system...... for electric power microgrids. The effectiveness of the proposed control is verified by simulating a microgrid test system....

  2. International Co-Operation in Control Engineering Education Using Online Experiments

    Science.gov (United States)

    Henry, Jim; Schaedel, Herbert M.

    2005-01-01

    This paper describes the international co-operation experience in teaching control engineering with laboratories being conducted remotely by students via the Internet. This paper describes how the students ran the experiments and their personal experiences with the laboratory. A tool for process identification and controller tuning based on…

  3. Cooperative Monitoring Center Occasional Paper/4: Missile Control in South Asia and the Role of Cooperative Monitoring Technology

    Energy Technology Data Exchange (ETDEWEB)

    Kamal, N.; Sawhney, P.

    1998-10-01

    The succession of nuclear tests by India and Pakistan in May 1998 has changed the nature of their missile rivalry, which is only one of numerous manifestations of their relationship as hardened adversaries, deeply sensitive to each other's existing and evolving defense capabilities. The political context surrounding this costly rivalry remains unmediated by arms control measures or by any nascent prospect of detente. As a parallel development, sensible voices in both countries will continue to talk of building mutual confidence through openness to avert accidents, misjudgments, and misinterpretations. To facilitate a future peace process, this paper offers possible suggestions for stabilization that could be applied to India's and Pakistan's missile situation. Appendices include descriptions of existing missile agreements that have contributed to better relations for other countries as well as a list of the cooperative monitoring technologies available to provide information useful in implementing subcontinent missile regimes.

  4. Remotely controlled biking is associated with improved adherence to prescribed cycling speed.

    Science.gov (United States)

    Jeong, In Cheol; Finkelstein, Joseph

    2015-01-01

    Individuals with mobility impairment may benefit from passive exercise mode which can be subsequently enhanced by an active exercise program. However, it is unclear which exercise mode promotes higher adherence to prescribed exercise intensity. The goal of this project was to compare adherence to prescribed speed during passive and active cycling exercise. We used cross-over study design in which subjects followed the same cycling intensity prescription for passive and active exercise modes in a random sequence. Coefficient of variation (CV) and speed differences were used to estimate extent of deviation from the prescribed trajectory. CV varied from 5.2% to 20.4% for the active mode and from 2.8% to 4.5% for the passive mode respectively. Though the CV differences did not reach statistical significance, analysis of cycling speed adherence of 120-second periods showed significantly higher cycling adherence during passive mode for each target cycling speed. Our results indicated that the passive mode may promote exercise safety and efficacy by helping patients who have safety concerns such as the frail elderly, patients with cardiovascular conditions or people with other contraindications for excessive exertion during exercise, in following the optimal intensity trajectory prescribed by their provider.

  5. Technology and Adherence in Web-based Intervantions for Weight Control: a Systematic Review

    NARCIS (Netherlands)

    Kelders, Saskia Marion; Haugtvedt, C.P.; Stibe, A.; Kok, Robin N.; van Gemert-Pijnen, Julia E.W.C.

    2011-01-01

    While technology based health interventions can be effective, high attrition rates are commonly observed in research and practice and are a major issue in eHealth. Research on adherence has recently gained some scientific attention, but little has been done as to how technology itself engages users.

  6. Support for cooperative control and maintenance operation in advanced nuclear power plant from generalized and intuitive viewpoints

    International Nuclear Information System (INIS)

    Numano, Masayoshi; Niwa, Yasuyuki; Miyazaki, Keiko; Fukuto, Junji; Tanaka, Kunihiko; Okazaki, Tadatsugi; Itoh, Hiroko; Matsuoka, Takeshi

    2002-01-01

    To keep safety and effectiveness in control and maintenance operations of large and complex plants like nuclear power plants, cooperative operation among human and machine agents is proposed. The concept is that the cooperation augments human capability as an individual by closely related team members with adequate interfaces. This paper describes a basic concept of the cooperation, necessary interface functions, infrastructure of the cooperation and communication logging for accumulation and sharing of knowledge. (author)

  7. Dynamic tensegrity based cooperative control of uninhabited vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Lau, Sook Yen; Naeem, Wasif [Queen' s Univ., Belfast (United Kingdom). School of Electronics, Electrical Engineering and Computer Science

    2013-07-01

    A new formation control methodology is presented in this paper. The proposed technique is modelled by using the concept of cross-tensegrity structures. The main task is to regulate the desired formation of a group of vehicles and to perform point-to-point manoeuvring in the plane. The position of the controlled vehicles in the formation changes with respect to the admissible tendon forces by varying the lengths of bars in the dynamic tensegrity structure modelling. This change of bars' dimensions for geometric transformation is not possible in the application of tensegrity concept in the physical structural engineering. It has been demonstrated that this control method allows more flexibility over a wide range of different shape switching tasks using the predictable tendon control forces under the limited communication's range. The proposed approach is also scalable to any number of pairs of autonomous vehicles in the formation.

  8. Packet-Based Control Algorithms for Cooperative Surveillance and Reconnaissance

    National Research Council Canada - National Science Library

    Murray, Richard M

    2007-01-01

    ..., and repeated transmissions. Results include analysis and design of estimation and control algorithms in the presence of packet loss and across multi-hop data networks, distributed estimation and sensor fusion algorithms...

  9. Cooperation-Controlled Learning for Explicit Class Structure in Self-Organizing Maps

    Science.gov (United States)

    Kamimura, Ryotaro

    2014-01-01

    We attempt to demonstrate the effectiveness of multiple points of view toward neural networks. By restricting ourselves to two points of view of a neuron, we propose a new type of information-theoretic method called “cooperation-controlled learning.” In this method, individual and collective neurons are distinguished from one another, and we suppose that the characteristics of individual and collective neurons are different. To implement individual and collective neurons, we prepare two networks, namely, cooperative and uncooperative networks. The roles of these networks and the roles of individual and collective neurons are controlled by the cooperation parameter. As the parameter is increased, the role of cooperative networks becomes more important in learning, and the characteristics of collective neurons become more dominant. On the other hand, when the parameter is small, individual neurons play a more important role. We applied the method to the automobile and housing data from the machine learning database and examined whether explicit class boundaries could be obtained. Experimental results showed that cooperation-controlled learning, in particular taking into account information on input units, could be used to produce clearer class structure than conventional self-organizing maps. PMID:25309950

  10. Cooperation-Controlled Learning for Explicit Class Structure in Self-Organizing Maps

    Directory of Open Access Journals (Sweden)

    Ryotaro Kamimura

    2014-01-01

    Full Text Available We attempt to demonstrate the effectiveness of multiple points of view toward neural networks. By restricting ourselves to two points of view of a neuron, we propose a new type of information-theoretic method called “cooperation-controlled learning.” In this method, individual and collective neurons are distinguished from one another, and we suppose that the characteristics of individual and collective neurons are different. To implement individual and collective neurons, we prepare two networks, namely, cooperative and uncooperative networks. The roles of these networks and the roles of individual and collective neurons are controlled by the cooperation parameter. As the parameter is increased, the role of cooperative networks becomes more important in learning, and the characteristics of collective neurons become more dominant. On the other hand, when the parameter is small, individual neurons play a more important role. We applied the method to the automobile and housing data from the machine learning database and examined whether explicit class boundaries could be obtained. Experimental results showed that cooperation-controlled learning, in particular taking into account information on input units, could be used to produce clearer class structure than conventional self-organizing maps.

  11. U.S. government-to-government cooperation on nuclear materials protection, control, and accounting

    International Nuclear Information System (INIS)

    Mladineo, S.; Bricker, K.; Alberque, W.

    1996-01-01

    The US Department of Energy (DOE) is cooperating with Russia, the Newly Independent States (NIS), and the Baltics to help prevent the proliferation of nuclear weapons through the improvement of national systems of nuclear material protection, control, and accounting (MPC and A). US cooperation with Russia is carried out under the DOE MPC and A Program and the Nunn-Lugar funded Cooperative Threat Reduction program for Russia. Presidential Decision Directive (PDD)-41 designated DOE as the government agency with primary responsibility for MPC and A efforts in Russia, the NIS, and Baltics. Cooperation is conducted in coordination with the Nuclear Regulatory Commission (NRC) for the development of a strong, independent national regulatory agency in Russia. DOE also coordinates these efforts with the European Community and other countries. DOE''s cooperation under the MPC and A program with Russia includes aggressive near-term activities to better secure nuclear materials through MPC and A system upgrades at facilities. Simultaneously, DOE is supporting Russia in its long-term goal of implementing upgraded MPC and A systems that can be maintained and supported from indigenous resources. Projects include the development of national regulations and laws, training of trainers, the development of a computerized federal information system, and other related tasks. NRC''s role in these efforts includes regulatory development activities, such as licensing and inspection program development, and related training. This paper provides an overview of the activities undertaken through DOE-Russian cooperation on MPC and A and how they complement each other

  12. Glycemic control and adherence to basal insulin therapy in Taiwanese patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Chien, Ming-Nan; Chen, Yen-Ling; Hung, Yi-Jen; Wang, Shu-Yi; Lu, Wen-Tsung; Chen, Chih-Hung; Lin, Ching-Ling; Huang, Tze-Pao; Tsai, Ming-Han; Tseng, Wei-Kung; Wu, Ta-Jen; Ho, Cheng; Lin, Wen-Yu; Chen, Bill; Chuang, Lee-Ming

    2016-11-01

    The aim of the present study was to assess the glycemic control, adherence and treatment satisfaction in a real-world setting with basal insulin therapy in type 2 diabetes patients in Taiwan. This was a multicenter, prospective, observational registry. A total of 836 patients with type 2 diabetes taking oral antidiabetic drugs with glycated hemoglobin (HbA1c) >7% entered the study. Basal insulin was given for 24 weeks. All treatment choices and medical instructions were at the physician's discretion to reflect real-life practice. After 24-week treatment, 11.7% of patients reached set HbA1c goals without severe hypoglycemia (primary effectiveness end-point). HbA1c and fasting blood glucose were significantly decreased from (mean ± SD) 10.1 ± 1.9% to 8.7 ± 1.7% (-1.4 ± 2.1%, P 1) and from 230.6 ± 68.8 mg/dL to 159.1 ± 55.6 mg/dL (-67.4 ± 72.3 mg/dL, P 1), respectively. Patients received insulin therapy at a frequency of nearly one shot per day on average, whereas self-monitoring of blood glucose was carried out approximately four times a week. Hypoglycemia was reported by 11.4% of patients, and only 0.7% of patients experienced severe hypoglycemia. Slight changes in weight (0.7 ± 2.4 kg) and a low incidence of adverse drug reactions (0.4%) were also noted. The score of 7-point treatment satisfaction rated by patients was significantly improved by 1.9 ± 1.7 (P 1). Basal insulin therapy was associated with a decrease in HbA1c and fasting blood glucose, and an improved treatment satisfaction. Most patients complied with physicians' instructions. The treatment was generally well tolerated by patients with type 2 diabetes, but findings pointed out the need to reinforce the early and appropriate uptitration to achieve treatment targets. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  13. Cooperative Control of Regenerative Braking and Antilock Braking for a Hybrid Electric Vehicle

    Directory of Open Access Journals (Sweden)

    Guodong Yin

    2013-01-01

    Full Text Available A new cooperative braking control strategy (CBCS is proposed for a parallel hybrid electric vehicle (HEV with both a regenerative braking system and an antilock braking system (ABS to achieve improved braking performance and energy regeneration. The braking system of the vehicle is based on a new method of HEV braking torque distribution that makes the antilock braking system work together with the regenerative braking system harmoniously. In the cooperative braking control strategy, a sliding mode controller (SMC for ABS is designed to maintain the wheel slip within an optimal range by adjusting the hydraulic braking torque continuously; to reduce the chattering in SMC, a boundary-layer method with moderate tuning of a saturation function is also investigated; based on the wheel slip ratio, battery state of charge (SOC, and the motor speed, a fuzzy logic control strategy (FLC is applied to adjust the regenerative braking torque dynamically. In order to evaluate the performance of the cooperative braking control strategy, the braking system model of a hybrid electric vehicle is built in MATLAB/SIMULINK. It is found from the simulation that the cooperative braking control strategy suggested in this paper provides satisfactory braking performance, passenger comfort, and high regenerative efficiency.

  14. Cooperative Control for Multiple Autonomous Vehicles Using Descriptor Functions

    Directory of Open Access Journals (Sweden)

    Marta Niccolini

    2014-01-01

    Full Text Available The paper presents a novel methodology for the control management of a swarm of autonomous vehicles. The vehicles, or agents, may have different skills, and be employed for different missions. The methodology is based on the definition of descriptor functions that model the capabilities of the single agent and each task or mission. The swarm motion is controlled by minimizing a suitable norm of the error between agents’ descriptor functions and other descriptor functions which models the entire mission. The validity of the proposed technique is tested via numerical simulation, using different task assignment scenarios.

  15. Heat shock response and autophagy--cooperation and control

    DEFF Research Database (Denmark)

    Dokladny, Karol; Myers, Orrin B; Moseley, Pope L

    2015-01-01

    Protein quality control (proteostasis) depends on constant protein degradation and resynthesis, and is essential for proper homeostasis in systems from single cells to whole organisms. Cells possess several mechanisms and processes to maintain proteostasis. At one end of the spectrum, the heat...

  16. Cooperative feeding and breeding, and the evolution of executive control

    NARCIS (Netherlands)

    Vaesen, K.

    2012-01-01

    Dubreuil (Biol Phil 25:53–73, 2010b, this journal) argues that modern-like cognitive abilities for inhibitory control and goal maintenance most likely evolved in Homo heidelbergensis, much before the evolution of oft-cited modern traits, such as symbolism and art. Dubreuil’s argument proceeds in two

  17. Exergames versus self-regulated exercises with instruction leaflets to improve adherence during geriatric rehabilitation: a randomized controlled trial.

    Science.gov (United States)

    Oesch, Peter; Kool, Jan; Fernandez-Luque, Luis; Brox, Ellen; Evertsen, Gunn; Civit, Anton; Hilfiker, Roger; Bachmann, Stefan

    2017-03-23

    Improving mobility in elderly persons is a primary goal in geriatric rehabilitation. Self-regulated exercises with instruction leaflets are used to increase training volume but adherence is often low. Exergames may improve adherence. This study therefore compared exergames with self-regulated exercise using instruction leaflets. The primary outcome was adherence. Secondary outcomes were enjoyment, motivation and balance during walking. Design: single center parallel group non-blinded randomized controlled trial with central stratified randomization. center for geriatric inpatient rehabilitation. Included were patients over 65 with mobility restrictions who were able to perform self-regulated exercise. Patients were assigned to self-regulated exercise using a) exergames on Windows Kinect® (exergame group EG) or b) instruction leaflets (conventional group CG). During two 30 min sessions physical therapists instructed self-regulated exercise to be conducted twice daily during thirty minutes during ten working days. Patients reported adherence (primary outcome), enjoyment and motivation daily. Balance during walking was measured blind before and after the treatment phase with an accelerometer. Analysis was by intention to treat. Repeated measures mixed models and Cohen's d effect sizes (ES, moderate if >0.5, large if > 0.8) with 95% CIs were used to evaluate between-group effects over time. Alpha was set at 0.05. From June 2014 to December 2015 217 patients were evaluated and 54 included, 26 in the EG and 28 in the CG. Adverse effects were observed in two patients in the EG who stopped because of pain during exercising. Adherence was comparable at day one (38 min. in the EG and 42 min. in the CG) and significantly higher in the CG at day 10 (54 min. in the CG while decreasing to 28 min. in the EG, p = 0.007, ES 0.94, 0.39-0.151). Benefits favoring the CG were also observed for enjoyment (p = 0.001, ES 0.88, 0.32 - 1.44) and motivation (p = 0

  18. Cooperative Control for A Hybrid Rehabilitation System Combining Functional Electrical Stimulation and Robotic Exoskeleton

    Directory of Open Access Journals (Sweden)

    Dingguo Zhang

    2017-12-01

    Full Text Available Functional electrical stimulation (FES and robotic exoskeletons are two important technologies widely used for physical rehabilitation of paraplegic patients. We developed a hybrid rehabilitation system (FEXO Knee that combined FES and an exoskeleton for swinging movement control of human knee joints. This study proposed a novel cooperative control strategy, which could realize arbitrary distribution of torque generated by FES and exoskeleton, and guarantee harmonic movements. The cooperative control adopted feedfoward control for FES and feedback control for exoskeleton. A parameter regulator was designed to update key parameters in real time to coordinate FES controller and exoskeleton controller. Two muscle groups (quadriceps and hamstrings were stimulated to generate active torque for knee joint in synchronization with torque compensation from exoskeleton. The knee joint angle and the interactive torque between exoskeleton and shank were used as feedback signals for the control system. Central pattern generator (CPG was adopted that acted as a phase predictor to deal with phase confliction of motor patterns, and realized synchronization between the two different bodies (shank and exoskeleton. Experimental evaluation of the hybrid FES-exoskeleton system was conducted on five healthy subjects and four paraplegic patients. Experimental results and statistical analysis showed good control performance of the cooperative control on torque distribution, trajectory tracking, and phase synchronization.

  19. Cooperative Control for A Hybrid Rehabilitation System Combining Functional Electrical Stimulation and Robotic Exoskeleton.

    Science.gov (United States)

    Zhang, Dingguo; Ren, Yong; Gui, Kai; Jia, Jie; Xu, Wendong

    2017-01-01

    Functional electrical stimulation (FES) and robotic exoskeletons are two important technologies widely used for physical rehabilitation of paraplegic patients. We developed a hybrid rehabilitation system (FEXO Knee) that combined FES and an exoskeleton for swinging movement control of human knee joints. This study proposed a novel cooperative control strategy, which could realize arbitrary distribution of torque generated by FES and exoskeleton, and guarantee harmonic movements. The cooperative control adopted feedfoward control for FES and feedback control for exoskeleton. A parameter regulator was designed to update key parameters in real time to coordinate FES controller and exoskeleton controller. Two muscle groups (quadriceps and hamstrings) were stimulated to generate active torque for knee joint in synchronization with torque compensation from exoskeleton. The knee joint angle and the interactive torque between exoskeleton and shank were used as feedback signals for the control system. Central pattern generator (CPG) was adopted that acted as a phase predictor to deal with phase confliction of motor patterns, and realized synchronization between the two different bodies (shank and exoskeleton). Experimental evaluation of the hybrid FES-exoskeleton system was conducted on five healthy subjects and four paraplegic patients. Experimental results and statistical analysis showed good control performance of the cooperative control on torque distribution, trajectory tracking, and phase synchronization.

  20. Does the presence of placental basal plate myometrial fibres increase the risk of subsequent morbidly adherent placenta: a case-control study.

    Science.gov (United States)

    Miller, E S; Linn, R L; Ernst, L M

    2016-12-01

    Antenatal diagnosis of morbidly adherent placenta has been shown to improve outcomes, but existing predictors lack sensitivity. Our objective was to determine whether the presence of myometrial fibres attached to the placental basal plate (BPMYO) in an antecedent pregnancy is associated with subsequent morbidly adherent placenta. A case-control study. Departments of Obstetrics and Gynecology and Pathology, Northwestern University, Chicago, IL, USA. Women who had at least two pregnancies with placental pathological evaluation. Cases were defined as women with evidence of morbidly adherent placenta (both clinically and pathologically) in their most recent pregnancy whereas women without evidence of morbidly adherent placenta served as controls. Pathological specimens of placentas from previous pregnancies were evaluated for BPMYO. The presence of BPMYO on a previous placenta was evaluated to determine whether it could be used to improve the antenatal diagnosis of morbidly adherent placenta. Of the 25 cases of morbidly adherent placenta, 19 (76%) had BPMYO present on their previous placenta compared with 41 (41%) of controls (odds ratio 4.8, 95% CI 1.8-13.0). Adding BPMYO to a regression including other risk factors for morbidly adherent placenta (i.e. maternal age, number of previous caesarean sections, placenta praevia, previous multiple gestation, any previous curettage, and ultrasonographic suspicion of placenta accreta) significantly improved the sensitivity of antenatal diagnosis of morbidly adherent placenta (61% versus 39%, P placental pathology is associated with an increased risk of morbidly adherent placenta in a subsequent pregnancy. These findings may shed light on the pathophysiology of accreta and inform future research on predictors of accreta. Previous basal plate myometrium improves the ability to detect subsequent morbidly adherent placenta. © 2015 Royal College of Obstetricians and Gynaecologists.

  1. A Probabilistic and Highly Efficient Topology Control Algorithm for Underwater Cooperating AUV Networks.

    Science.gov (United States)

    Li, Ning; Cürüklü, Baran; Bastos, Joaquim; Sucasas, Victor; Fernandez, Jose Antonio Sanchez; Rodriguez, Jonathan

    2017-05-04

    The aim of the Smart and Networking Underwater Robots in Cooperation Meshes (SWARMs) project is to make autonomous underwater vehicles (AUVs), remote operated vehicles (ROVs) and unmanned surface vehicles (USVs) more accessible and useful. To achieve cooperation and communication between different AUVs, these must be able to exchange messages, so an efficient and reliable communication network is necessary for SWARMs. In order to provide an efficient and reliable communication network for mission execution, one of the important and necessary issues is the topology control of the network of AUVs that are cooperating underwater. However, due to the specific properties of an underwater AUV cooperation network, such as the high mobility of AUVs, large transmission delays, low bandwidth, etc., the traditional topology control algorithms primarily designed for terrestrial wireless sensor networks cannot be used directly in the underwater environment. Moreover, these algorithms, in which the nodes adjust their transmission power once the current transmission power does not equal an optimal one, are costly in an underwater cooperating AUV network. Considering these facts, in this paper, we propose a Probabilistic Topology Control (PTC) algorithm for an underwater cooperating AUV network. In PTC, when the transmission power of an AUV is not equal to the optimal transmission power, then whether the transmission power needs to be adjusted or not will be determined based on the AUV's parameters. Each AUV determines their own transmission power adjustment probability based on the parameter deviations. The larger the deviation, the higher the transmission power adjustment probability is, and vice versa. For evaluating the performance of PTC, we combine the PTC algorithm with the Fuzzy logic Topology Control (FTC) algorithm and compare the performance of these two algorithms. The simulation results have demonstrated that the PTC is efficient at reducing the transmission power

  2. A Probabilistic and Highly Efficient Topology Control Algorithm for Underwater Cooperating AUV Networks

    Directory of Open Access Journals (Sweden)

    Ning Li

    2017-05-01

    Full Text Available The aim of the Smart and Networking Underwater Robots in Cooperation Meshes (SWARMs project is to make autonomous underwater vehicles (AUVs, remote operated vehicles (ROVs and unmanned surface vehicles (USVs more accessible and useful. To achieve cooperation and communication between different AUVs, these must be able to exchange messages, so an efficient and reliable communication network is necessary for SWARMs. In order to provide an efficient and reliable communication network for mission execution, one of the important and necessary issues is the topology control of the network of AUVs that are cooperating underwater. However, due to the specific properties of an underwater AUV cooperation network, such as the high mobility of AUVs, large transmission delays, low bandwidth, etc., the traditional topology control algorithms primarily designed for terrestrial wireless sensor networks cannot be used directly in the underwater environment. Moreover, these algorithms, in which the nodes adjust their transmission power once the current transmission power does not equal an optimal one, are costly in an underwater cooperating AUV network. Considering these facts, in this paper, we propose a Probabilistic Topology Control (PTC algorithm for an underwater cooperating AUV network. In PTC, when the transmission power of an AUV is not equal to the optimal transmission power, then whether the transmission power needs to be adjusted or not will be determined based on the AUV’s parameters. Each AUV determines their own transmission power adjustment probability based on the parameter deviations. The larger the deviation, the higher the transmission power adjustment probability is, and vice versa. For evaluating the performance of PTC, we combine the PTC algorithm with the Fuzzy logic Topology Control (FTC algorithm and compare the performance of these two algorithms. The simulation results have demonstrated that the PTC is efficient at reducing the

  3. Consensus seeking, formation keeping, and trajectory tracking in multiple vehicle cooperative control

    Science.gov (United States)

    Ren, Wei

    Cooperative control problems for multiple vehicle systems can be categorized as either formation control problems with applications to mobile robots, unmanned air vehicles, autonomous underwater vehicles, satellites, aircraft, spacecraft, and automated highway systems, or non-formation control problems such as task assignment, cooperative transport, cooperative role assignment, air traffic control, cooperative timing, and cooperative search. The cooperative control of multiple vehicle systems poses significant theoretical and practical challenges. For cooperative control strategies to be successful, numerous issues must be addressed. We consider three important and correlated issues: consensus seeking, formation keeping, and trajectory tracking. For consensus seeking, we investigate algorithms and protocols so that a team of vehicles can reach consensus on the values of the coordination data in the presence of imperfect sensors, communication dropout, sparse communication topologies, and noisy and unreliable communication links. The main contribution of this dissertation in this area is that we show necessary and/or sufficient conditions for consensus seeking with limited, unidirectional, and unreliable information exchange under fixed and switching interaction topologies (through either communication or sensing). For formation keeping, we apply a so-called "virtual structure" approach to spacecraft formation flying and multi-vehicle formation maneuvers. As a result, single vehicle path planning and trajectory generation techniques can be employed for the virtual structure while trajectory tracking strategies can be employed for each vehicle. The main contribution of this dissertation in this area is that we propose a decentralized architecture for multiple spacecraft formation flying in deep space with formation feedback introduced. This architecture ensures the necessary precision in the presence of actuator saturation, internal and external disturbances, and

  4. The impact of peer support and mp3 messaging on adherence to inhaled corticosteroids in minority adolescents with asthma: a randomized, controlled trial.

    Science.gov (United States)

    Mosnaim, Giselle; Li, Hong; Martin, Molly; Richardson, DeJuran; Belice, Paula Jo; Avery, Elizabeth; Ryan, Norman; Bender, Bruce; Powell, Lynda

    2013-01-01

    Poor adherence to inhaled corticosteroids (ICS) is a critical risk factor contributing to asthma morbidity among low-income minority adolescents. This trial tested whether peer support group meetings and peer asthma messages delivered via mp3 players improved adherence to ICS. Low-income African American and/or Hispanic adolescents, ages 11-16 years old, with persistent asthma, and poor (≤ 48%) adherence to prescription ICS during the 3-week run-in were randomized to intervention or attention control groups (ATG) for the 10-week treatment. During treatment, the intervention arm subjects participated in weekly coping peer group support sessions and received mp3 peer-recorded asthma messages that promoted adherence. The ATG participated in weekly meetings with a research assistant and received an equivalent number of mp3 physician-recorded asthma messages. Adherence was measured by using self-report and the Doser CT, an electronic dose counter. The primary outcome was the difference in adherence at 10 weeks between the 2 arms. Thirty-four subjects were randomized to each arm. At 10 weeks, no statistical difference in objectively measured adherence could be detected between the 2 arms when adjusting for baseline adherence (P = .929). Adherence declined in both groups over the course of the active treatment period. In both study arms, self-reported adherence by participants was significantly higher than their objectively measured adherence at week 10 (P mp3-delivered peer asthma messages may not be of sufficient dose to improve outcomes. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  5. ALLIANCE: An architecture for fault tolerant, cooperative control of heterogeneous mobile robots

    Energy Technology Data Exchange (ETDEWEB)

    Parker, L.E.

    1995-02-01

    This research addresses the problem of achieving fault tolerant cooperation within small- to medium-sized teams of heterogeneous mobile robots. The author describes a novel behavior-based, fully distributed architecture, called ALLIANCE, that utilizes adaptive action selection to achieve fault tolerant cooperative control in robot missions involving loosely coupled, largely independent tasks. The robots in this architecture possess a variety of high-level functions that they can perform during a mission, and must at all times select an appropriate action based on the requirements of the mission, the activities of other robots, the current environmental conditions, and their own internal states. Since such cooperative teams often work in dynamic and unpredictable environments, the software architecture allows the team members to respond robustly and reliably to unexpected environmental changes and modifications in the robot team that may occur due to mechanical failure, the learning of new skills, or the addition or removal of robots from the team by human intervention. After presenting ALLIANCE, the author describes in detail experimental results of an implementation of this architecture on a team of physical mobile robots performing a cooperative box pushing demonstration. These experiments illustrate the ability of ALLIANCE to achieve adaptive, fault-tolerant cooperative control amidst dynamic changes in the capabilities of the robot team.

  6. Distributed control of multi-robot teams: Cooperative baton passing task

    Energy Technology Data Exchange (ETDEWEB)

    Parker, L.E.

    1998-11-01

    This research addresses the problem of achieving fault tolerant cooperation within small- to medium-sized teams of heterogeneous mobile robots. The author describes a novel behavior-based, fully distributed architecture, called ALLIANCE, that utilizes adaptive action selection to achieve fault tolerant cooperative control. The robots in this architecture possess a variety of high-level functions that they can perform during a mission, and must at all times select an appropriate action based on the requirements of the mission, the activities of other robots, the current environmental conditions, and their own internal states. Since such cooperative teams often work in dynamic and unpredictable environments, the software architecture allows the team members to respond robustly and reliably to unexpected environmental changes and modifications in the robot team that may occur due to mechanical failure, the learning of new skills, or the addition or removal of robots from the team by human intervention. After presenting ALLIANCE, they describe the implementation of this architecture on a team of physical mobile robots performing a cooperative baton passing task. These experiments illustrate the ability of ALLIANCE to achieve adaptive, fault-tolerant cooperative control amidst dynamic changes during the task.

  7. Notification: Audit of EPA’s Adherence to Policies, Procedures and Oversight Controls Pertaining to the Administrator’s Travel (2nd notification)

    Science.gov (United States)

    Project #OA-FY17-0382, October 6, 2017 - The EPA OIG plans to expand the scope of preliminary research on the EPA’s adherence to policies, procedures and oversight controls pertaining to the Administrator’s travel.

  8. Adherence to the CONSORT Statement in the Reporting of Randomized Controlled Trials on Pharmacological Interventions Published in Iranian Medical Journals

    Directory of Open Access Journals (Sweden)

    Pooneh Sarveravan

    2017-11-01

    Full Text Available Background: Among manuscripts submitted to biomedical journals, randomized controlled trials (RCTs form the backbone of evidence-based medicine. Hence, their protocol should be designed rigorously and their results should be reported clearly. To improve the quality of RCT reporting, researchers developed the CONSORT Statement in 1996 and updated it in 2010. This study was designed to assess the quality of RCT reporting vis-à-vis adherence to CONSORT among articles published in Iranian medical journals (English, Persian, CONSORT-endorsing, and non-CONSORT-endorsing. Methods: In this cross-sectional study, all RCTs published in all Iranian medical journals from September 2012 to September 2013 were retrieved to evaluate their adherence to CONSORT. The journals’ instructions for authors were also reviewed to find out whether or not they endorsed CONSORT. The CONSORT 2010 Checklist was used. Microsoft Excel 2007 was applied to analyze the data, and MedCalc was employed to compare the groups. Results: Totally, 492 pharmacological RCTs that met our inclusion criteria were identified. Twenty-five items were reported in fewer than 50% of the articles. The differences between the articles published in Persian and English language journals were statistically significant in 17 items. The differences between the articles published in the CONSORT-endorsing and non-CONSORT-endorsing journals were significant in 8 items. Conclusion: Our findings showed very weak adherence to CONSORT. Authors, reviewers, and editors should be trained to use standards expressed by the CONSORT Group in reporting RCTs.

  9. The Effect of Social Support on Glycemic Control in Patients with Type 2 Diabetes Mellitus: The Mediating Roles of Self-Efficacy and Adherence

    Directory of Open Access Journals (Sweden)

    Yechang Shao

    2017-01-01

    Full Text Available Ample evidence suggests that social support, self-efficacy, and adherence significantly, independently, and together affect glycemic control in patients with type 2 diabetes mellitus (T2DM, but the pathway from social support to glycemic control remains unclear. This study hypothesized that the effect of social support on glycemic control was mediated sequentially by self-efficacy and adherence. Patients with T2DM were recruited from two hospitals in Guangzhou, China, from January 1 to July 31, 2014, and their sociodemographic clinical data and their assessments on social support, self-efficacy, and adherence were obtained from medical records and self-completed questionnaires. Of the 532 patients who participated, 35% achieved glycemic control (i.e., HbA1c < 7%. Social support, self-efficacy, and adherence had significant correlations with each other and with glycemic control (P<0.05. Regression analyses and structural equation modeling showed that better social support was associated to better patient self-efficacy, which, in turn, was associated with better medical adherence, which was associated with improved glycemic control, and the relationship between social support and glycemic control was sequentially and completely mediated by self-efficacy and adherence. The five goodness-of-fit indices confirmed that our data fitted the hypothesized pathway model strongly.

  10. Adaptive Opportunistic Cooperative Control Mechanism Based on Combination Forecasting and Multilevel Sensing Technology of Sensors for Mobile Internet of Things

    Directory of Open Access Journals (Sweden)

    Yong Jin

    2014-01-01

    Full Text Available In mobile Internet of Things, there are many challenges, including sensing technology of sensors, how and when to join cooperative transmission, and how to select the cooperative sensors. To address these problems, we studied the combination forecasting based on the multilevel sensing technology of sensors, building upon which we proposed the adaptive opportunistic cooperative control mechanism based on the threshold values such as activity probability, distance, transmitting power, and number of relay sensors, in consideration of signal to noise ratio and outage probability. More importantly, the relay sensors would do self-test real time in order to judge whether to join the cooperative transmission, for maintaining the optimal cooperative transmission state with high performance. The mathematical analyses results show that the proposed adaptive opportunistic cooperative control approach could perform better in terms of throughput ratio, packet error rate and delay, and energy efficiency, compared with the direct transmission and opportunistic cooperative approaches.

  11. Stroke patients and their attitudes toward mHealth monitoring to support blood pressure control and medication adherence.

    Science.gov (United States)

    Jenkins, Carolyn; Burkett, Nina-Sarena; Ovbiagele, Bruce; Mueller, Martina; Patel, Sachin; Brunner-Jackson, Brenda; Saulson, Raelle; Treiber, Frank

    2016-05-01

    Mobile health, or mHealth, has increasingly been signaled as an effective means to expedite communication and improve medical regimen adherence, especially for patients with chronic health conditions such as stroke. However, there is a lack of data on attitudes of stroke patients toward mHealth. Such information will aid in identifying key indicators for feasibility and optimal implementation of mHealth to prevent and/or decrease rates of secondary stroke. Our objective was to ascertain stroke patients' attitudes toward using mobile phone enabled blood pressure (BP) monitoring and medication adherence and identify factors that modulate these attitudes. Sixty stroke patients received a brief demonstration of mHealth devices to assist with BP control and medication adherence and a survey to evaluate willingness to use this technology. The 60 participants had a mean age of 57 years, were 43.3% male, and 53.3% were White. With respect to telecommunication prevalence, 93.3% owned a cellular device and 25% owned a smartphone. About 70% owned a working computer. Regarding attitudes, 85% felt comfortable with a doctor or nurse using mHealth technologies to monitor personal health information, 78.3% believed mHealth would help remind them to follow doctor's directions, and 83.3% were confident that technology could effectively be used to communicate with health care providers for medical needs. Mobile device use is high in stroke patients and they are amenable to mHealth for communication and assistance in adhering to their medical regimens. More research is needed to explore usefulness of this technology in larger stroke populations.

  12. The impact of health coaching on medication adherence in patients with poorly controlled diabetes, hypertension, and/or hyperlipidemia: a randomized controlled trial.

    Science.gov (United States)

    Thom, David H; Willard-Grace, Rachel; Hessler, Danielle; DeVore, Denise; Prado, Camille; Bodenheimer, Thomas; Chen, Ellen

    2015-01-01

    Lack of concordance between medications listed in the medical record and taken by the patient contributes to poor outcomes. We sought to determine whether patients who received health coaching by medical assistants improved their medication concordance and adherence. This was a nonblinded, randomized, controlled, pragmatic intervention trial. English- or Spanish-speaking patients, age 18 to 75 years, with poorly controlled type 2 diabetes, hypertension, and/or hyperlipidemia were enrolled from 2 urban safety net clinics and randomized to receive 12 months of health coaching versus usual care. Outcomes included concordance between medications documented in the medical record and those reported by the patient and adherence based on the patient-reported number of days (of the last 7) on which patient took all prescribed medications. The proportion of medications completely concordant increased in the coached group versus the usual care group (difference in change, 10%; P = .05). The proportion of medications listed in the chart but not taken significantly decreased in the coached group compared with the usual care group (difference in change, 17%; P = .013). The mean number of adherent days increased in the coached but not in the usual care group (difference in change, 1.08; P coaching by medical assistants significantly increases medication concordance and adherence. © Copyright 2015 by the American Board of Family Medicine.

  13. Perceived Barriers to Adherence to Tuberculosis Infection Control Measures among Health Care Workers in the Dominican Republic.

    Science.gov (United States)

    Chapman, Helena J; Veras-Estévez, Bienvenido A; Pomeranz, Jamie L; Pérez-Then, Eddy N; Marcelino, Belkys; Lauzardo, Michael

    2017-01-01

    INTRODUCTION Health care workers have an increased risk of infection due to occupational Mycobacterium tuberculosis exposure, including multidrug-resistant strains. Health care workers' risk of developing tuberculosis is greater than that of the general population, whether in low-, intermediate- or high-incidence countries. Adherence to infection control measures (administrative controls, environmental controls, and personal respiratory protection) is essential to reduce risk of disease transmission between suspected tuberculosis patients and health care workers, but for different reasons, both objective and subjective, adherence is low. Identifying the causes of low adherence is a prerequisite to effective programming to reduce risk. OBJECTIVE Identify perceived barriers to adherence to tuberculosis infection control measures among health care workers in the Dominican Republic. METHODS During August 2014, a qualitative study was conducted in two tertiary-level hospitals in different regions of the Dominican Republic. A semi-structured interview guide of nine questions was developed, based on the scientific literature and with consensus of clinical experts. Nine semi-structured interviews were conducted with a purposive sample of seven physicians (five men, two women) and two baccalaureate nurses (both women) working in the emergency medicine, internal medicine or nursing departments of those institutions. Question topics included clinical experience of M. tuberculosis infection and disease; knowledge of disease transmission and preventive practices; clinical management strategies; and perceptions of effectiveness of directly observed treatment, short-course, and disease coping strategies. RESULTS Perceived barriers were described as: 1) sense of invincibility of health care workers; 2) personal beliefs of health care workers related to direct patient communication; 3) low provider-to-patient ratios in hospitals; 4) absence of tuberculosis isolation units for

  14. The impact of cooperative adaptive cruise control on traffic- flow characteristics

    NARCIS (Netherlands)

    van Arem, Bart; van Driel, Cornelie; Visser, Ruben

    2006-01-01

    Cooperative adaptive cruise control (CACC) is an extension of ACC. In addition to measuring the distance to a predecessor, a vehicle can also exchange information with a predecessor by wireless communication. This enables a vehicle to follow its predecessor at a closer distance under tighter

  15. The Role of Inhibitory Control in Children's Cooperative Behaviors during a Structured Puzzle Task

    Science.gov (United States)

    Giannotta, Fabrizia; Burk, William J.; Ciairano, Silvia

    2011-01-01

    This study examined the role of inhibitory control (measured by Stroop interference) in children's cooperative behaviors during a structured puzzle task. The sample consisted of 250 8-, 10-, and 12-year-olds (117 girls and 133 boys) attending classrooms in three primary schools in Northern Italy. Children individually completed an elaborated…

  16. Quality Control Review of the PricewaterhouseCoopers LLP FY 2014 Single Audit of Carnegie Mellon University

    Science.gov (United States)

    2015-12-17

    No. DODIG-2016-034 D E C E M B E R 1 7 , 2 0 1 5 Quality Control Review of the PricewaterhouseCoopers LLP FY 2014 Single Audit of Carnegie ...ALEXANDRIA, VIRGINIA 22350-1500 December 17, 2015 Audit Partner PricewaterhouseCoopers LLP Board of Trustees Carnegie Mellon University Director, Sponsored...Projects Accounting Carnegie Mellon University SUBJECT: Quality Control Review of the PricewaterhouseCoopers LLP FY 2014 Single Audit of Carnegie

  17. Cellular Controlled Short-Range Communication for Cooperative P2P Networking

    DEFF Research Database (Denmark)

    Fitzek, Frank H. P.; Katz, Marcos; Zhang, Qi

    2009-01-01

    -range communication network among cooperating mobile and wireless devices. The role of the mobile device will change, from being an agnostic entity in respect to the surrounding world to a cognitive device. This cognitive device is capable of being aware of the neighboring devices as well as on the possibility......This article advocates a novel communication architecture and associated collaborative framework for future wireless communication systems. In contrast to the dominating cellular architecture and the upcoming peer-to-peer architecture, the new approach envisions a cellular controlled short...... to establish cooperation with them. The novel architecture together with several possible cooperative strategies will bring clear benefits for the network and service providers, mobile device manufacturers and also end users....

  18. Decentralized Model Predictive Control for Cooperative Multiple Vehicles Subject to Communication Loss

    Directory of Open Access Journals (Sweden)

    Hojjat A. Izadi

    2011-01-01

    Full Text Available The decentralized model predictive control (DMPC of multiple cooperative vehicles with the possibility of communication loss/delay is investigated. The neighboring vehicles exchange their predicted trajectories at every sample time to maintain the cooperation objectives. In the event of a communication loss (packet dropout, the most recent available information, which is potentially delayed, is used. Then the communication loss problem changes to a cooperative problem when random large communication delays are present. Such large communication delays can lead to poor cooperation performance and unsafe behaviors such as collisions. A new DMPC approach is developed to improve the cooperation performance and achieve safety in the presence of the large communication delays. The proposed DMPC architecture estimates the tail of neighbor's trajectory which is not available due to the large communication delays for improving the performance. The concept of the tube MPC is also employed to provide the safety of the fleet against collisions, in the presence of large intervehicle communication delays. In this approach, a tube shaped trajectory set is assumed around the trajectory of the neighboring vehicles whose trajectory is delayed/lost. The radius of tube is a function of the communication delay and vehicle's maneuverability (in the absence of model uncertainty. The simulation of formation problem of multiple vehicles is employed to illustrate the effectiveness of the proposed approach.

  19. Cooperative vehicle control, feature tracking and ocean sampling

    Science.gov (United States)

    Fiorelli, Edward A.

    This dissertation concerns the development of a feedback control framework for coordinating multiple, sensor-equipped, autonomous vehicles into mobile sensing arrays to perform adaptive sampling of observed fields. The use of feedback is central; it maintains the array, i.e. regulates formation position, orientation, and shape, and directs the array to perform its sampling mission in response to measurements taken by each vehicle. Specifically, we address how to perform autonomous gradient tracking and feature detection in an unknown field such as temperature or salinity in the ocean. Artificial potentials and virtual bodies are used to coordinate the autonomous vehicles, modelled as point masses (with unit mass). The virtual bodies consist of linked, moving reference points called virtual leaders. Artificial potentials couple the dynamics of the vehicles and the virtual bodies. The dynamics of the virtual body are then prescribed allowing the virtual body, and thus the vehicle group, to perform maneuvers that include translation, rotation and contraction/expansion, while ensuring that the formation error remains bounded. This methodology is called the Virtual Body and Artificial Potential (VBAP) methodology. We then propose how to utilize these arrays to perform autonomous gradient climbing and front tracking in the presence of both correlated and uncorrelated noise. We implement various techniques for estimation of gradients (first-order and higher), including finite differencing, least squares error minimization, averaging, and Kalman filtering. Furthermore, we illustrate how the estimation error can be used to optimally choose the formation size. To complement our theoretical work, we present an account of sea trials performed with a fleet of autonomous underwater gliders in Monterey Bay during the Autonomous Ocean Sampling Network (AOSN) II project in August 2003. During these trials, Slocum autonomous underwater gliders were coordinated into triangle

  20. Perturbed cooperative-state feedback strategy for model predictive networked control of interconnected systems.

    Science.gov (United States)

    Tran, Tri; Ha, Q P

    2018-01-01

    A perturbed cooperative-state feedback (PSF) strategy is presented for the control of interconnected systems in this paper. The subsystems of an interconnected system can exchange data via the communication network that has multiple connection topologies. The PSF strategy can resolve both issues, the sensor data losses and the communication network breaks, thanks to the two components of the control including a cooperative-state feedback and a perturbation variable, e.g., u i =K ij x j +w i . The PSF is implemented in a decentralized model predictive control scheme with a stability constraint and a non-monotonic storage function (ΔV(x(k))≥0), derived from the dissipative systems theory. Numerical simulation for the automatic generation control problem in power systems is studied to illustrate the effectiveness of the presented PSF strategy. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  1. Genes as early responders regulate quorum-sensing and control bacterial cooperation in Pseudomonas aeruginosa.

    Directory of Open Access Journals (Sweden)

    Kelei Zhao

    Full Text Available Quorum-sensing (QS allows bacterial communication to coordinate the production of extracellular products essential for population fitness at higher cell densities. It has been generally accepted that a significant time duration is required to reach appropriate cell density to activate the relevant quiescent genes encoding these costly but beneficial public goods. Which regulatory genes are involved and how these genes control bacterial communication at the early phases are largely un-explored. By determining time-dependent expression of QS-related genes of the opportunistic pathogen Pseudomonas aerugionsa, we show that the induction of social cooperation could be critically influenced by environmental factors to optimize the density of population. In particular, small regulatory RNAs (RsmY and RsmZ serving as early responders, can promote the expression of dependent genes (e.g. lasR to boost the synthesis of intracellular enzymes and coordinate instant cooperative behavior in bacterial cells. These early responders, acting as a rheostat to finely modulate bacterial cooperation, which may be quickly activated under environment threats, but peter off when critical QS dependent genes are fully functional for cooperation. Our findings suggest that RsmY and RsmZ critically control the timing and levels of public goods production, which may have implications in sociomicrobiology and infection control.

  2. Adherence and success in long-term weight loss diets: the dietary intervention randomized controlled trial (DIRECT).

    Science.gov (United States)

    Greenberg, Ilana; Stampfer, Meir J; Schwarzfuchs, Dan; Shai, Iris

    2009-04-01

    Data are limited as to whether participants in diet trials truly adhere to their assigned diet and the factors that affect their adherence. We evaluated success and adherence in a two-year dietary intervention randomized controlled trial (DIRECT) in which 322 moderately obese participants (mean age 52 yrs, mean body-mass-index (BMI) 31 kg/m(2), 86% men) were randomized to one of three groups: low-fat, Mediterranean, or low-carbohydrate diets. Overall compliance at month-24 was 85%, with 90% in low-fat, 85% in Mediterranean, and 78% in low-carbohydrate diet (p = .042 between groups). Attrition was higher in women (29% vs. 14% men, p = .001) and current smokers (25% vs. 14% among maintainers, p = 0.04). In a multivariate model, independent predictors of dropping-out were: higher baseline BMI (OR = 1.11; CI: 1.03-1.21) and less weight loss at month-6 (OR = 1.20; CI: 1.1-1.3). In a multivariate model, greater weight loss achieved at month-6 was the main predictor associated with success in weight loss (> 5%) over 2 years (OR = 1.5; CI: 1.35-1.67). Self-reported complete adherence score to diet was greater on low-carbohydrate diet (p low-fat) until month-6, but dropped overall from 81% at month-1 to 57% at month-24. Holidays were a trigger to a significant decrease in adherence followed by a partial rebound. Changes in diet composition from month-1 to month-12 were more pronounced in the multi-stage low-carbohydrate diet-group (p < .05). Generally, the most irresistible restricted food items were cookies (45% of dieters) and fruits (30%). Among the physically active (n = 107), 44% reported a tendency to eat less after exercising compared to 10% who tended to eat more. Initial 6-month reduction in weight is the main predictor of both long-term retention and success in weight loss. Special attention is needed for women, current smokers, and during holidays. Physical activity is associated with subsequent reduction in energy intake.

  3. Adherence to AHA Guidelines When Adapted for Augmented Reality Glasses for Assisted Pediatric Cardiopulmonary Resuscitation: A Randomized Controlled Trial.

    Science.gov (United States)

    Siebert, Johan N; Ehrler, Frederic; Gervaix, Alain; Haddad, Kevin; Lacroix, Laurence; Schrurs, Philippe; Sahin, Ayhan; Lovis, Christian; Manzano, Sergio

    2017-05-29

    The American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) are nowadays recognized as the world's most authoritative resuscitation guidelines. Adherence to these guidelines optimizes the management of critically ill patients and increases their chances of survival after cardiac arrest. Despite their availability, suboptimal quality of CPR is still common. Currently, the median hospital survival rate after pediatric in-hospital cardiac arrest is 36%, whereas it falls below 10% for out-of-hospital cardiac arrest. Among emerging information technologies and devices able to support caregivers during resuscitation and increase adherence to AHA guidelines, augmented reality (AR) glasses have not yet been assessed. In order to assess their potential, we adapted AHA Pediatric Advanced Life Support (PALS) guidelines for AR glasses. The study aimed to determine whether adapting AHA guidelines for AR glasses increased adherence by reducing deviation and time to initiation of critical life-saving maneuvers during pediatric CPR when compared with the use of PALS pocket reference cards. We conducted a randomized controlled trial with two parallel groups of voluntary pediatric residents, comparing AR glasses to PALS pocket reference cards during a simulation-based pediatric cardiac arrest scenario-pulseless ventricular tachycardia (pVT). The primary outcome was the elapsed time in seconds in each allocation group, from onset of pVT to the first defibrillation attempt. Secondary outcomes were time elapsed to (1) initiation of chest compression, (2) subsequent defibrillation attempts, and (3) administration of drugs, as well as the time intervals between defibrillation attempts and drug doses, shock doses, and number of shocks. All these outcomes were assessed for deviation from AHA guidelines. Twenty residents were randomized into 2 groups. Time to first defibrillation attempt (mean: 146 s) and adherence to AHA guidelines in terms of time to other

  4. [The impact of therapeutic inertia and the degree of the medication adherence on the control goals for patients with diabetes].

    Science.gov (United States)

    López-Simarro, F; Moral, I; Aguado-Jodar, A; Cols-Sagarra, C; Mancera-Romero, J; Alonso-Fernández, M; Miravet-Jiménez, S; Brotons, C

    2017-11-21

    The purpose of this study was to analyse both the impact of low therapeutic adherence (TA) and therapeutic inertia (TI) on poor blood glucose control and on risk factors for heart disease in patients with DM2. A cross-sectional study was conducted in a Primary Halth Care centre. A total of 320 patients with DM2 were included and an assessment was made of control goals (HbA1c≤7%, blood pressure ≤130/80mmHg, and LDL-cholesterol≤100mg/dl). A pharmacy retrieval inertia were found in a high percentage of poorly-controlled DM2 patients with bad control. Therapeutic inertia was found to be of great relevance in this study. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Allocation of control rights in the PPP Project: a cooperative game model

    Science.gov (United States)

    Zhang, Yunhua; Feng, Jingchun; Yang, Shengtao

    2017-06-01

    Reasonable allocation of control rights is the key to the success of Public-Private Partnership (PPP) projects. PPP are services or ventures which are financed and operated through cooperation between governmental and private sector actors and which involve reasonable control rights sharing between these two partners. After professional firm with capital and technology as a shareholder participating in PPP project firms, the PPP project is diversified in participants and input resources. Meanwhile the allocation of control rights of PPP project tends to be complicated. According to the diversification of participants and input resources of PPP projects, the key participants are divided into professional firms and pure investors. Based on the cost of repurchase of different input resources in markets, the cooperative game relationship between these two parties is analyzed, on the basis of which the allocation model of the cooperative game for control rights is constructed to ensure optimum allocation ration of control rights and verify the share of control rights in proportion to the cost of repurchase.

  6. Dental, periodontal and salivary conditions in diabetic children associated with metabolic control variables and nutritional plan adherence.

    Science.gov (United States)

    Díaz Rosas, C Y; Cárdenas Vargas, E; Castañeda-Delgado, J E; Aguilera-Galaviz, L A; Aceves Medina, M C

    2018-06-01

    Diabetes mellitus is a chronic disease that has manifestations other than alterations in endocrine regulation or in metabolic pathways. Several diseases of the oral cavity have been associated with diabetes mellitus type 1 and 2 in young people according to their evolution. Scarce information exists regarding the role of diabetes and its association with the oral health status in paediatric diabetic patients. The aims of the study were to assess the quality of saliva, saliva acidogenicity, dental caries experience, fluorosis and periodontal status in diabetic patients and to evaluate their relationship with metabolic control variables and nutritional plan adherence. The study population consisted of 60 paediatric patients with both types of diabetes mellitus. Saliva testing included stimulated flow, pH (using pH indicator strips), buffer capacity and Snyder's Test. DMFT/dmft and dental caries experience were determined on the basis of ICDAS II codes. The periodontal status was assessed by PI and GI and fluorosis by FI. Nutritional plan adherence was established from the subscale "Dietary Control" of the Diabetes Self-Management Profile questionnaire. Medical Data was retrieved from the clinical registers in the Diabetic Clinic. We describe the main characteristics of the oral cavity related variables of our population that might guide the clinical practice in similar settings; we found a dmft/DMFT of 1.71 ± 1.74 and 0.64 ± 1.03, PI of 1.91 ± 0.75, GI of 0.50 ± 0.56 and a fluorosis prevalence of 61%. We identified several correlated variables, which indicate strong associations between the nutritional habits of the patients and co-occurrence of oral cavity physiopathological alterations. Several correlations were found between acidogenic activity of the saliva (Snyder Test) and the percentage of adherence to the nutritional plan and to the dmft index. Furthermore, a significant correlation between the buffering capacity of the saliva and the glycemic control of

  7. Predictors of Medication Adherence and Blood Pressure Control among Saudi Hypertensive Patients Attending Primary Care Clinics: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Sarah M Khayyat

    Full Text Available To assess the level of medication adherence and to investigate predictors of medication adherence and blood pressure control among hypertensive patients attending primary healthcare clinics in Makkah, Saudi Arabia.Hypertensive patients meeting the eligibility criteria were recruited from eight primary care clinics between January and May 2016 for this study. The patients completed Arabic version of Morisky Medication Adherence Scale (MMAS-8, an eight-item validated, self-reported measure to assess medication adherence. A structured data collection form was used to record patients' sociodemographic, medical and medication data.Two hundred and four patients, of which 71.6% were females, participated in the study. Patients' mean age was 59.1 (SD 12.2. The mean number of medication used by patients was 4.4 (SD 1.89. More than half (110; 54% of the patients were non-adherent to their medications (MMAS score 65 years (OR 2.0 [95% CI: 1.0-4.2; P = 0.04], and being diabetic (OR 0.25 [95% CI: 0.1-0.6; P = 0.04] were found to be independent predictors of medication adherence.Medication adherence is alarmingly low among hypertensive patients attending primary care clinics in Saudi Arabia which may partly explain observed poor blood pressure control. There is a clear need to educate patients about the importance of medication adherence and its impact on improving clinical outcomes. Future research should identify barriers to medication adherence among Saudi hypertensive patients.

  8. Low-Speed Cooperative Car-Following Fuzzy Controller for Cybernetic Transport Systems

    OpenAIRE

    Milanés , Vicente; Marouf , Mohamed; Pérez Rastelli , Joshué; Gonzalez Bautista , David; Nashashibi , Fawzi

    2014-01-01

    International audience; — This paper describes the development of a Coop-erative Adaptive Cruise Control (CACC) for the future urban transportation system at low-speed. The control algorithm was evaluated using two Cybecars as prototype vehicles. A longitu-dinal response model for the vehicles was developed to design the CACC system. The control algorithm was implemented on a fuzzy logic-based controller that has been tuned to minimize a cost function in order to get a trade-off between a pro...

  9. Cooperation of nuclear reactor controller ARM-5S and turbine TVER-02

    International Nuclear Information System (INIS)

    Wagner, K.; Lnenicka, B.; Pokorny, F.; Prochazka, F.

    1985-01-01

    Turbines of Czechoslovak make provided with controllers TVER-02 are installed in WWER-440 nuclear power plants under construction in Czechoslovakia. Reactor output is controlled using Soviet-made controllers ARM-5S which already comprise turbine controllers. The problems are analyzed of cooperation of both controllers, especially their parameters and transient processes in typical operating situations. The analysis uses the results of measurements performed during the power start-up of Unit 1 of the V-2 nuclear power plant at Jaslovske Bohunice. The results show that two types of control modes can be selected for the operation of the entire unit: the control to constant unit output, and control of unit output varying with turbine load selected on the TVER-02 controller or given by the demand of the power network. (Z.M.)

  10. CHILDREN'S ADHERENCE TO HAART ADHERENCE

    African Journals Online (AJOL)

    han or equal IQ 2 log" and in 64% of children wirh smaller man 2 log,o decrease in viral load. Secondly, i caregivers are not well prepared for adherence issues before starting HAART, or if regimens are too onerous to follow, treatment is likely to fail. Every effort should be made to see the burden of adherence from the.

  11. Intelligent Control System Taking Account of Cooperativeness Using Weighting Information on System Objective

    Directory of Open Access Journals (Sweden)

    Masaki Takahashi

    2004-08-01

    Full Text Available This study considers an intelligent control system to integrate flexibly its components by using weighted information where the system evaluation is reflected. Such system evaluates the information flowing through the components and converts them by weighting depending on the degree of importance. Integration of components based on the system evaluation enables a system consisting of them to realize various, flexible and adaptive control. In this study, the intelligent control method is applied to a swing up and stabilization control problem of a number of cart and pendulum systems on a restricted straight guide. To stabilize the pendulum in a restricted environment, each system should realize not only a swing-up and stabilization control of the pendulum, but also a position control of the cart to avoid collision or deadlock. The experiment using a real apparatus demonstrated that the controller learning light interaction acquires egoistic character, the controller learning heavy interaction behaves altruistically, and the controller equally considering self cart and another cart becomes cooperative. In other words, these autonomous decentralized controllers can acquire various characters and flexibility for cooperation.

  12. [Adherence to a medical nutrition therapy program in pregnant women with diabetes, measured by three methods, and its association with glycemic control].

    Science.gov (United States)

    Balas-Nakash, Margie; Rodríguez-Cano, Ameyalli; Muñoz-Manrique, Cinthya; Vásquez-Peña, Paulina; Perichart-Perera, Otilia

    2010-01-01

    The measurement of adherence to nutrition therapy is essential to evaluate if the outcomes are related to given recommendations. The aim of this study was to describe adherence to a Medical Nutrition Therapy Program in Mexican pregnant women with diabetes, using three different methods; and evaluate its association with glycemic control. Adherence was measured with a questionnaire (0-100%), women's self-perception (0-100%) and energy intake adequacy by multiple pass 24 hour recall (85-115% of recommendation). Women were randomly assigned to two different dietary strategies. Glycemic control was determined by capillary glucose self-monitoring. Women analyzed in this study (n=69) had an age range of 22-42 years; 47.8% had type 2 diabetes (DM2) and 52.2% had gestational diabetes (GDM). Energy intake adequacy was higher in women with GDM (41.9% vs. 37.7%, p = 0.001). Average adherence measured with the questionnaire was 55%; no differences were found by type of diabetes. Self-perception was higher in women with DM2 (84%) when compared to women with GDM (70%) (p = 0.039). No differences were found in the three methods by study group. Optimal glycemic control was observed in 50% of women; no association was found with adherence measured with any of the three methods studied. The observed differences in adherences suggest that it may be recommendable to combine different measurement methods and include social and psychological factors that affect behavioral change.

  13. Mineralogic control on abundance and diversity of surface-adherent microbial communities

    Science.gov (United States)

    Mauck, Brena S.; Roberts, Jennifer A.

    2007-01-01

    In this study, we investigated the role of mineral-bound P and Fe in defining microbial abundance and diversity in a carbon-rich groundwater. Field colonization experiments of initially sterile mineral surfaces were combined with community structure characterization of the attached microbial population. Silicate minerals containing varying concentrations of P (∼1000 ppm P) and Fe (∼4 wt % Fe 2 O3), goethite (FeOOH), and apatite [Ca5(PO4)3(OH)] were incubated for 14 months in three biogeochemically distinct zones within a petroleum-contaminated aquifer. Phospholipid fatty acid analysis of incubated mineral surfaces and groundwater was used as a measure of microbial community structure and biomass. Microbial biomass on minerals exhibited distinct trends as a function of mineralogy depending on the environment of incubation. In the carbon-rich, aerobic groundwater attached biomass did not correlate to the P- or Fe- content of the mineral. In the methanogenic groundwater, however, biomass was most abundant on P-containing minerals. Similarly, in the Fe-reducing groundwater a correlation between Fe-content and biomass was observed. The community structure of the mineral-adherent microbial population was compared to the native groundwater community. These two populations were significantly different regardless of mineralogy, suggesting differentiation of the planktonic community through attachment, growth, and death of colonizing cells. Biomarkers specific for dissimilatory Fe-reducing bacteria native to the aquifer were identified only on Fe-containing minerals in the Fe-reducing groundwater. These results demonstrate that the trace nutrient content of minerals affects both the abundance and diversity of surface-adherent microbial communities. This behavior may be a means to access limiting nutrients from the mineral, creating a niche for a particular microbial population. These results suggest that heterogeneity of microbial populations and their associated

  14. Adherence to a Depression Self-Care Intervention among Primary Care Patients with Chronic Physical Conditions: A Randomised Controlled Trial

    Science.gov (United States)

    McCusker, Jane; Cole, Martin G.; Yaffe, Mark; Strumpf, Erin; Sewitch, Maida; Sussman, Tamara; Ciampi, Antonio; Lavoie, Kim; Belzile, Eric

    2016-01-01

    Objective: Among primary care patients with chronic physical conditions and comorbid depressive symptoms, to assess (1) the effect of lay telephone coaching on adherence to a psycho-educational intervention for depression, (2) demographic characteristics that predict adherence and (3) the association between adherence and 6-month outcomes. Design:…

  15. Assessing the treatment effect in a randomized controlled trial with extensive non-adherence: the EVOLVE trial.

    Science.gov (United States)

    Kubo, Yumi; Sterling, Lulu Ren; Parfrey, Patrick S; Gill, Karminder; Mahaffey, Kenneth W; Gioni, Ioanna; Trotman, Marie-Louise; Dehmel, Bastian; Chertow, Glenn M

    2015-01-01

    Intention-to-treat (ITT) analysis is widely used to establish efficacy in randomized clinical trials. However, in a long-term outcomes study where non-adherence to study drug is substantial, the on-treatment effect of the study drug may be underestimated using the ITT analysis. The analyses presented herein are from the EVOLVE trial, a double-blind, placebo-controlled, event-driven cardiovascular outcomes study conducted to assess whether a treatment regimen including cinacalcet compared with placebo in addition to other conventional therapies reduces the risk of mortality and major cardiovascular events in patients receiving hemodialysis with secondary hyperparathyroidism. Pre-specified sensitivity analyses were performed to assess the impact of non-adherence on the estimated effect of cinacalcet. These analyses included lag-censoring, inverse probability of censoring weights (IPCW), rank preserving structural failure time model (RPSFTM) and iterative parameter estimation (IPE). The relative hazard (cinacalcet versus placebo) of mortality and major cardiovascular events was 0.93 (95% confidence interval 0.85, 1.02) using the ITT analysis; 0.85 (0.76, 0.95) using lag-censoring analysis; 0.81 (0.70, 0.92) using IPCW; 0.85 (0.66, 1.04) using RPSFTM and 0.85 (0.75, 0.96) using IPE. These analyses, while not providing definitive evidence, suggest that the intervention may have an effect while subjects are receiving treatment. The ITT method remains the established method to evaluate efficacy of a new treatment; however, additional analyses should be considered to assess the on-treatment effect when substantial non-adherence to study drug is expected or observed. Copyright © 2015 John Wiley & Sons, Ltd.

  16. Use of participant focus groups to identify barriers and facilitators to worksite exercise therapy adherence in randomized controlled trials involving firefighters

    Directory of Open Access Journals (Sweden)

    Mayer JM

    2013-03-01

    Full Text Available John M Mayer,1 James L Nuzzo,1 Simon Dagenais2 1School of Physical Therapy and Rehabilitation Sciences, College of Medicine, University of South Florida, Tampa, FL, 2Palladian Health, West Seneca, NY, USA Background: Firefighters are at increased risk for back injuries, which may be mitigated through exercise therapy to increase trunk muscle endurance. However, long-term adherence to exercise therapy is generally poor, limiting its potential benefits. Focus groups can be used to identify key barriers and facilitators to exercise adherence among study participants. Objective: To explore barriers and facilitators to worksite exercise therapy adherence among firefighters to inform future randomized controlled trials (RCTs. Methods: Participants enrolled in a previous RCT requiring twice-weekly worksite exercise therapy for 24 weeks were asked to take part in moderated focus group discussions centered on eight open-ended questions related to exercise adherence. Responses were analyzed qualitatively using a social ecological framework to identify key intrapersonal, interpersonal, and institutional barriers and potential facilitators to exercise adherence. Results: A total of 27 participants were included in the four focus group discussions, representing 50% of those assigned to a worksite exercise therapy group in the previous RCT, in which only 67% of scheduled exercise therapy sessions were completed. Lack of self-motivation was cited as the key intrapersonal barrier to adherence, while lack of peer support was the key interpersonal barrier reported, and lack of time to exercise during work shifts was the key institutional barrier identified. Conclusion: Focus group discussions identified both key barriers and potential facilitators to increase worksite exercise therapy adherence among firefighters. Future studies should consider educating and reminding participants about the benefits of exercise, providing individual and group incentives based on

  17. Implementing Cooperative Behavior & Control Using Open Source Technology Across Heterogeneous Vehicles

    Science.gov (United States)

    2015-03-26

    cooperative control algorithms used for multiple SUAS to perform surveillance using equal angular spacing from the ground target [16]. The algorithm...allows each SUAS in the surveillance mission to loiter around a target at an equal angular spacing from one another on the same loiter path. This...Planner has included. For instance, Mission Planner has the ability to run Python scripts. Python is a programming language like Java . With the

  18. Disturbance Observer for Lateral Trajectory Tracking Control for Autonomous and Cooperative Driving

    OpenAIRE

    Christian Rathgeber; Franz Winkler; Dirk Odenthal; Steffen Muller

    2015-01-01

    In this contribution a structure for high level lateral vehicle tracking control based on the disturbance observer is presented. The structure is characterized by stationary compensating side forces disturbances and guaranteeing a cooperative behavior at the same time. Driver inputs are not compensated by the disturbance observer. Moreover the structure is especially useful as it robustly stabilizes the vehicle. Therefore the parameters are selected using the Parameter Space Approach. The imp...

  19. Tangible Cooperative Gestures: Improving Control and Initiative in Digital Photo Sharing

    Directory of Open Access Journals (Sweden)

    Elise van den Hoven

    2015-09-01

    Full Text Available This paper focuses on co-present digital photo sharing on a notebook and investigates how this could be supported. While analyzing the current digital photo sharing situation we noticed that there was a high threshold for visitors to take control of the personal computer of the photo owner, resulting in inequity of participation. It was assumed that visitors would have the opportunity to interact with the notebook more freely if this threshold was lowered by distributing the user interface and creating a more public, instead of personal, interaction space. This, in turn, could make them feel more involved and in control during a session, creating a more enjoyable experience. To test these assumptions a design prototype was created that stimulates participants to use tangible artifacts for cooperative gestures, a promising direction for the future of HCI. The situation with the cooperative gestures was compared with the regular digital photo sharing situation, which makes use of a keyboard. In dyads, visitors felt more involved and in control in the design prototype cooperative gestures condition (especially during storytelling, resulting in a more enjoyable digital photo sharing experience.

  20. Distributed Cooperative Search Control Method of Multiple UAVs for Moving Target

    Directory of Open Access Journals (Sweden)

    Chang-jian Ru

    2015-01-01

    Full Text Available To reduce the impact of uncertainties caused by unknown motion parameters on searching plan of moving targets and improve the efficiency of UAV’s searching, a novel distributed Multi-UAVs cooperative search control method for moving target is proposed in this paper. Based on detection results of onboard sensors, target probability map is updated using Bayesian theory. A Gaussian distribution of target transition probability density function is introduced to calculate prediction probability of moving target existence, and then target probability map can be further updated in real-time. A performance index function combining with target cost, environment cost, and cooperative cost is constructed, and the cooperative searching problem can be transformed into a central optimization problem. To improve computational efficiency, the distributed model predictive control method is presented, and thus the control command of each UAV can be obtained. The simulation results have verified that the proposed method can avoid the blindness of UAV searching better and improve overall efficiency of the team effectively.

  1. The Study of Cooperative Obstacle Avoidance Method for MWSN Based on Flocking Control

    Directory of Open Access Journals (Sweden)

    Zuo Chen

    2014-01-01

    Full Text Available Compared with the space fixed feature of traditional wireless sensor network (WSN, mobile WSN has better robustness and adaptability in unknown environment, so that it is always applied in the research of target tracking. In order to reach the target, the nodes group should find a self-adaptive method to avoid the obstacles together in their moving directions. Previous methods, which were based on flocking control model, realized the strategy of obstacle avoidance by means of potential field. However, these may sometimes lead the nodes group to fall into a restricted area like a trap and never get out of it. Based on traditional flocking control model, this paper introduced a new cooperative obstacle avoidance model combined with improved SA obstacle avoidance algorithm. It defined the tangent line of the intersection of node’s velocity line and the edge of obstacle as the steering direction. Furthermore, the cooperative obstacle avoidance model was also improved in avoiding complex obstacles. When nodes group encounters mobile obstacles, nodes will predict movement path based on the spatial location and velocity of obstacle. And when nodes group enters concave obstacles, nodes will temporarily ignore the gravity of the target and search path along the edge of the concave obstacles. Simulation results showed that cooperative obstacle avoidance model has significant improvement on average speed and time efficiency in avoiding obstacle compared with the traditional flocking control model. It is more suitable for obstacle avoidance in complex environment.

  2. The study of cooperative obstacle avoidance method for MWSN based on flocking control.

    Science.gov (United States)

    Chen, Zuo; Ding, Lei; Chen, Kai; Li, Renfa

    2014-01-01

    Compared with the space fixed feature of traditional wireless sensor network (WSN), mobile WSN has better robustness and adaptability in unknown environment, so that it is always applied in the research of target tracking. In order to reach the target, the nodes group should find a self-adaptive method to avoid the obstacles together in their moving directions. Previous methods, which were based on flocking control model, realized the strategy of obstacle avoidance by means of potential field. However, these may sometimes lead the nodes group to fall into a restricted area like a trap and never get out of it. Based on traditional flocking control model, this paper introduced a new cooperative obstacle avoidance model combined with improved SA obstacle avoidance algorithm. It defined the tangent line of the intersection of node's velocity line and the edge of obstacle as the steering direction. Furthermore, the cooperative obstacle avoidance model was also improved in avoiding complex obstacles. When nodes group encounters mobile obstacles, nodes will predict movement path based on the spatial location and velocity of obstacle. And when nodes group enters concave obstacles, nodes will temporarily ignore the gravity of the target and search path along the edge of the concave obstacles. Simulation results showed that cooperative obstacle avoidance model has significant improvement on average speed and time efficiency in avoiding obstacle compared with the traditional flocking control model. It is more suitable for obstacle avoidance in complex environment.

  3. Hierarchical Control Strategy for the Cooperative Braking System of Electric Vehicle.

    Science.gov (United States)

    Peng, Jiankun; He, Hongwen; Liu, Wei; Guo, Hongqiang

    2015-01-01

    This paper provides a hierarchical control strategy for cooperative braking system of an electric vehicle with separated driven axles. Two layers are defined: the top layer is used to optimize the braking stability based on two sliding mode control strategies, namely, the interaxle control mode and signal-axle control strategies; the interaxle control strategy generates the ideal braking force distribution in general braking condition, and the single-axle control strategy can ensure braking safety in emergency braking condition; the bottom layer is used to maximize the regenerative braking energy recovery efficiency with a reallocated braking torque strategy; the reallocated braking torque strategy can recovery braking energy as much as possible in the premise of meeting battery charging power. The simulation results show that the proposed hierarchical control strategy is reasonable and can adapt to different typical road surfaces and load cases; the vehicle braking stability and safety can be guaranteed; furthermore, the regenerative braking energy recovery efficiency can be improved.

  4. Exercise motivation and adherence in cancer survivors after participation in a randomized controlled trial: an attribution theory perspective.

    Science.gov (United States)

    Courneya, Kerry S; Friedenreich, Christine M; Sela, Rami A; Quinney, H Arthur; Rhodes, Ryan E; Jones, Lee W

    2004-01-01

    The purpose of this study was to examine postprogram exercise motivation and adherence in cancer survivors who participated in the Group Psychotherapy and Home-Based Physical Exercise (GROUP-HOPE; Courneya, Friedenreich, Sela, Quinney, & Rhodes, 2002) trial. At the completion of the GROUP-HOPE trial, 46 of 51 (90%) participants in the exercise group completed measures of attribution theory constructs. A 5-week follow-up self-report of exercise was then completed by 30 (65%) participants. Correlational analyses indicated that program exercise, perceived success, expected success, and affective reactions were strong predictors of postprogram exercise. In multivariate stepwise regression analyses, program exercise and perceived success were the strongest predictors of postprogram exercise. Additionally, perceived success was more important than objective success in understanding the attribution process, and it interacted with personal control to influence expected success and negative affect. Finally, postprogram quality of life and changes in physical fitness were correlates of perceived success. We concluded that attribution theory may have utility for understanding postprogram exercise motivation and adherence in cancer survivors.

  5. Using Large-Scale Cooperative Control to Manage Operational Uncertainties for Aquifer Thermal Energy Storage

    Science.gov (United States)

    Jaxa-Rozen, M.; Rostampour, V.; Kwakkel, J. H.; Bloemendal, M.

    2017-12-01

    Seasonal Aquifer Thermal Energy Storage (ATES) technology can help reduce the demand of energy for heating and cooling in buildings, and has become a popular option for larger buildings in northern Europe. However, the larger-scale deployment of this technology has evidenced some issues of concern for policymakers; in particular, recent research shows that operational uncertainties contribute to inefficient outcomes under current planning methods for ATES. For instance, systems in the Netherlands typically use less than half of their permitted pumping volume on an annual basis. This overcapacity gives users more flexibility to operate their systems in response to the uncertainties which drive building energy demand; these include short-term operational factors such as weather and occupancy, and longer-term, deeply uncertain factors such as changes in climate and aquifer conditions over the lifespan of the buildings. However, as allocated subsurface volume remains unused, this situation limits the adoption of the technology in dense areas. Previous work using coupled agent-based/geohydrological simulation has shown that the cooperative operation of neighbouring ATES systems can support more efficient spatial planning, by dynamically managing thermal interactions in response to uncertain operating conditions. An idealized case study with centralized ATES control thus showed significant improvements in the energy savings which could obtained per unit of allocated subsurface volume, without degrading the recovery performance of systems. This work will extend this cooperative approach for a realistic case study of ATES planning in the city of Utrecht, in the Netherlands. This case was previously simulated under different scenarios for individual ATES operation. The poster will compare these results with a cooperative case under which neighbouring systems can coordinate their operation to manage interactions. Furthermore, a cooperative game-theoretical framework will be

  6. A self-adherent, bullet-shaped microneedle patch for controlled transdermal delivery of insulin.

    Science.gov (United States)

    Seong, Keum-Yong; Seo, Min-Soo; Hwang, Dae Youn; O'Cearbhaill, Eoin D; Sreenan, Seamus; Karp, Jeffrey M; Yang, Seung Yun

    2017-11-10

    Proteins are important biologic therapeutics used for the treatment of various diseases. However, owing to low bioavailability and poor skin permeability, transdermal delivery of protein therapeutics poses a significant challenge. Here, we present a new approach for transdermal protein delivery using bullet-shaped double-layered microneedle (MN) arrays with water-swellable tips. This design enabled the MNs to mechanically interlock with soft tissues by selective distal swelling after skin insertion. Additionally, prolonged release of loaded proteins by passive diffusion through the swollen tips was obtained. The bullet-shaped MNs provided an optimal geometry for mechanical interlocking, thereby achieving significant adhesion strength (~1.6Ncm -2 ) with rat skin. By harnessing the MN's reversible swelling/deswelling property, insulin, a model protein drug, was loaded in the swellable tips using a mild drop/dry procedure. The insulin-loaded MN patch released 60% of insulin when immersed in saline over the course of 12h and approximately 70% of the released insulin appeared to have preserved structural integrity. An in vivo pilot study showed a prolonged release of insulin from swellable MN patches, leading to a gradual decrease in blood glucose levels. This self-adherent transdermal MN platform can be applied to a variety of protein drugs requiring sustained release kinetics. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. [Resource allocation analysis for international cooperation program for HIV/AIDS prevention and control].

    Science.gov (United States)

    Li, Hui; Xue, Hui; Liu, Hui; Guo, Hao-yan; Zhang, Hua; Sun, Jiang-ping

    2008-12-01

    To provide evidence for resource allocation and cooperation between domestic and international HIV/AIDS programs in China by analyzing the needs and current levels of resource input in provinces. National and provincial international cooperation program investment and allocation data from 2000 to 2006 were collected. Several factors in each province were analyzed through multiple regression analysis in order to determine whether they had a statistical correlation to the distribution of international HIV/AIDS program resources in China, including: the Gross Domestic Product (GDP), the number of accumulated people living with HIV/AIDS, and the number of accumulated people living with AIDS. Then the Z values were calculated at each provincial level and compared with related international investment. The resource allocation in different program areas were compared with the level of resource input by international and central government HIV/AIDS prevention and control programs through Chi-square test. The international cooperation program investment at local level from 2000 to 2006 were 4893, 24 669, 50 567, 52 950, 112 143, 363 396 and 247 045 thousand RMB respectively, and at national level were 3007, 19 726, 29 035, 37 530, 77 500, 105 786 and 77 035 thousand RMB respectively. There was a statistical correlation between international HIV/AIDS program resource input and the accumulated number of people living with AIDS (R is 0.56 and 0.69 accordingly, and P international resource input and the GDP of each province. International HIV/AIDS cooperation programs did not invest in each province according to its practical needs (R = 0.066, P = 0.725). The international cooperation program investments and needs in different province could not meet completely. The ranks of Z value in Guangdong, Shandong and Jiangsu were 3, 5 and 6, but the ranks of international cooperation program in those provinces were 18, 13 and 28 respectively. The investment proportion for national

  8. The Dynamics and Sliding Mode Control of Multiple Cooperative Welding Robot Manipulators

    Directory of Open Access Journals (Sweden)

    Bin Zi

    2012-08-01

    Full Text Available This paper deals with the design, dynamic modelling and sliding mode control of multiple cooperative welding robot manipulators (MWRMs. The MWRMs can handle complex tasks that are difficult or even impossible for a single manipulator. The kinematics and dynamics of the MWRMs are studied on the basis of the Denavit-Hartenberg and Lagrange method. Following that, considering the MWRM system with nonlinear and unknown disturbances, a non-singular terminal sliding mode control strategy is designed. By means of the Lyapunov function, the stability of the controller is proved. Simulation results indicate that the good control performance of the MWRMs is achieved by the non-singular terminal sliding mode controller, which also illustrates the correctness of the dynamic modelling and effectiveness of the proposed control strategy.

  9. Interference Information Based Power Control for Cognitive Radio with Multi-Hop Cooperative Sensing

    Science.gov (United States)

    Yu, Youngjin; Murata, Hidekazu; Yamamoto, Koji; Yoshida, Susumu

    Reliable detection of other radio systems is crucial for systems that share the same frequency band. In wireless communication channels, there is uncertainty in the received signal level due to multipath fading and shadowing. Cooperative sensing techniques in which radio stations share their sensing information can improve the detection probability of other systems. In this paper, a new cooperative sensing scheme that reduces the false detection probability while maintaining the outage probability of other systems is investigated. In the proposed system, sensing information is collected using multi-hop transmission from all sensing stations that detect other systems, and transmission decisions are based on the received sensing information. The proposed system also controls the transmit power based on the received CINRs from the sensing stations. Simulation results reveal that the proposed system can reduce the outage probability of other systems, or improve its link success probability.

  10. Distributed Cooperative Optimal Control for Multiagent Systems on Directed Graphs: An Inverse Optimal Approach.

    Science.gov (United States)

    Zhang, Huaguang; Feng, Tao; Yang, Guang-Hong; Liang, Hongjing

    2015-07-01

    In this paper, the inverse optimal approach is employed to design distributed consensus protocols that guarantee consensus and global optimality with respect to some quadratic performance indexes for identical linear systems on a directed graph. The inverse optimal theory is developed by introducing the notion of partial stability. As a result, the necessary and sufficient conditions for inverse optimality are proposed. By means of the developed inverse optimal theory, the necessary and sufficient conditions are established for globally optimal cooperative control problems on directed graphs. Basic optimal cooperative design procedures are given based on asymptotic properties of the resulting optimal distributed consensus protocols, and the multiagent systems can reach desired consensus performance (convergence rate and damping rate) asymptotically. Finally, two examples are given to illustrate the effectiveness of the proposed methods.

  11. Fuzzy variable impedance control based on stiffness identification for human-robot cooperation

    Science.gov (United States)

    Mao, Dachao; Yang, Wenlong; Du, Zhijiang

    2017-06-01

    This paper presents a dynamic fuzzy variable impedance control algorithm for human-robot cooperation. In order to estimate the intention of human for co-manipulation, a fuzzy inference system is set up to adjust the impedance parameter. Aiming at regulating the output fuzzy universe based on the human arm’s stiffness, an online stiffness identification method is developed. A drag interaction task is conducted on a 5-DOF robot with variable impedance control. Experimental results demonstrate that the proposed algorithm is superior.

  12. Effects of a Phone Call Intervention to Promote Adherence to Antiretroviral Therapy and Quality of Life of HIV/AIDS Patients in Baoshan, China: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Dongsheng Huang

    2013-01-01

    Full Text Available Background. Suboptimal adherence to antiretroviral therapy (ART is still pervasive. The effect of using a mobile phone call intervention to improve patient adherence is currently not known. Objective. This study aims to investigate the effects of a phone call intervention on adherence to ART and quality of life (QOL of treatment-naive and treatment-experienced patients. Methods. A randomized controlled trial was conducted in the three largest public hospitals. Adherence was measured by self-completed questionnaires. QOL was assessed by the WHOQOL-HIV BREF. Outcomes were assessed at day 15, at 1, 2, and 3 months after start of treatment for treatment-naive patients and at 3 months after study enrollment for treatment-experienced patients. Results. A total of 103 treatment-naive and 93 treatment-experienced HIV/AIDS patients were consecutively recruited. Results show that a phone call intervention could maintain high self-reported adherence among both treatment-naive and treatment-experienced patients. After three months, significant QOL improvements were observed in domains of physical health (P=0.003, level of independence (P=0.018, environment (P=0.002, and spirituality/religion/personal beliefs (P=0.021 among treatment-naive patients. Conclusion. A mobile phone call intervention to patients could maintain high adherence rates although no statistically significant differences were found. A phone call could improve some domains of QOL among treatment-naive patients.

  13. Towards cooperative guidance and control of highly automated vehicles: H-Mode and Conduct-by-Wire.

    Science.gov (United States)

    Flemisch, Frank Ole; Bengler, Klaus; Bubb, Heiner; Winner, Hermann; Bruder, Ralph

    2014-01-01

    This article provides a general ergonomic framework of cooperative guidance and control for vehicles with an emphasis on the cooperation between a human and a highly automated vehicle. In the twenty-first century, mobility and automation technologies are increasingly fused. In the sky, highly automated aircraft are flying with a high safety record. On the ground, a variety of driver assistance systems are being developed, and highly automated vehicles with increasingly autonomous capabilities are becoming possible. Human-centred automation has paved the way for a better cooperation between automation and humans. How can these highly automated systems be structured so that they can be easily understood, how will they cooperate with the human? The presented research was conducted using the methods of iterative build-up and refinement of framework by triangulation, i.e. by instantiating and testing the framework with at least two derived concepts and prototypes. This article sketches a general, conceptual ergonomic framework of cooperative guidance and control of highly automated vehicles, two concepts derived from the framework, prototypes and pilot data. Cooperation is exemplified in a list of aspects and related to levels of the driving task. With the concept 'Conduct-by-Wire', cooperation happens mainly on the guidance level, where the driver can delegate manoeuvres to the automation with a specialised manoeuvre interface. With H-Mode, a haptic-multimodal interaction with highly automated vehicles based on the H(orse)-Metaphor, cooperation is mainly done on guidance and control with a haptically active interface. Cooperativeness should be a key aspect for future human-automation systems. Especially for highly automated vehicles, cooperative guidance and control is a research direction with already promising concepts and prototypes that should be further explored. The application of the presented approach is every human-machine system that moves and includes high

  14. Exergames versus self-regulated exercises with instruction leaflets to improve adherence during geriatric rehabilitation: a randomized controlled trial

    OpenAIRE

    Oesch, Peter; Kool, Jan; Fernandez-Luque, Luis; Brox, Ellen; Evertsen, Gunn; Civit, Anton; Hilfiker, Roger; Bachmann, Stefan

    2017-01-01

    Background Improving mobility in elderly persons is a primary goal in geriatric rehabilitation. Self-regulated exercises with instruction leaflets are used to increase training volume but adherence is often low. Exergames may improve adherence. This study therefore compared exergames with self-regulated exercise using instruction leaflets. The primary outcome was adherence. Secondary outcomes were enjoyment, motivation and balance during walking. Methods Design: single center parallel group n...

  15. Exergames versus self-regulated exercises with instruction leaflets to improve adherence during geriatric rehabilitation: a randomized controlled trial.

    OpenAIRE

    Oesch, Peter; Kool, Jan; Fernandez-Luque, Luis; Brox, Ellen; Evertsen, Gunn; Civit, Anton; Hilfiker, Roger; Bachmann, Stefan

    2017-01-01

    BACKGROUND Improving mobility in elderly persons is a primary goal in geriatric rehabilitation. Self-regulated exercises with instruction leaflets are used to increase training volume but adherence is often low. Exergames may improve adherence. This study therefore compared exergames with self-regulated exercise using instruction leaflets. The primary outcome was adherence. Secondary outcomes were enjoyment, motivation and balance during walking. METHODS Design: single center para...

  16. Justification and choice of hardware for automatic control system by technical means at the garage consumer cooperative

    Directory of Open Access Journals (Sweden)

    Krasnykh V.Yu.

    2017-06-01

    Full Text Available the article describes the main system requirements of software of finished products for implementation of an automatic control system by technical means at the garage consumer cooperative.

  17. Distributed Cooperative Current-Sharing Control of Parallel Chargers Using Feedback Linearization

    Directory of Open Access Journals (Sweden)

    Jiangang Liu

    2014-01-01

    Full Text Available We propose a distributed current-sharing scheme to address the output current imbalance problem for the parallel chargers in the energy storage type light rail vehicle system. By treating the parallel chargers as a group of agents with output information sharing through communication network, the current-sharing control problem is recast as the consensus tracking problem of multiagents. To facilitate the design, input-output feedback linearization is first applied to transform the nonidentical nonlinear charging system model into the first-order integrator. Then, a general saturation function is introduced to design the cooperative current-sharing control law which can guarantee the boundedness of the proposed control. The cooperative stability of the closed-loop system under fixed and dynamic communication topologies is rigorously proved with the aid of Lyapunov function and LaSalle invariant principle. Simulation using a multicharging test system further illustrates that the output currents of parallel chargers are balanced using the proposed control.

  18. Consensus-Based Cooperative Control Based on Pollution Sensing and Traffic Information for Urban Traffic Networks.

    Science.gov (United States)

    Artuñedo, Antonio; Del Toro, Raúl M; Haber, Rodolfo E

    2017-04-26

    Nowadays many studies are being conducted to develop solutions for improving the performance of urban traffic networks. One of the main challenges is the necessary cooperation among different entities such as vehicles or infrastructure systems and how to exploit the information available through networks of sensors deployed as infrastructures for smart cities. In this work an algorithm for cooperative control of urban subsystems is proposed to provide a solution for mobility problems in cities. The interconnected traffic lights controller ( TLC ) network adapts traffic lights cycles, based on traffic and air pollution sensory information, in order to improve the performance of urban traffic networks. The presence of air pollution in cities is not only caused by road traffic but there are other pollution sources that contribute to increase or decrease the pollution level. Due to the distributed and heterogeneous nature of the different components involved, a system of systems engineering approach is applied to design a consensus-based control algorithm. The designed control strategy contains a consensus-based component that uses the information shared in the network for reaching a consensus in the state of TLC network components. Discrete event systems specification is applied for modelling and simulation. The proposed solution is assessed by simulation studies with very promising results to deal with simultaneous responses to both pollution levels and traffic flows in urban traffic networks.

  19. Consensus-Based Cooperative Control Based on Pollution Sensing and Traffic Information for Urban Traffic Networks

    Directory of Open Access Journals (Sweden)

    Antonio Artuñedo

    2017-04-01

    Full Text Available Nowadays many studies are being conducted to develop solutions for improving the performance of urban traffic networks. One of the main challenges is the necessary cooperation among different entities such as vehicles or infrastructure systems and how to exploit the information available through networks of sensors deployed as infrastructures for smart cities. In this work an algorithm for cooperative control of urban subsystems is proposed to provide a solution for mobility problems in cities. The interconnected traffic lights controller (TLC network adapts traffic lights cycles, based on traffic and air pollution sensory information, in order to improve the performance of urban traffic networks. The presence of air pollution in cities is not only caused by road traffic but there are other pollution sources that contribute to increase or decrease the pollution level. Due to the distributed and heterogeneous nature of the different components involved, a system of systems engineering approach is applied to design a consensus-based control algorithm. The designed control strategy contains a consensus-based component that uses the information shared in the network for reaching a consensus in the state of TLC network components. Discrete event systems specification is applied for modelling and simulation. The proposed solution is assessed by simulation studies with very promising results to deal with simultaneous responses to both pollution levels and traffic flows in urban traffic networks.

  20. Game controller modification for fMRI hyperscanning experiments in a cooperative virtual reality environment.

    Science.gov (United States)

    Trees, Jason; Snider, Joseph; Falahpour, Maryam; Guo, Nick; Lu, Kun; Johnson, Douglas C; Poizner, Howard; Liu, Thomas T

    2014-01-01

    Hyperscanning, an emerging technique in which data from multiple interacting subjects' brains are simultaneously recorded, has become an increasingly popular way to address complex topics, such as "theory of mind." However, most previous fMRI hyperscanning experiments have been limited to abstract social interactions (e.g. phone conversations). Our new method utilizes a virtual reality (VR) environment used for military training, Virtual Battlespace 2 (VBS2), to create realistic avatar-avatar interactions and cooperative tasks. To control the virtual avatar, subjects use a MRI compatible Playstation 3 game controller, modified by removing all extraneous metal components and replacing any necessary ones with 3D printed plastic models. Control of both scanners' operation is initiated by a VBS2 plugin to sync scanner time to the known time within the VR environment. Our modifications include:•Modification of game controller to be MRI compatible.•Design of VBS2 virtual environment for cooperative interactions.•Syncing two MRI machines for simultaneous recording.

  1. Management and control of the economic activities of the agricultural cooperatives

    Directory of Open Access Journals (Sweden)

    Amarilys de Jesús Pozo Contrera

    2017-07-01

    Full Text Available This article offers some recommendations to improve the efficiency of the cooperatives pointing out the deficiencies and irregularities in the management and administration as well as in the effective control of the supporting personal to the assigned tasks. It treats about the hidden arty-crafty and tricks which wait for us when we control or do not control, when we delegate or have been delegated, as well as team work. We point out how to analyze the pros and contras of these situations and how to proceed in each case. We also tell, as an effective procedure to improve the efficiency or the cooperatives, the control of the production and the material and human resources, due to the fact that the working climax is in danger in not few organizations. Accountability is one of the most vulnerable branches. In this activity there are inadequate primary data that make possible the manipulation of counts as to hide illegal events. Amen of the money in safe and the goods of value to which sudden archly are not made, these are some of the fissures that incite wrongdoing. To resolve such challenges are some of the premises in the bring up to date of the Cuban Economic Model.

  2. An integrated control scheme for space robot after capturing non-cooperative target

    Science.gov (United States)

    Wang, Mingming; Luo, Jianjun; Yuan, Jianping; Walter, Ulrich

    2018-06-01

    How to identify the mass properties and eliminate the unknown angular momentum of space robotic system after capturing a non-cooperative target is of great challenge. This paper focuses on designing an integrated control framework which includes detumbling strategy, coordination control and parameter identification. Firstly, inverted and forward chain approaches are synthesized for space robot to obtain dynamic equation in operational space. Secondly, a detumbling strategy is introduced using elementary functions with normalized time, while the imposed end-effector constraints are considered. Next, a coordination control scheme for stabilizing both base and end-effector based on impedance control is implemented with the target's parameter uncertainty. With the measurements of the forces and torques exerted on the target, its mass properties are estimated during the detumbling process accordingly. Simulation results are presented using a 7 degree-of-freedom kinematically redundant space manipulator, which verifies the performance and effectiveness of the proposed method.

  3. Impact of symptomatic hypoglycemia on medication adherence, patient satisfaction with treatment, and glycemic control in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Walz L

    2014-04-01

    Full Text Available Lotta Walz,1,3 Billie Pettersson,2,3 Ulf Rosenqvist,4 Anna Deleskog,3,5 Gunilla Journath,6 Per Wändell7 1Department of Oncology-Pathology, Karolinska Institutet, Stockholm, 2Center for Medical Technology Assessment, Linköping University, Linköping, 3Merck Sharp and Dohme (Sweden AB, Sollentuna, 4Department of Internal Medicine, Motala Hospital, Motala, 5Department of Molecular Medicine and Surgery, 6Department of Medicine, Karolinska Institutet, Stockholm, 7Department of Neurobiology, Care Sciences and Society, Centre for Family Medicine, Karolinska Institutet, Huddinge, Sweden Background: The purpose of this study was to evaluate the impact of symptomatic hypoglycemia on medication adherence, satisfaction with treatment, and glycemic control in patients with type 2 diabetes based on the treatment goals stated in the Swedish national guidelines. Methods: This cross-sectional, multicenter study was carried out between January and August 2009 in 430 consecutive primary health care patients on stable doses of metformin and sulfonylureas for at least 6 months. The patients completed questionnaires covering their experiences of low blood glucose and adherence, as well as barriers to and satisfaction with drug treatment (using the Treatment Satisfaction Questionnaire for Medication. Physicians collected the data from medical records. Results: Patients who experienced moderate or worse symptoms of hypoglycemia reported poorer adherence to medication (46% versus 67%; P<0.01 and were more likely to perceive barriers such as “bothered by medication side effects” (36% versus 14%; P<0.001 compared with patients with no or mild symptoms. Patients with moderate or worse symptoms of hypoglycemia were less satisfied with their treatment than those with no or mild symptoms as determined by the Treatment Satisfaction Questionnaire for Medication-Global satisfaction (67.0 versus 71.2; P<0.05. Overall, achievement of target glycated hemoglobin

  4. Cooperative control scheme for an HVDC system connected to an isolated BWR nuclear power plant

    International Nuclear Information System (INIS)

    Sakurai, T.; Goto, K.; Kawai, T.; Matori, I.; Nakao, T.; Watanabe, A.

    1983-01-01

    This paper describes a cooperative control system to achieve stable operation of an isolated BWR nuclear plant linked to an HVDC system. In the proposed control system, under normal conditions the power plant is controlled according to the generating power reference and the generator frequency deviation is adjusted by converter power control. Such frequency control is also effective in the case of AC-DC system faults. In addition to the frequency control, an overload control is provided with the HVDC system, where the DC transmission power in the sound poles is increased due to a fault detection signal from the faulty pole. Effects of the above mentioned control systems were studied using digital dynamic programs. The sets of simulation results confirmed that in the case of a DC single pole fault, the plant is able to continue operation without any use of the turbine speed control units even for a restarting failure in the faulty pole. In case of a DC two pole fault, the plant is able to continue operation, being assisted by turbine speed control units when restarting in the faulty poles succeeds. In case of an AC three-line to ground fault near the AC terminal of the converter at the sending or receiving end, the system is able to continue stable operation, being supplemented by the turbine control unit when the faulty section of the AC system is isolated by a main or back-up relaying system

  5. A role for the RNA chaperone Hfq in controlling adherent-invasive Escherichia coli colonization and virulence.

    Directory of Open Access Journals (Sweden)

    Karina T Simonsen

    Full Text Available Adherent-invasive Escherichia coli (AIEC has been linked with the onset and perpetuation of inflammatory bowel diseases. The AIEC strain LF82 was originally isolated from an ileal biopsy from a patient with Crohn's disease. The pathogenesis of LF82 results from its abnormal adherence to and subsequent invasion of the intestinal epithelium coupled with its ability to survive phagocytosis by macrophages once it has crossed the intestinal barrier. To gain further insight into AIEC pathogenesis we employed the nematode Caenorhabditis elegans as an in vivo infection model. We demonstrate that AIEC strain LF82 forms a persistent infection in C. elegans, thereby reducing the host lifespan significantly. This host killing phenotype was associated with massive bacterial colonization of the nematode intestine and damage to the intestinal epithelial surface. C. elegans killing was independent of known LF82 virulence determinants but was abolished by deletion of the LF82 hfq gene, which encodes an RNA chaperone involved in mediating posttranscriptional gene regulation by small non-coding RNAs. This finding reveals that important aspects of LF82 pathogenesis are controlled at the posttranscriptional level by riboregulation. The role of Hfq in LF82 virulence was independent of its function in regulating RpoS and RpoE activity. Further, LF82Δhfq mutants were non-motile, impaired in cell invasion and highly sensitive to various chemical stress conditions, reinforcing the multifaceted function of Hfq in mediating bacterial adaptation. This study highlights the usefulness of simple non-mammalian infection systems for the identification and analysis of bacterial virulence factors.

  6. The impact of pharmacist-led medication therapy management on medication adherence in patients with type 2 diabetes mellitus: a randomized controlled study

    Directory of Open Access Journals (Sweden)

    Erku DA

    2017-09-01

    Full Text Available Background: Poor adherence to antidiabetic medications leads to a higher rate of hospital admissions and adverse health outcomes in type 2 diabetes mellitus patients. Objective: This study aims to evaluate whether a pharmacist-led medication therapy management, compared to the usual care, could enhance medication adherence and reduce hospital admission in patients with type 2 diabetes mellitus. Methods: A prospective randomized controlled study was conducted in patients with type 2 diabetes mellitus from February 1 to July 30, 2016. Patients in the control group (n=65 received the usual care while patients in the intervention group (n=62 received a personalized pharmacotherapeutic care plan and diabetes education. The two groups were compared by repeated measure ANOVA at 3 and 6‐months with medication adherence (using Morisky medication adherence scale and number of hospital admissions as the main outcome variables. Results: A total of 127 patients were included in the study. A marked and statistically significant increase in medication adherence from baseline to 3 and 6 months were noted in the intervention group (increased from 9.2% at baseline to 61% at 6 month compared with the control group (increased from 13.2% at baseline (to 30.2% at 6 month; p-value<0.01. Furthermore, at the 6-month follow-up, only 23 patients in MTM group with poorly controlled blood glucose levels resulted in hospital admissions compared to 48 patients in non-MTM group, resulting in a 52.1% fewer hospital admissions (p< 0.001. Conclusions: The findings of this study implied that pharmacist-led medication therapy management might improve medication adherence and reduce number of hospitalizations in patients with type 2 diabetes mellitus. Hence, policies and guidelines should be in place in order for clinical pharmacists to fully engage in patient care and improve the medication therapy outcomes.

  7. Adherence to a diabetic care plan provides better glycemic control in ambulatory patients with type 2 diabetes.

    Science.gov (United States)

    Chiu, Yi-Wen; Chang, Jer-Ming; Lin, Li-Ing; Chang, Pi-Yu; Lo, Wan-Ching; Wu, Ling-Chu; Chen, Tun-Chieh; Hwang, Shang-Jyh

    2009-04-01

    Tight control of blood sugar improves the outcomes for diabetic patients, but it can only be achieved by adhering to a well-organized care plan. To evaluate the effect of a diabetes care plan with reinforcement of glycemic control in diabetic patients, 98 ambulatory patients with type 2 diabetes who visited our diabetes clinic every 3-4 months and who completed four education courses given by certified diabetes educators within 3 months after the first visit, were defined as the Intervention group. A total of 82 patients fulfilling the inclusion criteria for the Intervention group but who missed at least half of the diabetes education sessions were selected as controls. Both groups had comparable mean hemoglobin A1c (HbA1c) levels at baseline, which decreased significantly at 3 months and were maintained at approximately constant levels at intervals for up to 1 year. The HbA1c decrement in the Intervention group was significantly greater than that in the Control group over the 1-year follow-up period (HbA1c change: -2.5 +/- 1.8% vs. -1.1 +/- 1.7%, p decrement occurred during the first 3 months, and accounted for 95.6% and 94.6% of the total HbA1c decrements in the Intervention and Control groups, respectively. In the multiple regression model, after adjustment for age, body mass index, and duration of diabetes, the Intervention group may still have a 12.6% improvement in HbA1c from their original value to the end of 1 year treatment compared with the Control group (p < 0.05). Diabetes care, with reinforcement from certified diabetes educators, significantly improved and maintained the effects on glycemic control in ambulatory patients with type 2 diabetes.

  8. Adherence to A Diabetic Care Plan Provides Better Glycemic Control in Ambulatory Patients With Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Yi-Wen Chiu

    2009-04-01

    Full Text Available Tight control of blood sugar improves the outcomes for diabetic patients, but it can only be achieved by adhering to a well-organized care plan. To evaluate the effect of a diabetes care plan with reinforcement of glycemic control in diabetic patients, 98 ambulatory patients with type 2 diabetes who visited our diabetes clinic every 3–4 months and who completed four education courses given by certified diabetes educators within 3 months after the first visit, were defined as the Intervention group. A total of 82 patients fulfilling the inclusion criteria for the Intervention group but who missed at least half of the diabetes education sessions were selected as controls. Both groups had comparable mean hemoglobin A1c (HbA1c levels at baseline, which decreased significantly at 3 months and were maintained at approximately constant levels at intervals for up to 1 year. The HbA1c decrement in the Intervention group was significantly greater than that in the Control group over the 1-year follow-up period (HbA1c change: −2.5 ± 1.8% vs. −1.1 ± 1.7%, p < 0.01. The maximal HbA1c decrement occurred during the first 3 months, and accounted for 95.6% and 94.6% of the total HbA1c decrements in the Intervention and Control groups, respectively. In the multiple regression model, after adjustment for age, body mass index, and duration of diabetes, the Intervention group may still have a 12.6% improvement in HbA1c from their original value to the end of 1 year treatment compared with the Control group (p < 0.05. Diabetes care, with reinforcement from certified diabetes educators, significantly improved and maintained the effects on glycemic control in ambulatory patients with type 2 diabetes.

  9. Cooperative control system of the floating cranes for the dual lifting

    OpenAIRE

    Mihee Nam; Jinbeom Kim; Jaechang Lee; Daekyung Kim; Donghyuk Lee; Jangmyung Lee

    2018-01-01

    This paper proposes a dual lifting and its cooperative control system with two different kinds of floating cranes. The Mega-erection and Giga-erection in the ship building are used to handle heavier and wider blocks and modules as ships and off-shore platforms are enlarged. However, there is no equipment to handle such Tera-blocks. In order to overcome the limit on performance of existing floating cranes, the dual lifting is proposed in this research. In the dual lifting, two floating cranes ...

  10. Cooperative Control with Virtual Selective Harmonic Capacitance for Harmonic Voltage Compensation in Islanded MicroGrids

    DEFF Research Database (Denmark)

    Micallef, A.; Apap, M.; Spitero-Stanies, C.

    2012-01-01

    This paper focuses on the islanded operation of microgrids. In this mode of operation, the microsources are required to cooperate autonomously to regulate the local grid voltage and frequency. Droop control is typically used to achieve this autonomous voltage and frequency regulation. Inverters...... having LCL output filters would cause voltage distortion to be present at the PCC of the local load when non-linear current is supplied to the load due to the voltage drop across the grid side inductor. Techniques to reduce the output voltage distortion typically consist of installing either passive...

  11. Automatic Access Control Based on Face and Hand Biometrics in A Non-Cooperative Context

    DEFF Research Database (Denmark)

    Jahromi, Mohammad Naser Sabet; Bonderup, Morten Bojesen; Nasrollahi, Kamal

    2018-01-01

    a challenging bimodal database, including face and hand information of the users when they approach a door to open it by its handle in a noncooperative context. We have defined two (an easy and a challenging) protocols on how to use the database. We have reported results on many baseline methods, including deep...... learning techniques as well as conventional methods on the database. The obtained results show the merit of the proposed database and the challenging nature of access control with non-cooperative users....

  12. Evolving controllers for a homogeneous system of physical robots: structured cooperation with minimal sensors.

    Science.gov (United States)

    Quinn, Matt; Smith, Lincoln; Mayley, Giles; Husbands, Phil

    2003-10-15

    We report on recent work in which we employed artificial evolution to design neural network controllers for small, homogeneous teams of mobile autonomous robots. The robots were evolved to perform a formation-movement task from random starting positions, equipped only with infrared sensors. The dual constraints of homogeneity and minimal sensors make this a non-trivial task. We describe the behaviour of a successful system in which robots adopt and maintain functionally distinct roles in order to achieve the task. We believe this to be the first example of the use of artificial evolution to design coordinated, cooperative behaviour for real robots.

  13. Effectiveness of a group-based intervention to change medication beliefs and improve medication adherence in patients with rheumatoid arthritis: a randomized controlled trial.

    Science.gov (United States)

    Zwikker, Hanneke E; van den Ende, Cornelia H; van Lankveld, Wim G; den Broeder, Alfons A; van den Hoogen, Frank H; van de Mosselaar, Birgit; van Dulmen, Sandra; van den Bemt, Bart J

    2014-03-01

    To assess the effect of a group-based intervention on the balance between necessity beliefs and concern beliefs about medication and on medication non-adherence in patients with rheumatoid arthritis (RA). Non-adherent RA patients using disease-modifying anti-rheumatic drugs (DMARDs) were randomized to an intervention or control arm. The intervention consisted, amongst others, of two motivational interviewing-guided group sessions led by the same pharmacist. Control patients received brochures about their DMARDs. Questionnaires were completed up to 12 months follow-up. 123 patients (mean age: 60 years, female: 69%) were randomized. No differences in necessity beliefs and concern beliefs about medication and in medication non-adherence were detected between the intervention and control arm, except at 12 months' follow-up: participants in the intervention arm had less strong necessity beliefs about medication than participants in the control arm (b: -1.0 (95% CI: -2.0, -0.1)). This trial did not demonstrate superiority of our intervention over the control arm in changing beliefs about medication or in improving medication adherence over time. Absent intervention effects might have been due to, amongst others, selection bias and a suboptimal treatment integrity level. Hence, targeting beliefs about medication in clinical practice should not yet be ruled out. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Long-term adherence to daily controller medication in children with asthma : The role of outpatient clinic visits

    NARCIS (Netherlands)

    Keemink, Yvette S.; Klok, Ted; Brand, Paul L. P.

    2015-01-01

    ObjectiveTo investigate changes in inhaled corticosteroids adherence, both before and after a scheduled follow-up visit, in young children in a comprehensive asthma management program. Study designOne-year prospective follow-up study in 104 asthmatic children (mean age 4.8 years). Adherence to

  15. A model of parental distress and factors that mediate its link with parental monitoring of youth diabetes care, adherence, and glycemic control.

    Science.gov (United States)

    Robinson, Elizabeth M; Weaver, Patrick; Chen, Rusan; Streisand, Randi; Holmes, Clarissa S

    2016-12-01

    Parental monitoring of adolescents' diabetes self-care is associated with better adherence and glycemic control (A1c). A number of parent-level factors are associated with higher levels of parental monitoring, including lower levels of parental distress (depressive symptoms, stress, anxiety), as well as higher levels of parental self-efficacy for diabetes management and authoritative parenting. Often studied in isolation, these factors may be best considered simultaneously as they are interrelated and are associated with parental monitoring and youth adherence. Structural equation modeling with a cross-sectional sample of 257 parent/youth (aged 11-14) dyads: (a) examined a broad model of parental factors (i.e., parental distress, parental diabetes self-efficacy, authoritative parenting), and (b) assessed their relation to parental monitoring, youth adherence, and A1c. Post hoc analyses of variance (ANOVAs) evaluated clinical implications of daily parental monitoring. Parental distress was not related directly to parental monitoring. Instead less distress related indirectly to more monitoring via higher parental self-efficacy and more authoritative parenting which, in turn, related to better adherence and A1c. Higher parental self-efficacy also related directly to better youth adherence and then to better A1c. Clinically, more parental monitoring related to more daily blood glucose checks and to better A1c (8.48% vs. 9.17%). A broad model of parent-level factors revealed more parental distress was linked only indirectly to less monitoring via lower parental self-efficacy and less authoritative parenting. Behaviorally, more parental monitoring related to better adherence and to clinically better A1c in adolescents. Further study of parent-level factors that relate to parental distress and monitoring of adherence appears warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  16. A randomized controlled trial to evaluate the effectiveness of a cognitive behavioural group approach to improve patient adherence to peritoneal dialysis fluid restrictions: a pilot study.

    Science.gov (United States)

    Hare, Jennifer; Clark-Carter, David; Forshaw, Mark

    2014-03-01

    Peritoneal dialysis (PD) requires patients to take an active role in their adherence to fluid restrictions. Although fluid non-adherence had been identified among this patient group, no specific interventions have been researched or published with in the PD population. The current study sought to investigate whether an applied cognitive behavioural therapy (CBT-based intervention) used among haemodialysis patients would improve fluid adherence among PD patients; utilizing clinical indicators used in practice. Fifteen PD patients identified as fluid non-adherent were randomly assigned to an intervention group (IG) or a deferred-entry control group (CG). The study ran for a total of 21 weeks, with five data collection points; at baseline, post-intervention and at three follow-up points; providing a RCT phase and a combined longitudinal analysis phase. The content of the group intervention encompassed educational, cognitive and behavioural components, aimed to assist patients' self-management of fluid. No significant differences in weight (kg) reduction were found in either phase and undesirable changes in blood pressure (BP) were observed. However, in the longitudinal phase, a statistically significant difference in oedematous status was observed at 6-week follow-up; which may be indicative of fluid adherence. Positive and significant differences were observed in the desired direction for measures of psychological well-being, quality of life and health beliefs; areas correlated with enhanced fluid adherence in other research. This study reveals encouraging and significant changes in predictors of fluid adherence. Although there were no significant changes in weight as a crude clinical measure of fluid intake, significant reductions in oedematous status were observed as a consequence of this CBT-based group intervention.

  17. The Effectiveness of a Computer-Tailored E-Learning Program for Practice Nurses to Improve Their Adherence to Smoking Cessation Counseling Guidelines: Randomized Controlled Trial.

    Science.gov (United States)

    de Ruijter, Dennis; Candel, Math; Smit, Eline Suzanne; de Vries, Hein; Hoving, Ciska

    2018-05-22

    Improving practice nurses' (PN) adherence to smoking cessation counseling guidelines will benefit the quality of smoking cessation care and will potentially lead to higher smoking abstinence rates. However, support programs to aid PNs in improving their guideline uptake and adherence do not exist yet. The aim of this study was to assess the effects of a novel computer-tailored electronic learning (e-learning) program on PNs' smoking cessation guideline adherence. A Web-based randomized controlled trial (RCT) was conducted in which an intervention group (N=147) with full access to the e-learning program for 6 months was compared with a control group (N=122) without access. Data collection was fully automated at baseline and 6-month follow-up via online questionnaires, assessing PNs' demographics, work-related factors, potential behavioral predictors based on the I-Change model, and guideline adherence. PNs also completed counseling checklists to retrieve self-reported counseling activities for each consultation with a smoker (N=1175). To assess the program's effectiveness in improving PNs' guideline adherence (ie, overall adherence and adherence to individual counseling guideline steps), mixed linear and logistic regression analyses were conducted, thus accommodating for the smokers being nested within PNs. Potential effect moderation by work-related factors and behavioral predictors was also examined. After 6 months, 121 PNs in the intervention group (82.3%, 121/147) and 103 in the control group (84.4%, 103/122) completed the follow-up questionnaire. Mixed linear regression analysis revealed that counseling experience moderated the program's effect on PNs' overall guideline adherence (beta=.589; 95% CI 0.111-1.068; P Holm-Bonferroni =.048), indicating a positive program effect on adherence for PNs with a more than average level of counseling experience. Mixed logistic regression analyses regarding adherence to individual guideline steps revealed a trend toward

  18. Adherence with Preventive Medication in Childhood Asthma

    Directory of Open Access Journals (Sweden)

    Scott Burgess

    2011-01-01

    Full Text Available Suboptimal adherence with preventive medication is common and often unrecognised as a cause of poor asthma control. A number of risk factors for nonadherence have emerged from well-conducted studies. Unfortunately, patient report a physician's estimation of adherence and knowledge of these risk factors may not assist in determining whether non-adherence is a significant factor. Electronic monitoring devices are likely to be more frequently used to remind patients to take medication, as a strategy to motivate patients to maintain adherence, and a tool to evaluate adherence in subjects with poor disease control. The aim of this paper is to review non-adherence with preventive medication in childhood asthma, its impact on asthma control, methods of evaluating non-adherence, risk factors for suboptimal adherence, and strategies to enhance adherence.

  19. Optimal control of cooperative multi-vehicle systems; Optimalsteuerung kooperierender Mehrfahrzeugsysteme

    Energy Technology Data Exchange (ETDEWEB)

    Reinl, Christian; Stryk, Oskar von [Technische Univ. Darmstadt (Germany). FB Informatik; Glocker, Markus [Trimble Terrasat GmbH, Hoehenkirchen (Germany)

    2009-07-01

    Nonlinear hybrid dynamical systems for modeling optimal cooperative control enable a tight and formal coupling of discrete and continuous state dynamics, i.e. of dynamic role and task assignment with switching dynamics of motions. In the resulting mixed-integer multi-phase optimal control problems constraints on the discrete and continuous state and control variables can be considered, e.g., formation or communication requirements. Two numerical methods are investigated: a decomposition approach using branch-and-bound and direct collocation methods as well as an approximation by large-scale, mixed-integer linear problems. Both methods are applied to example problems: the optimal simultaneous waypoint sequencing and trajectory planning of a team of aerial vehicles and the optimization of role distribution and trajectories in robot soccer. (orig.)

  20. Distributed Cooperative Control of Multi Flywheel Energy Storage System for Electrical Vehicle Fast Charging Stations

    DEFF Research Database (Denmark)

    Sun, Bo; Dragicevic, Tomislav; Quintero, Juan Carlos Vasquez

    2015-01-01

    Plug-in electrical vehicles will play a critical role in future smart grid and sudden connection of electrical vehicles chargers may cause huge power-peaks with high slew-rates on grid. In order to cope with this issue, this paper applies a distributed cooperative control for fast charging station...... with dedicated paralleled flywheel-based energy storage system. The distributed DC-bus signaling method is employed in the power coordination of grid and flywheel converters, and a distributed secondary controller generates DC voltage correction term to adjust the local voltage set-point through a dynamic...... consensus based voltage observer by communicating with its neighbors. The control system can realize the power balancing and DC voltage regulation with low reliance on communications. Finally, real-time hardware-in-the-loop results have been reported in order to verify the feasibility of proposed approach....

  1. Efficacy of brief motivational interviewing to improve adherence to inhaled corticosteroids among adult asthmatics: results from a randomized controlled pilot feasibility trial

    Directory of Open Access Journals (Sweden)

    Lavoie KL

    2014-11-01

    Full Text Available Kim L Lavoie,1–3 Gregory Moullec,1,2,4 Catherine Lemiere,2 Lucie Blais,2 Manon Labrecque,2 Marie-France Beauchesne,2 Veronique Pepin,2,4 André Cartier,2 Simon L Bacon1,2,41Montreal Behavioural Medicine Centre, 2Research Centre, Hôpital du Sacré-Cœur de Montréal – A University of Montreal Affiliated Hospital, Montréal, 3Department of Psychology, University of Quebec at Montreal (UQAM, Succursale Center-Ville, Montreal, 4Department of Exercise Science, Concordia University, Montreal, Quebec, CanadaPurpose: Daily adherence to inhaled corticosteroid (ICS regimens is one of the most important factors linked to achieving optimal asthma control. Motivational interviewing (MI is a client-centered communication style that focuses on enhancing intrinsic motivation to engage in appropriate self-management behaviors. MI has been shown to improve a variety of health behaviors including medication adherence in other disorders, but its efficacy for the improvement of ICS adherence in asthmatics has yet to be examined. This pilot “proof of concept” trial assessed the feasibility of MI to improve daily ICS adherence and asthma control levels in adult asthmatics.Methods: Fifty-four poorly controlled (Asthma Control Questionnaire [ACQ] score ≥1.5, highly nonadherent (filled <50% of ICS medication in the last year adult asthmatics were recruited from the outpatient asthma clinic of a university-affiliated hospital. Participants underwent baseline assessments and were randomly assigned to MI (3×30 minutes sessions within a 6-week period, n=26 or a usual care (UC control group (n=28. ICS adherence (% pharmacy refills and asthma control (ACQ, Asthma Control Test [ACT] were measured at 6 and 12 months postintervention. Mixed model repeated measure analyses for both intent-to-treat and per-protocol were used. Results were adjusted for a priori-defined covariates including baseline adherence. Patients in the MI group also reported their impressions of

  2. Cooperative control system of the floating cranes for the dual lifting

    Directory of Open Access Journals (Sweden)

    Mihee Nam

    2018-01-01

    Full Text Available This paper proposes a dual lifting and its cooperative control system with two different kinds of floating cranes. The Mega-erection and Giga-erection in the ship building are used to handle heavier and wider blocks and modules as ships and off-shore platforms are enlarged. However, there is no equipment to handle such Tera-blocks. In order to overcome the limit on performance of existing floating cranes, the dual lifting is proposed in this research. In the dual lifting, two floating cranes are well-coordinated to add up the lift capabilities of both cranes without any loss such that virtually a single crane is lifting, maneuvering and unloading. Two main constraints for the dual lifting are as follows: First, two barges of floating cranes should be constrained as a rigid body not to cause a relative motion between two barges and main hooks of the two cranes should be controlled as main hooks of a single crane. In order words, it is necessary to develop the cooperative control of two floating cranes in order to sustain a center of gravity of the module and minimize the tilting angle during the lifting and unloading by the two floating cranes. Two floating cranes are handled as a master-slave system. The master crane is able to gather information about all working conditions and make a decision to control the individual hook speed, which communicates the slave crane by TCP/IP. The developed control system has been embedded in the real floating crane systems and the dual lifting has been demonstrated five times at SHI shipyard in 2015. The moving angles of the lifting module are analyzed and verified to be suitable for hoisting control. It is verified that the dual lifting can be applied for many heavier and wider blocks and modules to shorten the construction time of ships and off-shore platforms.

  3. Control Charts in Healthcare Quality Improvement A Systematic Review on Adherence to Methodological Criteria

    NARCIS (Netherlands)

    Koetsier, A.; van der Veer, S. N.; Jager, K. J.; Peek, N.; de Keizer, N. F.

    2012-01-01

    Objectives: Use of Shewhart control charts in quality improvement (QI) initiatives is increasing. These charts are typically used in one or more phases of the Plan Do Study Act (PDSA) cycle to monitor summaries of process and outcome data, abstracted from clinical information systems, over time. We

  4. Electronic adherence monitoring device performance and patient acceptability: a randomized control trial.

    Science.gov (United States)

    Chan, Amy Hai Yan; Stewart, Alistair William; Harrison, Jeff; Black, Peter Nigel; Mitchell, Edwin Arthur; Foster, Juliet Michelle

    2017-05-01

    To investigate the performance and patient acceptability of an inhaler electronic monitoring device in a real-world childhood asthma population. Children 6 to 15 years presenting with asthma to the hospital emergency department and prescribed inhaled corticosteroids were included. Participants were randomized to receive a device with reminder features enabled or disabled for use with their preventer. Device quality control tests were conducted. Questionnaires on device acceptability, utility and ergonomics were completed at six months. A total of 1306 quality control tests were conducted; 84% passed pre-issue and 87% return testing. The most common failure reason was actuation under-recording. Acceptability scores were high, with higher scores in the reminder than non-reminder group (median, 5 th -95 th percentile: 4.1, 3.1-5.0 versus 3.7, 2.3-4.8; p 90%) rated the device easy to use. Feedback was positive across five themes: device acceptability, ringtone acceptability, suggestions for improvement, effect on medication use, and effect on asthma control. This study investigates electronic monitoring device performance and acceptability in children using quantitative and qualitative measures. Results indicate satisfactory reliability, although failure rates of 13-16% indicate the importance of quality control. Favorable acceptability ratings support the use of these devices in children.

  5. Adherence to Hunger Training over 6 Months and the Effect on Weight and Eating Behaviour: Secondary Analysis of a Randomised Controlled Trial.

    Science.gov (United States)

    Jospe, Michelle R; Taylor, Rachael W; Athens, Josie; Roy, Melyssa; Brown, Rachel C

    2017-11-17

    Monitoring blood glucose prior to eating can teach individuals to eat only when truly hungry, but how adherence to 'hunger training' influences weight loss and eating behaviour is uncertain. This exploratory, secondary analysis from a larger randomized controlled trial examined five indices of adherence to 'hunger training', chosen a priori, to examine which adherence measure best predicted weight loss over 6 months. We subsequently explored how the best measure of adherence influenced eating behavior in terms of intuitive and emotional eating. Retention was 72% ( n = 36/50) at 6 months. Frequency of hunger training booklet entry most strongly predicted weight loss, followed by frequency of blood glucose measurements. Participants who completed at least 60 days of booklet entry (of recommended 63 days) lost 6.8 kg (95% CI: 2.6, 11.0; p food choice congruence and 0.79 (0.06, 1.51) for eating for physical rather than emotional reasons. Adherent participants also reported significantly lower scores for emotional eating of -0.70 (-1.13, -0.27). Following hunger training and focusing on simply recording ratings of hunger on a regular basis can produce clinically significant weight loss and clinically relevant improvements in eating behaviour.

  6. Effectiveness of a mobile cooperation intervention during the clinical practicum of nursing students: a parallel group randomized controlled trial protocol.

    Science.gov (United States)

    Strandell-Laine, Camilla; Saarikoski, Mikko; Löyttyniemi, Eliisa; Salminen, Leena; Suomi, Reima; Leino-Kilpi, Helena

    2017-06-01

    The aim of this study was to describe a study protocol for a study evaluating the effectiveness of a mobile cooperation intervention to improve students' competence level, self-efficacy in clinical performance and satisfaction with the clinical learning environment. Nursing student-nurse teacher cooperation during the clinical practicum has a vital role in promoting the learning of students. Despite an increasing interest in using mobile technologies to improve the clinical practicum of students, there is limited robust evidence regarding their effectiveness. A multicentre, parallel group, randomized, controlled, pragmatic, superiority trial. Second-year pre-registration nursing students who are beginning a clinical practicum will be recruited from one university of applied sciences. Eligible students will be randomly allocated to either a control group (engaging in standard cooperation) or an intervention group (engaging in mobile cooperation) for the 5-week the clinical practicum. The complex mobile cooperation intervention comprises of a mobile application-assisted, nursing student-nurse teacher cooperation and a training in the functions of the mobile application. The primary outcome is competence. The secondary outcomes include self-efficacy in clinical performance and satisfaction with the clinical learning environment. Moreover, a process evaluation will be undertaken. The ethical approval for this study was obtained in December 2014 and the study received funding in 2015. The results of this study will provide robust evidence on mobile cooperation during the clinical practicum, a research topic that has not been consistently studied to date. © 2016 John Wiley & Sons Ltd.

  7. Radiometric compensation for cooperative distributed multi-projection system through 2-DOF distributed control.

    Science.gov (United States)

    Tsukamoto, Jun; Iwai, Daisuke; Kashima, Kenji

    2015-11-01

    This paper proposes a novel radiometric compensation technique for cooperative projection system based-on distributed optimization. To achieve high scalability and robustness, we assume cooperative projection environments such that 1. each projector does not have information about other projectors as well as target images, 2. the camera does not have information about the projectors either, while having the target images, and 3. only a broadcast communication from the camera to the projectors is allowed to suppress the data transfer bandwidth. To this end, we first investigate a distributed optimization based feedback mechanism that is suitable for the required decentralized information processing environment. Next, we show that this mechanism works well for still image projection, however not necessary for moving images due to the lack of dynamic responsiveness. To overcome this issue, we propose to implement an additional feedforward mechanism. Such a 2 Degree Of Freedom (2-DOF) control structure is well-known in control engineering community as a typical method to enhance not only disturbance rejection but also reference tracking capability, simultaneously. We theoretically guarantee and experimentally demonstrate that this 2-DOF structure yields the moving image projection accuracy that is overwhelming the best achievable performance only by the distributed optimization mechanisms.

  8. Assessing the influence of health systems on Type 2 Diabetes Mellitus awareness, treatment, adherence, and control: A systematic review.

    Science.gov (United States)

    Ong, Suan Ee; Koh, Joel Jun Kai; Toh, Sue-Anne Ee Shiow; Chia, Kee Seng; Balabanova, Dina; McKee, Martin; Perel, Pablo; Legido-Quigley, Helena

    2018-01-01

    Type 2 Diabetes Mellitus (T2DM) is reported to affect one in 11 adults worldwide, with over 80% of T2DM patients residing in low-to-middle-income countries. Health systems play an integral role in responding to this increasing global prevalence, and are key to ensuring effective diabetes management. We conducted a systematic review to examine the health system-level factors influencing T2DM awareness, treatment, adherence, and control. A protocol for this study was published on the PROSPERO international prospective register of systematic reviews (PROSPERO 2016: CRD42016048185). Studies included in this review reported the effects of health systems factors, interventions, policies, or programmes on T2DM control, awareness, treatment, and adherence. The following databases were searched on 22 February 2017: Medline, Embase, Global health, LILACS, Africa-Wide, IMSEAR, IMEMR, and WPRIM. There were no restrictions on date, language, or study designs. Two reviewers independently screened studies for eligibility, extracted the data, and screened for risk of bias. Thereafter, we performed a narrative synthesis. A meta-analysis was not conducted due to methodological heterogeneity across different aspects of included studies. 93 studies were included for qualitative synthesis; 7 were conducted in LMICs. Through this review, we found two key health system barriers to effective T2DM care and management: financial constraints faced by the patient and limited access to health services and medication. We also found three health system factors that facilitate effective T2DM care and management: the use of innovative care models, increased pharmacist involvement in care delivery, and education programmes led by healthcare professionals. This review points to the importance of reducing, or possibly eliminating, out-of-pocket costs for diabetes medication and self-monitoring supplies. It also points to the potential of adopting more innovative and integrated models of care, and the

  9. Hybrid FES-robot cooperative control of ambulatory gait rehabilitation exoskeleton.

    Science.gov (United States)

    del-Ama, Antonio J; Gil-Agudo, Angel; Pons, José L; Moreno, Juan C

    2014-03-04

    Robotic and functional electrical stimulation (FES) approaches are used for rehabilitation of walking impairment of spinal cord injured individuals. Although devices are commercially available, there are still issues that remain to be solved. Control of hybrid exoskeletons aims at blending robotic exoskeletons and electrical stimulation to overcome the drawbacks of each approach while preserving their advantages. Hybrid actuation and control have a considerable potential for walking rehabilitation but there is a need of novel control strategies of hybrid systems that adequately manage the balance between FES and robotic controllers. Combination of FES and robotic control is a challenging issue, due to the non-linear behavior of muscle under stimulation and the lack of developments in the field of hybrid control. In this article, a cooperative control strategy of a hybrid exoskeleton is presented. This strategy is designed to overcome the main disadvantages of muscular stimulation: electromechanical delay and change in muscle performance over time, and to balance muscular and robotic actuation during walking.Experimental results in healthy subjects show the ability of the hybrid FES-robot cooperative control to balance power contribution between exoskeleton and muscle stimulation. The robotic exoskeleton decreases assistance while adequate knee kinematics are guaranteed. A new technique to monitor muscle performance is employed, which allows to estimate muscle fatigue and implement muscle fatigue management strategies. Kinesis is therefore the first ambulatory hybrid exoskeleton that can effectively balance robotic and FES actuation during walking. This represents a new opportunity to implement new rehabilitation interventions to induce locomotor activity in patients with paraplegia.Acronym list: 10 mWT: ten meters walking test; 6 MWT: six minutes walking test; FSM: finite-state machine; t-FSM: time-domain FSM; c-FSM: cycle-domain FSM; FES: functional electrical

  10. Exercise training in older patients with systolic heart failure: Adherence, exercise capacity, inflammation and glycemic control

    DEFF Research Database (Denmark)

    Prescott, Eva; Hjardem-Hansen, Rasmus; Dela, Flemming

    2009-01-01

    markers of glycemic control (glucose, insulin, glycerol, free fatty acids, HbA1c), inflammation and endothelial function (hsCRP, orosomucoid, interleukin 6, TNF-alpha, urine-orosomucoid and -albumin/creatinin), lipid metabolism, NT-proBNP or other regulatory hormones (cortisol, epinephrine and IGF-1......). There were no changes in quality of life. Conclusions. The effect of exercise training in these older CHF-patients was not as impressive as reported in younger and more selected patients. More studies on the efficiency of exercise training that reflect the age- and co-morbidity of the majority of CHF...

  11. Hierarchical Control Strategy for the Cooperative Braking System of Electric Vehicle

    Directory of Open Access Journals (Sweden)

    Jiankun Peng

    2015-01-01

    Full Text Available This paper provides a hierarchical control strategy for cooperative braking system of an electric vehicle with separated driven axles. Two layers are defined: the top layer is used to optimize the braking stability based on two sliding mode control strategies, namely, the interaxle control mode and signal-axle control strategies; the interaxle control strategy generates the ideal braking force distribution in general braking condition, and the single-axle control strategy can ensure braking safety in emergency braking condition; the bottom layer is used to maximize the regenerative braking energy recovery efficiency with a reallocated braking torque strategy; the reallocated braking torque strategy can recovery braking energy as much as possible in the premise of meeting battery charging power. The simulation results show that the proposed hierarchical control strategy is reasonable and can adapt to different typical road surfaces and load cases; the vehicle braking stability and safety can be guaranteed; furthermore, the regenerative braking energy recovery efficiency can be improved.

  12. Hierarchical Control Strategy for the Cooperative Braking System of Electric Vehicle

    Science.gov (United States)

    Peng, Jiankun; He, Hongwen; Guo, Hongqiang

    2015-01-01

    This paper provides a hierarchical control strategy for cooperative braking system of an electric vehicle with separated driven axles. Two layers are defined: the top layer is used to optimize the braking stability based on two sliding mode control strategies, namely, the interaxle control mode and signal-axle control strategies; the interaxle control strategy generates the ideal braking force distribution in general braking condition, and the single-axle control strategy can ensure braking safety in emergency braking condition; the bottom layer is used to maximize the regenerative braking energy recovery efficiency with a reallocated braking torque strategy; the reallocated braking torque strategy can recovery braking energy as much as possible in the premise of meeting battery charging power. The simulation results show that the proposed hierarchical control strategy is reasonable and can adapt to different typical road surfaces and load cases; the vehicle braking stability and safety can be guaranteed; furthermore, the regenerative braking energy recovery efficiency can be improved. PMID:26236772

  13. Cooperative Mmonitoring Center Occasional Paper/5: Propspects of Conventional Arms Control in South Asia

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Amit; Kamal, Nazir

    1998-11-01

    The intensely adversarial relationship between India and Pakistan is marked by military rivalry, mutual distrust, and suspicion. The most dividing disagreement has been over the Kashmir region. An inability to discuss the Kashmir issue has prevented discussion on other important issues. Since there is little prospect of detente, at least in the near-term, the question is whether this rivalry can be contained by other means, such as arms control approaches. Conventional arms control has been applied flexibly and successfully in some regions to reduce threat-perceptions and achieve reassuring military stability. Some lessons from other international models might be applied to the India/Pakistan context. This paper discusses the status of conventional arms control in South Asia, the dominant Indian and Pakistani perceptions about arms control, the benefits that could be derived from arms control, as well as the problems and prospects of arms control. It also discusses existing conventional arms control agreements at the regional and global levels as well as the potential role of cooperative monitoring technology.

  14. The Use of Cell Phone Support for Non-adherent HIV-Infected Youth and Young Adults: An Initial Randomized and Controlled Intervention Trial

    Science.gov (United States)

    Belzer, Marvin E.; Naar-King, Sylvie; Olson, Johanna; Sarr, Moussa; Thornton, Sarah; Kahana, Shoshana Y.; Gaur, Aditya H.; Clark, Leslie F.

    2014-01-01

    This randomized behavioral trial examined whether youth living with HIV (YLH) receiving cell-phone support with study funded phone plans, demonstrated improved adherence and viral control during the 24 week intervention and 24 weeks post-intervention compared to controls. Monday through Friday phone calls confirmed medications were taken, provided problem-solving support, and referred to services to address adherence barriers. Of 37 participants (ages 15–24), 62 % were male and 70 % were African American. Self-reported adherence was significantly higher in the intervention group compared to the control at 24 and 48 weeks for the past month (P = 0.007) and log 10 HIV VL was significantly lower at both 24 weeks (2.82 versus 4.52 P = 0.002) and 48 weeks (3.23 versus 4.23 P = 0.043). Adherence and viral load showed medium to large effect sizes across the 48 week study. This is the first study to demonstrate sustained clinically significant reductions in HIV VL using youth friendly technology. PMID:24271347

  15. Conducting Cancer Control and Survivorship Research via Cooperative Groups: A Report from the American Society of Preventive Oncology

    OpenAIRE

    Palesh, Oxana; Demark-Wahnefried, Wendy; Mustian, Karen; Minasian, Lori; Rowland, Julia; Sprod, Lisa; Janelsins, Michelle; Peppone, Luke; Sloan, Jeff; Engquist, Karen Basen; Jones, Lee; Buist, Diana; Paskett, Electra

    2011-01-01

    As the number of cancer survivors expands, the need for cancer control and survivorship research becomes increasingly important. The National Cancer Institute (NCI) Cooperative Groups may offer a viable platform to perform such research. Observational, preventive, and behavioral research can often be performed within the cooperative group setting, especially if resources needed for evaluation are fairly simple, if protocols are easily implemented within the typical clinical setting, and if in...

  16. Study of a Dynamic Cooperative Trading Queue Routing Control Scheme for Freeways and Facilities with Parallel Queues

    OpenAIRE

    Lloret-Batlle, Roger; Jayakrishnan, R.

    2018-01-01

    This article explores the coalitional stability of a new cooperative control policy for freeways and parallel queuing facilities with multiple servers. Based on predicted future delays per queue or lane, a VOT-heterogeneous population of agents can agree to switch lanes or queues and transfer payments to each other in order to minimize the total cost of the incoming platoon. The strategic interaction is captured by an n-level Stackelberg model with coalitions, while the cooperative structure ...

  17. Transborder cooperation on the protection, surveillance and control of endemic diseases

    International Nuclear Information System (INIS)

    Encho, S.; Doganov, B.; Kamenov, G.; Anelov, K.; Kalvachev, Z.; Rusev, A.; Dimova, J.

    2009-01-01

    This paper discuss some concern and challenges regards the Bulgarian-Greek transborder cooperation with respect the protection, surveillance and control of some endemic for this transborder region diseases like: Q-fever, Brucellosis, Lyme disease, Crimean-Congo hemorrhagic fever and Marseilles fever. The study examines transborder activities, including a background for the infection diseases state for the period 2004-2007, the problems of training and equipment of the specialists for sampling and identification of these diseases, development of strategy and conception for control of spreading of the infectious agents in 4 bulgarian regions / Blagoevgrad, Haskovo, Smoljan and Kardjeli/ and in the corresponding regions in Greece - Seres, Drama, Ksanti and Evro. Additionally, there is presented the role of local governmental representatives to manage these transnational border issues.(author)

  18. Man-Robot Symbiosis: A Framework For Cooperative Intelligence And Control

    Science.gov (United States)

    Parker, Lynne E.; Pin, Francois G.

    1988-10-01

    The man-robot symbiosis concept has the fundamental objective of bridging the gap between fully human-controlled and fully autonomous systems to achieve true man-robot cooperative control and intelligence. Such a system would allow improved speed, accuracy, and efficiency of task execution, while retaining the man in the loop for innovative reasoning and decision-making. The symbiont would have capabilities for supervised and unsupervised learning, allowing an increase of expertise in a wide task domain. This paper describes a robotic system architecture facilitating the symbiotic integration of teleoperative and automated modes of task execution. The architecture reflects a unique blend of many disciplines of artificial intelligence into a working system, including job or mission planning, dynamic task allocation, man-robot communication, automated monitoring, and machine learning. These disciplines are embodied in five major components of the symbiotic framework: the Job Planner, the Dynamic Task Allocator, the Presenter/Interpreter, the Automated Monitor, and the Learning System.

  19. Disappointment and adherence among parents of newborns allocated to the control group

    DEFF Research Database (Denmark)

    Meinich Petersen, Sandra; Zoffmann, Vibeke; Kjærgaard, Jesper

    2014-01-01

    among parents of newborns who were randomized to the control group, but also a broad expression of understanding and accepting the idea of randomization. The trial staff might use the model of reactions in understanding the parents' disappointment and in this way support their motives for participation......BACKGROUND: When a child participates in a clinical trial, informed consent has to be given by the parents. Parental motives for participation are complex, but the hope of getting a new and better treatment for the child is important. We wondered how parents react when their child is allocated...... to achieve saturation. Thematic analysis was used to identify themes across the data sets. RESULTS: The parents reported good understanding of the randomization process. Their most common reaction to allocation was disappointment, though relief was also seen. A model of reactions to being allocated...

  20. A randomized controlled trial of cognitive behavioral therapy for adherence and depression (CBT-AD) in patients with uncontrolled type 2 diabetes.

    Science.gov (United States)

    Safren, Steven A; Gonzalez, Jeffrey S; Wexler, Deborah J; Psaros, Christina; Delahanty, Linda M; Blashill, Aaron J; Margolina, Aleksandra I; Cagliero, Enrico

    2014-01-01

    To test cognitive behavioral therapy for adherence and depression (CBT-AD) in type 2 diabetes. We hypothesized that CBT-AD would improve adherence; depression; and, secondarily, hemoglobin A1c (A1C). Eighty-seven adults with unipolar depression and uncontrolled type 2 diabetes received enhanced treatment as usual (ETAU), including medication adherence, self-monitoring of blood glucose (SMBG), and lifestyle counseling; a provider letter documented psychiatric diagnoses. Those randomized to the intervention arm also received 9-11 sessions of CBT-AD. Immediately after acute treatment (4 months), adjusting for baseline, CBT-AD had 20.7 percentage points greater oral medication adherence on electronic pill cap (95% CI -31.14 to -10.22, P = 0.000); 30.2 percentage points greater SMBG adherence through glucometer downloads (95% CI -42.95 to -17.37, P = 0.000); 6.44 points lower depression scores on the Montgomery-Asberg Depression Rating Scale (95% CI 2.33-10.56, P = 0.002); 0.74 points lower on the Clinical Global Impression (95% CI 0.16-1.32, P = 0.01); and 0.72 units lower A1C (95% CI 0.29-1.15, P = 0.001) relative to ETAU. Analyses of 4-, 8-, and 12-month follow-up time points indicated that CBT-AD maintained 24.3 percentage points higher medication adherence (95% CI -38.2 to -10.3, P = 0.001); 16.9 percentage points greater SMBG adherence (95% CI -33.3 to -0.5, P = 0.043); and 0.63 units lower A1C (95% CI 0.06-1.2, P = 0.03) after acute treatment ended. For depression, there was some evidence of continued improvement posttreatment, but no between-group differences. CBT-AD is an effective intervention for adherence, depression, and glycemic control, with enduring and clinically meaningful benefits for diabetes self-management and glycemic control in adults with type 2 diabetes and depression.

  1. Consensus-based distributed cooperative learning from closed-loop neural control systems.

    Science.gov (United States)

    Chen, Weisheng; Hua, Shaoyong; Zhang, Huaguang

    2015-02-01

    In this paper, the neural tracking problem is addressed for a group of uncertain nonlinear systems where the system structures are identical but the reference signals are different. This paper focuses on studying the learning capability of neural networks (NNs) during the control process. First, we propose a novel control scheme called distributed cooperative learning (DCL) control scheme, by establishing the communication topology among adaptive laws of NN weights to share their learned knowledge online. It is further proved that if the communication topology is undirected and connected, all estimated weights of NNs can converge to small neighborhoods around their optimal values over a domain consisting of the union of all state orbits. Second, as a corollary it is shown that the conclusion on the deterministic learning still holds in the decentralized adaptive neural control scheme where, however, the estimated weights of NNs just converge to small neighborhoods of the optimal values along their own state orbits. Thus, the learned controllers obtained by DCL scheme have the better generalization capability than ones obtained by decentralized learning method. A simulation example is provided to verify the effectiveness and advantages of the control schemes proposed in this paper.

  2. Design and implementation of co-operative control strategy for hybrid AC/DC microgrids

    Science.gov (United States)

    Mahmud, Rasel

    This thesis is mainly divided in two major sections: 1) Modeling and control of AC microgrid, DC microgrid, Hybrid AC/DC microgrid using distributed co-operative control, and 2) Development of a four bus laboratory prototype of an AC microgrid system. At first, a distributed cooperative control (DCC) for a DC microgrid considering the state-of-charge (SoC) of the batteries in a typical plug-in-electric-vehicle (PEV) is developed. In DC microgrids, this methodology is developed to assist the load sharing amongst the distributed generation units (DGs), according to their ratings with improved voltage regulation. Subsequently, a DCC based control algorithm for AC microgrid is also investigated to improve the performance of AC microgrid in terms of power sharing among the DGs, voltage regulation and frequency deviation. The results validate the advantages of the proposed methodology as compared to traditional droop control of AC microgrid. The DCC-based control methodology for AC microgrid and DC microgrid are further expanded to develop a DCC-based power management algorithm for hybrid AC/DC microgrid. The developed algorithm for hybrid microgrid controls the power flow through the interfacing converter (IC) between the AC and DC microgrids. This will facilitate the power sharing between the DGs according to their power ratings. Moreover, it enables the fixed scheduled power delivery at different operating conditions, while maintaining good voltage regulation and improved frequency profile. The second section provides a detailed explanation and step-by-step design and development of an AC/DC microgrid testbed. Controllers for the three-phase inverters are designed and tested on different generation units along with their corresponding inductor-capacitor-inductor (LCL) filters to eliminate the switching frequency harmonics. Electric power distribution line models are developed to form the microgrid network topology. Voltage and current sensors are placed in the proper

  3. Active and Inactive Enhancers Cooperate to Exert Localized and Long-Range Control of Gene Regulation.

    Science.gov (United States)

    Proudhon, Charlotte; Snetkova, Valentina; Raviram, Ramya; Lobry, Camille; Badri, Sana; Jiang, Tingting; Hao, Bingtao; Trimarchi, Thomas; Kluger, Yuval; Aifantis, Iannis; Bonneau, Richard; Skok, Jane A

    2016-06-07

    V(D)J recombination relies on the presence of proximal enhancers that activate the antigen receptor (AgR) loci in a lineage- and stage-specific manner. Unexpectedly, we find that both active and inactive AgR enhancers cooperate to disseminate their effects in a localized and long-range manner. Here, we demonstrate the importance of short-range contacts between active enhancers that constitute an Igk super-enhancer in B cells. Deletion of one element reduces the interaction frequency between other enhancers in the hub, which compromises the transcriptional output of each component. Furthermore, we establish that, in T cells, long-range contact and cooperation between the inactive Igk enhancer MiEκ and the active Tcrb enhancer Eβ alters enrichment of CBFβ binding in a manner that impacts Tcrb recombination. These findings underline the complexities of enhancer regulation and point to a role for localized and long-range enhancer-sharing between active and inactive elements in lineage- and stage-specific control. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

  4. Active and Inactive Enhancers Cooperate to Exert Localized and Long-Range Control of Gene Regulation

    Directory of Open Access Journals (Sweden)

    Charlotte Proudhon

    2016-06-01

    Full Text Available V(DJ recombination relies on the presence of proximal enhancers that activate the antigen receptor (AgR loci in a lineage- and stage-specific manner. Unexpectedly, we find that both active and inactive AgR enhancers cooperate to disseminate their effects in a localized and long-range manner. Here, we demonstrate the importance of short-range contacts between active enhancers that constitute an Igk super-enhancer in B cells. Deletion of one element reduces the interaction frequency between other enhancers in the hub, which compromises the transcriptional output of each component. Furthermore, we establish that, in T cells, long-range contact and cooperation between the inactive Igk enhancer MiEκ and the active Tcrb enhancer Eβ alters enrichment of CBFβ binding in a manner that impacts Tcrb recombination. These findings underline the complexities of enhancer regulation and point to a role for localized and long-range enhancer-sharing between active and inactive elements in lineage- and stage-specific control.

  5. Optimal Control of Holding Motion by Nonprehensile Two-Cooperative-Arm Robot

    Directory of Open Access Journals (Sweden)

    Changan Jiang

    2016-01-01

    Full Text Available Recently, more researchers have focused on nursing-care assistant robot and placed their hope on it to solve the shortage problem of the caregivers in hospital or nursing home. In this paper, a nonprehensile two-cooperative-arm robot is considered to realize holding motion to keep a two-rigid-link object (regarded as a care-receiver stable on the robot arms. By applying Newton-Euler equations of motion, dynamic model of the object is obtained. In this model, for describing interaction behavior between object and robot arms in the normal direction, a viscoelastic model is employed to represent the normal forces. Considering existence of friction between object and robot arms, LuGre dynamic model is applied to describe the friction. Based on the obtained model, an optimal regulator is designed to control the holding motion of two-cooperative-arm robot. In order to verify the effectiveness of the proposed method, simulation results are shown.

  6. Messenger RNA Interferase RelE Controls relBE Transcription by Conditional Cooperativity

    DEFF Research Database (Denmark)

    Overgaard, Martin; Borch, Jonas; Jørgensen, Mikkel G

    2008-01-01

    Prokaryotic toxin-antitoxin (TA) loci consist of two genes in an operon that encodes a metabolically stable toxin and an unstable antitoxin. The antitoxin neutralises its cognate toxin by forming a tight complex with it. In all cases known, the antitoxin autoregulates TA operon transcription by b...... operator DNA. A mutational analysis of the operator-sites showed that RelE in excess counteracted cooperative binding of the RelB(2)*RelE complexes to the operator-sites. Thus, RelE controls relBE transcription by conditional cooperativity.......Prokaryotic toxin-antitoxin (TA) loci consist of two genes in an operon that encodes a metabolically stable toxin and an unstable antitoxin. The antitoxin neutralises its cognate toxin by forming a tight complex with it. In all cases known, the antitoxin autoregulates TA operon transcription...... by binding to one or more operators in the promoter region while the toxin functions as a co-repressor of transcription. Interestingly, the toxin can also stimulate TA operon transcription. Here we analyse mechanistic aspects of how RelE of Escherichia coli can function both as a co-repressor and derepressor...

  7. A 3-Year Prospective Study of Parent–Child Communication in Early Adolescents With Type 1 Diabetes: Relationship to Adherence and Glycemic Control

    Science.gov (United States)

    Rohan, Jennifer M.; Pendley, Jennifer Shroff; Delamater, Alan; Drotar, Dennis

    2015-01-01

    Objective To examine changes in parent–child communication patterns and their relation to glycemic control and treatment adherence using observational data in a 3-year prospective multisite study of youth with type 1 diabetes aged 9–11 years at baseline and their families (n = 217). Methods Adolescents and caregivers participated in a diabetes problem-solving discussion. Families were rated on negative and positive communication and interactions using the Interaction Behavior Code. Results Maternal and paternal negative communication decreased over time, whereas adolescent and maternal positive communication and positive reciprocity increased. Baseline preadolescent youth and maternal positive communication predicted adherence 3 years later. Changes in family communication did not predict changes in glycemic control or adherence. Conclusions During the transition to adolescence, family communication changed in unexpected and positive ways. Additionally, the relationship of baseline family communication to subsequent adherence suggests the need to assess family communication concerning diabetes-related management during preadolescence. PMID:24839292

  8. A 3-year prospective study of parent-child communication in early adolescents with type 1 diabetes: relationship to adherence and glycemic control.

    Science.gov (United States)

    Iskander, Jeannette M; Rohan, Jennifer M; Pendley, Jennifer Shroff; Delamater, Alan; Drotar, Dennis

    2015-01-01

    To examine changes in parent-child communication patterns and their relation to glycemic control and treatment adherence using observational data in a 3-year prospective multisite study of youth with type 1 diabetes aged 9-11 years at baseline and their families (n = 217). Adolescents and caregivers participated in a diabetes problem-solving discussion. Families were rated on negative and positive communication and interactions using the Interaction Behavior Code. Maternal and paternal negative communication decreased over time, whereas adolescent and maternal positive communication and positive reciprocity increased. Baseline preadolescent youth and maternal positive communication predicted adherence 3 years later. Changes in family communication did not predict changes in glycemic control or adherence. During the transition to adolescence, family communication changed in unexpected and positive ways. Additionally, the relationship of baseline family communication to subsequent adherence suggests the need to assess family communication concerning diabetes-related management during preadolescence. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. An improved cooperative adaptive cruise control (CACC) algorithm considering invalid communication

    Science.gov (United States)

    Wang, Pangwei; Wang, Yunpeng; Yu, Guizhen; Tang, Tieqiao

    2014-05-01

    For the Cooperative Adaptive Cruise Control (CACC) Algorithm, existing research studies mainly focus on how inter-vehicle communication can be used to develop CACC controller, the influence of the communication delays and lags of the actuators to the string stability. However, whether the string stability can be guaranteed when inter-vehicle communication is invalid partially has hardly been considered. This paper presents an improved CACC algorithm based on the sliding mode control theory and analyses the range of CACC controller parameters to maintain string stability. A dynamic model of vehicle spacing deviation in a platoon is then established, and the string stability conditions under improved CACC are analyzed. Unlike the traditional CACC algorithms, the proposed algorithm can ensure the functionality of the CACC system even if inter-vehicle communication is partially invalid. Finally, this paper establishes a platoon of five vehicles to simulate the improved CACC algorithm in MATLAB/Simulink, and the simulation results demonstrate that the improved CACC algorithm can maintain the string stability of a CACC platoon through adjusting the controller parameters and enlarging the spacing to prevent accidents. With guaranteed string stability, the proposed CACC algorithm can prevent oscillation of vehicle spacing and reduce chain collision accidents under real-world circumstances. This research proposes an improved CACC algorithm, which can guarantee the string stability when inter-vehicle communication is invalid.

  10. A Cooperative Congestion Control Approach within VANETs: Formal Verification and Performance Evaluation

    Directory of Open Access Journals (Sweden)

    Bouassida MohamedSalah

    2010-01-01

    Full Text Available The main objective of congestion control is to best exploit the available network resources while preventing sustained overloads of network nodes and links. Appropriate congestion control mechanisms are essential to provide effcient operation of a network. Ensuring congestion control within vehicular ad hoc networks faces special challenges, due to the specificities of such environment (High mobility of nodes, high rate of topology changes, high variability in nodes density and neighborhood configuration, broadcast/geocast communication nature, etc.. In this context, we present in this paper a cooperative and fully distributed congestion control approach, based on dynamic scheduling and transmission of priority-based messages, to ensure reliable and safe communication architecture within VANET. Messages priorities are dynamically evaluated according to their types, the network context, and the neighboring nodes configuration. Considering the context of high reliability and real-time response required for intervehicular communications (including emergency breaking notification for example, we propose a complete validation method of our congestion control algorithms, taking into account reliability, temporal, and operational aspects.

  11. Flocking small smart machines: An experiment in cooperative, multi-machine control

    International Nuclear Information System (INIS)

    Klarer, P.R.

    1998-03-01

    The intent and purpose of this work was to investigate and demonstrate cooperative behavior among a group of mobile robot machines. The specific goal of this work was to build a small swarm of identical machines and control them in such a way as to show a coordinated movement of the group in a flocking manner, similar to that observed in nature. Control of the swarm's individual members and its overall configuration is available to the human user via a graphic man-machine interface running on a base station control computer. Any robot may be designated as the nominal leader through the interface tool, which then may be commanded to proceed to a particular geographic destination. The remainder of the flock follows the leader by maintaining their relative positions in formation, as specified by the human controller through the interface. The formation's configuration can be altered manually through an interactive graphic-based tool. An alternative mode of control allows for teleoperation of one robot, with the flock following along as described above

  12. Adherence to self-monitoring via interactive voice response technology in an eHealth intervention targeting weight gain prevention among Black women: randomized controlled trial.

    Science.gov (United States)

    Steinberg, Dori M; Levine, Erica L; Lane, Ilana; Askew, Sandy; Foley, Perry B; Puleo, Elaine; Bennett, Gary G

    2014-04-29

    eHealth interventions are effective for weight control and have the potential for broad reach. Little is known about the use of interactive voice response (IVR) technology for self-monitoring in weight control interventions, particularly among populations disproportionately affected by obesity. This analysis sought to examine patterns and predictors of IVR self-monitoring adherence and the association between adherence and weight change among low-income black women enrolled in a weight gain prevention intervention. The Shape Program was a randomized controlled trial comparing a 12-month eHealth behavioral weight gain prevention intervention to usual care among overweight and obese black women in the primary care setting. Intervention participants (n=91) used IVR technology to self-monitor behavior change goals (eg, no sugary drinks, 10,000 steps per day) via weekly IVR calls. Weight data were collected in clinic at baseline, 6, and 12 months. Self-monitoring data was stored in a study database and adherence was operationalized as the percent of weeks with a successful IVR call. Over 12 months, the average IVR completion rate was 71.6% (SD 28.1) and 52% (47/91) had an IVR completion rate ≥80%. At 12 months, IVR call completion was significantly correlated with weight loss (r =-.22; P=.04) and participants with an IVR completion rate ≥80% had significantly greater weight loss compared to those with an IVR completion rate self-monitoring. Adherence to IVR self-monitoring was high among socioeconomically disadvantaged black women enrolled in a weight gain prevention intervention. Higher adherence to IVR self-monitoring was also associated with greater weight change. IVR is an effective and useful tool to promote self-monitoring and has the potential for widespread use and long-term sustainability. Clinicaltrials.gov NCT00938535; http://www.clinicaltrials.gov/ct2/show/NCT00938535.

  13. Interventions to increase adherence in patients taking immunosuppressive drugs after kidney transplantation: a systematic review of controlled trials.

    Science.gov (United States)

    Mathes, Tim; Großpietsch, Kirsten; Neugebauer, Edmund A M; Pieper, Dawid

    2017-11-29

    Immunosuppressive drugs have to be taken through the whole duration of kidney transplant survival to avoid rejection. Low adherence can increase the risk of allograft rejection. The objective was to evaluate the effectiveness of adherence-enhancing interventions (AEI) in kidney transplantation recipients taking immunosuppressive drugs. A search was performed in Medline, Embase, CINAHL, and PsycINFO. The search was performed in May 2016. We included comparative studies on AEI for kidney transplant recipients taking immunosuppressive drugs. The primary outcome was medication adherence. All identified articles were screened according to the predefined inclusion criteria. The risk of bias was assessed with the Cochrane risk of bias tool. Study selection and risk of bias assessment were performed by two reviewers independently. Data were extracted in standardized tables. Data extraction was verified by a second reviewer. All discrepancies were resolved through discussion. Data were synthesized in a structured narrative way. There is no registered or published protocol for this systematic review. We identified 12 studies. The number of participants ranged from 24 to 1830. Nine studies included adults, two children, and one adults and children. Risk of bias was high. The main reasons for high risk of bias were inadequate allocation sequence (confounding) and that studies were not blinded. Eleven studies evaluated AEI consisting of educational and/or behavioral components. All these studies showed an effect direction in favor of the intervention. Intervention effect was only moderate. Most adherence measures in studies on educational and behavioral interventions showed statistically significant differences. Studies that combined educational and behavioral intervention components showed larger effects. All studies that were statistically significant were multimodal. Studies that included an individualized component and more intensive interventions showed larger effects. One

  14. A cooperative reduction model for regional air pollution control in China that considers adverse health effects and pollutant reduction costs.

    Science.gov (United States)

    Xie, Yujing; Zhao, Laijun; Xue, Jian; Hu, Qingmi; Xu, Xiang; Wang, Hongbo

    2016-12-15

    How to effectively control severe regional air pollution has become a focus of global concern recently. The non-cooperative reduction model (NCRM) is still the main air pollution control pattern in China, but it is both ineffective and costly, because each province must independently fight air pollution. Thus, we proposed a cooperative reduction model (CRM), with the goal of maximizing the reduction in adverse health effects (AHEs) at the lowest cost by encouraging neighboring areas to jointly control air pollution. CRM has two parts: a model of optimal pollutant removal rates using two optimization objectives (maximizing the reduction in AHEs and minimizing pollutant reduction cost) while meeting the regional pollution control targets set by the central government, and a model that allocates the cooperation benefits (i.e., health improvement and cost reduction) among the participants according to their contributions using the Shapley value method. We applied CRM to the case of sulfur dioxide (SO 2 ) reduction in Yangtze River Delta region. Based on data from 2003 to 2013, and using mortality due to respiratory and cardiovascular diseases as the health endpoints, CRM saves 437 more lives than NCRM, amounting to 12.1% of the reduction under NCRM. CRM also reduced costs by US $65.8×10 6 compared with NCRM, which is 5.2% of the total cost of NCRM. Thus, CRM performs significantly better than NCRM. Each province obtains significant benefits from cooperation, which can motivate them to actively cooperate in the long term. A sensitivity analysis was performed to quantify the effects of parameter values on the cooperation benefits. Results shown that the CRM is not sensitive to the changes in each province's pollutant carrying capacity and the minimum pollutant removal capacity, but sensitive to the maximum pollutant reduction capacity. Moreover, higher cooperation benefits will be generated when a province's maximum pollutant reduction capacity increases. Copyright

  15. Control and applications of cooperating disparate robotic manipulators relevant to nuclear waste management

    Science.gov (United States)

    Lew, Jae Young; Book, Wayne J.

    1991-01-01

    Remote handling in nuclear waste management requires a robotic system with precise motion as well as a large workspace. The concept of a small arm mounted on the end of a large arm may satisfy such needs. However, the performance of such a serial configuration lacks payload capacity which is a crucial factor for handling a massive object. Also, this configuration induces more flexibility on the structure. To overcome these problems, the topology of bracing the tip of the small arm (not the large arm) and having an end effector in the middle of the chain is proposed in this paper. Also, control of these cooperating disparate manipulators is accomplished in computer simulations. Thus, this robotic system can have the accuracy of the small arm, and at the same time, it can have the payload capacity and large workspace of the large arm.

  16. Cooperative control of UAVs for localization of intermittently emitting mobile targets.

    Science.gov (United States)

    Pack, Daniel J; Delima, Pedro; Toussaint, Gregory J; York, George

    2009-08-01

    Compared with a single platform, cooperative autonomous unmanned aerial vehicles (UAVs) offer efficiency and robustness in performing complex tasks. Focusing on ground mobile targets that intermittently emit radio frequency signals, this paper presents a decentralized control architecture for multiple UAVs, equipped only with rudimentary sensors, to search, detect, and locate targets over large areas. The proposed architecture has in its core a decision logic which governs the state of operation for each UAV based on sensor readings and communicated data. To support the findings, extensive simulation results are presented, focusing primarily on two success measures that the UAVs seek to minimize: overall time to search for a group of targets and the final target localization error achieved. The results of the simulations have provided support for hardware flight tests.

  17. Identifying a cooperative control mechanism between an applied field and the environment of open quantum systems

    Science.gov (United States)

    Gao, Fang; Rey-de-Castro, Roberto; Wang, Yaoxiong; Rabitz, Herschel; Shuang, Feng

    2016-05-01

    Many systems under control with an applied field also interact with the surrounding environment. Understanding the control mechanisms has remained a challenge, especially the role played by the interaction between the field and the environment. In order to address this need, here we expand the scope of the Hamiltonian-encoding and observable-decoding (HE-OD) technique. HE-OD was originally introduced as a theoretical and experimental tool for revealing the mechanism induced by control fields in closed quantum systems. The results of open-system HE-OD analysis presented here provide quantitative mechanistic insights into the roles played by a Markovian environment. Two model open quantum systems are considered for illustration. In these systems, transitions are induced by either an applied field linked to a dipole operator or Lindblad operators coupled to the system. For modest control yields, the HE-OD results clearly show distinct cooperation between the dynamics induced by the optimal field and the environment. Although the HE-OD methodology introduced here is considered in simulations, it has an analogous direct experimental formulation, which we suggest may be applied to open systems in the laboratory to reveal mechanistic insights.

  18. Adherence to Hunger Training over 6 Months and the Effect on Weight and Eating Behaviour: Secondary Analysis of a Randomised Controlled Trial

    Science.gov (United States)

    Taylor, Rachael W.; Athens, Josie; Brown, Rachel C.

    2017-01-01

    Monitoring blood glucose prior to eating can teach individuals to eat only when truly hungry, but how adherence to ‘hunger training’ influences weight loss and eating behaviour is uncertain. This exploratory, secondary analysis from a larger randomized controlled trial examined five indices of adherence to ‘hunger training’, chosen a priori, to examine which adherence measure best predicted weight loss over 6 months. We subsequently explored how the best measure of adherence influenced eating behavior in terms of intuitive and emotional eating. Retention was 72% (n = 36/50) at 6 months. Frequency of hunger training booklet entry most strongly predicted weight loss, followed by frequency of blood glucose measurements. Participants who completed at least 60 days of booklet entry (of recommended 63 days) lost 6.8 kg (95% CI: 2.6, 11.0; p hunger training and focusing on simply recording ratings of hunger on a regular basis can produce clinically significant weight loss and clinically relevant improvements in eating behaviour. PMID:29149038

  19. A Review of NEPA, a Novel Fixed Antiemetic Combination with the Potential for Enhancing Guideline Adherence and Improving Control of Chemotherapy-Induced Nausea and Vomiting

    Directory of Open Access Journals (Sweden)

    Paul J. Hesketh

    2015-01-01

    Full Text Available Combination antiemetic regimens targeting multiple molecular pathways associated with emesis have become the standard of care for prevention of chemotherapy-induced nausea and vomiting (CINV related to highly and moderately emetogenic chemotherapies. Antiemetic consensus guidelines from several professional societies are widely available and updated regularly as new data emerges. Unfortunately, despite substantial research supporting the notion that guideline conformity improves CINV control, adherence to antiemetic guidelines is unsatisfactory. While studies are needed to identify specific barriers to guideline use and explore measures to enhance adherence, a novel approach has been taken to improve clinician adherence and patient compliance, with the development of a new combination antiemetic. NEPA is an oral fixed combination of a new highly selective NK1 receptor antagonist (RA, netupitant, and the pharmacologically and clinically distinct 5-HT3 RA, palonosetron. This convenient antiemetic combination offers guideline-consistent prophylaxis by targeting two critical pathways associated with CINV in a single oral dose administered only once per cycle. This paper will review and discuss the NEPA data in the context of how this first combination antiemetic may overcome some of the barriers interfering with adherence to antiemetic guidelines, enhance patient compliance, and offer a possible advance in the prevention of CINV for patients.

  20. Excessive daytime sleepiness and adherence to antihypertensive medications among Blacks: analysis of the counseling African Americans to control hypertension (CAATCH trial

    Directory of Open Access Journals (Sweden)

    Williams NJ

    2014-03-01

    Full Text Available Natasha J Williams,1 Girardin Jean-Louis,1 Abhishek Pandey,2 Joseph Ravenell,1 Carla Boutin-Foster,3 Gbenga Ogedegbe1 1Center for Healthful Behavior Change, Division of Internal Medicine, NYU Medical Center, New York, 2Department of Family Medicine, SUNY Downstate Medical Center, Brooklyn, 3Center of Excellence in Disparities Research, Weill Cornell Medical College, New York, NY, USA Background: Excessive daytime sleepiness (EDS often occurs as a result of insufficient sleep, sleep apnea, illicit substance use, and other medical and psychiatric conditions. This study tested the hypothesis that blacks exhibiting EDS would have poorer self-reported adherence to hypertensive medication using cross-sectional data from the Counseling African-Americans to Control Hypertension (CAATCH trial. Methods: A total of 1,058 hypertensive blacks (average age 57±12 years participated in CAATCH, a randomized controlled trial evaluating the effectiveness of a multilevel intervention for participants who receive care from community health centers in New York City. Data analyzed in this study included baseline sociodemographics, medical history, EDS, and medication adherence. We used the Epworth Sleepiness Scale, with a cutoff score of ≥10, to define EDS. Medication adherence was measured using an abbreviated Morisky Medication Adherence scale, with a score >0 indicating nonadherence. Results: Of the sample, 71% were female, 72% received at least a high school education, 51% reported a history of smoking, and 33% had a history of alcohol consumption. Overall, 27% of the participants exhibited EDS, and 44% of those who exhibited EDS were classified as adherent to prescribed antihypertensive medications. Multivariable logistic regression analysis, adjusting for effects of age, body mass index, sex, education, and smoking and drinking history indicated that participants who exhibited EDS were more than twice as likely to be nonadherent (odds ratio 2.28, 95

  1. Impact of late-to-refill reminder calls on medication adherence in the Medicare Part D population: evaluation of a randomized controlled study

    Directory of Open Access Journals (Sweden)

    Taitel MS

    2017-02-01

    Full Text Available Michael S Taitel, Ying Mu, Angshuman Gooptu, Youbei Lou Health Analytics, Research & Reporting, Walgreen Co., Deerfield, IL, USA Objectives: This study evaluates a nationwide pharmacy chain’s late-to-refill (LTR reminder program that entails local pharmacists placing reminder calls to Medicare Part D patients. Methods: We conducted a randomized controlled study among 735,218 patients who exhibited nonadherent behavior by not refilling a maintenance medication 3 days from an expected refill date. Patients were randomly assigned to an intervention group who received LTR reminder calls or to a control group. We used Walgreens pharmaceutical claims data from 2015 to estimate the impact of LTR calls on short-term and annual adherence. Results: The initial refill rate within the first 14 days of the expected refill date significantly increased in the intervention group by 22.8% (6.09 percentage points compared to the control group (P<0.001. The proportion of days covered (PDC in the intervention group increased significantly by 1.5% (0.856 percentage points relative to the control group (P<0.001 over 365 days. Patients in the intervention group were significantly more adherent (PDC ≥80% by 3% (0.97 percentage points compared to the control group (P<0.001. Over a 270-day follow-up period, persistence significantly increased by 2.15 days in the intervention group (P<0.001. Conclusion: Results from this study suggest that LTR reminder calls increased adherence for Medicare Part D patients who are late in refilling their medications and therefore have the potential to reduce their risk for hospitalization and health care costs. Additionally, the intervention increased the number of patients with PDC ≥80% by ~3%, positively impacting Medicare Part D plan quality rating. Keywords: reminder system, tailored intervention, Medicare Part D, adherence, persistence

  2. Conducting cancer control and survivorship research via cooperative groups: a report from the American Society of Preventive Oncology.

    Science.gov (United States)

    Palesh, Oxana; Demark-Wahnefried, Wendy; Mustian, Karen; Minasian, Lori; Rowland, Julia; Sprod, Lisa; Janelsins, Michelle; Peppone, Luke; Sloan, Jeff; Engquist, Karen Basen; Jones, Lee; Buist, Diana; Paskett, Electra D

    2011-05-01

    As the number of cancer survivors expands, the need for cancer control and survivorship research becomes increasingly important. The National Cancer Institute (NCI) Cooperative Groups may offer a viable platform to perform such research. Observational, preventive, and behavioral research can often be performed within the cooperative group setting, especially if resources needed for evaluation are fairly simple, if protocols are easily implemented within the typical clinical setting, and if interventions are well standardized. Some protocols are better suited to cooperative groups than are others, and there are advantages and disadvantages to conducting survivorship research within the cooperative group setting. Behavioral researchers currently involved in cooperative groups, as well as program staff within the NCI, can serve as sources of information for those wishing to pursue symptom management and survivorship studies within the clinical trial setting. The structure of the cooperative groups is currently changing, but going forward, survivorship is bound to be a topic of interest and one that perhaps may be more easily addressed using the proposed more centralized structure. ©2011 AACR.

  3. Banks’ internal controls and risk management: Value-added functions in Italian credit cooperative banks

    Directory of Open Access Journals (Sweden)

    Rosaria Cerrone

    2013-12-01

    Full Text Available A critical component of safe and sound bank management is constituted by an effective and efficient system of internal controls, which help to ensure that the goals and objectives of a bank will be met, that long-term profitability targets will be achieved, and maintain reliable financial and managerial reporting. Such a system can also ensure that the bank will comply with laws and regulations as well as policies, plans, internal rules and procedures, and decrease the risk of unexpected losses or damage to the bank’s reputation. The paper describes the essential elements of a sound internal control system and through a qualitative approach, it shows how is tied to the rules attaining capital requirements and, above all, to the purpose of the Internal Capital Adequacy Assessment Process (ICAAP which aims at determining the adequate capitalisation of a bank given the risks endured as well as future risks arising from growth, and new business lines. After the recent financial crisis ICAAP is becoming more and more relevant and a central component of an effective strategy for managing risk and creating value. All principles and considerations are referred to Italian Credit Cooperative Banks particular both for dimension and for governance and risk management. They have been contacted though local federations and the results confirm the existing of weakness in internal controls.

  4. Employment-based reinforcement of adherence to depot naltrexone in unemployed opioid-dependent adults: a randomized controlled trial.

    Science.gov (United States)

    Everly, Jeffrey J; DeFulio, Anthony; Koffarnus, Mikhail N; Leoutsakos, Jeannie-Marie S; Donlin, Wendy D; Aklin, Will M; Umbricht, Annie; Fingerhood, Michael; Bigelow, George E; Silverman, Kenneth

    2011-07-01

    Naltrexone can be used to treat opioid dependence, but patients refuse to take it. Extended-release depot formulations may improve adherence, but long-term adherence rates to depot naltrexone are not known. This study determined long-term rates of adherence to depot naltrexone and whether employment-based reinforcement can improve adherence. Participants who were inducted onto oral naltrexone were assigned randomly to contingency (n = 18) or prescription (n = 17) groups. Participants were offered six depot naltrexone injections and invited to work at the therapeutic workplace on week days for 26 weeks, where they earned stipends for participating in job skills training. Contingency participants were required to accept naltrexone injections to maintain workplace access and to maintain maximum pay. Prescription participants could work independently of whether they accepted injections. The therapeutic workplace, a model employment-based intervention for drug addiction and unemployment. Opioid-dependent unemployed adults. Depot naltrexone injections accepted and opiate-negative urine samples. Contingency participants accepted significantly more naltrexone injections than prescription participants (81% versus 42%), and were more likely to accept all injections (66% versus 35%). At monthly assessments (with missing urine samples imputed as positive), the groups provided similar percentages of samples negative for opiates (74% versus 62%) and for cocaine (56% versus 54%). Opiate-positive samples were more likely when samples were also positive for cocaine. Employment-based reinforcement can maintain adherence to depot naltrexone. Future research should determine whether persistent cocaine use compromises naltrexone's effect on opiate use. Workplaces may be useful for promoting sustained adherence to depot naltrexone. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

  5. Co-operation - the way out (introducing the Natural Materials Radiation Control Initiative)

    International Nuclear Information System (INIS)

    Kruger, I.D.

    2002-01-01

    The Natural Materials Radiation Control Initiative (NMRCI), a forum of regulators, advisory bodies and operators in NORM industries from Australia, Brazil, Malaysia, Netherlands, Poland, South Africa and USA, reported on its activities that were aimed at addressing NORM regulatory issues through industry/regulatory co-operation. The objective was to generate comprehensive information on quantifying exposures to both workers and the general public, through the consolidation of existing data and the collection of data from new studies. In its interactions with the IAEA to date, the NMRCI had proposed that it assist in drafting a Safety Report identifying exposure sources and providing information on suggested methods for national regulatory bodies, advisory bodies and NORM industries to make quantitative assessments and to identify how best to meet the requirements of the BSS. It was envisaged that the Safety Report should reflect the principles contained in ICRP recommendations and IAEA Safety Standards, should make maximum use of measured data, and should deal separately with different industries such as phosphates, coal and niobium, taking account of the differences in chemical, physical and radiological properties of the materials as well as differences in work practices. It had been decided that occupational exposure issues should be addressed as a first priority, before moving on to the public exposure arena where waste management issues such as waste disposal and remediation of contaminated sites would be addressed. The NMRCI also aimed to promote co-operation between NORM industries and regulatory authorities on the matter of regulations and their impact on international trade in commodities containing NORM

  6. Cooperative learning neural network output feedback control of uncertain nonlinear multi-agent systems under directed topologies

    Science.gov (United States)

    Wang, W.; Wang, D.; Peng, Z. H.

    2017-09-01

    Without assuming that the communication topologies among the neural network (NN) weights are to be undirected and the states of each agent are measurable, the cooperative learning NN output feedback control is addressed for uncertain nonlinear multi-agent systems with identical structures in strict-feedback form. By establishing directed communication topologies among NN weights to share their learned knowledge, NNs with cooperative learning laws are employed to identify the uncertainties. By designing NN-based κ-filter observers to estimate the unmeasurable states, a new cooperative learning output feedback control scheme is proposed to guarantee that the system outputs can track nonidentical reference signals with bounded tracking errors. A simulation example is given to demonstrate the effectiveness of the theoretical results.

  7. Adherence to Dietary Approaches to Stop Hypertension (DASH) Dietary Pattern in Relation to Chronic Obstructive Pulmonary Disease (COPD): A Case-Control Study.

    Science.gov (United States)

    Ardestani, Mohammad Emami; Onvani, Shokouh; Esmailzadeh, Ahmad; Feizi, Awat; Azadbakht, Leila

    2017-01-01

    This case-control study was designed to investigate the association between adherences to the Dietary Approaches to Stop Hypertension (DASH) diet in patients with chronic obstructive pulmonary disease (COPD) in comparison to subjects without COPD. This is a case-control study. Usual dietary intake was assessed using a validated food frequency questionnaire. Lung function was evaluated with spirometry testing, and one of the researchers inquired about other respiratory symptoms, including chronic cough, sputum, and breathlessness. Adherence to the DASH dietary pattern was assessed according to the Fung method. This study was conducted at Alzahra University Hospital of Isfahan, Iran, in 2015. Eight-four patients with COPD and 80 subjects without a history of COPD participated in study. The mean age of participants was 57 years. Average smoking in the case group was about 27.5 pack-years. Spirometry tests including forced expiratory volume in 1 second (FEV 1 ), forced vital capacity (FVC), and FEV 1 /FVC were significantly lower in patients with COPD (p = 0.0001). Among COPD symptoms, cough was significantly decreased across tertiles of DASH score (p = 0.03). Significant differences were found for DASH score between patients with COPD and control subjects (19.82 + 3.63 vs 21.13 + 3.82, p = 0.02). Vitamin C, vitamin E, and dietary fiber intake were lower in patients with COPD (144.32 + 70.51 vs 166.97 + 71.88, p = 0.04, 7.49 + 3.91 vs 8.72 + 3.21, p = 0.02 and 19.34 + 7.05 vs 22.19 + 7.87, p = 0.01, respectively). We observed that adherence to a DASH dietary pattern among patients with COPD was significantly lower compared to the control group. Cough was significantly decreased by increments in adherence to a DASH dietary pattern.

  8. Adherence to Hunger Training over 6 Months and the Effect on Weight and Eating Behaviour: Secondary Analysis of a Randomised Controlled Trial

    Directory of Open Access Journals (Sweden)

    Michelle R. Jospe

    2017-11-01

    Full Text Available Monitoring blood glucose prior to eating can teach individuals to eat only when truly hungry, but how adherence to ‘hunger training’ influences weight loss and eating behaviour is uncertain. This exploratory, secondary analysis from a larger randomized controlled trial examined five indices of adherence to ‘hunger training’, chosen a priori, to examine which adherence measure best predicted weight loss over 6 months. We subsequently explored how the best measure of adherence influenced eating behavior in terms of intuitive and emotional eating. Retention was 72% (n = 36/50 at 6 months. Frequency of hunger training booklet entry most strongly predicted weight loss, followed by frequency of blood glucose measurements. Participants who completed at least 60 days of booklet entry (of recommended 63 days lost 6.8 kg (95% CI: 2.6, 11.0; p < 0.001 more weight than those who completed fewer days. They also had significantly higher intuitive eating scores than those who completed 30 days or less of booklet entry; a difference (95% CI of 0.73 (0.12, 1.35 in body-food choice congruence and 0.79 (0.06, 1.51 for eating for physical rather than emotional reasons. Adherent participants also reported significantly lower scores for emotional eating of −0.70 (−1.13, −0.27. Following hunger training and focusing on simply recording ratings of hunger on a regular basis can produce clinically significant weight loss and clinically relevant improvements in eating behaviour.

  9. US-Russian laboratory-to-laboratory cooperation in nuclear materials protection, control, and accounting

    International Nuclear Information System (INIS)

    Mullen, M.; Augustson, R.; Horton, R.

    1995-01-01

    Under the guidance of the Department of Energy (DOE), six DOE laboratories have initiated a new program of cooperation with the Russian Federation's nuclear institutes. The purpose of the program is to accelerate progress toward a common goal shared by both the US and Russia--to reduce the risks of nuclear weapons proliferation, including such threats as theft, diversion, and unauthorized possession of nuclear materials, by strengthening systems of nuclear materials protection, control, and accounting. This new program is called the Laboratory-to-Laboratory Nuclear Materials Protection, Control, and Accounting (Lab-to-Lab MPC and A) Program. It is designed to complement other US-Russian MPC and A programs such as the government-to-government (Nunn-Lugar) programs. The Lab-to-Lab MPC and A program began in 1994 with pilot projects at two sites: Arzamas-16 and the Kurchitov Institute. This paper presents an overview of the Laboratory-to-Laboratory MPC and A Program. It describes the background and need for the program; the objectives and strategy; the participating US and Russian laboratories, institutes and enterprises; highlights of the technical work; and plans for the next several years

  10. Self-organized control in cooperative robots using a pattern formation principle

    International Nuclear Information System (INIS)

    Starke, Jens; Ellsaesser, Carmen; Fukuda, Toshio

    2011-01-01

    Self-organized modular approaches proved in nature to be robust and optimal and are a promising strategy to control future concepts of flexible and modular manufacturing processes. We show how this can be applied to a model of flexible manufacturing based on time-dependent robot-target assignment problems where robot teams have to serve manufacturing targets such that an objective function is optimized. Feasibility of the self-organized solutions can be guaranteed even for unpredictable situations like sudden changes in the demands or breakdowns of robots. As example an uncrewed space mission is visualized in a simulation where robots build a space station. - Highlights: → Adapting a pattern formation principle to control cooperative robots in a robust way. → Flexible manufacturing systems are modelled by time-dependent assignment problems. → Coupled selection equations guarantee feasibility of solutions. → Solution structure (permutations) is not destroyed by inhomogeneous growth rates. → Example of an uncrewed space mission shows effectivity and robustness.

  11. A randomized, controlled study of an educational intervention to improve recall of auxiliary medication labeling and adherence to antibiotics

    Directory of Open Access Journals (Sweden)

    Jade A Pham

    2013-06-01

    Full Text Available Purpose: To evaluate whether medication counseling with emphasis on auxiliary labels improves recall of auxiliary label information and adherence to medication schedules. Methods: A prospective, randomized study of an educational intervention in community pharmacies near Baltimore, Maryland. Fifty literate, English-speaking adults receiving one of the 18 commonly dispensed antibiotics were randomized to receive a counseling session or no counseling. Five to seven days after medication pickup, a structured phone interview was conducted to capture data on recall of auxiliary labels and adherence. Results: A total of 39 subjects completed the phone interview (78%. The rate of correct recall was high: 77% correct recall for all three labels. Among those with incorrect recall, 7 out of 9 subjects received no counseling (p = 0.11. The auxiliary labels incorrectly recalled were all related to dietary restrictions. Conclusion: The findings from this study suggest that medication counseling emphasizing auxiliary label information may lead to improved recall and adherence to antibiotics. Additional studies are required to confirm the preliminary findings and determine whether they correspond to improved adherence. Information most commonly misunderstood were related to dietary restrictions. Additional research focusing on counseling related to dietary restrictions is recommended.

  12. Training mental health professionals in suicide practice guideline adherence : Cost-effectiveness analysis alongside a randomized controlled trial

    NARCIS (Netherlands)

    de Beurs, Derek P.; Bosmans, Judith E.; de Groot, Marieke H.; de Keijser, Jos; van Duijn, Erik; de Winter, Remco F. P.; Kerkhof, Ad J. F. M.

    2015-01-01

    Background: There is a lack of information on the cost-effectiveness of suicide prevention interventions. The current study examines the cost-effectiveness of a multifaceted structured intervention aiming to improve adherence to the national suicide practice guideline in comparison with usual

  13. Adherence With Bisphosphonates and Long-Term Risk of Hip Fractures: A Nested Case-Control Study Using Real-World Data.

    Science.gov (United States)

    Shalev, Varda; Sharman Moser, Sarah; Goldshtein, Inbal; Yu, Jingbo; Weil, Clara; Ish-Shalom, Sophia; Rouach, Vanessa; Chodick, Gabriel

    2017-09-01

    Hip fracture is a major complication of osteoporosis. Bisphosphonate medication is the mainstay of treatment for osteoporosis. However, concerns have been raised regarding the effectiveness of bisphosphonates in reducing hip fracture risk after long-term use, particularly among patients with suboptimal adherence. To examine the association between adherence with bisphosphonate therapy and long-term risk of hip fracture. Included in the present nested case-control study were osteoporotic women (n = 14 357) who initiated bisphosphonate therapy in 2000-2010 and were retrospectively followed for incident hip fracture through November 2014. Within this cohort, each case of primary hip fractures was individually matched to 3 controls without a primary hip fracture. Proportion of follow-up days covered (PDC) with bisphosphonates was calculated from bisphosphonate purchases. Adherence was categorized into the following groups: purchase of 1 or 2 months' supply (reference group), at least 3 months' supply to PDC ≤20%, PDC >20% to ≤80%, PDC >80% to ≤100%. Included in the analysis were 426 case-control groups with a mean age (SD) of 73.7 years (7.9). Compared with the reference group, PDC of 80% to 100% with bisphosphonates was associated with a significant reduction in hip fracture risk for patients with 8 to 15 years of follow-up (OR = 0.39; 95% CI = 0.18-0.87). Among patients with a follow-up of up to 3 years, OR was 0.58 (95% CI = 0.31-1.06). Adherence with bisphosphonates among osteoporotic patients is associated with lower risk of hip fracture, with no indication of diminished effectiveness with long-term use.

  14. Dietary Adherence, Glycemic Control, and Psychological Factors Associated with Binge Eating Among Indigenous and Non-Indigenous Chileans with Type 2 Diabetes.

    Science.gov (United States)

    Herbozo, Sylvia; Flynn, Patricia M; Stevens, Serena D; Betancourt, Hector

    2015-12-01

    Despite the strong association between obesity and binge eating, limited research has examined the implications of binge eating on dietary adherence and psychological factors in ethnically diverse type 2 diabetes patients. This study investigated the prevalence of binge eating and its association with dietary adherence, glycemic control, and psychological factors among indigenous and non-indigenous type 2 diabetes patients in Chile. Participants were 387 indigenous (Mapuche) and non-indigenous (non-Mapuche) adults with type 2 diabetes. Self-report measures of binge eating, dietary adherence, diet self-efficacy, body image dissatisfaction, and psychological well-being were administered. Participants' weight, height, and glycemic control (HbA(1c)) were also obtained. Approximately 8 % of the type 2 diabetes patients reported binge eating. The prevalence among Mapuche patients was 4.9 %, and among non-Mapuche patients, it was 9.9 %. Compared to non-binge eaters, binge eating diabetes patients had greater body mass index values, consumed more high-fat foods, were less likely to adhere to their eating plan, and reported poorer body image and emotional well-being. Results of this study extend previous research by examining the co-occurrence of binge eating and type 2 diabetes as well as the associated dietary behaviors, glycemic control, and psychological factors among indigenous and non-indigenous patients in Chile. These findings may increase our understanding of the health challenges faced by indigenous populations from other countries and highlight the need for additional research that may inform interventions addressing binge eating in diverse patients with type 2 diabetes.

  15. The monitoring and control systems in cooperatives: application to the case of Costa Rica

    Directory of Open Access Journals (Sweden)

    Oscar Alonso Hernández Vargas

    2005-12-01

    Full Text Available The Costa Rican government through the Cooperative Development Institute encourages, promotes, finances, reports and supports the cooperative movement at all levels, promoting the requisite conditions and the essential elements to a greater and more effective participation of the population in the development of economic and social activity.

  16. Does providing prescription information or services improve medication adherence among patients discharged from the emergency department? A randomized controlled trial.

    Science.gov (United States)

    McCarthy, Melissa L; Ding, Ru; Roderer, Nancy K; Steinwachs, Donald M; Ortmann, Melinda J; Pham, Julius Cong; Bessman, Edward S; Kelen, Gabor D; Atha, Walter; Retezar, Rodica; Bessman, Sara C; Zeger, Scott L

    2013-09-01

    We determine whether prescription information or services improve the medication adherence of emergency department (ED) patients. Adult patients treated at one of 3 EDs between November 2010 and September 2011 and prescribed an antibiotic, central nervous system, gastrointestinal, cardiac, or respiratory drug at discharge were eligible. Subjects were randomly assigned to usual care or one of 3 prescription information or services intervention groups: (1) practical services to reduce barriers to prescription filling (practical prescription information or services); (2) consumer drug information from MedlinePlus (MedlinePlus prescription information or services); or (3) both services and information (combination prescription information or services). Self-reported medication adherence, measured by primary adherence (prescription filling) and persistence (receiving medicine as prescribed) rates, was determined during a telephone interview 1 week postdischarge. Of the 3,940 subjects enrolled and randomly allocated to treatment, 86% (N=3,386) completed the follow-up interview. Overall, primary adherence was 88% and persistence was 48%. Across the sites, primary adherence and persistence did not differ significantly between usual care and the prescription information or services groups. However, at site C, subjects who received the practical prescription information or services (odds ratio [OR]=2.4; 95% confidence interval [CI] 1.4 to 4.3) or combination prescription information or services (OR=1.8; 95% CI 1.1 to 3.1) were more likely to fill their prescription compared with usual care. Among subjects prescribed a drug that treats an underlying condition, subjects who received the practical prescription information or services were more likely to fill their prescription (OR=1.8; 95% CI 1.0 to 3.1) compared with subjects who received usual care. Prescription filling and receiving medications as prescribed was not meaningfully improved by offering patients patient

  17. Dynamics for a discrete competition and cooperation model of two enterprises with multiple delays and feedback controls

    Directory of Open Access Journals (Sweden)

    Lu Lin

    2017-03-01

    Full Text Available This paper is concerned with a competition and cooperation model of two enterprises with multiple delays and feedback controls. With the aid of the difference inequality theory, we have obtained some sufficient conditions which guarantee the permanence of the model. Under a suitable condition, we prove that the system has global stable periodic solution. The paper ends with brief conclusions.

  18. Protocol for SAMS (Support and Advice for Medication Study: A randomised controlled trial of an intervention to support patients with type 2 diabetes with adherence to medication

    Directory of Open Access Journals (Sweden)

    Sutton Stephen

    2008-04-01

    Full Text Available Abstract Background Although some interventions have been shown to improve adherence to medication for diabetes, results are not consistent. We have developed a theory-based intervention which we will evaluate in a well characterised population to test efficacy and guide future intervention development and trial design. Methods and Design The SAMS (Supported Adherence to Medication Study trial is a primary care based multi-centre randomised controlled trial among 200 patients with type 2 diabetes and an HbA1c of 7.5% or above. It is designed to evaluate the efficacy of a two-component motivational intervention based on the Theory of Planned Behaviour and volitional action planning to support medication adherence compared with standard care. The intervention is delivered by practice nurses. Nurses were trained using a workshop approach with role play and supervised using assessment of tape-recorded consultations. The trial has a two parallel groups design with an unbalanced three-to-two individual randomisation eight weeks after recruitment with twelve week follow-up. The primary outcome is medication adherence measured using an electronic medication monitor over 12 weeks and expressed as the difference between intervention and control in mean percentage of days on which the correct number of medication doses is taken. Subgroup analyses will explore impact of number of medications taken, age, HbA1c, and self-reported adherence at baseline on outcomes. The study also measures the effect of dispensing medication to trial participants packaged in the electronic medication-monitoring device compared with conventional medication packaging. This will be achieved through one-to-one randomisation at recruitment to these conditions with assessment of the difference between groups in self-report of medication adherence and change in mean HbA1c from baseline to eight weeks. Anonymised demographic data are collected on non-respondents. Central randomisation

  19. Relating Health Locus of Control to Health Care Use, Adherence, and Transition Readiness Among Youths With Chronic Conditions, North Carolina, 2015.

    Science.gov (United States)

    Nazareth, Meaghan; Richards, Jordan; Javalkar, Karina; Haberman, Cara; Zhong, Yi; Rak, Eniko; Jain, Nina; Ferris, Maria; van Tilburg, Miranda A L

    2016-07-21

    Health locus of control refers to the belief that health is in one's control (internal control) or is not in one's control (external control). Among adults, external locus of control is associated with negative health outcomes, whereas internal locus of control is associated with favorable outcomes. Few studies examined these associations among youths. The objective of our study was to determine how locus of control relates to health care use, medication adherence, missed school, and readiness for transition to adult medical care for youths with chronic conditions. Participants at a camp for youths aged 6 to 17 years with chronic health conditions completed a survey measuring locus of control, readiness for transition to adult care, and medication adherence. Their parents completed a separate part of the survey about health care use and missed school days in the past year. A total of 163 youths completed the survey (78.5% white; 52.1% female; mean age, 12.3 y). Internal locus of control (β = 0.196; P = .013) and external Doctor locus of control with doctors controlling disease (β = 0.181; P = .025) were positively associated with transition readiness. External control by chance or with others controlling disease was negatively associated with transition readiness (β = -0.248; P = .002) and positively associated with emergency department visits (β = 0.225; P = .004) and with number of hospital inpatient nights at hospital (β = 0.166; P = .04). Adolescents with external control of their health by chance or by other people are at increased risk for negative health outcomes and may fail to develop the self-management skills needed for successful transitioning to adult care. Future studies should examine effects of changes in locus of control on health outcomes among youths.

  20. Using daily text messages to improve adherence to infant micronutrient powder (MNP) packets in rural western China: A cluster-randomized controlled trial.

    Science.gov (United States)

    Wang, Xu; Luo, Renfu; Liu, Chengfang; Zhang, Linxiu; Yue, Ai; Medina, Alexis; Rozelle, Scott

    2018-01-01

    To evaluate the effectiveness of daily text messages as a means to improve caregivers' adherence to infant micronutrient powder (MNP) in rural Shaanxi Province of China. 638 infants aged 6-11 months in 234 villages were involved in a cluster-randomized controlled trial (RCT). All caregivers were given free infant MNP packets at baseline in April 2013 and the follow-up survey was in July 2013. We randomly assigned 318 infants in 117 villages to treatment group (receiving daily text message) and 320 infants in the other 117 villages as control group. On average, daily text messages increased the number of MNP packets fed (marginal effect = 4.63; 95% confidence interval (CI) = 0.16, 9.10). The text message is more likely to increase the consumption of MNP packets if the primary caregiver was the mother (marginal effect = 12.19; 95% CI = 0.69, 23.68). Receiving the text message appears to significantly increase the likelihood of full adherence when the primary caregiver can either check (odds ratio = 2.93; 95% CI = 1.34, 6.40) or knows how to send (odds ratio = 3.26; 95% CI = 1.53, 6.97) text messages. Daily text messages improved the consumption of infant MNP packets. However, the impact was not large enough to increase the probability of caregivers being fully adherent to the feeding instruction, which is to feed 5-7 packets per week as recommended. In addition, when the mother is the caregiver and when the caregiver can check or knows how to send text messages there is greater adherence by the primary caregivers. http://www.isrctn.com/ISRCTN44149146.

  1. Using daily text messages to improve adherence to infant micronutrient powder (MNP) packets in rural western China: A cluster-randomized controlled trial

    Science.gov (United States)

    Wang, Xu; Liu, Chengfang; Zhang, Linxiu; Yue, Ai; Medina, Alexis; Rozelle, Scott

    2018-01-01

    Objective To evaluate the effectiveness of daily text messages as a means to improve caregivers’ adherence to infant micronutrient powder (MNP) in rural Shaanxi Province of China. Methodology 638 infants aged 6–11 months in 234 villages were involved in a cluster-randomized controlled trial (RCT). All caregivers were given free infant MNP packets at baseline in April 2013 and the follow-up survey was in July 2013. We randomly assigned 318 infants in 117 villages to treatment group (receiving daily text message) and 320 infants in the other 117 villages as control group. Results On average, daily text messages increased the number of MNP packets fed (marginal effect = 4.63; 95% confidence interval (CI) = 0.16, 9.10). The text message is more likely to increase the consumption of MNP packets if the primary caregiver was the mother (marginal effect = 12.19; 95% CI = 0.69, 23.68). Receiving the text message appears to significantly increase the likelihood of full adherence when the primary caregiver can either check (odds ratio = 2.93; 95% CI = 1.34, 6.40) or knows how to send (odds ratio = 3.26; 95% CI = 1.53, 6.97) text messages. Conclusion Daily text messages improved the consumption of infant MNP packets. However, the impact was not large enough to increase the probability of caregivers being fully adherent to the feeding instruction, which is to feed 5–7 packets per week as recommended. In addition, when the mother is the caregiver and when the caregiver can check or knows how to send text messages there is greater adherence by the primary caregivers. Trial registration http://www.isrctn.com/ISRCTN44149146 PMID:29352304

  2. Development and Evaluation of cooperative control system for an HVDC transmission system connected with an isolated BWR power plant

    International Nuclear Information System (INIS)

    Horiuchi, Susumu; Hara, Tsukusi; Matori, Iwao; Hirayama, Kaiichirou.

    1987-01-01

    In the cooperative control system developed for an HVDC transmission system connected with an isolated BWR power plant, the equilibrium state between power plant output and DC transmission power is examined by way of the detection of the generator frequency. And, thereby start-up and shutdown of the DC system and controlling of the transmission power are made, so that the signal transmission with the power plant becomes unnecessary, enabling the easy cooperative operation. In order to investigate validity of this control system, various digital simulation and simulator test with the control system were carried out. In this way, behavior of the power plant and stability of the DC transmission system were evaluated in the connection to the DC system at power plant start-up, follow of the transmission power in change of the power plant output and in various system failures. (Mori, K.)

  3. Can Telemedicine Improve Adherence to Resuscitation Guidelines for Critically Ill Children at Community Hospitals? A Randomized Controlled Trial Using High-Fidelity Simulation.

    Science.gov (United States)

    Yang, Chris P; Hunt, Elizabeth A; Shilkofski, Nicole; Dudas, Robert; Egbuta, Chinyere; Schwartz, Jamie M

    2017-07-01

    Children transferred from community hospitals lacking specialized pediatric care are more seriously ill than those presenting to pediatric centers. Pediatric consultation and adherence to management guidelines improve outcomes. The aims of the study were (1) to assess whether telemedicine consultation in critical situations is feasible and (2) to compare the impact of pediatric critical care medicine (PCCM) consultation via telemedicine versus telephone on community hospital adherence to resuscitation guidelines through a randomized controlled telemedicine trial. In situ, high-fidelity simulation scenarios of critically ill children presenting to a community hospital and progressing to cardiopulmonary arrest were performed. Scenarios were randomized to PCCM consultation via telephone (control) or telemedicine (intervention). Primary outcome measure was proportion of teams who successfully defibrillated in 180 seconds or less from presentation of pulseless ventricular tachycardia. The following 30 scenarios were completed: 15 control and 15 intervention. Only 11 (37%) of 30 teams, defibrillated in 180 seconds or less from presentation of pulseless ventricular tachycardia; control: 6 (40%) of 15 versus intervention: 5 (33%) of 15, P = 0.7. Request for or use of backboard during cardiopulmonary resuscitation occurred in 24 (80%) of 30 scenarios; control: 9 (60%) of 15 versus intervention: 15 (100%) of 15, P = 0.006. Request for or use of stepstool during cardiopulmonary resuscitation occurred in 6 (20%) of 30 scenarios; control: 1 (7%) of 15 versus intervention: 5 (33%) of 15, P = 0.07. This study demonstrates the feasibility of using telemedicine to support acute management of children who present to community hospitals. Neither study arm adhered to current resuscitation guidelines and telemedicine consultation with PCCM experts was not associated with improvement. However, further research on optimizing telemedicine impact on the quality of pediatric care at

  4. MEDication reminder APPs to improve medication adherence in Coronary Heart Disease (MedApp-CHD) Study: a randomised controlled trial protocol.

    Science.gov (United States)

    Santo, Karla; Chow, Clara K; Thiagalingam, Aravinda; Rogers, Kris; Chalmers, John; Redfern, Julie

    2017-10-08

    The growing number of smartphone health applications available in the app stores makes these apps a promising tool to help reduce the global problem of non-adherence to long-term medications. However, to date, there is limited evidence that available medication reminder apps are effective. This study aims to determine the impact of medication reminder apps on adherence to cardiovascular medication when compared with usual care for people with coronary heart disease (CHD) and to determine whether an advanced app compared with a basic app is associated with higher adherence. Randomised controlled trial with follow-up at 3 months to evaluate the feasibility and effectiveness of medication reminder apps on medication adherence compared with usual care. An estimated sample size of 156 patients with CHD will be randomised to one of three groups (usual care group, basic medication reminder app group and advanced medication reminder app group). The usual care group will receive standard care for CHD with no access to a medication reminder app. The basic medication reminder app group will have access to a medication reminder app with a basic feature of providing simple daily reminders with no interactivity. The advanced medication reminder app group will have access to a medication reminder app with additional interactive and customisable features. The primary outcome is medication adherence measured by the eight-item Morisky Medication Adherence Scale at 3 months. Secondary outcomes include clinical measurements of blood pressure and cholesterol levels, and medication knowledge. A process evaluation will also be performed to assess the feasibility of the intervention by evaluating the acceptability, utility and engagement with the apps. Ethical approval has been obtained from the Western Sydney Local Health Network Human Research Ethics Committee (AU/RED/HREC/1/WMEAD/3). Study findings will be disseminated via usual scientific forums. ACTRN12616000661471; Pre-results.

  5. “It All Started from Worms”: Korea-Japan Parasite Control Cooperation and Asian Network, 1960s - 1980s

    Directory of Open Access Journals (Sweden)

    Junho JUNG

    2018-04-01

    Full Text Available The Korea Association of Health Promotion and Japanese Organization for International Cooperation in Family Planning (JOICFP, and Taiwan’s Chinese Foundation of Health all originated from parasite control organizations. Currently these organizations hold no apparent relations to parasite control activities. However, many of the senior leaderships of these organizations including presidents, have parasitology as their background. Kunii Chojiro (the founder of Japan Association of Parasite Control (JAPC and JOICFP explained it as “it all started from worms.” In 1949, Kunii Chojiro established JAPC after personally experienced intestinal parasite infection. The JAPC people conducted mass examination and mass chemotherapy focusing on school children, which allowed them to have sustainable income. In 1965, the Korea Association of Parasite Eradication (KAPE requested JAPC to assist Korea’s parasite control activity. In 1968, when Korea-Japan cooperation for parasite control activity established, Japan’s operating procedures were directly absorbed by KAPE. With support from JAPC and official development aid through Overseas Technical Cooperation Agency in Japan (now Japan International Cooperation Agency, Korea successfully controlled parasite infection. Post-war and cold-war geopolitics had a significant impact on Korea-Japan cooperation. In 1960s the president of KAPE, Chong-Chin Lee and Kunii Chojiro were well known figures in population control network. They did understand the importance of population control, but did not agree with the approaches taken by western population control experts. From their point of view, it had to be self-initiated, economically self sustainable grass-root activities rather than top-down activities, as experienced in their parasite control in Japan and Korea. This lead to a new Asian model named “Integrated Program”. Together with their influence in population control network, Kunii and Lee manage to

  6. Healthy Beyond Pregnancy, a Web-Based Intervention to Improve Adherence to Postpartum Care: Randomized Controlled Feasibility Trial.

    Science.gov (United States)

    Himes, Katherine Park; Donovan, Heidi; Wang, Stephanie; Weaver, Carrie; Grove, Jillian Rae; Facco, Francesca Lucia

    2017-10-10

    During the postpartum visit, health care providers address issues with short- and long-term implications for maternal and child health. Women with Medicaid insurance are less likely to return for a postpartum visit compared with women with private insurance. Behavioral economics acknowledges that people do not make exclusively rational choices, rather immediate gratification, cognitive and psychological biases, and social norms influence decision making. Drawing on insights from decision science, behavioral economists have examined how these biases can be modulated through carefully designed interventions. We have developed a Web-based tool, Healthy Beyond Pregnancy, that incorporates empirically derived concepts of behavioral economics to improve adherence rates to the postpartum visit. The primary objectives of this pilot study were to (1) refine and assess the usability of Healthy Beyond Pregnancy and (2) assess the feasibility of a randomized controlled trial (RCT) of the intervention. We used a multistep process and multidisciplinary team of maternal-fetal medicine physicians, a behavioral economist, and researchers with expertise in behavioral interventions to design Healthy Beyond Pregnancy. We assessed the usability of the program with the Post-Study System Usability Questionnaire (PSSUQ), a validated 7-point scale, and semistructured interviews with postpartum women. We then conducted a feasibility trial to determine the proportion of eligible women who were willing to participate in an RCT of Healthy Beyond Pregnancy and the proportion of women willing to complete the Web-based program. Exploratory outcomes of the pilot trial included attendance at the postpartum visit, uptake of long-acting reversible contraception, and uptake of any contraception. The median PSSUQ score for Healthy Beyond Pregnancy was 6.5 (interquartile range: 6.1-7) demonstrating high usability. Semistructured interviews (n=10) provided in-depth comments about users' experience and

  7. Policy on Hazard Analysis and Critical Control Point (HACCP) and adherence to food preparation guidelines: a cross sectional survey of stakeholders in food service in Kumasi, Ghana.

    Science.gov (United States)

    Agyei-Baffour, Peter; Sekyere, Kofi Boateng; Addy, Ernestine Akosua

    2013-11-04

    Food borne diseases claim more lives and are growing public health concerns. Simple preventive techniques such as adoption and adherence to hazard analysis and critical control point (HACCP) policy can significantly reduce this disease burden. Though food screening and inspection are done, the ultimate regulation, Hazard Analysis and Critical Control Point, which is known and accepted worldwide, appears not to be popular among food operators in Ghana. This paper examines the level of awareness of the existence of policy on hazard analysis and critical control point (HACCP) and its adherence to food preparation guidelines among food service providers in Ghana. The results revealed the mean age of food providers as 33.1 years with a standard deviation of 7.5, range of 18-55 years, more females, in full time employment and with basic education. Of the fifty institutional managers, 42 (84%) were senior officers and had worked for more than five years. Education and type of food operator had strong statistically significant relationship with the implementation of HCCP policy and adherence with food preparation guidelines. The enforcement of HACCP policy and adherence with food safety guidelines was led by the Ghana Tourist Board, Public Health officers, and KMA, respectively. While a majority of food operators 373/450 (83.3%) did not know HACCP policy is part of food safety guidelines, staff of food safety law enforcement 44/50 (88%) confirmed knowing that food operators were not aware of the HACCP policy. The study documents evidence on the practice of food safety principles or HACCP policy or adherence to food preparation guidelines. Existing food safety guidelines incorporate varying principles of HACCP, however, awareness is low among food operators. The implication is that food production is likely to fall short of acceptable standards and not be wholesome putting consumers at health risk. Repeating this study in rural and urban areas in Ghana is necessary to

  8. Diabetes treatment satisfaction, medication adherence, and glycemic control among ambulatory type 2 diabetic nigerians in a primary care clinic of a tertiary hospital situated in a resource-limited environment of Southeast Nigeria

    Directory of Open Access Journals (Sweden)

    Iloh Gabriel Uche Pascal

    2016-01-01

    Full Text Available Background: Diabetic treatment satisfaction, medication adherence, and glycemic control are widely recognized as the cornerstones for successful management of diabetes and proxy indicators of quality of care. However, in Nigeria, nothing is known on the role of diabetic treatment satisfaction on medication adherence and blood glucose control. Aim: The study was aimed at determining the role of diabetes treatment satisfaction in medication adherence and glycemic control among ambulatory type 2 diabetic Nigerians in a primary care clinic in Southeast Nigeria. Materials and Methods: This was a descriptive study that was carried out on 120 type 2 diabetic Nigerians who were on treatment for at least 3 months at the primary care clinic of a tertiary hospital in Nigeria. Diabetes treatment satisfaction and medication adherence were assessed in the previous 30 days using pretested, interviewer-administered questionnaire on self-reported satisfaction and adherence to therapy, respectively. Glycemic control was assessed in the previous 1 month. A patient was defined to have goal glycemic control if the fasting blood glucose at the end of the study, visit was between 70 and 130 mg/dL. Results: Diabetic treatment satisfaction, medication adherence, and glycemic control rates were 85.8%, 72.5%, and 61.7%, respectively. Diabetic treatment satisfaction was significantly associated with medication adherence (P = 0.025 and glycemic control (P = 0.04. Conclusion: Diabetic treatment satisfaction was significantly associated with medication adherence and glycemic control. However, treatment satisfaction did not translate marginally to higher medication and glycemic control. Diabetic treatment satisfaction should be integrated into a standard care package for diabetic patients in primary care settings.

  9. Therapist adherence in the strong without anorexia nervosa (SWAN) study: A randomized controlled trial of three treatments for adults with anorexia nervosa.

    Science.gov (United States)

    Andony, Louise J; Tay, Elaine; Allen, Karina L; Wade, Tracey D; Hay, Phillipa; Touyz, Stephen; McIntosh, Virginia V W; Treasure, Janet; Schmidt, Ulrike H; Fairburn, Christopher G; Erceg-Hurn, David M; Fursland, Anthea; Crosby, Ross D; Byrne, Susan M

    2015-12-01

    To develop a psychotherapy rating scale to measure therapist adherence in the Strong Without Anorexia Nervosa (SWAN) study, a multi-center randomized controlled trial comparing three different psychological treatments for adults with anorexia nervosa. The three treatments under investigation were Enhanced Cognitive Behavioural Therapy (CBT-E), the Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), and Specialist Supportive Clinical Management (SSCM). The SWAN Psychotherapy Rating Scale (SWAN-PRS) was developed, after consultation with the developers of the treatments, and refined. Using the SWAN-PRS, two independent raters initially rated 48 audiotapes of treatment sessions to yield inter-rater reliability data. One rater proceeded to rate a total of 98 audiotapes from 64 trial participants. The SWAN-PRS demonstrated sound psychometric properties, and was considered a reliable measure of therapist adherence. The three treatments were highly distinguishable by independent raters, with therapists demonstrating significantly more behaviors consistent with the actual allocated treatment compared to the other two treatment modalities. There were no significant site differences in therapist adherence observed. The findings provide support for the internal validity of the SWAN study. The SWAN-PRS was deemed suitable for use in other trials involving CBT-E, MANTRA, or SSCM. The Authors. International Journal of Eating Disorders Published by Wiley Periodicals, Inc.

  10. Adherence to a lifestyle programme in overweight/obese pregnant women and effect on gestational diabetes mellitus: a randomized controlled trial.

    Science.gov (United States)

    Bruno, Raffaele; Petrella, Elisabetta; Bertarini, Valentina; Pedrielli, Giulia; Neri, Isabella; Facchinetti, Fabio

    2017-07-01

    This study aims to determine whether the prescription of a detailed lifestyle programme in overweight/obese pregnant women influences the occurrence of gestational diabetes (GDM), and if this kind of prescription increases the adherence to a healthier lifestyle in comparison to standard care. The study was designed as a randomized controlled trial, with open allocation, enrolling women at 9-12 weeks of pregnancy with a BMI ≥ 25 kg/m 2 . The women assigned to the Intervention group (I = 96) received a hypocaloric, low-glycaemic, low-saturated fat diet and physical activity recommendations. Those assigned to the Standard Care group (SC = 95) received lifestyle advices regarding healthy nutrition and exercise. Follow-up was planned at the 16 th , 20 th , 28 th and 36 th weeks. A total of 131 women completed the study (I = 69, SC = 62). The diet adherence was higher in the I (57.9%) than in the SC (38.7%) group. GDM occurred less frequently in the I (18.8%) than in the SC (37.1%, P = 0.019) group. The adherent women from either groups showed a lower GDM rate (12.5% vs. 41.8%, P  4000 g were significantly lower in I group. The incidence of small for gestational age babies was not different. These findings demonstrate that the adherence to a personalized, hypocaloric, low-glycaemic, low-saturated fat diet started early in pregnancy prevents GDM occurrence, in women with BMI ≥ 25 kg/m 2 . © 2016 John Wiley & Sons Ltd.

  11. A randomized controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia

    OpenAIRE

    Stip, Emmanuel; Vincent, Philippe D.; Sablier, Juliette; Guevremont, Catherine; Zhornitsky, Simon; Tranulis, Constantin

    2013-01-01

    Objective: Medication adherence is extremely important in preventing relapse and lowering symptoms in schizophrenic patients. However, estimates show that nearly half of these patients have poor adherence. The Brief Adherence Rating Scale (BARS) seems to be the most reliable tool assessing adherence in schizophrenia and shows that the antipsychotic adherence ratio (AAR) is about 49.5% in schizophrenia. The aim of the study was to test if an electronic pill dispenser named DoPill® improved AAR...

  12. A randomized-controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia

    OpenAIRE

    Emmanuel eStip; Emmanuel eStip; Emmanuel eStip; Philippe D. Vincent; Philippe D. Vincent; Philippe D. Vincent; Catherine eGuevremont; Simon eZhornitsky; Constantin eTranulis; Constantin eTranulis; Constantin eTranulis; Juliette eSablier; Juliette eSablier

    2013-01-01

    Objective: Medication adherence is extremely important in preventing relapse and lowering symptoms in schizophrenic patients. However, estimates show that nearly half of these patients have poor adherence. The Brief Adherence Rating Scale (BARS) seems to be the most reliable tool assessing adherence in schizophrenia and shows that the antipsychotic adherence ratio (AAR) is about 49.5 % in schizophrenia. The aim of the study was to test if an electronic pill dispenser named DoPill® improv...

  13. Cooperative Control of Multi-Master-Slave Islanded Microgrid with Power Quality Enhancement Based on Conservative Power Theory

    DEFF Research Database (Denmark)

    Mortezaei, Ali; Simoes, Marcelo; Savaghebi, Mehdi

    2018-01-01

    Cooperative control of power converters in a microgrid offers power quality enhancement at sensitive load buses. Such cooperation is particularly important in the presence of reactive, nonlinear and unbalanced loads. In this paper, a multi-master-slave-based control of Distributed Generators (DGs...... in a selective control strategy able to share each current component with desired percentage among the microgrid inverters. Simulation results are presented to demonstrate the effectiveness of the proposed method.......) interface converters in a three-phase four-wire islanded microgrid using the Conservative Power Theory (CPT) is proposed. Inverters located in close proximity operate as a group in master-salve mode. Slaves inject the available energy and compensate selectively unwanted current components of local loads...

  14. An fMRI study of joint action – varying levels of cooperation correlates with activity in sensorimotor control, but not mentalization, networks

    Directory of Open Access Journals (Sweden)

    Thierry eChaminade

    2012-06-01

    Full Text Available As social agents, humans continuously interact with with the people around them. Here, motor cooperation was investigated by designing a situation in which pairs of participants, one being scanned with fMRI, controlled jointly a visually presented object with joystick movements. The object oscillated dynamically along two dimensions, shades of pink and width of gratings, corresponding to the two cardinal directions of joystick movements. While the overall control of each participant on the object was kept constant, the amount of cooperation along the two dimensions varied along four levels, from no (each participant controlled exclusively one dimension to full (each participant controlled half of each dimension cooperation. Increasing cooperation correlated with BOLD signal in the left parietal operculum and anterior cingulate cortex, while decreasing cooperation correlated with activity in the right inferior frontal and superior temporal gyri, in the intraparietal sulci and inferior temporal gyrii bilaterally, and in the dorsomedial prefrontal cortex. As joint control improved with the level of cooperation, we assessed the brain responses correlating with joint performance, and found that activity in most of the areas associated with levels of cooperation also correlated with the joint performance. The only brain area found exclusively in the negative correlation with cooperation was within the posterior region of the rostral medial frontal cortex, involved in the monitoring of action outcome. We therefore propose that this region responds to the predictability of visual feedback given the motor commands, which is maximal when participants do not cooperate as they fully control one dimension. Our results therefore indicate that, in the current experimental paradigm, the level of cooperation affects sensorimotor processing, but not mentalizing. Altogether, humans do not need to have access to others’ intentional states to cooperate on a joint

  15. The Effect of Using Assessment Instruments on Substance-abuse Outpatients' Adherence to Treatment: a Multi-centre Randomised Controlled Trial

    Directory of Open Access Journals (Sweden)

    Broekaert Eric

    2011-05-01

    Full Text Available Abstract Background Drop-out is an important problem in the treatment of substance use disorder. The focus of this study was to investigate the effectiveness of within treatment assessment with feedback directly to patients with multiple substance use disorder on outpatient individual treatment adherence. Feedback consisted of personal resources' and readiness to change status and progress that facilitate or hinder change, thereby using graphical representation. Methods Informed consent was obtained from both the control and experimental groups to be involved in research and follow-up. Following Zelen's single consent design, baseline participants (n = 280 were randomised (sample-size-estimation: 80%power, p=.05, 2-sided and treatment consent was obtained from those allocated to the experiment (n = 142. In both groups, equal numbers of patients did not attend sessions after allocation. So, 227 persons were analyzed according to intention-to-treat analysis (ITT: experiment n = 116;control n = 111. Excluding refusals 211 participants remained for per-protocol analysis (PP: experiment n = 100; control n = 111, The study was conducted in five outpatient treatment-centres of a large network (De Sleutel in Belgium. Participants were people with multiple substance use disorder -abuse and dependence- who had asked for treatment and who had been advised to start individual treatment after a standardised admission assessment with the European Addiction Severity Index. The experimental condition consisted of informing the patient about the intervention and of subsequent assessments plus feedback following a protocol within the first seven sessions. Assessments were made with the Readiness to Change Questionnaire and the Personal Resources Diagnostic System. The control group received the usual treatment without within treatment assessment with feedback. The most important outcome measure in this analysis of the study was the level of adherence to treatment

  16. Influences on Energy Savings of Heavy Trucks Using Cooperative Adaptive Cruise Control

    Energy Technology Data Exchange (ETDEWEB)

    Lammert, Michael P [National Renewable Energy Laboratory (NREL), Golden, CO (United States); McAuliffe, Brian [National Research Council Canada; Lu, Xiao-Yun [University of California-Berkeley; Shladover, Steven [University of California-Berkeley; Surcel, Marius-Dorin [FPInnovations; Kailas, Aravind [Volvo Group

    2018-04-03

    An integrated adaptive cruise control (ACC) and cooperative ACC (CACC) was implemented and tested on three heavy-duty tractor-trailer trucks on a closed test track. The first truck was always in ACC mode, and the followers were in CACC mode using wireless vehicle-vehicle communication to augment their radar sensor data to enable safe and accurate vehicle following at short gaps. The fuel consumption for each truck in the CACC string was measured using the SAE J1321 procedure while travelling at 65 mph and loaded to a gross weight of 65,000 lb, demonstrating the effects of: inter-vehicle gaps (ranging from 3.0 s or 87 m to 0.14 s or 4 m, covering a much wider range than previously reported tests), cut-in and cut-out maneuvers by other vehicles, speed variations, the use of mismatched vehicles (standard trailers mixed with aerodynamic trailers with boat tails and side skirts), and the presence of a passenger vehicle ahead of the platoon. The results showed that energy savings generally increased in a non-linear fashion as the gap was reduced. The middle truck saved the most fuel at gaps shorter than 12 m and the trailing truck saved the most at longer gaps, while lead truck saved the least at all gaps. The cut-in and cut-out maneuvers had only a marginal effect on fuel consumption even when repeated every two miles. The presence of passenger-vehicle traffic had a measurable impact. The fuel-consumption savings on the curves was less than on the straight sections.

  17. Treating Depression and Adherence (CBT-AD) in Patients with HIV in Care: A Three-arm Randomized Controlled Trial

    Science.gov (United States)

    Safren, Steven A.; Bedoya, C. Andres; O’Cleirigh, Conall; Biello, Katie B.; Pinkston, Megan M.; Stein, Michael D.; Traeger, Lara; Kojic, Erna; Robbins, Gregory K.; Lerner, Jonathan A.; Herman, Debra S.; Mimiaga, Matthew J.; Mayer, Kenneth H.

    2016-01-01

    Summary Background Depression, highly prevalent in HIV, is consistently associated with worse ART adherence. Integrating CBT for depression with adherence counseling using the “Life-Steps” approach (CBT-AD) has an emerging evidence base. The aim of the current study was to test the efficacy of CBT-AD. Methods We conducted a three-arm RCT (N=240 HIV-positive adults with depression), comparing CBT-AD to Life-Steps integrated with information and supportive psychotherapy (ISP-AD) (both 12 sessions), and to ETAU (1 session Life-Steps). Participants were recruited from three sites in New England area, two being hospital settings, and one being a community health center. Randomization was done via a 2:2:1 ratio, using random allocation software by the data manager, in pairs, stratified by three variables: site, whether or not the participant was prescribed antidepressant medications, and history of injection drug use. The primary outcome was adherence assessed via electronic pill caps (MEMs) with correction for “pocketed” doses. Secondary outcomes included depression, plasma HIV RNA and CD4. Follow-ups occurred at 4, 8 and 12 months. We used intent-to treat analyses with ANCOVA for independent-assessor pre-post assessments of depression and mixed effects modeling for longitudinal assessments. Clinical Trial Registration: NCT00951028, https://clinicaltrials.gov/ct2/show/NCT00951028), closed to new participants. Findings The period of recruitment was February 26, 2009 to June 21, 2012, with the 12-month follow-up period extending until April 29, 2013. There were no study-related adverse events. CBT-AD (n=94 randomized, 83 retained) had greater improvements in adherence (Est.=1·00, CI=0·34, 1·66, p=0·003) and depression (CES-D Est.=−0·41, CI=−0·66, −0·16, p=0·001; MADRS Est.=−4·69, CI=−8·09, −1·28, p=0·007; CGI Est.=−0·66, CI=−1·11,-0·21, p=0·005) than ETAU (49 randomized, 46 retained) at post-treatment (4-month). Over follow-ups, CBT

  18. Modelling and Simulation of Cooperative Control for Bus Rapid Transit Vehicle Platoon in a Connected Vehicle Environment

    Directory of Open Access Journals (Sweden)

    Jiahui Liu

    2017-02-01

    Full Text Available The aim of this paper is to develop a cooperative control model for improving the operational efficiency of Bus Rapid Transit (BRT vehicles. The model takes advantage of the emerging connected vehicle technology. A connected vehicle centre is established to assign a specific reservation time interval and transmit the corresponding dynamic speed guidance to each BRT vehicle. Furthermore, a set of constraints have been set up to avoid bus queuing and waiting phenomena in downstream BRT stations. Therefore, many BRT vehicles are strategically guided to form a platoon, which can pass through an intersection with no impedance. An actual signalized intersection along the Guangzhou BRT corridor is employed to verify and assess the cooperative control model in various traffic conditions. The simulation-based evaluation results demonstrate that the proposed approach can reduce delays, decrease the number of stops, and improve the sustainability of the BRT vehicles.

  19. US/Belarusian government-to-government material protection, control, and accounting cooperation at the Sosny Science and Technology Center

    International Nuclear Information System (INIS)

    Case, R.S. Jr.; Baumann, M.; Madsen, R.W.; Krevsum, E.; Haase, M.

    1996-01-01

    A formal program of cooperation between the US Department of Energy and the Belarusian regulatory agency Promatomnazdor (PAN) began in 1994. A visit to the Belarusian Sosny Science and Technology Center (SSTC) by representatives from the US, Sweden, Japan, and the International Atomic Energy Agency resulted in a multinational program of cooperation to enhance the existing material protection, control, and accounting systems in place at Sosny. Specific physical-protection-related recommendations included upgrades to the physical protection systems at Buildings 33 and 40 at Sosny and the security systems in the SSTC central alarm station. US experts in conjunction with the multinational team and Belarus representatives, have reviewed initial designs for physical protection upgrades at Sosny. Subsequently, the US assumed an essential role for funding and technical oversight for enhancements at the SSTC, aspects of its emergency communication systems, and the upgrade of the SSTC site access control system. This paper addresses the status of physical protection enhancements at the Sosny site

  20. A Cooperative Traffic Control of Vehicle–Intersection (CTCVI) for the Reduction of Traffic Delays and Fuel Consumption

    Science.gov (United States)

    Li, Jinjian; Dridi, Mahjoub; El-Moudni, Abdellah

    2016-01-01

    The problem of reducing traffic delays and decreasing fuel consumption simultaneously in a network of intersections without traffic lights is solved by a cooperative traffic control algorithm, where the cooperation is executed based on the connection of Vehicle-to-Infrastructure (V2I). This resolution of the problem contains two main steps. The first step concerns the itinerary of which intersections are chosen by vehicles to arrive at their destination from their starting point. Based on the principle of minimal travel distance, each vehicle chooses its itinerary dynamically based on the traffic loads in the adjacent intersections. The second step is related to the following proposed cooperative procedures to allow vehicles to pass through each intersection rapidly and economically: on one hand, according to the real-time information sent by vehicles via V2I in the edge of the communication zone, each intersection applies Dynamic Programming (DP) to cooperatively optimize the vehicle passing sequence with minimal traffic delays so that the vehicles may rapidly pass the intersection under the relevant safety constraints; on the other hand, after receiving this sequence, each vehicle finds the optimal speed profiles with the minimal fuel consumption by an exhaustive search. The simulation results reveal that the proposed algorithm can significantly reduce both travel delays and fuel consumption compared with other papers under different traffic volumes. PMID:27999333

  1. A Cooperative Traffic Control of Vehicle–Intersection (CTCVI for the Reduction of Traffic Delays and Fuel Consumption

    Directory of Open Access Journals (Sweden)

    Jinjian Li

    2016-12-01

    Full Text Available The problem of reducing traffic delays and decreasing fuel consumption simultaneously in a network of intersections without traffic lights is solved by a cooperative traffic control algorithm, where the cooperation is executed based on the connection of Vehicle-to-Infrastructure (V2I. This resolution of the problem contains two main steps. The first step concerns the itinerary of which intersections are chosen by vehicles to arrive at their destination from their starting point. Based on the principle of minimal travel distance, each vehicle chooses its itinerary dynamically based on the traffic loads in the adjacent intersections. The second step is related to the following proposed cooperative procedures to allow vehicles to pass through each intersection rapidly and economically: on one hand, according to the real-time information sent by vehicles via V2I in the edge of the communication zone, each intersection applies Dynamic Programming (DP to cooperatively optimize the vehicle passing sequence with minimal traffic delays so that the vehicles may rapidly pass the intersection under the relevant safety constraints; on the other hand, after receiving this sequence, each vehicle finds the optimal speed profiles with the minimal fuel consumption by an exhaustive search. The simulation results reveal that the proposed algorithm can significantly reduce both travel delays and fuel consumption compared with other papers under different traffic volumes.

  2. Choosing the cooperative option

    Energy Technology Data Exchange (ETDEWEB)

    English, G. (National Rural Electric Cooperative Association (United States))

    1999-06-01

    Cooperatives do not ask to be exempted from the law. They do ask that laws and regulations be designed to allow them to meet the needs of their consumer-owners in accordance with cooperative principles, at a time that the marginal consumers being abandoned by for-profit utilities may be ready to gravitate toward cooperatives. The cooperative principles are worth reviewing because they explain the focus on the consumer and the cooperative concept of service: cooperatives are voluntary organizations, open to all persons able to use their services and willing to accept the responsibilities of membership; cooperatives are democratic organizations controlled by their members, who actively participate in setting policies and making decisions, the elected representatives are accountable to the membership; members contribute equitably to, and democratically control, the capital of their cooperative; cooperatives are autonomous, self-help organizations controlled by their members, if they enter into agreements with other organizations, including governments, they do so on terms that ensure democratic control by their members and maintain their cooperative autonomy; cooperatives provide education and training for their members, elected representatives, managers, and employees so they can contribute effectively to the development of their cooperatives, they inform the general public, particularly young people and opinion leaders, about the nature and benefits of cooperation; cooperatives serve their members most effectively and strength the cooperative movement by working together through local, national, regional, and international structures; and while focusing on member needs, cooperatives work for the sustainable development of their communities through policies accepted by their members.

  3. Controlling the transmitted information of a multi-photon interacting with a single-Cooper pair box

    Energy Technology Data Exchange (ETDEWEB)

    Kadry, Heba, E-mail: hkadry1@yahoo.com; Abdel-Aty, Abdel-Haleem, E-mail: hkadry1@yahoo.com; Zakaria, Nordin, E-mail: hkadry1@yahoo.com [Computer and Information Science Department, Universiti Teknologi Petronas, Seri Iskandar, 31750 Tronoh, Perak (Malaysia); Cheong, Lee Yen [Fundamental and Applied Science Department, Universiti Teknologi Petronas, Seri Iskandar, 31750 Tronoh, Perak (Malaysia)

    2014-10-24

    We study a model of a multi-photon interaction of a single Cooper pair box with a cavity field. The exchange of the information using this system is studied. We quantify the fidelity of the transmitted information. The effect of the system parameters (detuning parameter, field photons, state density and mean photon number) in the fidelity of the transmitted information is investigated. We found that the fidelity of the transmitted information can be controlled using the system parameters.

  4. Controlling the transmitted information of a multi-photon interacting with a single-Cooper pair box

    International Nuclear Information System (INIS)

    Kadry, Heba; Abdel-Aty, Abdel-Haleem; Zakaria, Nordin; Cheong, Lee Yen

    2014-01-01

    We study a model of a multi-photon interaction of a single Cooper pair box with a cavity field. The exchange of the information using this system is studied. We quantify the fidelity of the transmitted information. The effect of the system parameters (detuning parameter, field photons, state density and mean photon number) in the fidelity of the transmitted information is investigated. We found that the fidelity of the transmitted information can be controlled using the system parameters

  5. Community cooperatives and insecticide-treated materials for malaria control: a new experience in Latin America.

    Science.gov (United States)

    Kroeger, Axel; Aviñna, Ana; Ordoñnez-Gonzalez, José; Escandon, Celia

    2002-11-15

    Insecticide-treated materials (ITMs) are effective in substantially reducing the burden of malaria and other vector-borne diseases; but how can high coverage rates of ITMs be achieved and maintained? In south Mexico and on the Pacific and Atlantic coasts of Colombia 14 community-based cooperatives offering three different kinds of ITM services (sale of impregnation services; sale of impregnated nets; production of nets and sale of impregnated nets) were formed and supervised by a national health service (IMSS-SOLIDARIDAD, Mexico) and by an academic institution (the Colombian Institute of Tropical Medicine) along with local district health services. The objectives of this research were to analyse the processes and results of this approach and to identify the favourable and limiting factors. The methods used for data collection and analysis were group discussions, individual and semi-structured interviews with users and non-users of ITMs, individual in-depth interviews with cooperative members and supervisors, checks of sales book and observation of impregnation services. Coverage with unimpregnated nets was above 50% in all study areas. The fastest increase of ITM coverage was achieved through the exclusive sale of impregnation services. Low-cost social marketing techniques were used to increase demand. The large-scale production of nets in two cooperatives was only possible with the aid of an international NGO which ordered impregnated bednets for their target group. A number of favourable and limiting factors relating to the success of ITM cooperatives were identified. Of particular importance for the more successful Mexican cooperatives were: a) support by health services, b) smaller size, c) lesser desire for quick returns and d) lower ITM unit costs. ITM community cooperatives supported and supervised by the health services have good potential in the Latin American context for achieving and maintaining high impregnation rates.

  6. Community cooperatives and insecticide-treated materials for malaria control: a new experience in Latin America

    Directory of Open Access Journals (Sweden)

    Ordoñnez-Gonzalez José

    2002-11-01

    Full Text Available Abstract Background and objectives Insecticide-treated materials (ITMs are effective in substantially reducing the burden of malaria and other vector-borne diseases; but how can high coverage rates of ITMs be achieved and maintained? In south Mexico and on the Pacific and Atlantic coasts of Colombia 14 community-based cooperatives offering three different kinds of ITM services (sale of impregnation services; sale of impregnated nets; production of nets and sale of impregnated nets were formed and supervised by a national health service (IMSS-SOLIDARIDAD, Mexico and by an academic institution (the Colombian Institute of Tropical Medicine along with local district health services. The objectives of this research were to analyse the processes and results of this approach and to identify the favourable and limiting factors. Methods The methods used for data collection and analysis were group discussions, individual and semi-structured interviews with users and non-users of ITMs, individual in-depth interviews with cooperative members and supervisors, checks of sales book and observation of impregnation services. Results Coverage with unimpregnated nets was above 50% in all study areas. The fastest increase of ITM coverage was achieved through the exclusive sale of impregnation services. Low-cost social marketing techniques were used to increase demand. The large-scale production of nets in two cooperatives was only possible with the aid of an international NGO which ordered impregnated bednets for their target group. A number of favourable and limiting factors relating to the success of ITM cooperatives were identified. Of particular importance for the more successful Mexican cooperatives were: a support by health services, b smaller size, c lesser desire for quick returns and d lower ITM unit costs. Conclusions ITM community cooperatives supported and supervised by the health services have good potential in the Latin American context for achieving

  7. 14 CFR 1260.72 - Adherence to original budget estimates.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Adherence to original budget estimates... COOPERATIVE AGREEMENTS General Post-Award Requirements § 1260.72 Adherence to original budget estimates. (a) Although NASA assumes no responsibility for budget overruns, the recipient may spend grant funds without...

  8. Cooperativeness and competitiveness as two distinct constructs: validating the Cooperative and Competitive Personality Scale in a social dilemma context.

    Science.gov (United States)

    Lu, Su; Au, Wing-Tung; Jiang, Feng; Xie, Xiaofei; Yam, Paton

    2013-01-01

    The present research validated the construct and criterion validities of the Cooperative and Competitive Personality Scale (CCPS) in a social dilemma context. The results from three studies supported the notion that cooperativeness and competitiveness are two independent dimensions, challenging the traditional view that they are two ends of a single continuum. First, confirmatory factor analyses revealed that a two-factor structure fit the data significantly better than a one-factor structure. Moreover, cooperativeness and competitiveness were either not significantly correlated (Studies 1 and 3) or only moderately positively correlated (Study 2). Second, cooperativeness and competitiveness were differentially associated with Schwartz's Personal Values. These results further supported the idea that cooperativeness and competitiveness are two distinct constructs. Specifically, the individuals who were highly cooperative emphasized self-transcendent values (i.e., universalism and benevolence) more, whereas the individuals who were highly competitive emphasized self-enhancement values (i.e., power and achievement) more. Finally, the CCPS, which adheres to the trait perspective of personality, was found to be a useful supplement to more prevalent social motive measures (i.e., social value orientation) in predicting cooperative behaviors. Specifically, in Study 2, when social value orientation was controlled for, the CCPS significantly predicted cooperative behaviors in a public goods dilemma (individuals who score higher on cooperativeness scale contributed more to the public goods). In Study 3, when social value orientation was controlled for, the CCPS significantly predicted cooperative behaviors in commons dilemmas (individuals who score higher on cooperativeness scale requested fewer resources from the common resource pool). The practical implications of the CCPS in conflict resolution, as well as in recruitment and selection settings, are discussed.

  9. Adherence to the Tobacco Control Act, 2007: presence of a workplace policy on tobacco use in bars and restaurants in Nairobi, Kenya.

    Science.gov (United States)

    Karimi, K J; Ayah, R; Olewe, T

    2016-09-28

    Despite extensive knowledge about effective tobacco control interventions, the prevalence of tobacco use in many middle- and low-income countries continues to rise. In these countries, public appreciation of levels of protection provided by laws and regulations on tobacco use and exposure to tobacco smoke is limited. After ratification of the Framework Convention on Tobacco Control, Kenya enacted the Tobacco Control Act, 2007, banning smoking in public places except in designated smoking areas. To assess adherence to the Tobacco Control Act, 2007 by determining the presence of a workplace policy on tobacco use in bars and restaurants. A survey of 176 liquor licensed bars and restaurants in Nairobi County was carried out. Their managers were asked about the presence of a workplace policy governing smoking of tobacco, and observations made on provisions that determine adherence to the Tobacco Control Act, 2007. Smoking took place in almost all bars and restaurants (150 (85%)). Half the establishments (86 (49%)) had a workplace policy governing tobacco use among employees, although a difference between bars (11 (23%)) and restaurants (75 (58%)) was recorded (pworkplace policy (p<0.001) and less likely to have 'no smoking' signs and designated smoking areas (p<0.005). Kenya's implementation of the Tobacco Control Act, 2007 does not provide sufficient protection of patrons and workers in bars and restaurants. It is important to sensitise hospitality workers to the dangers of tobacco smoke. Bar and restaurants managers should have a minimum post-secondary education level. The Tobacco Control Act, 2007 requires strengthening to ensure that bars and restaurants have a smoke-free environment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  10. Adesão ao tratamento e controle da pressão arterial em idosos com hipertensão Treatment adherence and blood pressure control in older individuals with hypertension

    Directory of Open Access Journals (Sweden)

    Rachel G. Bastos-Barbosa

    2012-07-01

    Full Text Available FUNDAMENTO: A não adesão ao tratamento tem sido identificada como a causa principal da Pressão Arterial (PA não controlada, e pode representar um risco maior em idosos. OBJETIVO: O objetivo deste estudo foi avaliar e comparar a taxa de adesão ao tratamento da hipertensão arterial por diferentes métodos, para estimar a taxa de controle da PA, e observar se há uma associação entre controle da pressão arterial e adesão. MÉTODOS: A adesão ao tratamento foi avaliada em pacientes idosos com hipertensão, acompanhados pelo serviço público de saúde, por meio de quatro métodos, incluindo o teste de Morisky-Green (referência, o questionário sobre atitudes referentes à ingestão de medicação (AMI, uma avaliação da adesão por parte do enfermeiro em consultório (AEC, e avaliação domiciliar da adesão (ADA. A ingestão de sal foi estimada pela excreção urinária de sódio de 24 horas. O controle da pressão arterial foi avaliado pelo monitorização ambulatorial da pressão arterial na vigília. RESULTADOS: A concordância entre o teste de Morisky-Green e o AMI (Kappa = 0,27 ou a AEC (Kappa = 0,05 foi pobre. Houve uma concordância moderada entre o teste de Morisky-Green e a ADA. Oitenta por cento tinham a PA controlada, incluindo 42% com efeito do jaleco branco. O grupo com menor excreção de sal relatou evitar o consumo de sal mais vezes (p BACKGROUND: Non-adherence to treatment has been identified as the main cause of uncontrolled blood pressure (BP, and may represent a greater risk in older individuals. OBJECTIVE: The aim of this study was to evaluate and compare the rate of adherence to hypertension treatment using different methods, to estimate the BP control rate, and to observe if there is an association between BP control and adherence. METHODS: Treatment adherence was evaluated in older patients with hypertension, followed by the public primary health care, through four methods, including the Morisky-Green test

  11. Improving adherence to antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Nischal K

    2005-01-01

    Full Text Available Antiretroviral therapy (ART has transformed HIV infection into a treatable, chronic condition. However, the need to continue treatment for decades rather than years, calls for a long-term perspective of ART. Adherence to the regimen is essential for successful treatment and sustained viral control. Studies have indicated that at least 95% adherence to ART regimens is optimal. It has been demonstrated that a 10% higher level of adherence results in a 21% reduction in disease progression. The various factors affecting success of ART are social aspects like motivation to begin therapy, ability to adhere to therapy, lifestyle pattern, financial support, family support, pros and cons of starting therapy and pharmacological aspects like tolerability of the regimen, availability of the drugs. Also, the regimen′s pill burden, dosing frequency, food requirements, convenience, toxicity and drug interaction profile compared with other regimens are to be considered before starting ART. The lack of trust between clinician and patient, active drug and alcohol use, active mental illness (e.g. depression, lack of patient education and inability of patients to identify their medications, lack of reliable access to primary medical care or medication are considered to be predictors of inadequate adherence. Interventions at various levels, viz. patient level, medication level, healthcare level and community level, boost adherence and overall outcome of ART.

  12. Status report on US-Russian laboratory-to-laboratory cooperation in nuclear materials protection, control and accounting

    International Nuclear Information System (INIS)

    Mullen, M.

    1996-01-01

    In April 1994, a new program of cooperation on nuclear materials protection, control, and accounting (MPC and A) was initiated between (1) the US Department of Energy and its laboratories and (2) nuclear institutes and enterprises of the Russian Federation. The program is called the Laboratory-to-Laboratory Nuclear Materials Protection, Control, and Accounting Program (Lab-to-Lab MPC and A Program); it is one of several, complementary US-Russian MPC and A programs. The purpose of the Lab-to-Lab MPC and A Program is to accelerate progress toward a goal that is vital to the national security interests of both countries: reducing the risk of nuclear weapons proliferation by strengthening MPC and A systems. In its first two years, the program has made significant progress and has expanded to include many additional Russian participants. It has also fostered a spirit of mutual understanding, partnership, and respect between US and Russian nuclear specialists, which has paved the way for advances in other MPC and A and nuclear security cooperative efforts. This paper reviews the current status of the program. In addition to summarizing the background and objectives of the program, the paper describes highlights of recent work and outlines future directions for Lab-to-Lab MPC and A cooperation

  13. Design and Control of Cooperativity in Spin-Crossover in Metal–Organic Complexes: A Theoretical Overview

    Directory of Open Access Journals (Sweden)

    Hrishit Banerjee

    2017-07-01

    Full Text Available Metal organic complexes consisting of transition metal centers linked by organic ligands, may show bistability which enables the system to be observed in two different electronic states depending on external condition. One of the spectacular examples of molecular bistability is the spin-crossover phenomena. Spin-Crossover (SCO describes the phenomena in which the transition metal ion in the complex under the influence of external stimuli may show a crossover between a low-spin and high-spin state. For applications in memory devices, it is desirable to make the SCO phenomena cooperative, which may happen with associated hysteresis effect. In this respect, compounds with extended solid state structures containing metal ions connected by organic spacer linkers like linear polymers, coordination network solids are preferred candidates over isolated molecules or molecular assemblies. The microscopic understanding, design and control of mechanism driving cooperativity, however, are challenging. In this review we discuss the recent theoretical progress in this direction.

  14. The effect of perceived adherence to the Bobath concept on physiotherapists' choice of intervention used to treat postural control after stroke.

    Science.gov (United States)

    Tyson, S F; Selley, A B

    2007-03-15

    The Bobath concept is the predominant stroke physiotherapy approach in the UK but there is little literature about its operationalization. The aim of this study was to assess the effect of perceived adherence to the Bobath concept on interventions used by physiotherapists to treat postural control problems after stroke. The physiotherapists' experience, clinical grade and the type of patients treated were also compared. The design was a cross sectional survey involving 11 NHS Trusts. The participants were 35 stroke physiotherapists who recorded the treatment of 132 patients in 644 sessions using the Stroke Physiotherapy Intervention Recording Tool. Descriptive statistics, independent t-tests and Chi-squares were used in the analysis to describe the physiotherapists and patients, and compare the effects of perceived adherence to the Bobath concept on intervention choice, clinical grade, experience and the type of patient treated. Most physiotherapists perceived their practice to be eclectic but the interventions used followed a traditional Bobath model. Perceived adherence to the Bobath concept had little effect on the choice of intervention. The only significant difference was that 'preparation for treatment' techniques were used more frequently by 'strongly Bobath' physiotherapists then 'eclectic' physiotherapists. There were no other significant differences, nor were there any differences in the physiotherapists' clinical grade, post-graduate training or the type of patient treated except that 'eclectic' physiotherapists' patients were older. Most of the 'strongly Bobath' physiotherapists were experienced and most of the 'eclectic' physiotherapists were novices (pBobath model; recent developments of the Bobath concept were not incorporated into clinical practice. The reasons for the mismatch between physiotherapists' perception and their actual practice are discussed.

  15. Financial incentives for improving adherence to maintenance treatment in patients with psychotic disorders (Money for Medication): a multicentre, open-label, randomised controlled trial.

    Science.gov (United States)

    Noordraven, Ernst L; Wierdsma, André I; Blanken, Peter; Bloemendaal, Anthony F T; Staring, Anton B P; Mulder, Cornelis L

    2017-03-01

    Provision of financial incentives is a promising intervention for improving adherence in patients taking antipsychotic medication. We aimed to assess the effectiveness of this intervention for improving adherence to antipsychotic depot medication in patients with psychotic disorders, irrespective of their previous compliance. We did this multicentre, open-label, randomised controlled trial at three mental health-care institutions in secondary psychiatric care services in the Netherlands. Eligible patients were aged 18-65 years, had been diagnosed with schizophrenia or another psychotic disorder, had been prescribed antipsychotic depot medication or had an indication to start using depot medication, and were participating in outpatient treatment. Patients were randomly assigned (1:1), via computer-generated randomisation with a block size of four, to receive 12 months of either treatment as usual plus a financial reward for each depot of medication received (€30 per month if fully compliant; intervention group) or treatment as usual alone (control group). Randomisation was stratified by treatment site and suspected prognostic factors: sex, comorbid substance-use disorder (absent vs present), and compliance with antipsychotic medication in the 4 months before baseline (taking antipsychotic medication. We did analysis by intention to treat. This trial is registered with the Nederlands Trial Register, number NTR2350. Between May 21, 2010, and Oct 15, 2014, we randomly assigned 169 patients to the intervention group (n=84) or the control group (n=85). Primary outcome data were available for 155 (92%) patients. At baseline, the mean MPR was 76·0% (SD 28·2%) in the intervention group versus 77·9% (28·5%) in the control group. At 12 months, the mean MPR was higher in the intervention group (94·3% [SD 11·3%]) than in the control group (80·3% [19·1%]), with an adjusted difference of 14·9% (95% CI 8·9-20·9%; pcontrol group (adjusted difference 6·5%, 95% CI 2·0

  16. Towards reducing traffic congestion using cooperative adaptive cruise control on a freeway with a ramp

    Directory of Open Access Journals (Sweden)

    Georges Arnaout

    2011-12-01

    Full Text Available Purpose: In this paper, the impact of Cooperative Adaptive Cruise Control (CACC systems on traffic performance is examined using microscopic agent-based simulation. Using a developed traffic simulation model of a freeway with an on-ramp - created to induce perturbations and to trigger stop-and-go traffic, the CACC system’s effect on the traffic performance is studied. The previously proposed traffic simulation model is extended and validated. By embedding CACC vehicles in different penetration levels, the results show significance and indicate the potential of CACC systems to improve traffic characteristics and therefore can be used to reduce traffic congestion. The study shows that the impact of CACC is positive but is highly dependent on the CACC market penetration. The flow rate of the traffic using CACC is proportional to the market penetration rate of CACC equipped vehicles and the density of the traffic.Design/methodology/approach: This paper uses microscopic simulation experiments followed by a quantitative statistical analysis. Simulation enables researchers manipulating the system variables to straightforwardly predict the outcome on the overall system, giving researchers the unique opportunity to interfere and make improvements to performance. Thus with simulation, changes to variables that might require excessive time, or be unfeasible to carry on real systems, are often completed within seconds.Findings: The findings of this paper are summarized as follow:•\tProvide and validate a platform (agent-based microscopic traffic simulator in which any CACC algorithm (current or future may be evaluated.•\tProvide detailed analysis associated with implementation of CACC vehicles on freeways.•\tInvestigate whether embedding CACC vehicles on freeways has a significant positive impact or not.Research limitations/implications: The main limitation of this research is that it has been conducted solely in a computer laboratory. Laboratory

  17. Possibility of Cooper-pair formation controlled by multi-terminal spin injection

    Science.gov (United States)

    Ohnishi, K.; Sakamoto, M.; Ishitaki, M.; Kimura, T.

    2018-03-01

    A multi-terminal lateral spin valve consisting of three ferromagnetic nanopillars on a Cu/Nb bilayer has been fabricated. We investigated the influence of the spin injection on the superconducting properties at the Cu/Nb interface. The non-local spin valve signal exhibits a clear spin insulation signature due to the superconducting gap of the Nb. The magnitude of the spin signal is found to show the probe configuration dependence. From the careful analysis of the bias current dependence, we found the suppression of the superconductivity due to the exchange interaction between the Cooper pair and accumulated spin plays an important role in the multi-terminal spin injections. We also discuss about the possibility of the Cooper-pair formation due to the spin injection from the two injectors with the anti-parallel alignment.

  18. Cooperative Control of Active Power Filters in Power Systems without Mutual Communication

    Czech Academy of Sciences Publication Activity Database

    Tlustý, J.; Škramlík, Jiří; Švec, J.; Valouch, Viktor

    2010-01-01

    Roč. 2010, č. 517184 (2010), s. 1-13 ISSN 1024-123X R&D Projects: GA AV ČR IAA200760703 Institutional research plan: CEZ:AV0Z20570509 Keywords : active power filter * power system * wireless cooperation Subject RIV: JA - Electronics ; Optoelectronics, Electric al Engineering Impact factor: 0.689, year: 2010 http://www.hindawi.com/journals/mpe/2010/517184.html

  19. A Landscape of Therapeutic Cooperativity in KRAS Mutant Cancers Reveals Principles for Controlling Tumor Evolution

    OpenAIRE

    Grace R. Anderson; Peter S. Winter; Kevin H. Lin; Daniel P. Nussbaum; Merve Cakir; Elizabeth M. Stein; Ryan S. Soderquist; Lorin Crawford; Jim C. Leeds; Rachel Newcomb; Priya Stepp; Catherine Yip; Suzanne E. Wardell; Jennifer P. Tingley; Moiez Ali

    2017-01-01

    Combinatorial inhibition of effector and feedback pathways is a promising treatment strategy for KRAS mutant cancers. However, the particular pathways that should be targeted to optimize therapeutic responses are unclear. Using CRISPR/Cas9, we systematically mapped the pathways whose inhibition cooperates with drugs targeting the KRAS effectors MEK, ERK, and PI3K. By performing 70 screens in models of KRAS mutant colorectal, lung, ovarian, and pancreas cancers, we uncovered universal and tiss...

  20. Effect of Financial Incentives on Glucose Monitoring Adherence and Glycemic Control Among Adolescents and Young Adults With Type 1 Diabetes: A Randomized Clinical Trial.

    Science.gov (United States)

    Wong, Charlene A; Miller, Victoria A; Murphy, Kathryn; Small, Dylan; Ford, Carol A; Willi, Steven M; Feingold, Jordyn; Morris, Alexander; Ha, Yoonhee P; Zhu, Jingsan; Wang, Wenli; Patel, Mitesh S

    2017-12-01

    Glycemic control often deteriorates during adolescence and the transition to young adulthood for patients with type 1 diabetes. The inability to manage type 1 diabetes effectively during these years is associated with poor glycemic control and complications from diabetes in adult life. To determine the effect of daily financial incentives on glucose monitoring adherence and glycemic control in adolescents and young adults with type 1 diabetes. The Behavioral Economic Incentives to Improve Glycemic Control Among Adolescents and Young Adults With Type 1 Diabetes (BE IN CONTROL) study was an investigator-blinded, 6-month, 2-arm randomized clinical trial conducted between January 22 and November 2, 2016, with 3-month intervention and follow-up periods. Ninety participants (aged 14-20) with suboptimally controlled type 1 diabetes (hemoglobin A1c [HbA1c] >8.0%) were recruited from the Diabetes Center for Children at the Children's Hospital of Philadelphia. All participants were given daily blood glucose monitoring goals of 4 or more checks per day with 1 or more level within the goal range (70-180 mg/dL) collected with a wireless glucometer. The 3-month intervention consisted of a $60 monthly incentive in a virtual account, from which $2 was subtracted for every day of nonadherence to the monitoring goals. During a 3-month follow-up period, the intervention was discontinued. The primary outcome was change in HbA1c levels at 3 months. Secondary outcomes included adherence to glucose monitoring and change in HbA1c levels at 6 months. All analyses were by intention to treat. Of the 181 participants screened, 90 (52 [57.8%] girls) were randomized to the intervention (n = 45) or control (n = 45) arms. The mean (SD) age was 16.3 (1.9) years. The intervention group had significantly greater adherence to glucose monitoring goals in the incentive period (50.0% vs 18.9%; adjusted difference, 27.2%; 95% CI, 9.5% to 45.0%; P = .003) but not in the follow-up period (15

  1. A MULTI-CENTER CLUSTER-RANDOMIZED TRIAL OF A MULTI-FACTORIAL INTERVENTION TO IMPROVE ANTIHYPERTENSIVE MEDICATION ADHERENCE AND BLOOD PRESSURE CONTROL AMONG PATIENTS AT HIGH CARDIOVASCULAR RISK (The COM99 study)*

    Science.gov (United States)

    Pladevall, Manel; Brotons, Carlos; Gabriel, Rafael; Arnau, Anna; Suarez, Carmen; de la Figuera, Mariano; Marquez, Emilio; Coca, Antonio; Sobrino, Javier; Divine, George; Heisler, Michele; Williams, L Keoki

    2010-01-01

    Background Medication non-adherence is common and results in preventable disease complications. This study assesses the effectiveness of a multifactorial intervention to improve both medication adherence and blood pressure control and to reduce cardiovascular events. Methods and Results In this multi-center, cluster-randomized trial, physicians from hospital-based hypertension clinics and primary care centers across Spain were randomized to receive and provide the intervention to their high-risk patients. Eligible patients were ≥50 years of age, had uncontrolled hypertension, and had an estimated 10-year cardiovascular risk greater than 30%. Physicians randomized to the intervention group counted patients’ pills, designated a family member to support adherence behavior, and provided educational information to patients. The primary outcome was blood pressure control at 6 months. Secondary outcomes included both medication adherence and a composite end-point of all cause mortality and cardiovascular-related hospitalizations. Seventy-nine physicians and 877 patients participated in the trial. The mean duration of follow-up was 39 months. Intervention patients were less likely to have an uncontrolled systolic blood pressure (odds ratio 0.62; 95% confidence interval [CI] 0.50–0.78) and were more likely to be adherent (OR 1.91; 95% CI 1.19–3.05) when compared with control group patients at 6 months. After five years 16% of the patients in the intervention group and 19% in the control group met the composite end-point (hazard ratio 0.97; 95% CI 0.67–1.39). Conclusions A multifactorial intervention to improve adherence to antihypertensive medication was effective in improving both adherence and blood pressure control, but it did not appear to improve long-term cardiovascular events. PMID:20823391

  2. A pilot controlled trial to determine the feasibility, acceptability and effectiveness of a PAPA-based online intervention to address practical and perceptual barriers to medication adherence in Inflammatory Bowel Disease.

    Directory of Open Access Journals (Sweden)

    Sarah Chapman

    2015-11-01

    The intervention was effective in addressing perceptual barriers to adherence, as well as having a positive impact on IBD-related illness perceptions: increasing treatment control beliefs, and reducing concerns and emotional response. Fewer episodes of non-adherence were reported in the Intervention Group compared to the Control Group. Satisfaction with information about IBD medication improved following the intervention. However, the number of reported practical barriers was similar between the Intervention and Control groups, suggesting that other support might need to be incorporated into the intervention. Limitations of this study include potential bias due to drop-out, potential lack of generalisability to patient populations not recruited online and a reliance on self-report rather than objective outcome measures. However, this controlled trial suggests that the IBD-Helper intervention may be an effective, feasible and acceptable method of addressing perceptual barriers to adherence.

  3. US/Russia government-to-government cooperation in material protection, control and accounting at the SSC-RIAR, Dimitrovgrad

    International Nuclear Information System (INIS)

    Kharlanov, Y.I.; Gadzhiev, G.I.; Satkowiak, L.

    1996-01-01

    The US/Russia Government-to-Government Cooperation in Material Protection, Control, and Accounting (MPC and A) was established in an agreement between the Department of Defense of the US and the Ministry of the russian Federation for Atomic Energy (MINATOM). A subsequent agreement between the Department of Energy (DOE) and MINATOM, resulted in the selection of the State Scientific Center-Research Institute of Atomic Reactors (SSC-RIAR) in Dimitrovgrad as one of the Russian enterprises that would participate with US national laboratories in expanded cooperation aimed at enhancing MPC and A systems in both countries. The SSC-RIAR facilities under consideration for MPC and A enhancements consist of a reactor building, a fuel fabrication building, and a storage building. The long term goal of this project is the completion of a comprehensive implementation plan, and its subsequent execution, addressing key MPC and A elements for all, or as many as possible, facilities at SSC-RIAR containing appreciable amounts of highly enriched uranium and plutonium. This paper describes the nature and scope of the expanded cooperation involving SSC-RIAR and six US national laboratories

  4. Development of Regenerative Braking Co-operative Control System for Automatic Transmission-based Hybrid Electric Vehicle using Electronic Wedge Brake

    OpenAIRE

    Ko, Jiweon; Ko, Sungyeon; Bak, Yongsun; Jang, Mijeong; Yoo, Byoungsoo; Cheon, Jaeseung; Kim, Hyunsoo

    2013-01-01

    This research proposes a regenerative braking co-operative control system for the automatic transmission (AT)-based hybrid electric vehicle (HEV). The brake system of the subject HEV consists of the regenerative braking and the electronic wedge brake (EWB) friction braking for the front wheel, and the hydraulic friction braking for the rear wheel. A regenerative braking co-operative control algorithm is suggested for the regenerative braking and friction braking, which distributes the braking...

  5. Advisory and autonomous cooperative driving systems

    NARCIS (Netherlands)

    Broek, T.H.A. van den; Ploeg, J.; Netten, B.D.

    2011-01-01

    In this paper, the traffic efficiency of an advisory cooperative driving system, Advisory Acceleration Control is examined and compared to the efficiency of an autonomous cooperative driving system, Cooperative Adaptive Cruise Control. The algorithms and implementation thereof are explained. The

  6. A Cooperative Search and Coverage Algorithm with Controllable Revisit and Connectivity Maintenance for Multiple Unmanned Aerial Vehicles

    Directory of Open Access Journals (Sweden)

    Zhong Liu

    2018-05-01

    Full Text Available In this paper, we mainly study a cooperative search and coverage algorithm for a given bounded rectangle region, which contains several unknown stationary targets, by a team of unmanned aerial vehicles (UAVs with non-ideal sensors and limited communication ranges. Our goal is to minimize the search time, while gathering more information about the environment and finding more targets. For this purpose, a novel cooperative search and coverage algorithm with controllable revisit mechanism is presented. Firstly, as the representation of the environment, the cognitive maps that included the target probability map (TPM, the uncertain map (UM, and the digital pheromone map (DPM are constituted. We also design a distributed update and fusion scheme for the cognitive map. This update and fusion scheme can guarantee that each one of the cognitive maps converges to the same one, which reflects the targets’ true existence or absence in each cell of the search region. Secondly, we develop a controllable revisit mechanism based on the DPM. This mechanism can concentrate the UAVs to revisit sub-areas that have a large target probability or high uncertainty. Thirdly, in the frame of distributed receding horizon optimizing, a path planning algorithm for the multi-UAVs cooperative search and coverage is designed. In the path planning algorithm, the movement of the UAVs is restricted by the potential fields to meet the requirements of avoiding collision and maintaining connectivity constraints. Moreover, using the minimum spanning tree (MST topology optimization strategy, we can obtain a tradeoff between the search coverage enhancement and the connectivity maintenance. The feasibility of the proposed algorithm is demonstrated by comparison simulations by way of analyzing the effects of the controllable revisit mechanism and the connectivity maintenance scheme. The Monte Carlo method is employed to validate the influence of the number of UAVs, the sensing radius

  7. International cooperation

    International Nuclear Information System (INIS)

    2008-01-01

    In this chapter international cooperation of the Division for Radiation Safety, NPP Decommissioning and Radwaste Management of the VUJE, a. s. is presented. Very important is cooperation with the International Atomic Energy Agency. This cooperation has various forms - national and regional projects of technical cooperation, coordinated research activities, participation of our experts in preparation of the IAEA documentation etc.

  8. Adesão ao tratamento e controle da pressão arterial por meio da monitoração ambulatorial de 24 horas Blood pressure treatment adherence and control through 24-hour ambulatory monitoring

    Directory of Open Access Journals (Sweden)

    Guilherme Brasil Grezzana

    2013-04-01

    Full Text Available FUNDAMENTO: A hipertensão arterial sistêmica (HAS é um importante fator de risco cardiovascular, no entanto os níveis de controle pressórico persistem inadequados. A avaliação da adesão ao tratamento anti-hipertensivo com a utilização da monitoração ambulatorial da pressão arterial (MAPA de 24 horas pode representar um importante auxílio na busca de metas de controle da HAS. OBJETIVO: Avaliar a adesão ao tratamento anti-hipertensivo e a sua relação com os valores de PA obtidos pela MAPA de 24 horas entre pacientes hipertensos de centros de atenção primária à saúde (APS. MÉTODOS: Estudo transversal com 143 pacientes hipertensos de amostra representativa de serviço de APS do município de Antônio Prado, RS. Foi realizada aplicação do teste de Morisky e Green para avaliar a aderência ao tratamento e a verificação do número de medicamentos utilizados, seguida pela aplicação da MAPA de 24 horas. RESULTADOS: Observou-se que 65,7% da amostra foram considerados aderentes ao tratamento proposto, 20,3% eram moderadamente aderentes, enquanto somente 14% foram classificados como não aderentes. Do total de 143 pacientes avaliados, 79 (55,2% foram identificados como HAS controlada (130/80 mmHg, 103 (72% apresentaram ausência de descenso noturno da PA e 60 (41,9% não estavam controlados durante o período de vigília. CONCLUSÃO: Verificamos, no presente estudo, que não há um controle adequado da HAS, com consequente perda de oportunidade dos profissionais envolvidos na APS de ajuste adequado das metas de PA preconizados. Esse fato ocorre a despeito de apropriada adesão ao tratamento anti-hipertensivo dos pacientes vinculados ao ambulatório de APS.BACKGROUND: Although systemic arterial hypertension (SAH is an important cardiovascular risk factor, blood pressure level control often remains inadequate. Assessment of adherence to antihypertensive treatment through 24-hour ambulatory blood pressure monitoring (ABPM may

  9. Short- and long-term effects of real-time medication monitoring with short message service (SMS) reminders for missed doses on the refill adherence of people with Type 2 diabetes: evidence from a randomised controlled trial.

    NARCIS (Netherlands)

    Vervloet, M.; Dijk, L. van; Bakker, D.H. de; Souverein, P.C.; Santen-Reestman, J.; Vlijmen, B. van; Aarle, M.C.W. van; Hoek, L.S. van der; Bouvy, M.L.

    2014-01-01

    Aims: To investigate short- and long-term effects of real-time monitoring medication use combined with short message service (SMS) reminders for missed doses on refill adherence to oral anti-diabetic medication. Methods: A randomized controlled trial with two intervention groups and one control

  10. Adherence to infection prevention and control guidelines: A vignette-based study of decision-making and risk-taking in young adults with cystic fibrosis.

    Science.gov (United States)

    Bowmer, Grace; Latchford, Gary; Duff, Alistair; Denton, Miles; Dye, Louise; Lawton, Clare; Lee, Tim

    2017-01-01

    Balancing cystic fibrosis (CF) care with demands of normal life is associated with decreased adherence to infection prevention and control (IPC) guidelines. Adults with CF, aged 18-25years, were invited to participate via UK CF Trust social media platforms. An online survey evaluated participants' decision-making in nine clinician-rated vignettes and assessed the perceived influence of infection-related information sources. Participants (n=87, mean 21.4years [SD=2.45]; 75% female) were less likely to engage in the high-risk scenarios, although demonstrated greater awareness of cross-infection than environmental risks. Associations between risk-perception and willingness to participate in five vignette-based hypothetical activities were significant (prisk-levels but are not always based on robust knowledge. They also show some inclination towards engaging in risky behaviours. Copyright © 2016 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  11. Cooperative control of blood compatibility and re-endothelialization by immobilized heparin and substrate topography.

    Science.gov (United States)

    Ding, Yonghui; Yang, Meng; Yang, Zhilu; Luo, Rifang; Lu, Xiong; Huang, Nan; Huang, Pingbo; Leng, Yang

    2015-03-01

    A wide variety of environmental cues provided by the extracellular matrix, including biophysical and biochemical cues, are responsible for vascular cell behavior and function. In particular, substrate topography and surface chemistry have been shown to regulate blood and vascular compatibility individually. The combined impact of chemical and topographic cues on blood and vascular compatibility, and the interplay between these two types of cues, are subjects that are currently being explored. In the present study, a facile polydopamine-mediated approach is introduced for immobilization of heparin on topographically patterned substrates, and the combined effects of these cues on blood compatibility and re-endothelialization are systematically investigated. The results show that immobilized heparin and substrate topography cooperatively modulate anti-coagulation activity, endothelial cell (EC) attachment, proliferation, focal adhesion formation and endothelial marker expression. Meanwhile, the substrate topography is the primary determinant of cell alignment and elongation, driving in vivo-like endothelial organization. Importantly, combining immobilized heparin with substrate topography empowers substantially greater competitive ability of ECs over smooth muscle cells than each cue individually. Moreover, a model is proposed to elucidate the cooperative interplay between immobilized heparin and substrate topography in regulating cell behavior. Copyright © 2014 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  12. Controlling Cooperative CO2 Adsorption in Diamine-Appended Mg2(dobpdc) Metal-Organic Frameworks.

    Science.gov (United States)

    Siegelman, Rebecca L; McDonald, Thomas M; Gonzalez, Miguel I; Martell, Jeffrey D; Milner, Phillip J; Mason, Jarad A; Berger, Adam H; Bhown, Abhoyjit S; Long, Jeffrey R

    2017-08-02

    In the transition to a clean-energy future, CO 2 separations will play a critical role in mitigating current greenhouse gas emissions and facilitating conversion to cleaner-burning and renewable fuels. New materials with high selectivities for CO 2 adsorption, large CO 2 removal capacities, and low regeneration energies are needed to achieve these separations efficiently at scale. Here, we present a detailed investigation of nine diamine-appended variants of the metal-organic framework Mg 2 (dobpdc) (dobpdc 4- = 4,4'-dioxidobiphenyl-3,3'-dicarboxylate) that feature step-shaped CO 2 adsorption isotherms resulting from cooperative and reversible insertion of CO 2 into metal-amine bonds to form ammonium carbamate chains. Small modifications to the diamine structure are found to shift the threshold pressure for cooperative CO 2 adsorption by over 4 orders of magnitude at a given temperature, and the observed trends are rationalized on the basis of crystal structures of the isostructural zinc frameworks obtained from in situ single-crystal X-ray diffraction experiments. The structure-activity relationships derived from these results can be leveraged to tailor adsorbents to the conditions of a given CO 2 separation process. The unparalleled versatility of these materials, coupled with their high CO 2 capacities and low projected energy costs, highlights their potential as next-generation adsorbents for a wide array of CO 2 separations.

  13. Cooperative control of VSC-HVDC connected offshore wind farm with Low-Voltage Ride-Through capability

    DEFF Research Database (Denmark)

    Liu, Yan; Wang, Xiongfei; Chen, Zhe

    2012-01-01

    The Low-Voltage Ride-Through (LVRT) has become an important grid requirement for offshore wind farms connecting with Voltage Source Converter based High Voltage Direct Current (VSC-HVDC) links. In this paper, a cooperative control strategy with LVRT ability is proposed for a VSC-HVDC connected...... variable speed Squirrel-Cage Induction Generator (SCIG) wind farm. The approach employs a DC-link voltage versus offshore AC-bus frequency droop control on the offshore converter of VSC-HVDC link. Thus, the back-to-back converters of SCIG wind turbines can adjust the generated active power based on the AC......-bus frequency deviations, so that a fast power reduction on the wind farm side can be achieved. The EMTDC/PSCAD simulations are performed on a 300 MW offshore variable speed SCIG wind farm. Simulation results confirm the effectiveness of the proposed control method....

  14. Effect of self-care education on lifestyle modification, medication adherence and blood pressure in hypertensive adults: Randomized controlled clinical trial.

    Science.gov (United States)

    Golshahi, Jafar; Ahmadzadeh, Hamid; Sadeghi, Masoumeh; Mohammadifard, Noushin; Pourmoghaddas, Ali

    2015-01-01

    Self-care management has recently been suggested as an effective approach for secondary prevention of hypertension. This study was conducted to examine whether self-care behaviors could modulate blood pressure levels and also comparing the different training methods of self-care on patients' adherence and controlling hypertension. This study was a prospective randomized controlled clinical trial, conducted on 180 hypertensive patients referring to four centers in Isfahan, Iran, between July and December 2013. Block randomization method were applied to divide eligible subjects into four equal groups, including group A in which the patients and their family were educated by cardiology resident about self-care behaviors through eight sessions, group B and group C were obtained self-care education through four pamphlets or eight short message services (SMS), respectively and group D were obtained only usual care of hypertension without any training about self-care management. Increasing vegetable intake and frequency of subject who took antihypertensive medication regularly and the reduction in the frequency of subjects who consumed high salt were significantly more in group A than the others (P = 0.001, P < 0.001 and P < 0.001, respectively). The systolic and diastolic blood pressure had significantly more reduction in the group A than the other groups (-8.18 ± 18.3 and - 3.89 ± 4.1; P < 0.001, respectively). The self-care management education integration into the usual care along with using SMS and other educational materials may improve the efficient and effective adherence strategies.

  15. Impact on Congestion and Fuel Consumption of a Cooperative Adaptive Cruise Control System with Lane-Level Position Estimation

    Directory of Open Access Journals (Sweden)

    Edgar Talavera

    2018-01-01

    Full Text Available In recent years, vehicular communications systems have evolved and allowed for the improvement of adaptive cruise control (ACC systems to make them cooperative (cooperative adaptive cruise control, CACC. Conventional ACC systems use sensors on the ego-vehicle, such as radar or computer vision, to generate their behavioral decisions. However, by having vehicle-to-X (V2X onboard communications, the need to incorporate perception in the vehicle is drastically reduced. Thus, in this paper a CACC solution is proposed that only uses communications to make its decisions with the help of previous road mapping. At the same time, a method to develop these maps is presented, combining the information of a computer vision system to correct the positions obtained from the navigation system. In addition, the cut-in and cut-out maneuvers for a CACC platoon are taken into account, showing the tests of these situations in real environments with instrumented vehicles. To show the potential of the system in a larger-scale implementation, simulations of the behavior are provided under dense traffic conditions where the positive impact on the reduction of traffic congestion and fuel consumption is appreciated.

  16. Cooperative jamming power control to enhance secrecy communications of AF Relaying systems for Rayleigh fading channel

    KAUST Repository

    Park, Kihong

    2012-09-01

    In this paper, we investigate secrecy communications in two-hop wireless relaying networks which consist of one source, one amplify-and-forward (AF) relay, one legitimate destination, and one eavesdropper. To prevent the eavesdropper from intercepting the source message, we make the destination send the intended noise to the AF relay during the first phase. This is referred to as cooperative jamming. According to the channel information at the destination, we address two types of jamming power allocation; (i) rate-optimal power allocation and (ii) outage-optimal power allocation. More specifically, without the instantaneous channel knowledge for the eavesdropper side, the outage probability of the secrecy rate is minimized with respect to the intended noise power level. We show that the outage-optimal allocation gives almost the same outage probability as the rateoptimal one. In addition, the jamming power consumption can be significantly reduced compared to the fixed and rate-optimal power allocation methods. © 2012 IEEE.

  17. Control Algorithm Trajectory Planning for Dual Cooperative Manipulators with Experimental Verification

    Directory of Open Access Journals (Sweden)

    Omar Ahmed

    2016-01-01

    Full Text Available In order to achieve cooperation of multi-robots simultaneously, this paper presents an approach of Trajectory planning for two decoupled robots with six degrees of freedom (DOF each to execute packing task. The Denavit-Hartenberg (D-H representation is used to model robot links and solve the transformation matrices of each joint. The inverse kinematics solution using for a 6- DOF Robotic arm is presented, for given initial and final configurations of the robots, the robots are placed so that their workspaces overlap. An algorithm successfully finds a set of configurations to ensure, collision free transition from start to end configuration. Simulation and experiments based on 6-dof robot are carried out and the results verified the effectiveness of the proposed algorithm.

  18. A Landscape of Therapeutic Cooperativity in KRAS Mutant Cancers Reveals Principles for Controlling Tumor Evolution

    Directory of Open Access Journals (Sweden)

    Grace R. Anderson

    2017-07-01

    Full Text Available Combinatorial inhibition of effector and feedback pathways is a promising treatment strategy for KRAS mutant cancers. However, the particular pathways that should be targeted to optimize therapeutic responses are unclear. Using CRISPR/Cas9, we systematically mapped the pathways whose inhibition cooperates with drugs targeting the KRAS effectors MEK, ERK, and PI3K. By performing 70 screens in models of KRAS mutant colorectal, lung, ovarian, and pancreas cancers, we uncovered universal and tissue-specific sensitizing combinations involving inhibitors of cell cycle, metabolism, growth signaling, chromatin regulation, and transcription. Furthermore, these screens revealed secondary genetic modifiers of sensitivity, yielding a SRC inhibitor-based combination therapy for KRAS/PIK3CA double-mutant colorectal cancers (CRCs with clinical potential. Surprisingly, acquired resistance to combinations of growth signaling pathway inhibitors develops rapidly following treatment, but by targeting signaling feedback or apoptotic priming, it is possible to construct three-drug combinations that greatly delay its emergence.

  19. Assessment of adherence to the CONSORT statement for quality of reports on randomized controlled trial abstracts from four high-impact general medical journals.

    Science.gov (United States)

    Ghimire, Saurav; Kyung, Eunjung; Kang, Wonku; Kim, Eunyoung

    2012-06-07

    The extended Consolidated Standards of Reporting Trials (CONSORT) Statement for Abstracts was developed to improve the quality of reports of randomized controlled trials (RCTs) because readers often base their assessment of a trial solely on the abstract. To date, few data exist regarding whether it has achieved this goal. We evaluated the extent of adherence to the CONSORT for Abstract statement for quality of reports on RCT abstracts by four high-impact general medical journals. A descriptive analysis of published RCT abstracts in The New England Journal of Medicine (NEJM), The Lancet, The Journal of American Medical Association (JAMA), and the British Medical Journal (BMJ) in the year 2010 was conducted by two reviewers, independently extracting data from a MEDLINE/PubMed search. We identified 271 potential RCT abstracts meeting our inclusion criteria. More than half of the abstracts identified the study as randomized in the title (58.7%; 159/271), reported the specific objective/hypothesis (72.7%; 197/271), described participant eligibility criteria with settings for data collection (60.9%; 165/271), detailed the interventions for both groups (90.8%; 246/271), and clearly defined the primary outcome (94.8%; 257/271). However, the methodological quality domains were inadequately reported: allocation concealment (11.8%; 32/271) and details of blinding (21.0%; 57/271). Reporting the primary outcome results for each group was done in 84.1% (228/271). Almost all of the abstracts reported trial registration (99.3%; 269/271), whereas reports of funding and of harm or side effects from the interventions were found in only 47.6% (129/271) and 42.8% (116/271) of the abstracts, respectively. These findings show inconsistencies and non-adherence to the CONSORT for abstract guidelines, especially in the methodological quality domains. Improvements in the quality of RCT reports can be expected by adhering to existing standards and guidelines as expressed by the CONSORT group.

  20. Adherence to antidepressants

    Directory of Open Access Journals (Sweden)

    Abimbola Farinde

    2013-01-01

    Full Text Available While major depression is considered a frequent mental illness there are ongoing reports of high non-adherence to antidepressant medications which places suffers at high risk for relapse, recurrence, or greater impairment,. The World Health Organization (WHO defines adherence as the extent to which a person′s behavior (e.g. taking medications can align with the agreed recommendations of a health care provider. Unfortunately while patient may recognize the importance of adherence to antidepressant medications the majority of patients do not adhere to their prescribed antidepressants. Some of the factors that may contribute to or lead to non-adherence include knowingly or unknowingly missing doses, taking extra doses, delaying administration times, or taking drug holidays. Pharmacists have the unique ability to deter non-adherence through the performance of continuous assessment and monitoring of adherence in this population given these accessibility. Additionally, pharmacists are able to develop therapeutic alliances with patients that can help to increase the likelihood of achieving positive patient outcomes. Antidepressant non-adherence can be viewed as a significant public health concern so it is important for patients to be educated about the importance of adherence, and health care professionals should be aware of factors or patient characteristics that can serve as barriers to non-adherence.

  1. Educational video to improve CPAP use in patients with obstructive sleep apnoea at risk for poor adherence: a randomised controlled trial.

    Science.gov (United States)

    Guralnick, Amy S; Balachandran, Jay S; Szutenbach, Shane; Adley, Kevin; Emami, Leila; Mohammadi, Meelad; Farnan, Jeanne M; Arora, Vineet M; Mokhlesi, Babak

    2017-12-01

    Suboptimal adherence to CPAP limits its clinical effectiveness in patients with obstructive sleep apnoea (OSA). Although rigorous behavioural interventions improve CPAP adherence, their labour-intensive nature has limited widespread implementation. Moreover, these interventions have not been tested in patients at risk of poor CPAP adherence. Our objective was to determine whether an educational video will improve CPAP adherence in patients at risk of poor CPAP adherence. Patients referred by clinicians without sleep medicine expertise to an urban sleep laboratory that serves predominantly minority population were randomised to view an educational video about OSA and CPAP therapy before the polysomnogram, or to usual care. The primary outcome was CPAP adherence during the first 30 days of therapy. Secondary outcomes were show rates to sleep clinic (attended appointment) and 30-day CPAP adherence after the sleep clinic visit date. A total of 212 patients met the eligibility criteria and were randomised to video education (n=99) or to usual care (n=113). There were no differences in CPAP adherence at 30 days (3.3, 95% CI 2.8 to 3.8 hours/day video education; vs 3.5, 95% CI 3.1 to 4.0 hours/day usual care; p=0.44) or during the 30 days after sleep clinic visit. Sleep clinic show rate was 54% in the video education group and 59% in the usual care group (p=0.41). CPAP adherence, however, significantly worsened in patients who did not show up to the sleep clinic. In patients at risk for poor CPAP adherence, an educational video did not improve CPAP adherence or show rates to sleep clinic compared with usual care. ClinicalTrials.gov Identifier: NCT02553694. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Interventions to improve medication adherence among Chinese patients with hypertension: a systematic review and meta-analysis of randomized controlled trails.

    Science.gov (United States)

    Xu, Rixiang; Xie, Xuefeng; Li, Shuting; Chen, Xiaoyu; Wang, Sheng; Hu, Chengyang; Lv, Xiongwen

    2018-04-25

    A systematic review and meta-analysis of randomized controlled trials (RCTs) were performed to understand the effectiveness of medication adherence (MA) interventions among Chinese patients with hypertension. A literature search was conducted with three English databases (PubMed, Web of Science and Embase) and three Chinese databases (China National Knowledge Infrastructure, Wanfang and VIP Database for Chinese Technical Periodicals) for the period from 1970 to October 2017. Only both RCTs with a minimum of 10 participants in each intervention group and Chinese patients with hypertension as participants were included. A random-effects model was applied to calculate pooled effect sizes with 95% CI. Subgroup analysis was conducted to identify potential sources of heterogeneity from duration of intervention, type of intervener, methods of intervention and sites of intervention. Funnel plots and Egger's test were used to evaluate for publication bias. A total of 48 studies met criteria for the meta-analysis, including 14 568 participants, testing 57 independent comparisons. Overall, the effect size revealed that interventions significantly improved MA (pooled relative risk = 1.59, 95% CI: 1.43 to 1.78; pooled Cohen's d = 1.42, 95% CI: 0.976 to 1.876). Interventions were found to significantly reduce blood pressure (BP) (systolic BP: Cohen's d = -0.85, 95% CI: -1.11 to -0.60 and diastolic BP: Cohen's d = -0.73, 95% CI: -1.00 to -0.46). Longer duration of intervention gave better effectiveness. Physician as interventionist, regular follow-up visits and interventions conducted at a hospital were associated with better effectiveness. Adherence interventions improve MA and reduce uncontrolled BP among Chinese patients with hypertension. In the future, investigators should adopt a skill set to address the problem of poor MA. © 2018 Royal Pharmaceutical Society.

  3. THE EFFECT OF TELE-MONITORING ON EXERCISE TRAINING ADHERENCE, FUNCTIONAL CAPACITY, QUALITY OF LIFE AND GLYCEMIC CONTROL IN PATIENTS WITH TYPE II DIABETES

    Directory of Open Access Journals (Sweden)

    Tracy Marios

    2012-03-01

    Full Text Available We used tele-monitoring to attempt to improve exercise adherence (number of hours of exercise completed, peak VO2, HbA1c% and quality of life in an unsupervised, home based exercise program in people with type II diabetes, a cost analysis was also conducted. Thirty-nine patients with type II diabetes were randomized to tele-monitoring (TELE or control (CON groups. All patients were asked to complete 6 months exercise training and complete an exercise activity diary. The TELE group was instructed to record their exercise heart rates using a monitor and received weekly telephone calls from an exercise physiologist. Six TELE patients and seven CON patients did not complete the 6 month testing. TELE patients completed a mean weekly volume of 138 minutes, moderate intensity exercise, while CON patients completed 58 minutes weekly (p < 0.02. Neither group achieved the American Heart Association statement guideline for weekly exercise volume of 150 minutes. TELE patients improved peak VO2 (5.5 %, but neither group improved HbA1c% or quality of life. The CON group showed a 4.9% reduction in peak VO2. While tele-monitored patients completed more hours of exercise and demonstrated improved peak VO2 compared to controls, the exercise volume completed was insufficient to improve glycemic control. There is the potential via tele-monitoring to enable people with diabetes to meet exercise training guidelines.

  4. Cognitive Behavioral Therapy for Adherence and Depression (CBT-AD) in HIV-Infected Injection Drug Users: A Randomized Controlled Trial

    Science.gov (United States)

    Safren, Steven A.; O'Cleirigh, Conall M.; Bullis, Jacqueline R.; Otto, Michael W.; Stein, Michael D.; Pollack, Mark H.

    2012-01-01

    Objective: Depression and substance use, the most common comorbidities with HIV, are both associated with poor treatment adherence. Injection drug users comprise a substantial portion of individuals with HIV in the United States and globally. The present study tested cognitive behavioral therapy for adherence and depression (CBT-AD) in patients…

  5. Psychological and Educational Intervention to Improve Tuberculosis Treatment Adherence in Ethiopia Based on Health Belief Model: A Cluster Randomized Control Trial

    NARCIS (Netherlands)

    Tola, Habteyes Hailu; Shojaeizadeh, Davoud; Tol, Azar; Garmaroudi, Gholamreza; Yekaninejad, Mir Saeed; Kebede, Abebaw; Ejeta, Luche Tadesse; Kassa, Desta; Klinkenberg, Eveline

    2016-01-01

    Treatment non-adherence results in treatment failure, prolonged transmission of disease and emergence of drug resistance. Although the problem widely investigated, there remains an information gap on the effectiveness of different methods to improve treatment adherence and the predictors of

  6. Effectiveness of a group-based intervention to change medication beliefs and improve medication adherence in patients with rheumatoid arthritis: a randomized controlled trial.

    NARCIS (Netherlands)

    Zwikker, H.E.; Ende, C.H. van den; Lankveld, W.G. van; Broeder, A.A. den; Hoogen, F.H. van den; Mosselaar, B. van de; Dulmen, S. van; Bemt, B.J. van den

    2014-01-01

    Objective: To assess the effect of a group-based intervention on the balance between necessity beliefs and concern beliefs about medication and on medication non-adherence in patients with rheumatoid arthritis (RA). Methods: Non-adherent RA patients using disease-modifying anti-rheumatic drugs

  7. Real/binary co-operative and co-evolving swarms based multivariable PID controller design of ball mill pulverizing system

    International Nuclear Information System (INIS)

    Menhas, Muhammad Ilyas; Fei Minrui; Wang Ling; Qian Lin

    2012-01-01

    Highlights: ► We extend the concept of co-operation and co-evolution in some PSO variants. ► We use developed co-operative PSOs in multivariable PID controller design/tuning. ► We find that co-operative PSOs converge faster and give high quality solutions. ► Dividing the search space among swarms improves search efficiency. ► The proposed methods allow the practitioner for heterogeneous problem formulation. - Abstract: In this paper, multivariable PID controller design based on cooperative and coevolving multiple swarms is demonstrated. A simplified multi-variable MIMO process model of a ball mill pulverizing system with steady state decoupler is considered. In order to formulate computational models of cooperative and coevolving multiple swarms three different algorithms like real coded PSO, discrete binary PSO (DBPSO) and probability based discrete binary PSO (PBPSO) are employed. Simulations are carried out on three composite functions simultaneously considering multiple objectives. The cooperative and coevolving multiple swarms based results are compared with the results obtained through single swarm based methods like real coded particle swarm optimization (PSO), discrete binary PSO (DBPSO), and probability based discrete binary PSO (PBPSO) algorithms. The cooperative and coevolving swarms based techniques outperform the real coded PSO, PBPSO, and the standard discrete binary PSO (DBPSO) algorithm in escaping from local optima. Furthermore, statistical analysis of the simulation results is performed to calculate the comparative reliability of various techniques. All of the techniques employed are suitable for controller tuning, however, the multiple cooperative and coevolving swarms based results are considerably better in terms of mean fitness, variance of fitness, and success rate in finding a feasible solution in comparison to those obtained using single swarm based methods.

  8. Designing for cooperation - cooperating in design

    DEFF Research Database (Denmark)

    Kyng, Morten

    1991-01-01

    This article will discuss how to design computer applications that enhance the quality of work and products, and will relate the discussion to current themes in the field of Computer-Supported Cooperative Work (CSCW). Cooperation is a key element of computer use and work practice, yet here...... a specific "CSCW approach is not taken." Instead the focus is cooperation as an important aspect of work that should be integrated into most computer support efforts in order to develop successful computer support, however, other aspects such as power, conflict and control must also be considered....

  9. Active and inactive enhancers co-operate to exert localized and long-range control of gene regulation

    Science.gov (United States)

    Proudhon, Charlotte; Snetkova, Valentina; Raviram, Ramya; Lobry, Camille; Badri, Sana; Jiang, Tingting; Hao, Bingtao; Trimarchi, Thomas; Kluger, Yuval; Aifantis, Iannis; Bonneau, Richard; Skok, Jane A

    2016-01-01

    V(D)J recombination relies on the presence of proximal enhancers that activate the antigen receptor (AgR) loci in a lineage and stage specific manner. Unexpectedly we find that both active and inactive AgR enhancers co-operate to disseminate their effects in a localized and long-range manner. Here we demonstrate the importance of short-range contacts between active enhancers that constitute an Igk super-enhancer in B cells. Deletion of one element reduces the interaction frequency between other enhancers in the hub, which compromises the transcriptional output of each component. We further establish that in T cells long-range contact and co-operation between the inactive Igk enhancer, MiEκ and the active Tcrb enhancer, Eβ, alters enrichment of CBFβ binding in a manner that impacts Tcrb recombination. These findings underline the complexities of enhancer regulation and point to a role for localized and long-range enhancer-sharing between active and inactive elements in lineage and stage specific control. PMID:27239026

  10. Cooperative control for self-organizing microgrids and game strategies for optimal dispatch of distributed renewable generations

    Energy Technology Data Exchange (ETDEWEB)

    Maknouninejad, Ali; Lin, Wei; Harno, Hendra G.; Qu, Zhihua; Simaan, Marwan A. [University of Central Florida, Department of EECS, Orlando, FL (United States)

    2012-03-15

    The small size, extensively dispersed and decentralized, and high penetration level of renewable energy sources in the future smart grids make the application of conventional optimal power flow (OPF) neither practical nor economical. In this paper, a practical approach is proposed to realize high penetration of distributed generators (DGs) by organizing them in some groups within a microgrid and dispatching the generated power aggregately. Each group may have virtual leaders which define the power policy of the group, and all other DGs cooperatively follow that policy. A fair utilization ratio is defined and will be introduced to the group by the virtual leaders. The utilization ratio indicates what percentage of the available power each DG has to feed to the grid, and this ratio will also be propagated within the group using cooperative control. As such, a smartgrid may treat microgrids as individually dispatchable loads or generators. Meanwhile, the interaction between each microgrid and the main grid can be formulated as a Stackelberg game. The main grid as the leader, by offering proper energy price to the micro grid, minimizes its cost and secures the power supply that the microgrid, as the follower, is willing to dispatch. It is shown that this game theoretic approach not only guarantees profit optimization, but also provides a convenient technique to optimize power flow from microgrids to the main grid. Numerical and simulation results for a case of study are provided to demonstrate the effectiveness of the proposed techniques. (orig.)

  11. Conflictual cooperation

    DEFF Research Database (Denmark)

    Axel, Erik

    2011-01-01

    , cooperation appeared as the continuous reworking of contradictions in the local arrangement of societal con- ditions. Subjects were distributed and distributed themselves according to social privileges, resources, and dilemmas in cooperation. Here, the subjects’ activities and understandings took form from...

  12. Lateral Spread of Orientation Selectivity in V1 is Controlled by Intracortical Cooperativity

    Science.gov (United States)

    Chavane, Frédéric; Sharon, Dahlia; Jancke, Dirk; Marre, Olivier; Frégnac, Yves; Grinvald, Amiram

    2011-01-01

    Neurons in the primary visual cortex receive subliminal information originating from the periphery of their receptive fields (RF) through a variety of cortical connections. In the cat primary visual cortex, long-range horizontal axons have been reported to preferentially bind to distant columns of similar orientation preferences, whereas feedback connections from higher visual areas provide a more diverse functional input. To understand the role of these lateral interactions, it is crucial to characterize their effective functional connectivity and tuning properties. However, the overall functional impact of cortical lateral connections, whatever their anatomical origin, is unknown since it has never been directly characterized. Using direct measurements of postsynaptic integration in cat areas 17 and 18, we performed multi-scale assessments of the functional impact of visually driven lateral networks. Voltage-sensitive dye imaging showed that local oriented stimuli evoke an orientation-selective activity that remains confined to the cortical feedforward imprint of the stimulus. Beyond a distance of one hypercolumn, the lateral spread of cortical activity gradually lost its orientation preference approximated as an exponential with a space constant of about 1 mm. Intracellular recordings showed that this loss of orientation selectivity arises from the diversity of converging synaptic input patterns originating from outside the classical RF. In contrast, when the stimulus size was increased, we observed orientation-selective spread of activation beyond the feedforward imprint. We conclude that stimulus-induced cooperativity enhances the long-range orientation-selective spread. PMID:21629708

  13. Cooperativity of HIV-Specific Cytolytic CD4 T Cells and CD8 T Cells in Control of HIV Viremia

    Science.gov (United States)

    Johnson, Susan; Eller, Michael; Teigler, Jeffrey E.; Maloveste, Sebastien M.; Schultz, Bruce T.; Soghoian, Damien Z.; Lu, Richard; Oster, Alexander F.; Chenine, Agnès-Laurence; Alter, Galit; Dittmer, Ulf; Marovich, Mary; Robb, Merlin L.; Michael, Nelson L.; Bolton, Diane

    2015-01-01

    ABSTRACT CD4+ T cells play a pivotal role in the control of chronic viral infections. Recently, nontraditional CD4+ T cell functions beyond helper effects have been described, and a role for cytolytic CD4+ T cells in the control of HIV infection has been suggested. We define here the transcriptional, phenotypic, and functional profiles of HIV-specific cytolytic CD4+ T cells. Fluidigm BioMark and multiparameter flow cytometric analysis of HIV-specific cytolytic CD4+ T cells revealed a distinct transcriptional signature compared to Th1 CD4+ cells but shared similar features with HIV-specific cytolytic CD8+ T cells. Furthermore, HIV-specific cytolytic CD4+ T cells showed comparable killing activity relative to HIV-specific CD8+ T cells and worked cooperatively in the elimination of virally infected cells. Interestingly, we found that cytolytic CD4+ T cells emerge early during acute HIV infection and tightly follow acute viral load trajectory. This emergence was associated to the early viral set point, suggesting an involvement in early control, in spite of CD4 T cell susceptibility to HIV infection. Our data suggest cytolytic CD4+ T cells as an independent subset distinct from Th1 cells that show combined activity with CD8+ T cells in the long-term control of HIV infection. IMPORTANCE The ability of the immune system to control chronic HIV infection is of critical interest to both vaccine design and therapeutic approaches. Much research has focused on the effect of the ability of CD8+ T cells to control the virus, while CD4+ T cells have been overlooked as effectors in HIV control due to the fact that they are preferentially infected. We show here that a subset of HIV-specific CD4+ T cells cooperate in the cytolytic control of HIV replication. Moreover, these cells represent a distinct subset of CD4+ T cells showing significant transcriptional and phenotypic differences compared to HIV-specific Th1 cells but with similarities to CD8+ T cells. These findings are

  14. Attrition and Adherence in a Web-Based Distress Management Program for Implantable Cardioverter Defibrillator Patients (WEBCARE): Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Habibovic, M.; Cuijpers, P.; Alings, M.

    2014-01-01

    Background: WEB-Based Distress Management Program for Implantable CARdioverter defibrillator Patients (WEBCARE) is a Web-based randomized controlled trial, designed to improve psychological well-being in patients with an implantable cardioverter defibrillator (ICD). As in other Web-based trials, ...

  15. Cooperative efforts to improve nuclear materials accounting, control and physical protection at the National Science Center, Kharkov Institute of Physics and Technology

    International Nuclear Information System (INIS)

    Zelensky, V.F.; Mikhailov, V.A.

    1996-01-01

    The US Department of Energy (DOE) and the Ukrainian Government are engaged in a program of cooperation to enhance the nonproliferation of nuclear weapons by developing a strong national system of nuclear material protection, control, and accounting (MPC and A). This paper describes the capabilities and work of the Kharkov Institute of Physics and Technology (KIPT) and cooperative efforts to improve MPC and A at this facility. It describes how these cooperative efforts grew out of Ukraine''s decision to become a non-nuclear weapon state and the shortcomings in MPC and A that developed at KIPT after the disintegration of the former Soviet Union. It also envisions expanded future cooperation in other areas of nuclear materials management

  16. Clonogenic assay: adherent cells.

    Science.gov (United States)

    Rafehi, Haloom; Orlowski, Christian; Georgiadis, George T; Ververis, Katherine; El-Osta, Assam; Karagiannis, Tom C

    2011-03-13

    The clonogenic (or colony forming) assay has been established for more than 50 years; the original paper describing the technique was published in 1956. Apart from documenting the method, the initial landmark study generated the first radiation-dose response curve for X-ray irradiated mammalian (HeLa) cells in culture. Basically, the clonogenic assay enables an assessment of the differences in reproductive viability (capacity of cells to produce progeny; i.e. a single cell to form a colony of 50 or more cells) between control untreated cells and cells that have undergone various treatments such as exposure to ionising radiation, various chemical compounds (e.g. cytotoxic agents) or in other cases genetic manipulation. The assay has become the most widely accepted technique in radiation biology and has been widely used for evaluating the radiation sensitivity of different cell lines. Further, the clonogenic assay is commonly used for monitoring the efficacy of radiation modifying compounds and for determining the effects of cytotoxic agents and other anti-cancer therapeutics on colony forming ability, in different cell lines. A typical clonogenic survival experiment using adherent cells lines involves three distinct components, 1) treatment of the cell monolayer in tissue culture flasks, 2) preparation of single cell suspensions and plating an appropriate number of cells in petri dishes and 3) fixing and staining colonies following a relevant incubation period, which could range from 1-3 weeks, depending on the cell line. Here we demonstrate the general procedure for performing the clonogenic assay with adherent cell lines with the use of an immortalized human keratinocyte cell line (FEP-1811). Also, our aims are to describe common features of clonogenic assays including calculation of the plating efficiency and survival fractions after exposure of cells to radiation, and to exemplify modification of radiation-response with the use of a natural antioxidant

  17. Maternal Fetal Attachment, Locus of Control and Adherence to STI/HIV Prevention and Prenatal Care Promotion Behaviors in Urban Women.

    Science.gov (United States)

    Kornfield, Sara L; Geller, Pamela A; Epperson, C Neill

    Young women of childbearing age are disproportionately affected by sexually transmitted infections (STIs) including HIV. In particular, young women have more frequent and more serious health problems from STI or HIV infection than men, and among women, African American women have especially high rates of infection. Pregnancy is an important time for beginning or continued STI and HIV prevention behaviors as discontinuing condom use when the contraceptive motivation is gone puts women and their fetuses at risk for contraction of STIs and HIV if they remain sexually active. There are many personal attributes that predict adherence to STI risk reduction behaviors including health related locus of control. The current study surveyed a group of 100 low-income, urban dwelling minority women during their pregnancies to determine whether maternal-fetal attachment, a characteristic specific to pregnancy, favorably influences pregnant women's health related locus of control such that women might be more inclined to engage in preventative STI/HIV risk reduction behaviors. Our findings revealed that while our sample has very high levels of MFA despite the high rate of unplanned pregnancy, condom use is not the method used to reduce the risk of contracting STIs/HIV. Rather, women are more likely to limit their number of sexual partners during pregnancy. While this is beneficial, pregnant women in non-monogamous relationships may discount the importance of condom use during pregnancy. Prenatal care providers can provide education about condom use as a beneficial prenatal care behavior similar to taking prenatal vitamins.

  18. Adherence to nutrition-based cancer prevention guidelines and breast, prostate and colorectal cancer risk in the MCC-Spain case-control study.

    Science.gov (United States)

    Romaguera, Dora; Gracia-Lavedan, Esther; Molinuevo, Amaia; de Batlle, Jordi; Mendez, Michelle; Moreno, Victor; Vidal, Carmen; Castelló, Adela; Pérez-Gómez, Beatriz; Martín, Vicente; Molina, Antonio J; Dávila-Batista, Verónica; Dierssen-Sotos, Trinidad; Gómez-Acebo, Inés; Llorca, Javier; Guevara, Marcela; Castilla, Jesús; Urtiaga, Carmen; Llorens-Ivorra, Cristóbal; Fernández-Tardón, Guillermo; Tardón, Adonina; Lorca, José Andrés; Marcos-Gragera, Rafael; Huerta, José María; Olmedo-Requena, Rocío; Jimenez-Moleon, José Juan; Altzibar, Jone; de Sanjosé, Silvia; Pollán, Marina; Aragonés, Núria; Castaño-Vinyals, Gemma; Kogevinas, Manolis; Amiano, Pilar

    2017-07-01

    Prostate, breast and colorectal cancer are the most common tumours in Spain. The aim of the present study was to evaluate the association between adherence to nutrition-based guidelines for cancer prevention and prostate, breast and colorectal cancer, in the MCC-Spain case-control study. A total of 1,718 colorectal, 1,343 breast and 864 prostate cancer cases and 3,431 population-based controls recruited between 2007 and 2012, were included in the present study. The World Cancer Research Fund/American Institute for Cancer Research (WCRC/AICR) score based on six recommendations for cancer prevention (on body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods and alcoholic drinks; score range 0-6) was constructed. We used unconditional logistic regression analysis adjusting for potential confounders. One-point increment in the WCRF/AICR score was associated with 25% (95% CI 19-30%) lower risk of colorectal, and 15% (95% CI 7-22%) lower risk of breast cancer; no association with prostate cancer was detected, except for cases with a Gleason score ≥7 (poorly differentiated/undifferentiated tumours) (OR 0.87, 95% CI 0.76-0.99). These results add to the wealth of evidence indicating that a great proportion of common cancer cases could be avoided by adopting healthy lifestyle habits. © 2017 UICC.

  19. Efficacy of Pseudomonas fluorescens (Pf-CL145A) spray dried powder for controlling zebra mussels adhering to test substrates

    Science.gov (United States)

    Luoma, James A.; Severson, Todd J.; Weber, Kerry L.; Mayer, Denise A.

    2015-01-01

    A mobile bioassay trailer was used to assess the efficacy of Pseudomonas fluorescens (Pf-CL145A) spray dried powder (SDP) formulation for controlling zebra mussels (Dreissena polymorpha) from two midwestern lakes: Lake Carlos (Alexandria, Minnesota) and Shawano Lake (Shawano, Wisconsin). The effects of SDP exposure concentration and exposure duration on zebra mussel survival were evaluated along with the evaluation of a benthic injection application technique to reduce the amount of SDP required to induce zebra mortality.

  20. Two homologous Agr-like quorum-sensing systems cooperatively control adherence, cell morphology, and cell viability properties in Lactobacillus plantarum WCFS1

    NARCIS (Netherlands)

    Fujii, T.; Ingham, C.J.; Nakayama, J.; Beerthuyzen, M.M.; Kunuki, R.; Molenaar, D.; Sturme, M.H.J.; Vaughan, E.E.; Kleerebezem, M.; Vos, de W.M.

    2008-01-01

    A two-component regulatory system of Lactobacillus plantarum, encoded by genes designated lamK and lamR (hpk10 and rrp10), was studied. The lamK and lamR genes encode proteins which are highly homologous to the quorum-sensing histidine kinase LamC and the response regulator LamA, respectively.

  1. Cooperation between Magnesium and Metabolite Controls Collapse of the SAM-I Riboswitch.

    Science.gov (United States)

    Roy, Susmita; Onuchic, José N; Sanbonmatsu, Karissa Y

    2017-07-25

    The S-adenosylmethionine (SAM)-I riboswitch is a noncoding RNA that regulates the transcription termination process in response to metabolite (SAM) binding. The aptamer portion of the riboswitch may adopt an open or closed state depending on the presence of metabolite. Although the transition between the open and closed states is critical for the switching process, its atomistic details are not well understood. Using atomistic simulations, we calculate the effect of SAM and magnesium ions on the folding free energy landscape of the SAM-I riboswitch. These molecular simulation results are consistent with our previous wetlab experiments and aid in interpreting the SHAPE probing measurements. Here, molecular dynamics simulations explicitly identify target RNA motifs sensitive to magnesium ions and SAM. In the simulations, we observe that, whereas the metabolite mostly stabilizes the P1 and P3 helices, magnesium serves an important role in stabilizing a pseudoknot interaction between the P2 and P4 helices, even at high metabolite concentrations. The pseudoknot stabilization by magnesium, in combination with P1 stabilization by SAM, explains the requirement of both SAM and magnesium to form the fully collapsed metabolite-bound closed state of the SAM-I riboswitch. In the absence of SAM, frequent open-to-closed conformational transitions of the pseudoknot occur, akin to breathing. These pseudoknot fluctuations disrupt the binding site by facilitating fluctuations in the 5'-end of helix P1. Magnesium biases the landscape toward a collapsed state (preorganization) by coordinating pseudoknot and 5'-P1 fluctuations. The cooperation between SAM and magnesium in stabilizing important tertiary interactions elucidates their functional significance in transcription regulation. Published by Elsevier Inc.

  2. Does Prescription Drug Adherence Reduce Hospitalizations and Costs?

    OpenAIRE

    William Encinosa; Didem Bernard; Avi Dor

    2010-01-01

    We estimate the impact of diabetic drug adherence on hospitalizations, ER visits, and hospital costs, using insurance claims from MarketScan® employer data. However, it is often difficult to measure the impact of drug adherence on hospitalizations since both adherence and hospitalizations may be correlated with unobservable patient severity. We control for such unobservables using propensity score methods and instrumental variables for adherence such as drug coinsurance levels and direct-to- ...

  3. Distributed cooperative H∞ optimal tracking control of MIMO nonlinear multi-agent systems in strict-feedback form via adaptive dynamic programming

    Science.gov (United States)

    Luy, N. T.

    2018-04-01

    The design of distributed cooperative H∞ optimal controllers for multi-agent systems is a major challenge when the agents' models are uncertain multi-input and multi-output nonlinear systems in strict-feedback form in the presence of external disturbances. In this paper, first, the distributed cooperative H∞ optimal tracking problem is transformed into controlling the cooperative tracking error dynamics in affine form. Second, control schemes and online algorithms are proposed via adaptive dynamic programming (ADP) and the theory of zero-sum differential graphical games. The schemes use only one neural network (NN) for each agent instead of three from ADP to reduce computational complexity as well as avoid choosing initial NN weights for stabilising controllers. It is shown that despite not using knowledge of cooperative internal dynamics, the proposed algorithms not only approximate values to Nash equilibrium but also guarantee all signals, such as the NN weight approximation errors and the cooperative tracking errors in the closed-loop system, to be uniformly ultimately bounded. Finally, the effectiveness of the proposed method is shown by simulation results of an application to wheeled mobile multi-robot systems.

  4. Individualised motivational counselling to enhance adherence to antiretroviral therapy is not superior to didactic counselling in South African patients: findings of the CAPRISA 058 randomised controlled trial.

    Science.gov (United States)

    van Loggerenberg, Francois; Grant, Alison D; Naidoo, Kogieleum; Murrman, Marita; Gengiah, Santhanalakshmi; Gengiah, Tanuja N; Fielding, Katherine; Abdool Karim, Salim S

    2015-01-01

    Concerns that standard didactic adherence counselling may be inadequate to maximise antiretroviral therapy (ART) adherence led us to evaluate more intensive individualised motivational adherence counselling. We randomised 297 HIV-positive ART-naïve patients in Durban, South Africa, to receive either didactic counselling, prior to ART initiation (n = 150), or an intensive motivational adherence intervention after initiating ART (n = 147). Study arms were similar for age (mean 35.8 years), sex (43.1 % male), CD4+ cell count (median 121.5 cells/μl) and viral load (median 119,000 copies/ml). Virologic suppression at 9 months was achieved in 89.8 % of didactic and 87.9 % of motivational counselling participants (risk ratio [RR] 0.98, 95 % confidence interval [CI] 0.90-1.07, p = 0.62). 82.9 % of didactic and 79.5 % of motivational counselling participants achieved >95 % adherence by pill count at 6 months (RR 0.96, 95 % CI 0.85-1.09, p = 0.51). Participants receiving intensive motivational counselling did not achieve higher treatment adherence or virological suppression than those receiving routinely provided didactic adherence counselling. These data are reassuring that less resource intensive didactic counselling was adequate for excellent treatment outcomes in this setting.

  5. Current Situation of Medication Adherence in Hypertension.

    Science.gov (United States)

    Vrijens, Bernard; Antoniou, Sotiris; Burnier, Michel; de la Sierra, Alejandro; Volpe, Massimo

    2017-01-01

    Despite increased awareness, poor adherence to treatments for chronic diseases remains a global problem. Adherence issues are common in patients taking antihypertensive therapy and associated with increased risks of coronary and cerebrovascular events. Whilst there has been a gradual trend toward improved control of hypertension, the number of patients with blood pressure values above goal has remained constant. This has both personal and economic consequences. Medication adherence is a multifaceted issue and consists of three components: initiation, implementation, and persistence. A combination of methods is recommended to measure adherence, with electronic monitoring and drug measurement being the most accurate. Pill burden, resulting from free combinations of blood pressure lowering treatments, makes the daily routine of medication taking complex, which can be a barrier to optimal adherence. Single-pill fixed-dose combinations simplify the habit of medication taking and improve medication adherence. Re-packing of medication is also being utilized as a method of improving adherence. This paper presents the outcomes of discussions by a European group of experts on the current situation of medication adherence in hypertension.

  6. Research and development of a control system for multi axis cooperative motion based on PMAC

    Science.gov (United States)

    Guo, Xiao-xiao; Dong, Deng-feng; Zhou, Wei-hu

    2017-10-01

    Based on Programmable Multi-axes Controller (PMAC), a design of a multi axis motion control system for the simulator of spatial targets' dynamic optical properties is proposed. According to analysis the properties of spatial targets' simulator motion control system, using IPC as the main control layer, TurboPMAC2 as the control layer to meet coordinated motion control, data acquisition and analog output. A simulator using 5 servomotors which is connected with speed reducers to drive the output axis was implemented to simulate the motion of both the sun and the space target. Based on PMAC using PID and a notch filter algorithm, negative feedback, the speed and acceleration feed forward algorithm to satisfy the axis' requirements of the good stability and high precision at low speeds. In the actual system, it shows that the velocity precision is higher than 0.04 s ° and the precision of repetitive positioning is better than 0.006° when each axis is at a low-speed. Besides, the system achieves the control function of multi axis coordinated motion. The design provides an important technical support for detecting spatial targets, also promoting the theoretical research.

  7. Non-linear sliding mode control of the lower extremity exoskeleton based on human–robot cooperation

    Directory of Open Access Journals (Sweden)

    Shiqiang Zhu

    2016-10-01

    Full Text Available This article presents a human–robot cooperation controller towards the lower extremity exoskeleton which aims to improve the tracking performance of the exoskeleton and reduce the human–robot interaction force. Radial basis function neural network is introduced to model the human–machine interaction which can better approximate the non-linear relationship than the general impedance model. A new method to calculate the inverse Jacobian matrix is presented. Compared to traditional damped least squares method, the novel method is proved to be able to avoid the orientation change of the velocity of the human–robot interaction point by the simulation result. This feature is very important in human–robot system. Then, an improved non-linear robust sliding mode controller is designed to promote the tracking performance considering system uncertainties and model errors, where a new non-linear integral sliding surface is given. The stability analysis of the proposed controller is performed using Lyapunov stability theory. Finally, the novel methods are applied to the swing leg control of the lower extremity exoskeleton, its effectiveness is validated by simulation and comparative experiments.

  8. Referral for psychological therapy of people with long term conditions improves adherence to antidepressants and reduces emergency department attendance: Controlled before and after study

    Science.gov (United States)

    de Lusignan, Simon; Chan, Tom; Tejerina Arreal, Maria C.; Parry, Glenys; Dent-Brown, Kim; Kendrick, Tony

    2013-01-01

    Background Referral to psychological therapies is recommended for people with common mental health problems (CMHP) however its impact on healthcare utilisation in people with long term conditions (LTCs) is not known. Method Routinely collected primary care, psychological therapy clinic and hospital data were extracted for the registered population of 20 practices (N = 121199). These data were linked using the SAPREL (Secure and Private Record Linkage) method. We linked the 1118 people referred to psychological therapies with 6711 controls, matched for age, gender and practice. We compared utilisation of healthcare resources by people with LTCs, 6 months before and after referral, and conducted a controlled before and after study to compare health utilisation with controls. We made the assumption that collection of a greater number of repeat prescriptions for antidepressants was associated with greater adherence. Results Overall 21.8% of people with an LTC had CMHP vs. 18.8% without (p < 0.001). People with LTCs before referral were more likely to use health care resources (2-tailed t-test p < 0.001). Cases with LTCs showed referral to the psychological therapies clinic was associated with increased antidepressant medication prescribing (mean differences 0.62, p < 0.001) and less use of emergency department than controls (mean difference −0.21, p = 0.003). Conclusions Referral to improved access to psychological therapies (IAPT) services appears of value to people with LTC. It is associated with the issue of a greater number of prescriptions for anti-depressant medicines and less use of emergency services. Further studies are needed to explore bed occupancy and outpatient attendance. PMID:23639304

  9. Riboflavin as an independent and accurate biomarker for adherence in a randomized double-blind and placebo-controlled clinical trial.

    Science.gov (United States)

    Ramanujam, V-M S; Nayeem, Fatima; Anderson, Karl E; Kuo, Yong-Fang; Chen, Nai-Wei; Ju, Hyunsu; Lu, Lee-Jane W

    2017-09-01

    Medication adherence is critical for success of clinical trials. To assess oral riboflavin is an adherence marker. Riboflavin was incorporated into active treatment and placebo pills for a clinical trial lasting for 2 years. The accuracy (area under the receiver operating curve) of urinary riboflavin was 0.91 as a binary classifier of adherence, and was similar or better than for two active study ingredients daidzein (0.92) and genistein (0.87) (all p Riboflavin is an accurate and useful biomarker for study pill ingestion.

  10. Distributed Cooperative Control of Multiple Nonlinear Systems with Nonholonomic Constraints and Uncertainty

    Science.gov (United States)

    2015-04-04

    this testbed, there are four P3-AT mobile robots. Each robot is equipped with a camera and a laser sensor. Between robots, there is wireless...shows the formation tracking of the 4 followers, the blue spots represent each follower robot, the black spot represent the trajectory of centroid of...P. Jiang, “Lyapunov design of global state and output trackers for nonholonomic control systems,” Int. J. of Control, pp. 744–761, 2000. [97] Y. P

  11. Cooperative Rendezvous and Docking for Underwater Robots Using Model Predictive Control and Dual Decomposition

    DEFF Research Database (Denmark)

    Nielsen, Mikkel Cornelius; Johansen, Tor Arne; Blanke, Mogens

    2018-01-01

    This paper considers the problem of rendezvous and docking with visual constraints in the context of underwater robots with camera-based navigation. The objective is the convergence of the vehicles to a common point while maintaining visual contact. The proposed solution includes the design of a ...... of a distributed model predictive controller based on dual decomposition, which allows for optimization in a decentralized fashion. The proposed distributed controller enables rendezvous and docking between vehicles while maintaining visual contact....

  12. An internet-based virtual coach to promote physical activity adherence in overweight adults: randomized controlled trial.

    Science.gov (United States)

    Watson, Alice; Bickmore, Timothy; Cange, Abby; Kulshreshtha, Ambar; Kvedar, Joseph

    2012-01-26

    Addressing the obesity epidemic requires the development of effective, scalable interventions. Pedometers and Web-based programs are beneficial in increasing activity levels but might be enhanced by the addition of nonhuman coaching. We hypothesized that a virtual coach would increase activity levels, via step count, in overweight or obese individuals beyond the effect observed using a pedometer and website alone. We recruited 70 participants with a body mass index (BMI) between 25 and 35 kg/m(2) from the Boston metropolitan area. Participants were assigned to one of two study arms and asked to wear a pedometer and access a website to view step counts. Intervention participants also met with a virtual coach, an automated, animated computer agent that ran on their home computers, set goals, and provided personalized feedback. Data were collected and analyzed in 2008. The primary outcome measure was change in activity level (percentage change in step count) over the 12-week study, split into four 3-week time periods. Major secondary outcomes were change in BMI and participants' satisfaction. The mean age of participants was 42 years; the majority of participants were female (59/70, 84%), white (53/70, 76%), and college educated (68/70, 97%). Of the initial 70 participants, 62 completed the study. Step counts were maintained in intervention participants but declined in controls. The percentage change in step count between those in the intervention and control arms, from the start to the end, did not reach the threshold for significance (2.9% vs -12.8% respectively, P = .07). However, repeated measures analysis showed a significant difference when comparing percentage changes in step counts between control and intervention participants over all time points (analysis of variance, P = .02). There were no significant changes in secondary outcome measures. The virtual coach was beneficial in maintaining activity level. The long-term benefits and additional applications of

  13. Radiation protection: Creating capacity, legislation and regulation, control of exposure and emergency preparedness through technical cooperation

    International Nuclear Information System (INIS)

    2007-01-01

    Every year, the IAEA technical cooperation (TC) programme provides more than US $70 million worth of training services, and equipment in approximately 100 countries and territories throughout Africa, Asia and the Pacific, Europe and Latin America. TC projects span an ever increasing range of sectors that have direct links to human and environmental health. Wherever nuclear and other radiation based technologies are applied, protecting the safety and health of employees, medical patients and the public at large is a top priority and a demanding responsibility. One of the primary aims of the TC's radiation protection programme is to help Member States fulfil their safety and security obligations. Rarely in the history of the IAEA has radiation based technology provided so much opportunity. Just as Member States - particularly developing countries - acquire the expertise needed to utilize technologies that contribute to social and economic development, they need to ensure that they have an adequate national infrastructure for radiation safety and security. Beyond the existing infrastructure for radiation safety and security, other factors increasingly call for attention. They are, on the one hand: - The development and deployment of new nuclear technologies; - Renewed interest in large scale nuclear energy production and on the other hand: - Geopolitical instability and global terrorism, which create a black market for radioactive materials; - Ongoing attempts to acquire capacity in nuclear weapons. If the world is to realize the potential of radiation based technologies for peaceful purposes, each country must be prepared to confront the associated risks. The nature of today's global environment is such that a significant threat can arise virtually any time, anywhere. Thus, there is a pressing need to strengthen the safety and security network at every level. The TC programme is committed to building a global safety regime for nuclear technology, country by country

  14. The More Supply Chain Control Power, the Better? A Comparison among Four Kinds of Cooperation Models

    Directory of Open Access Journals (Sweden)

    Weihua Liu

    2015-01-01

    Full Text Available This paper introduces the parameter of supply chain control power into existing supply chain coordination models and explores the impacts of control power on the profits of manufacturer, retailer, and the overall supply chain under four modes of decision-making, including the decentralized decision-making dominated by manufacturer, the decentralized decision-making dominated by retailer, centralized decision-making, and Nash negotiation decision-making. Some significant conclusions are obtained. Firstly, supply chain control power does have great impact on the supply chain profits. The profit of the whole supply chain with centralized decision-making is higher than those of the other three modes, while the overall profit of supply chain with decentralized decision-making is superior to the profit when retailer and manufacturer dominate the supply chain together. Secondly, with decentralized decision-making, for manufacturer and retailer, it is beneficial to gain the control powers of the supply chain; however, control power has an optimal value, not the bigger, the better. Thirdly, under certain circumstances, order quantity will increase and the wholesale price will decrease when control power is transferred from manufacturer to retailer. In this case, the total profit of supply chain dominated by retailer will be greater than that dominated by manufacturer.

  15. [Family adherence in serious mental disorder].

    Science.gov (United States)

    Martín Padilla, Ernesto; Obando Posada, Diana; Sarmiento Medina, Pedro

    2017-10-09

    Identify attitudes and behaviors that evidence and characterize family adherence to treatment in patients with severe mental disorder. Qualitative descriptive, from an interpretative social approach. Chia, Colombia, with professionals in the psychiatric and geriatric settings. Twelve professionals in psychiatry, nursing and psychology, with experience in care of patients with serious mental disorder and their families. Intentional sampling. Twelve semi-structured interviews were carried out. The analysis strategy was made from the procedures of constant comparison and open coding of the grounded theory. As validation strategies, triangulation was done between researchers and methods, as interviews and results survey. Two categories of family adherence were defined: family and treatment (treatment cooperation, knowledge about the disease and attention to the disease evolution), and family attitudes towards the patient (patient's care, patient's promotion of autonomy, and affective attachment with the patient). A third category showed aspects that diminished family adherence, such as lack or distortion of information regarding mental disorder, or family and patient endurance attitudes. Participants agree about the relevance of the construct named «family adherence», which describes the behaviors and attitudes of the family regarding the treatment of patients with severe mental disorder. Family adherence can be seen as active participation behavior, but also as a process of strengthening relationships, which can reduce the burden and suffering on family members, caregivers and patients. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  16. Adherence to phosphate binders in hemodialysis patients: prevalence and determinants.

    Science.gov (United States)

    Van Camp, Yoleen P M; Vrijens, Bernard; Abraham, Ivo; Van Rompaey, Bart; Elseviers, Monique M

    2014-12-01

    Phosphate control is a crucial treatment goal in end-stage renal disease, but poor patient adherence to phosphate binder therapy remains a challenge. This study aimed to estimate the extent of phosphate binder adherence in hemodialysis patients and to identify potential determinants. Phosphate binder adherence was measured blindly in 135 hemodialysis patients for 2 months using the medication event monitoring system. Patient data, gathered at inclusion through medical records, ad hoc questionnaires and the short form (SF)-36 health survey, included: (1) demographics, (2) perceived side-effects, belief in benefit, self-reported adherence to the therapy, (3) knowledge about phosphate binder therapy, (4) social support, and (5) quality of life (SF-36). Phosphatemia data was collected from charts. 'Being adherent' was defined as missing adherent' as missing adherent. Over the entire 8-week period, 22 % of patients were totally adherent. Mean phosphatemia levels were 0.55 mg/dl lower in adherent than nonadherent patients (4.76 vs. 5.31 mg/dl). Determinants for being totally adherent were living with a partner, higher social support (both were interrelated) and higher physical quality of life. Experiencing intake-related inconvenience negatively affected adherence. The social support and quality of life physical score explained 26 % of the variance in adherence. Phosphate binder nonadherence remains a major problem. Interventions should aim, at least, to improve social support. With few associated factors found and yet low adherence, an individualized approach seems indicated.

  17. FY1995 distributed control of man-machine cooperative multi agent systems; 1995 nendo ningen kyochogata multi agent kikai system no jiritsu seigyo

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    In the near future, distributed autonomous systems will be practical in many situations, e.g., interactive production systems, hazardous environments, nursing homes, and individual houses. The agents which consist of the distributed system must not give damages to human being and should be working economically. In this project man-machine cooperative multi agent systems are studied in many kind of respects, and basic design technology, basic control technique are developed by establishing fundamental theories and by constructing experimental systems. In this project theoretical and experimental studies are conducted in the following sub-projects: (1) Distributed cooperative control in multi agent type actuation systems (2) Control of non-holonomic systems (3) Man-machine Cooperative systems (4) Robot systems learning human skills (5) Robust force control of constrained systems In each sub-project cooperative nature between machine agent systems and human being, interference between artificial multi agents and environment and new function emergence in coordination of the multi agents and the environment, robust force control against for the environments, control methods for non-holonomic systems, robot systems which can mimic and learn human skills were studied. In each sub-project, some problems were hi-lighted and solutions for the problems have been given based on construction of experimental systems. (NEDO)

  18. Effect of a Behavioral Self-Regulation Intervention on Patient Adherence to Fluid-Intake Restrictions in Hemodialysis: a Randomized Controlled Trial.

    Science.gov (United States)

    Howren, M Bryant; Kellerman, Quinn D; Hillis, Stephen L; Cvengros, Jamie; Lawton, William; Christensen, Alan J

    2016-04-01

    The purpose of this study is to evaluate the efficacy of a behavioral self-regulation intervention vs. active control condition using a parallel-group randomized clinical trial with a sample of center hemodialysis patients with chronic kidney disease. Participants were recruited from 8 hemodialysis treatment centers in the Midwest. Eligible patients were (a) fluid nonadherent as defined by an interdialytic weight gain >2.5 kg over a 4-week period, (b) >18 years of age, (c) English-speaking without severe cognitive impairment, (d) treated with center-based hemodialysis for >3 months, and (e) not living in a care facility in which meals were managed. Medical records were used to identify eligible patients. Patients were randomly assigned to either a behavioral self-regulation intervention or active control condition in which groups of 3-8 patients met for hour-long, weekly sessions for 7 weeks at their usual hemodialysis clinic. Primary analyses were intention-to-treat. Sixty-one patients were randomized to the intervention while 58 were assigned to the attention-placebo support and discussion control. Covariate-adjusted between-subjects analyses demonstrated no unique intervention effect for the primary outcome, interdialytic weight gain (β = 0.13, p = 0.48). Significant within-subjects improvement over time was observed for the intervention group (β = -0.32, p = 0.014). The present study found that participation in a behavioral self-regulation intervention resulted in no unique intervention effect on a key indicator of adherence for those with severe chronic kidney disease. There was, however, modest within-subjects improvement in interdialytic weight gain for the intervention group which meshes with other evidence showing the utility of behavioral interventions in this patient population. ClinicalTrials.gov Identifier: NCT01066949.

  19. A randomized-controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Emmanuel eStip

    2013-08-01

    Full Text Available Objective: Medication adherence is extremely important in preventing relapse and lowering symptoms in schizophrenic patients. However, estimates show that nearly half of these patients have poor adherence. The Brief Adherence Rating Scale (BARS seems to be the most reliable tool assessing adherence in schizophrenia and shows that the antipsychotic adherence ratio (AAR is about 49.5 % in schizophrenia. The aim of the study was to test if an electronic pill dispenser named DoPill® improved AAR of schizophrenic patients. Furthermore, we compared AAR obtained by the DoPill® and the BARS, in order to verify whether the DoPill® provides reliable assessment of medication adherence. Methods: The DoPill® is a smart pill dispenser that beeps and flashes at the appropriate time of the day. Each of its 28 compartments is covered by a plastic lamina that, when taken off, sends a signal to the pharmacist. Patients were randomized to the DoPill® or Treatment As Usual group (TAU for six weeks. The BARS was used as a reference measure. Results: Forty-six percent of patients were deemed to be non-adherent with antipsychotic medication. The mean AAR was 67 % after six weeks. DoPill® recorded better AAR than some of those found in the literature and were lower than the BARS estimate we found. Conclusion: These results suggest that DoPill® is a valid tool that provides more reliable and objective data for the clinician about their patient’s adherence, than existing assessment tools like the BARS. Furthermore, the device may help patients successfully manage their medication regimen.

  20. A randomized controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia.

    Science.gov (United States)

    Stip, Emmanuel; Vincent, Philippe D; Sablier, Juliette; Guevremont, Catherine; Zhornitsky, Simon; Tranulis, Constantin

    2013-01-01

    Medication adherence is extremely important in preventing relapse and lowering symptoms in schizophrenic patients. However, estimates show that nearly half of these patients have poor adherence. The Brief Adherence Rating Scale (BARS) seems to be the most reliable tool assessing adherence in schizophrenia and shows that the antipsychotic adherence ratio (AAR) is about 49.5% in schizophrenia. The aim of the study was to test if an electronic pill dispenser named DoPill(®) improved AAR of schizophrenic patients. Furthermore, we compared AAR obtained by the DoPill(®) and the BARS, in order to verify whether the DoPill(®) provides reliable assessment of medication adherence. The DoPill(®) is a smart pill dispenser that beeps and flashes at the appropriate time of the day. Each of its 28 compartments is covered by a plastic lamina that, when taken off, sends a signal to the pharmacist. Patients were randomized to the DoPill(®) or treatment as usual groups for 6 weeks. The BARS was used as a reference measure. Forty-six percent of patients were deemed to be non-adherent with antipsychotic medication. The mean AAR was 67% after 6 weeks. DoPill(®) recorded better AAR than some of those found in the literature and were lower than the BARS estimate we found. These results suggest that DoPill(®) is a valid tool that provides more reliable and objective data for the clinician about their patient's adherence, than existing assessment tools like the BARS. Furthermore, the device may help patients successfully manage their medication regimen.

  1. Congruence between patient characteristics and interventions may partly explain medication adherence intervention effectiveness: an analysis of 190 randomized controlled trials from a Cochrane systematic review.

    Science.gov (United States)

    Allemann, Samuel S; Nieuwlaat, Robby; Navarro, Tamara; Haynes, Brian; Hersberger, Kurt E; Arnet, Isabelle

    2017-11-01

    Due to the negative outcomes of medication nonadherence, interventions to improve adherence have been the focus of countless studies. The congruence between adherence-related patient characteristics and interventions may partly explain the variability of effectiveness in medication adherence studies. In their latest update of a Cochrane review reporting inconsistent effects of adherence interventions, the authors offered access to their database for subanalysis. We aimed to use this database to assess congruence between adherence-related patient characteristics and interventions and its association with intervention effects. We developed a congruence score consisting of six features related to inclusion criteria, patient characteristics at baseline, and intervention design. Two independent raters extracted and scored items from the 190 studies available in the Cochrane database. We correlated overall congruence score and individual features with intervention effects regarding adherence and clinical outcomes using Kruskal-Wallis rank sum test and Fisher's exact test. Interrater reliability for newly extracted data was almost perfect with a Cohen's Kappa of 0.92 [95% confidence interval (CI) = 0.89-0.94; P congruence score nor any other individual feature (i.e., "determinants of nonadherence as inclusion criteria," "tailoring of interventions to the inclusion criteria," "reasons for nonadherence assessed at baseline," "adjustment of intervention to individual patient needs," and "theory-based interventions") was significantly associated with intervention effects. The presence of only six studies that included nonadherent patients and the interdependency of this feature with the remaining five might preclude a conclusive assessment of congruence between patient characteristics and adherence interventions. In order to obtain clinical benefits from effective adherence interventions, we encourage researchers to focus on the inclusion of nonadherent patients. Copyright

  2. An online community improves adherence in an internet-mediated walking program. Part 1: results of a randomized controlled trial.

    Science.gov (United States)

    Richardson, Caroline R; Buis, Lorraine R; Janney, Adrienne W; Goodrich, David E; Sen, Ananda; Hess, Michael L; Mehari, Kathleen S; Fortlage, Laurie A; Resnick, Paul J; Zikmund-Fisher, Brian J; Strecher, Victor J; Piette, John D

    2010-12-17

    Approximately half of American adults do not meet recommended physical activity guidelines. Face-to-face lifestyle interventions improve health outcomes but are unlikely to yield population-level improvements because they can be difficult to disseminate, expensive to maintain, and inconvenient for the recipient. In contrast, Internet-based behavior change interventions can be disseminated widely at a lower cost. However, the impact of some Internet-mediated programs is limited by high attrition rates. Online communities that allow participants to communicate with each other by posting and reading messages may decrease participant attrition. Our objective was to measure the impact of adding online community features to an Internet-mediated walking program on participant attrition and average daily step counts. This randomized controlled trial included sedentary, ambulatory adults who used email regularly and had at least 1 of the following: overweight (body mass index [BMI] ≥ 25), type 2 diabetes, or coronary artery disease. All participants (n = 324) wore enhanced pedometers throughout the 16-week intervention and uploaded step-count data to the study server. Participants could log in to the study website to view graphs of their walking progress, individually-tailored motivational messages, and weekly calculated goals. Participants were randomized to 1 of 2 versions of a Web-based walking program. Those randomized to the "online community" arm could post and read messages with other participants while those randomized to the "no online community" arm could not read or post messages. The main outcome measures were participant attrition and average daily step counts over 16 weeks. Multiple regression analyses assessed the effect of the online community access controlling for age, sex, disease status, BMI, and baseline step counts. Both arms significantly increased their average daily steps between baseline and the end of the intervention period, but there were no

  3. Effectiveness and sustainability of a structured group-based educational program (MEDIHEALTH) in improving medication adherence among Malay patients with underlying type 2 diabetes mellitus in Sarawak State of Malaysia: study protocol of a randomized controlled trial.

    Science.gov (United States)

    Ting, Chuo Yew; Ahmad Zaidi Adruce, Shahren; Hassali, Mohamed Azmi; Ting, Hiram; Lim, Chien Joo; Ting, Rachel Sing-Kiat; Abd Jabar, Abu Hassan Alshaari; Osman, Nor Anizah; Shuib, Izzul Syazwan; Loo, Shing Chyi; Sim, Sui Theng; Lim, Su Ee; Morisky, Donald E

    2018-06-05

    Amidst the high disease burden, non-adherence to medications among patients with type 2 diabetes mellitus (T2DM) has been reported to be common and devastating. Sarawak Pharmaceutical Services Division has formulated a pharmacist-led, multiple-theoretical-grounding, culturally sensitive and structured group-based program, namely "Know Your Medicine - Take if for Health" (MEDIHEALTH), to improve medication adherence among Malay patients with T2DM. However, to date, little is known about the effectiveness and sustainability of the Program. This is a prospective, parallel-design, two-treatment-group randomized controlled trial to evaluate the effectiveness and sustainability of MEDIHEALTH in improving medication adherence. Malay patients who have underlying T2DM, who obtain medication therapy at Petra Jaya Health Clinic and Kota Samarahan Health Clinic, and who have a moderate to low adherence level (8-item Morisky Medication Adherence Scale, Malaysian specific, score sustainability of the Program will be triangulated by findings from semi-structured interviews with five selected participants conducted 1 month after the intervention and in-depth interviews with two main facilitators and two managerial officers in charge of the Program 12 months after the intervention. Statistical analyses of quantitative data were conducted using SPSS version 22 and Stata version 14. Thematic analysis for qualitative data were conducted with the assistance of ATLAS.ti 8. This study provides evidence on the effectiveness and sustainability of a structured group-based educational program that employs multiple theoretical grounding and a culturally sensitive approach in promoting medication adherence among Malays with underlying T2DM. Both the quantitative and qualitative findings of this study could assist in the future development of the Program. National Medical Research Register, NMRR-17-925-35875 (IIR). Registered on 19 May 2017. ClinicalTrials.gov, NCT03228706 . Registered on 25

  4. The efficacy and stability of an information and communication technology-based centralized monitoring system of adherence to immunosuppressive medication in kidney transplant recipients: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Jung, Hee-Yeon; Seong, Sook Jin; Choi, Ji-Young; Cho, Jang-Hee; Park, Sun-Hee; Kim, Chan-Duck; Yoon, Young-Ran; Kim, Hyung-Kee; Huh, Seung; Yoon, Se-Hee; Lee, Jong Soo; Kim, Yong-Lim

    2017-10-16

    Immunosuppression non-adherence in kidney transplant recipients (KTRs) not only increases the risk of medical intervention due to acute rejection and graft loss but burdens the socioeconomic system in the form of increased healthcare costs. An aggressive preemptive effort by healthcare professionals, geared to ensure adherence to immunosuppressants in KTRs, is significant and imperative. This study was designed as a prospective, open-label, multicenter, randomized controlled study aimed at evaluating the efficacy and stability of an information and communication technology (ICT)-based centralized monitoring system in boosting medication adherence in KTRs. One hundred fourteen KTRs registered throughout the year 2017 to 2018 are randomized into either the ICT-based centralized home monitoring system or to ambulatory follow-up. The planned follow-up duration is 6 months. The ICT-based centralized home monitoring system described consists of a smart pill box equipped with personal identification system, a home monitoring system, an electronic Case Report Form (eCRF) system, and a comprehensive clinical trial management system (CTMS). It alerts both patients and medical staff with texts and pill box alarms if there is a dosage/dosing time error or a missed dose. Medication adherence and transplant outcomes for the follow-up period are compared between the two groups, while patient satisfaction as well as the stability and cost-effectiveness of the ICT-based monitoring system are to be evaluated. This on-going study is expected to determine if consistent use of the ICT-based centralized monitoring system described could maximize mediation adherence and subsequently enhance transplant outcomes in KTRs. Further, it would lay the foundation for successful implementation of this ICT-based monitoring system for effective management of medication adherence in KTRs. ClinicalTrials.gov, Identifier: NCT03136588 . Registered on 20 April 2017.

  5. Traffic flow impacts of adaptive cruise control deactivation and (Re)activation with cooperative driver behavior

    NARCIS (Netherlands)

    Klunder, G.; Li, M.; Minderhoud, M.

    2009-01-01

    In 2006 in the Netherlands, a field operational test was carried out to study the effect of adaptive cruise control (ACC) and lane departure warning on driver behavior and traffic flow in real traffic. To estimate the effect for larger penetration rates, simulations were needed. For a reliable

  6. Behavioral Dynamics in the Cooperative Control of Mixed Human/Robotic Teams

    Science.gov (United States)

    2015-01-05

    0528 John Baillieul Intelligent Mechatronics Laboratory Boston University Francesco Bullo, David Castañón, Jonathan D. Cohen, Philip...Interaction,” John Baillieul, The International Conference on Instrumentation, Control, and Information Technology -SICE 2008, Chofu, Tokyo, Japan...Aspects of Simple Decisions in Search and Reconnaissance 2007 MURI Topic 16 Final Report Baillieul et al. • United Technologies Research Center

  7. 76 FR 4702 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Cooperative...

    Science.gov (United States)

    2011-01-26

    ... the National Academic Centers of Excellence in Youth Violence Prevention (U01), Funding Opportunity... Centers of Excellence in Youth Violence Prevention (U01), FOA CE10-004, initial review''. Agenda items are... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Disease...

  8. The governance of cooperative societies

    Directory of Open Access Journals (Sweden)

    Yaiza Juanes Sobradillo

    2005-12-01

    Full Text Available The present work aims to expose the appropriate legislation for cooperative societies to which Article 129 of the Spanish Constitution refers, deepen the analysis of the organs of management and control based on the Spanish and Basque Laws on Cooperatives and the Statute for the European Cooperative Societies.

  9. Cooperative Control of Mobile Sensor Networks for Environmental Monitoring: An Event-Triggered Finite-Time Control Scheme.

    Science.gov (United States)

    Lu, Qiang; Han, Qing-Long; Zhang, Botao; Liu, Dongliang; Liu, Shirong

    2017-12-01

    This paper deals with the problem of environmental monitoring by developing an event-triggered finite-time control scheme for mobile sensor networks. The proposed control scheme can be executed by each sensor node independently and consists of two parts: one part is a finite-time consensus algorithm while the other part is an event-triggered rule. The consensus algorithm is employed to enable the positions and velocities of sensor nodes to quickly track the position and velocity of a virtual leader in finite time. The event-triggered rule is used to reduce the updating frequency of controllers in order to save the computational resources of sensor nodes. Some stability conditions are derived for mobile sensor networks with the proposed control scheme under both a fixed communication topology and a switching communication topology. Finally, simulation results illustrate the effectiveness of the proposed control scheme for the problem of environmental monitoring.

  10. A European Quality Control Programme as a cooperative tool between users and a diagnostic company.

    Science.gov (United States)

    Costongs, G M; Janson, P C

    1993-12-01

    Achievement of appropriate precision is a major challenge for the clinical laboratory, particularly in specialized fields such as enzymology and immunochemistry. Especially in immunochemistry, where accuracy can only poorly be checked because of a lack of reference methods and a multitude of detectable epitopes, precision remains an important index of quality. In immunochemical methods there are three main sources of variation: differences in methodology, lot-to-lot variation and performance of the assay, the latter including the skill of the technicians and instrument performance. The results of a European Quality Control Programme for the users of one type of automated immunoassay analyser were compared with a similar Italian Quality Control Programme for users of different immunometric techniques. The precisions (%CV) of the two programmes were compared, as well as the number of values lying within one half of the biological variation of the analysed serum components. Feedback between users and manufacturers leads to a clear improvement in analysis performance, so that most of the considered values come to lie within the acceptable limits of 1/2 of the biological variation. It is concluded that both national and international quality control programmes are very useful for indicating the intrinsic quality of the quantities used in the clinical laboratory.

  11. Epic Allies, a Gamified Mobile Phone App to Improve Engagement in Care, Antiretroviral Uptake, and Adherence Among Young Men Who Have Sex With Men and Young Transgender Women Who Have Sex With Men: Protocol for a Randomized Controlled Trial.

    Science.gov (United States)

    LeGrand, Sara; Muessig, Kathryn E; Platt, Alyssa; Soni, Karina; Egger, Joseph R; Nwoko, Nkechinyere; McNulty, Tobias; Hightow-Weidman, Lisa B

    2018-04-05

    In the United States, young men who have sex with men (YMSM) and transgender women who have sex with men (YTWSM) bear a disproportionate burden of prevalent and incident HIV infections. Once diagnosed, many YMSM and YTWSM struggle to engage in HIV care, adhere to antiretroviral therapy (ART), and achieve viral suppression. Computer-based interventions, including those focused on behavior change, are recognized as effective tools for engaging youth. The purpose of the study described in this protocol is to evaluate the efficacy of Epic Allies, a theory-based mobile phone app that utilizes game mechanics and social networking features to improve engagement in HIV care, ART uptake, ART adherence, and viral suppression among HIV-positive YMSM and YTWSM. The study also qualitatively assesses intervention acceptability, perceived impact, and sustainability. This is a two-group, active-control randomized controlled trial of the Epic Allies app. YMSM and YTWSM aged 16 to 24 inclusive, with detectable HIV viral load are randomized 1:1 within strata of new to care (newly entered HIV medical care ≤12 months of baseline visit) or ART-nonadherent (first entered HIV medical care >12 months before baseline visit) to intervention or control conditions. The intervention condition addresses ART adherence barriers through medication reminders and adherence monitoring, tracking of select adherence-related behaviors (eg, alcohol and marijuana use), an interactive dashboard that displays the participant's adherence-related behaviors and provides tailored feedback, encouragement messages from other users, daily HIV/ART educational articles, and gamification features (eg, mini-games, points, badges) to increase motivation for behavior change and app engagement. The control condition features weekly phone-based notifications to encourage participants to view educational information in the control app. Follow-up assessments are administered at 13, 26, and 39 weeks for each arm. The

  12. International cooperation

    International Nuclear Information System (INIS)

    Prieto, F.E.

    1984-01-01

    It looks doubtless that the need for an international cooperation to solve the worldwide energy problems is already a concern of individuals, institutions, and governments. This is an improvement. But there is something lacking. The author refers to the Atoms for Peace speech, the origin of the IAEA and of the subsequent spreading of the nuclear option. He also refers back to the call made by the Mexican government for a worldwide energy cooperation. He stresses the need for governments to cooperate, so that this international cooperation on energy can be put into operation for the benefit of mankind

  13. Conference of Radiation Control Program Directors, Inc. (CRCPD). A model for networking, cooperation, resource sharing, information exchange and regulation harmonization

    International Nuclear Information System (INIS)

    2007-01-01

    The focus of the talk will be to introduce the participants to the Conference of Radiation Control Program Directors, Inc. (CRCPD) and their proven methods for networking, information exchange, regulation development and standardization, and radiation protection guidance on emerging technologies. The presentation will describe how radiation control programs and staff from all 50 states in the US work collaboratively to ensure adequate radiation protection standards are uniformly applied throughout the country by pooling of resources and networking between all the states and the federal government, as well as with international members and partners. The products of CRCPD, such as the Suggested State Regulations along with other relevant informational documents, will be discussed along with how participants can access these products for use in their respective countries. CRCPD and its members represent a comprehensive radiation regulatory structure, covering all radiation sources and activities, (radioactive materials, licensing, registration, radioactive waste, x-ray, accelerators, emergency response, environmental monitoring, radon, and security). Networks are in place for all radiation issues. At the completion of this presentation, the participants will better understand a proven method to develop and implement a cooperative partnership with other countries. They will also gain knowledge on how to access CRCPD products that can be tailored for their own use and how to request technical assistance from membership. (author)

  14. The Conference of Radiation Control Program Directors (CRCPD): a model for networking, cooperation, information exchange and regulation harmonization

    International Nuclear Information System (INIS)

    Gilley, Debbie Bray

    2008-01-01

    This presentation will be to introduce to the participants the Conference of Radiation Control Program Directors, Inc. (CRCPD) and the proven methods used by this organization for networking, information exchange, regulation development and standardization, and radiation protection guidance on emerging technologies. The presentation will describe how radiation control programs and staff from all 50 states in the US work collaboratively to ensure adequate radiation protection standards are uniformly applied throughout the country through the pooling of resources and networking between all the states and the federal government, as well as with international members and partners. The products of CRCPD, such as the Suggested State Regulations along with other relevant informational documents, will be discussed along with how participants can access these products for use in their respective countries. CRCPD and its members represent a comprehensive radiation regulatory structure, covering radioactive materials, radioactive waste, X-ray, accelerators, emergency response, environmental monitoring, radon, and security. Networks are in place for all radiation issues. After the presentation, participants will better understand how to develop and implement a cooperative partnership with other countries. They will also know how to access our products that can be tailored for their own use. They will also be informed of how to contact CRCPD and request technical assistance from one of our 1000 members through our international outreach initiative. (author)

  15. Retinal Expression of the Drosophila eyes absent Gene Is Controlled by Several Cooperatively Acting Cis-regulatory Elements

    Science.gov (United States)

    Neuman, Sarah D.; Bashirullah, Arash; Kumar, Justin P.

    2016-01-01

    The eyes absent (eya) gene of the fruit fly, Drosophila melanogaster, is a member of an evolutionarily conserved gene regulatory network that controls eye formation in all seeing animals. The loss of eya leads to the complete elimination of the compound eye while forced expression of eya in non-retinal tissues is sufficient to induce ectopic eye formation. Within the developing retina eya is expressed in a dynamic pattern and is involved in tissue specification/determination, cell proliferation, apoptosis, and cell fate choice. In this report we explore the mechanisms by which eya expression is spatially and temporally governed in the developing eye. We demonstrate that multiple cis-regulatory elements function cooperatively to control eya transcription and that spacing between a pair of enhancer elements is important for maintaining correct gene expression. Lastly, we show that the loss of eya expression in sine oculis (so) mutants is the result of massive cell death and a progressive homeotic transformation of retinal progenitor cells into head epidermis. PMID:27930646

  16. Dataglove-based interface for impedance control of manipulators in cooperative human–robot environments

    International Nuclear Information System (INIS)

    Paredes-Madrid, L; Gonzalez de Santos, P

    2013-01-01

    A dataglove-based interface is presented for tracking the forces applied by the hand during contact tasks with a 6-degree-of-freedom (DOF) manipulator. The interface uses 11 force sensors carefully placed on the palm-side fabric of a 16 DOF dataglove. The force sensors use piezoresistive technology to measure the individual force components from the hand. Based on the dataglove measurements, these components are transformed and summed to assemble the resultant force vector. Finally, this force vector is translated into the manipulator frame using orientation measurements from an inertial measurement unit placed on the dorsal side of the dataglove. Static tests show that the dataglove-based interface can effectively measure the applied hand force, but there are inaccuracies in orientation and magnitude when compared to the load cell measurements used as the reference for error calculation. Promising results were achieved when controlling the 6 DOF manipulator based on the force readings acquired from the dataglove interface; the decoupled dynamics of the dataglove interface with respect to the robot structure yielded smooth force readings of the human intention that could be effectively used in the impedance control of the manipulator. (paper)

  17. A Game-theoretical Approach for Distributed Cooperative Control of Autonomous Underwater Vehicles

    KAUST Repository

    Lu, Yimeng

    2018-05-01

    This thesis explores a game-theoretical approach for underwater environmental monitoring applications. We first apply game-theoretical algorithm to multi-agent resource coverage problem in drifting environments. Furthermore, existing utility design and learning process of the algorithm are modified to fit specific constraints of underwater exploration/monitoring tasks. The revised approach can take the real scenario of underwater monitoring applications such as the effect of sea current, previous knowledge of the resource and occasional communications between agents into account, and adapt to them to reach better performance. As the motivation of this thesis is from real applications, in this work we emphasize highly on implementation phase. A ROS-Gazebo simulation environment was created for preparation of actual tests. The algorithms are implemented in simulating both the dynamics of vehicles and the environment. After that, a multi-agent underwater autonomous robotic system was developed for hardware test in real settings with local controllers to make their own decisions. These systems are used for testing above mentioned algorithms and future development of other underwater projects. After that, other works related to robotics during this thesis will be briefly mentioned, including contributions in MBZIRC robotics competition and distributed control of UAVs in an adversarial environment.

  18. HIV Medication Adherence

    Science.gov (United States)

    ... AIDS Drugs Clinical Trials Apps skip to content HIV Treatment Home Understanding HIV/AIDS Fact Sheets HIV ... 4 p.m. ET) Send us an email HIV Medication Adherence Last Reviewed: January 17, 2018 Key ...

  19. Using cooperative control to manage uncertainties for Aquifer Thermal Energy Storage (ATES)

    Science.gov (United States)

    Jaxa-Rozen, Marc; Rostampour, Vahab; Kwakkel, Jan; Bloemendal, Martin

    2017-04-01

    Aquifer Thermal Energy Storage (ATES) technology can lead to major reductions in energy demand for heating and cooling in buildings. ATES systems rely on shallow aquifers to seasonally store thermal energy and have become popular in the Netherlands, where a combination of easily accessible aquifers and strict energy regulations makes the technology especially relevant. However, this rapid adoption has made their management in dense urban areas more challenging. For instance, thermal interferences between neighboring systems can degrade storage efficiency. Policies for the permitting and spatial layout of ATES thus tend to be conservative to ensure the performance of individual systems, but this limits the space available for new systems - leading to a trade-off between individual system performance, and the overall energy savings obtained from ATES in a given area. Furthermore, recent studies show that operational uncertainties contribute to poor outcomes under current planning practices; systems in the Netherlands typically use less than half of their permitted water volume. This further reduces energy savings compared to expectations and also leads to an over-allocation of subsurface space. In this context, this work investigates the potential of a more flexible approach for ATES planning and operation, under which neighboring systems coordinate their operation. This is illustrated with a three-building idealized case, using a model predictive control approach for two control schemes: a decoupled formulation, and a centralized scheme that aims to avoid interferences between neighboring systems (assuming perfect information exchange). These control schemes are compared across a range of scenarios for spatial layout, building energy demand, and climate, using a coupled agent-based/geohydrological simulation. The simulation indicates that centralized operation could significantly improve the spatial layout efficiency of ATES systems, by allowing systems to be placed

  20. A cooperative effort to pass tobacco control ordinances in Wichita, Kansas.

    Science.gov (United States)

    Pippert, K; Jecha, L; Coen, S; MacDonald, P; Francisco, J; Pickard, S

    1995-01-01

    In October 1993, the Tobacco-Free Wichita Coalition proposed ordinances to the Wichita City Council that would tightly control access of minors to tobacco and prohibit smoking in public places. The subsequent successful change in local health policy required the collaborative efforts of local and state organizations and health agencies. A simple random telephone survey commissioned and financed by the coalition demonstrated that 76 percent (95 percent CI = 72 percent to 80 percent) of adult Wichita-Sedgwick County residents favored enforced penalties for merchants selling tobacco to minors, and 62 percent (95 percent CI = 58 percent to 66 percent) favored a ban on tobacco vending machines. Fifty-four percent (95 percent CI = 50 percent to 58 percent) favored a smoking ban in all public places.

  1. Safeguard Verification as Cooperative Measure for Non Proliferation Control in Peru

    International Nuclear Information System (INIS)

    Ramirez, R.

    2010-01-01

    Peru applies the safeguard measures on its nuclear activities based in the International Atomic Energy Agency (IAEA) Safeguard Agreement and the Additional Protocol which has been fully implemented becoming part of the Integrated Safeguard since 2005. In addition to international safeguard commitments Peru is also committed with the United Nations 1540 Resolution by which national controls has to be established for preventing the proliferation of mass destruction weapons and their vector systems. The safeguards measures have become an important part of the verification activities related to this Resolution by analyzing of materials and equipment to be imported or that may be in transit across the country. These activities are part of those developed jointly with other governmental organizations. (author)

  2. Fuzzy logic controller for cooperative mobile robotics implemented in leader-follower formation approach

    Directory of Open Access Journals (Sweden)

    Manuel Alejandro Molina-Villa

    2015-01-01

    Full Text Available Este artículo presenta el diseño de un controlador de lógica difusa implementandoel método líder-seguidor para un sistema de robótica cooperativa móvil, que permita a ungrupo de robots establecer y mantener una formación geométrica especifi ca mientras sedesplazan siguiendo una trayectoria de referencia. Como resultado de la investigación, seprobó mediante simulación un sistema de control cooperativo, que permite a un grupo derobots mantener una formación específi ca mientras desarrollan una misión determinada.Este controlador permite evadir obstáculos cambiando la formación o cambiando el líder delgrupo en cualquier momento.

  3. Cooperative Fault Tolerant Tracking Control for Multiagent Systems: An Intermediate Estimator-Based Approach.

    Science.gov (United States)

    Zhu, Jun-Wei; Yang, Guang-Hong; Zhang, Wen-An; Yu, Li

    2017-10-17

    This paper studies the observer based fault tolerant tracking control problem for linear multiagent systems with multiple faults and mismatched disturbances. A novel distributed intermediate estimator based fault tolerant tracking protocol is presented. The leader's input is nonzero and unavailable to the followers. By applying a projection technique, the mismatched disturbances are separated into matched and unmatched components. For each node, a tracking error system is established, for which an intermediate estimator driven by the relative output measurements is constructed to estimate the sensor faults and a combined signal of the leader's input, process faults, and matched disturbance component. Based on the estimation, a fault tolerant tracking protocol is designed to eliminate the effects of the combined signal. Besides, the effect of unmatched disturbance component can be attenuated by directly adjusting some specified parameters. Finally, a simulation example of aircraft demonstrates the effectiveness of the designed tracking protocol.This paper studies the observer based fault tolerant tracking control problem for linear multiagent systems with multiple faults and mismatched disturbances. A novel distributed intermediate estimator based fault tolerant tracking protocol is presented. The leader's input is nonzero and unavailable to the followers. By applying a projection technique, the mismatched disturbances are separated into matched and unmatched components. For each node, a tracking error system is established, for which an intermediate estimator driven by the relative output measurements is constructed to estimate the sensor faults and a combined signal of the leader's input, process faults, and matched disturbance component. Based on the estimation, a fault tolerant tracking protocol is designed to eliminate the effects of the combined signal. Besides, the effect of unmatched disturbance component can be attenuated by directly adjusting some

  4. Stepwise strategy to improve Cervical Cancer Screening Adherence (SCAN-CC): automated text messages, phone calls and face-to-face interviews: protocol of a population-based randomised controlled trial.

    Science.gov (United States)

    Firmino-Machado, João; Mendes, Romeu; Moreira, Amélia; Lunet, Nuno

    2017-10-05

    Screening is highly effective for cervical cancer prevention and control. Population-based screening programmes are widely implemented in high-income countries, although adherence is often low. In Portugal, just over half of the women adhere to cervical cancer screening, contributing for greater mortality rates than in other European countries. The most effective adherence raising strategies are based on patient reminders, small/mass media and face-to-face educational programmes, but sequential interventions targeting the general population have seldom been evaluated. The aim of this study is to assess the effectiveness of a stepwise approach, with increasing complexity and cost, to improve adherence to organised cervical cancer screening: step 1a-customised text message invitation; step 1b-customised automated phone call invitation; step 2-secretary phone call; step 3-family health professional phone call and face-to-face appointment. A population-based randomised controlled trial will be implemented in Portuguese urban and rural areas. Women eligible for cervical cancer screening will be randomised (1:1) to intervention and control. In the intervention group, women will be invited for screening through text messages, automated phone calls, manual phone calls and health professional appointments, to be applied sequentially to participants remaining non-adherent after each step. Control will be the standard of care (written letter). The primary outcome is the proportion of women adherent to screening after step 1 or sequences of steps from 1 to 3. The secondary outcomes are: proportion of women screened after each step (1a, 2 and 3); proportion of text messages/phone calls delivered; proportion of women previously screened in a private health institution who change to organised screening. The intervention and control groups will be compared based on intention-to-treat and per-protocol analyses. The study was approved by the Ethics Committee of the Northern Health

  5. Randomized Controlled Trial of Daily Text Messages to Support Adherence to Preexposure Prophylaxis in Individuals at Risk for Human Immunodeficiency Virus: The TAPIR Study.

    Science.gov (United States)

    Moore, David J; Jain, Sonia; Dubé, Michael P; Daar, Eric S; Sun, Xiaoying; Young, Jason; Corado, Katya; Ellorin, Eric; Milam, Joel; Collins, Deborah; Blumenthal, Jill; Best, Brookie M; Anderson, Peter; Haubrich, Richard; Morris, Sheldon R

    2018-05-02

    Adherence is critical for efficacy of tenofovir disoproxil fumarate/emtricitabine (FTC) as preexposure prophylaxis (PrEP). Between February 2013 and February 2016, 398 men who have sex with men and transgender women were randomized 1:1 to receive individualized texting for adherence building (iTAB) or standard care (SoC) for 48 weeks. The primary endpoint was dried blood spot (DBS) tenofovir diphosphate (TFV-DP) concentrations at both week 12 and the last on-drug visit of >719 fmol/punch (ie, adequate adherence). Secondary outcomes included DBS TFV-DP concentrations of >1246 fmol/punch (ie, near-perfect adherence) and plasma FTC >350 ng/mL (consistent with dosing within the past 24 hours). Concentrations >719 fmol/punch of TFV-DP were found in 88.6% of participants at week 12 and 82.5% at week 48. For the primary endpoint, the study arms did not differ (72.0% in iTAB and 69.2% in SoC; P > .05). For the secondary composite endpoint of >1246 fmol/punch the iTAB arm was superior to SoC (33.5% vs 24.8%; P = .06), reaching statistical significance when adjusting for age (odds ratio, 1.56 [95% confidence interval, 1.00-2.42]; P .05). Automated text messaging is a low-burden tool that improves durability of near-perfect PrEP adherence. NCT01761643.

  6. Amino acids and autophagy: cross-talk and co-operation to control cellular homeostasis.

    Science.gov (United States)

    Carroll, Bernadette; Korolchuk, Viktor I; Sarkar, Sovan

    2015-10-01

    Maintenance of amino acid homeostasis is important for healthy cellular function, metabolism and growth. Intracellular amino acid concentrations are dynamic; the high demand for protein synthesis must be met with constant dietary intake, followed by cellular influx, utilization and recycling of nutrients. Autophagy is a catabolic process via which superfluous or damaged proteins and organelles are delivered to the lysosome and degraded to release free amino acids into the cytoplasm. Furthermore, autophagy is specifically activated in response to amino acid starvation via two key signaling cascades: the mammalian target of rapamycin (mTOR) complex 1 (mTORC1) and the general control nonderepressible 2 (GCN2) pathways. These pathways are key regulators of the integration between anabolic (amino acid depleting) and catabolic (such as autophagy which is amino acid replenishing) processes to ensure intracellular amino acid homeostasis. Here, we discuss the key roles that amino acids, along with energy (ATP, glucose) and oxygen, are playing in cellular growth and proliferation. We further explore how sophisticated methods are employed by cells to sense intracellular amino acid concentrations, how amino acids can act as a switch to dictate the temporal and spatial activation of anabolic and catabolic processes and how autophagy contributes to the replenishment of free amino acids, all to ensure cell survival. Relevance of these molecular processes to cellular and organismal physiology and pathology is also discussed.

  7. International cooperation

    International Nuclear Information System (INIS)

    1996-01-01

    In 1995, Nuclear Regulatory Authority of the Slovak Republic (NRA SR) ensured foreign cooperation particularly in the frame of the Slovak Republic is membership in the IAEA, as well as cooperation with the Nuclear Energy Agency of the Organization for Economic Cooperation and Development (OECD NEA), cooperation with European Union in the frame of PHARE programmes, and intergovernmental cooperation and cooperation among nuclear regulatory authorities. With respect to an international importance, prestige and a wide-scope possibilities of a technical assistance , either a direct one (expert assessments, technology supplies, work placement, scientific trips, training courses) or indirect one (participation at various conferences, seminars, technical committees, etc), the most important cooperation with the IAEA in Vienna. In 1994, the Slovak Republic, was elected to the Board Governors, the represent the group of Eastern European countries. The Slovak Government entrusted the NRA SR's Chairman with representing the Slovak Republic in the Board of Governors. Owing to a good name of Slovakia was elected to the one of two Vice-Chairmen of the Board of Governors at the 882-nd session on the Board. IAEA approved and developed 8 national projects for Slovakia in 1995. Generally, IAEA is contracting scientific contracts with research institutes, nuclear power plants and other organizations. Slovak organizations used these contracts as complementary funding of their tasks. In 1995, there were 12 scientific contracts in progress, or approved respectively. Other international activities of the NRA SR, international co-operations as well as foreign affairs are reported

  8. Cooperation of phosphates and carboxylates controls calcium oxalate crystallization in ultrafiltered urine.

    Science.gov (United States)

    Grohe, Bernd; Chan, Brian P H; Sørensen, Esben S; Lajoie, Gilles; Goldberg, Harvey A; Hunter, Graeme K

    2011-10-01

    Osteopontin (OPN) is one of a group of proteins found in urine that are believed to limit the formation of kidney stones. In the present study, we investigate the roles of phosphate and carboxylate groups in the OPN-mediated modulation of calcium oxalate (CaOx), the principal mineral phase found in kidney stones. To this end, crystallization was induced by addition of CaOx solution to ultrafiltered human urine containing either human kidney OPN (kOPN; 7 consecutive carboxylates, 8 phosphates) or synthesized peptides corresponding to residues 65-80 (pSHDHMDDDDDDDDDGD; pOPAR) or 220-235 (pSHEpSTEQSDAIDpSAEK; P3) of rat bone OPN. Sequence 65-80 was also synthesized without the phosphate group (OPAR). Effects on calcium oxalate monohydrate (COM) and dihydrate (COD) formation were studied by scanning electron microscopy. We found that controls form large, partly intergrown COM platelets; COD was never observed. Adding any of the polyelectrolytes was sufficient to prevent intergrowth of COM platelets entirely, inhibiting formation of these platelets strongly, and inducing formation of the COD phase. Strongest effects on COM formation were found for pOPAR and OPAR followed by kOPN and then P3, showing that acidity and hydrophilicity are crucial in polyelectrolyte-affected COM crystallization. At higher concentrations, OPAR also inhibited COD formation, while P3, kOPN and, in particular, pOPAR promoted COD, a difference explainable by the variations of carboxylate and phosphate groups present in the molecules. Thus, we conclude that carboxylate groups play a primary role in inhibiting COM formation, but phosphate and carboxylate groups are both important in initiating and promoting COD formation.

  9. Effect on adherence to nicotine replacement therapy of informing smokers their dose is determined by their genotype: a randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Theresa M Marteau

    Full Text Available BACKGROUND: The behavioural impact of pharmacogenomics is untested. We tested two hypotheses concerning the behavioural impact of informing smokers their oral dose of NRT is tailored to analysis of DNA. METHODS AND FINDINGS: We conducted an RCT with smokers in smoking cessation clinics (N = 633. In combination with NRT patch, participants were informed that their doses of oral NRT were based either on their mu-opioid receptor (OPRM1 genotype, or their nicotine dependence questionnaire score (phenotype. The proportion of prescribed NRT consumed in the first 28 days following quitting was not significantly different between groups: (68.5% of prescribed NRT consumed in genotype vs 63.6%, phenotype group, difference = 5.0%, 95% CI -0.9,10.8, p = 0.098. Motivation to make another quit attempt among those (n = 331 not abstinent at six months was not significantly different between groups (p = 0.23. Abstinence at 28 days was not different between groups (p = 0.67; at six months was greater in genotype than phenotype group (13.7% vs 7.9%, difference = 5.8%, 95% CI 1.0,10.7, p = 0.018. CONCLUSIONS: Informing smokers their oral dose of NRT was tailored to genotype not phenotype had a small, statistically non-significant effect on 28-day adherence to NRT. Among those still smoking at six months, there was no evidence that saying NRT was tailored to genotype adversely affected motivation to make another quit attempt. Higher abstinence rate at six months in the genotype arm requires investigation. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN14352545.

  10. Cooperation Between the Russian Federation and the United States to Enhance the Existing Nuclear-Material Protection, Control, and Accounting Systems at Mayak Production Association

    International Nuclear Information System (INIS)

    Cahalane, P.T.; Ehinger, M.H.; James, L.T.; Jarrett, J.H.; Lundgren, R.A.; Manatt, D.R.; Niederauer, G.F.; Olivos, J.D.; Prishchepov, A.I.; Starodubtsev, G.S.; Suda, S.C.; Tittemore, G.W.; Zatorsky, Y.M.

    1999-01-01

    The Ministry of the Russian Federation for Atomic Energy (MINATOM) and the US Department of Energy (DOE) are engaged in joint, cooperative efforts to reduce the likelihood of nuclear proliferation by enhancing Material Protection, Control and Accounting (MPC and A) systems in both countries. Mayak Production Association (Mayak) is a major Russian nuclear enterprise within the nuclear complex that is operated by lylINATOM. This paper describes the nature, scope, and status of the joint, cooperative efforts to enhance existing MPC and A systems at Mayak. Current cooperative efforts are focused on enhancements to the existing MPC and A systems at two of the plants operated by Mayak that work with proliferation-sensitive nuclear materials

  11. Cooperation between the Russian Federation and the United States to enhance the existing nuclear-material protection, control, and accounting systems at Mayak Production Association

    International Nuclear Information System (INIS)

    Starodubtsev, G.S.; Prishchepov, A.I.; Zatorsky, Y.M.; James, L.T.

    1997-01-01

    The Ministry of the Russian Federation for Atomic Energy (MINATOM) and the US Department of Energy (DOE) are engaged in joint, cooperative efforts to reduce the likelihood of nuclear proliferation by enhancing Material Protection, Control and Accounting (MPC ampersand A) systems in both countries. Mayak Production Association (MPA) is a major Russian nuclear enterprise within the nuclear complex that is operated by MINATOM. This paper describes the nature, scope, and status of the joint, cooperative efforts to enhance existing MPC ampersand A systems at MPA. Current cooperative efforts are focused on enhancements to the existing MPC ampersand A systems at four plants that are operated by MPA and that produce, process, handle and/or store proliferation-sensitive nuclear materials

  12. Cooperation between the Russian Federation and the United States to enhance the existing nuclear-material protection, control, and accounting systems at Mayak Production Association

    Energy Technology Data Exchange (ETDEWEB)

    Starodubtsev, G.S.; Prishchepov, A.I.; Zatorsky, Y.M.; James, L.T. [and others

    1997-11-01

    The Ministry of the Russian Federation for Atomic Energy (MINATOM) and the US Department of Energy (DOE) are engaged in joint, cooperative efforts to reduce the likelihood of nuclear proliferation by enhancing Material Protection, Control and Accounting (MPC&A) systems in both countries. Mayak Production Association (MPA) is a major Russian nuclear enterprise within the nuclear complex that is operated by MINATOM. This paper describes the nature, scope, and status of the joint, cooperative efforts to enhance existing MPC&A systems at MPA. Current cooperative efforts are focused on enhancements to the existing MPC&A systems at four plants that are operated by MPA and that produce, process, handle and/or store proliferation-sensitive nuclear materials.

  13. Communication style and exercise compliance in physiotherapy (CONNECT. A cluster randomized controlled trial to test a theory-based intervention to increase chronic low back pain patients’ adherence to physiotherapists’ recommendations: study rationale, design, and methods

    Directory of Open Access Journals (Sweden)

    Lonsdale Chris

    2012-06-01

    Full Text Available Abstract Background Physical activity and exercise therapy are among the accepted clinical rehabilitation guidelines and are recommended self-management strategies for chronic low back pain. However, many back pain sufferers do not adhere to their physiotherapist’s recommendations. Poor patient adherence may decrease the effectiveness of advice and home-based rehabilitation exercises. According to self-determination theory, support from health care practitioners can promote patients’ autonomous motivation and greater long-term behavioral persistence (e.g., adherence to physiotherapists’ recommendations. The aim of this trial is to assess the effect of an intervention designed to increase physiotherapists’ autonomy-supportive communication on low back pain patients’ adherence to physical activity and exercise therapy recommendations. Methods/Design This study will be a single-blinded cluster randomized controlled trial. Outpatient physiotherapy centers (N =12 in Dublin, Ireland (population = 1.25 million will be randomly assigned using a computer-generated algorithm to either the experimental or control arm. Physiotherapists in the experimental arm (two hospitals and four primary care clinics will attend eight hours of communication skills training. Training will include handouts, workbooks, video examples, role-play, and discussion designed to teach physiotherapists how to communicate in a manner that promotes autonomous patient motivation. Physiotherapists in the waitlist control arm (two hospitals and four primary care clinics will not receive this training. Participants (N = 292 with chronic low back pain will complete assessments at baseline, as well as 1 week, 4 weeks, 12 weeks, and 24 weeks after their first physiotherapy appointment. Primary outcomes will include adherence to physiotherapy recommendations, as well as low back pain, function, and well-being. Participants will be blinded to treatment allocation, as

  14. Developing a Distributed Consensus-Based Cooperative Adaptive Cruise Control System for Heterogeneous Vehicles with Predecessor Following Topology

    Directory of Open Access Journals (Sweden)

    Ziran Wang

    2017-01-01

    Full Text Available Connected and automated vehicle (CAV has become an increasingly popular topic recently. As an application, Cooperative Adaptive Cruise Control (CACC systems are of high interest, allowing CAVs to communicate with each other and coordinating their maneuvers to form platoons, where one vehicle follows another with a constant velocity and/or time headway. In this study, we propose a novel CACC system, where distributed consensus algorithm and protocol are designed for platoon formation, merging maneuvers, and splitting maneuvers. Predecessor following information flow topology is adopted for the system, where each vehicle only communicates with its following vehicle to reach consensus of the whole platoon, making the vehicle-to-vehicle (V2V communication fast and accurate. Moreover, different from most studies assuming the type and dynamics of all the vehicles in a platoon to be homogenous, we take into account the length, location of GPS antenna on vehicle, and braking performance of different vehicles. A simulation study has been conducted under scenarios including normal platoon formation, platoon restoration from disturbances, and merging and splitting maneuvers. We have also carried out a sensitivity analysis on the distributed consensus algorithm, investigating the effect of the damping gain on convergence rate, driving comfort, and driving safety of the system.

  15. Evaluation of the impacts of cooperative adaptive cruise control on reducing rear-end collision risks on freeways.

    Science.gov (United States)

    Li, Ye; Wang, Hao; Wang, Wei; Xing, Lu; Liu, Shanwen; Wei, Xueyan

    2017-01-01

    Although plenty of studies have been conducted recently about the impacts of cooperative adaptive cruise control (CACC) system on traffic efficiency, there are few researches analyzing the safety effects of this advanced driving-assistant system. Thus, the primary objective of this study is to evaluate the impacts of the CACC system on reducing rear-end collision risks on freeways. The CACC model is firstly developed, which is based on the Intelligent Driver Model (IDM). Then, two surrogated safety measures, derived from the time-to-collision (TTC), denoting time exposed time-to-collision (TET) and time integrated time-to-collision (TIT), are introduced for quantifying the collision risks. And the safety effects are analyzed both theoretically and experimentally, by the linear stability analysis and simulations. The theoretical and simulation results conformably indicate that the CACC system brings dramatic benefits for reducing rear-end collision risks (TET and TIT are reduced more than 90%, respectively), when the desired time headway and time delay are set properly. The sensitivity analysis indicates there are few differences among different values of the threshold of TTC and the length of a CACC platoon. The results also show that the safety improvements weaken with the decrease of the penetration rates of CACC on the market and the increase of time delay between platoons. We also evaluate the traffic efficiency of the CACC system with different desired time headway. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Improved Adherence to Vision Self-monitoring with the Vision and Memory Stimulating (VMS) Journal for Non-neovascular Age-related Macular Degeneration during a Randomized Controlled Trial

    OpenAIRE

    Bittner, Ava K; Torr-Brown, Sheryl; Arnold, Ellen; Nwankwo, Antonia; Beaton, Patricia; Rampat, Radhika; Dagnelie, Gislin; Roser, Mark

    2014-01-01

    Objective An educational, interactive journal [Vision and Memory Stimulating (VMS) journal] was developed to boost patient confidence and promote long-term adherence with weekly vision self-monitoring in age-related macular degeneration (AMD) patients at risk for vision loss from new-onset neovascularization. Methods In a multicenter randomized controlled trial, 198 subjects with intermediate stage, non-neovascular AMD received the VMS journal or followed usual care (e.g. their doctor’s instr...

  17. Smartphone- and internet-assisted self-management and adherence tools to manage Parkinson's disease (SMART-PD): study protocol for a randomised controlled trial (v7; 15 August 2014).

    Science.gov (United States)

    Lakshminarayana, Rashmi; Wang, Duolao; Burn, David; Chaudhuri, K Ray; Cummins, Gemma; Galtrey, Clare; Hellman, Bruce; Pal, Suvankar; Stamford, Jon; Steiger, Malcolm; Williams, Adrian

    2014-09-25

    Nonadherence to treatment leads to suboptimal treatment outcomes and enormous costs to the economy. This is especially important in Parkinson's disease (PD). The progressive nature of the degenerative process, the complex treatment regimens and the high rates of comorbid conditions make treatment adherence in PD a challenge. Clinicians have limited face-to-face consultation time with PD patients, making it difficult to comprehensively address non-adherence. The rapid growth of digital technologies provides an opportunity to improve adherence and the quality of decision-making during consultation. The aim of this randomised controlled trial (RCT) is to evaluate the impact of using a smartphone and web applications to promote patient self-management as a tool to increase treatment adherence and working with the data collected to enhance the quality of clinical consultation. A 4-month multicentre RCT with 222 patients will be conducted to compare use of a smartphone- and internet-enabled Parkinson's tracker smartphone app with treatment as usual for patients with PD and/or their carers. The study investigators will compare the two groups immediately after intervention. Seven centres across England (6) and Scotland (1) will be involved. The primary objective of this trial is to assess whether patients with PD who use the app show improved medication adherence compared to those receiving treatment as usual alone. The secondary objectives are to investigate whether patients who receive the app and those who receive treatment as usual differ in terms of quality of life, quality of clinical consultation, overall disease state and activities of daily living. We also aim to investigate the experience of those receiving the intervention by conducting qualitative interviews with a sample of participants and clinicians, which will be administered by independent researchers. ISRCTN45824264 (registered 5 November 2013).

  18. Communication style and exercise compliance in physiotherapy (CONNECT): a cluster randomized controlled trial to test a theory-based intervention to increase chronic low back pain patients' adherence to physiotherapists' recommendations: study rationale, design, and methods.

    Science.gov (United States)

    Lonsdale, Chris; Hall, Amanda M; Williams, Geoffrey C; McDonough, Suzanne M; Ntoumanis, Nikos; Murray, Aileen; Hurley, Deirdre A

    2012-06-15

    Physical activity and exercise therapy are among the accepted clinical rehabilitation guidelines and are recommended self-management strategies for chronic low back pain. However, many back pain sufferers do not adhere to their physiotherapist's recommendations. Poor patient adherence may decrease the effectiveness of advice and home-based rehabilitation exercises. According to self-determination theory, support from health care practitioners can promote patients' autonomous motivation and greater long-term behavioral persistence (e.g., adherence to physiotherapists' recommendations). The aim of this trial is to assess the effect of an intervention designed to increase physiotherapists' autonomy-supportive communication on low back pain patients' adherence to physical activity and exercise therapy recommendations. This study will be a single-blinded cluster randomized controlled trial. Outpatient physiotherapy centers (N =12) in Dublin, Ireland (population = 1.25 million) will be randomly assigned using a computer-generated algorithm to either the experimental or control arm. Physiotherapists in the experimental arm (two hospitals and four primary care clinics) will attend eight hours of communication skills training. Training will include handouts, workbooks, video examples, role-play, and discussion designed to teach physiotherapists how to communicate in a manner that promotes autonomous patient motivation. Physiotherapists in the waitlist control arm (two hospitals and four primary care clinics) will not receive this training. Participants (N = 292) with chronic low back pain will complete assessments at baseline, as well as 1 week, 4 weeks, 12 weeks, and 24 weeks after their first physiotherapy appointment. Primary outcomes will include adherence to physiotherapy recommendations, as well as low back pain, function, and well-being. Participants will be blinded to treatment allocation, as they will not be told if their physiotherapist has

  19. Intelligent Distributed Generation and Storage Units for DC Microgrids - A New Concept on Cooperative Control without Communications Beyond Droop Control

    DEFF Research Database (Denmark)

    Aldana, Nelson Leonardo Diaz; Dragicevic, Tomislav; Vasquez, Juan Carlos

    2014-01-01

    . Typically, voltage droop loops are used for interconnecting several different units in parallel to a microgrid. This paper proposes a new decentralized strategy based on fuzzy logic that ensures stored energy balance, for a low voltage DC microgrid with distributed battery energy storage systems......Low voltage DC microgrids have been widely used for supplying critical loads, such as data centers and remote communication stations. Consequently, it is important to ensure redundancy and enough energy capacity in order to support possible increments in load consumption. This is achieved by means...... of expansion of the energy storage system by adding extra distributed energy storage units. However, using distributed energy storage units adds more challenges in microgrids control, since stored energy should be balanced in order to avoid deep discharge or over-charge in one of the energy storage units...

  20. Determinants of adherence to methylphenidate and the impact of poor adherence on maternal and family measures.

    Science.gov (United States)

    Gau, Susan S F; Shen, Hsin-Yi; Chou, Miao-Churn; Tang, Ching-Shu; Chiu, Yen-Nan; Gau, Churn-Shiouh

    2006-06-01

    The aim of this study was to examine the association between adherence to immediate-release methylphenidate (IR MPH) and maternal psychological distress, parenting style, parent- child relationship, and perceived family support. The sample consisted of 307 children with attention-deficit hyperactivity disorder (ADHD) (271 boys and 36 girls), 6-17 years of age, who had been treated with IR MPH for the past 6 months. The measures included the Chinese Health Questionnaire, Parental Bonding Instrument, Family APGAR, and Home Behaviors of the Social Adjustment Inventory for Children and Adolescents. Reasons for poor adherence (n = 79; 25.7%) included forgetting medication (72.7%), the medication having no effect (20.0%), and refusing medication (12.7%). Increased age and three-times-daily administration were the major predictors for poor adherence to IR MPH. Poor adherence was associated with increased degree of maternal psychological distress, indifferent parenting, maternal overprotection/control, poor family support, decreased interaction with parents, and increased problems at home. Findings indicate that multiple daily dosing of MPH increases the likelihood of poor adherence, particularly in adolescents, and that poor adherence is associated with impaired maternal/family process. Once-daily administration of MPH is necessary to improve adherence and to decrease the possible exacerbation of tense parent-child relationships caused by poor drug adherence.

  1. The Effect of Using Assessment Instruments on Substance-abuse Outpatients' Adherence to Treatment: a Multi-centre Randomised Controlled Trial

    NARCIS (Netherlands)

    Raes, V.; Jong, C.A.J. de; Bacquer, D. De; Broekaert, E.; Maeseneer, J. De

    2011-01-01

    Background: Drop-out is an important problem in the treatment of substance use disorder. The focus of this study was to investigate the effectiveness of within treatment assessment with feedback directly to patients with multiple substance use disorder on outpatient individual treatment adherence.

  2. The effect of using assessment instruments on substance-abuse outpatients' adherence to treatment: a multi-centre randomised controlled trial.

    NARCIS (Netherlands)

    Raes, V.; Jong, C.A.J. de; Bacquer, D. De; Broekaert, E.; Maeseneer, J. De

    2011-01-01

    BACKGROUND: Drop-out is an important problem in the treatment of substance use disorder. The focus of this study was to investigate the effectiveness of within treatment assessment with feedback directly to patients with multiple substance use disorder on outpatient individual treatment adherence.

  3. Adherence to Mediterranean-style dietary pattern and risk of esophageal squamous cell carcinoma: a case-control study in Iran

    Science.gov (United States)

    The benefit of adherence to a Mediterranean-style dietary pattern in relation to the risk of esophageal squamous cell carcinoma (ESCC) has not been investigated among non-Mediterranean high-risk populations. The objective of the present study was to examine the association of compliance with the Med...

  4. Effectiveness of an interactive postgraduate educational intervention with patient participation on the adherence to a physiotherapy guideline for hip and knee osteoarthritis: a randomised controlled trial.

    Science.gov (United States)

    Peter, Wilfred; van der Wees, Philip J; Verhoef, John; de Jong, Zusana; van Bodegom-Vos, Leti; Hilberdink, Wim K H A; Fiocco, Marta; Vliet Vlieland, Thea P M

    2015-01-01

    To determine the effectiveness of an interactive educational intervention on a physiotherapy guideline for hip and knee osteoarthritis. Physiotherapists were randomly allocated to a 3-h interactive educational course with the collaboration of three patient partners or no intervention. Assessments comprised questionnaires on adherence (score range 0-24), knowledge (score range 0-76), and barriers to use the guideline (score range 0-80). Assessments were conducted 1 week before the interactive course (T0) immediately after (T1), and 3 months thereafter (T2). Change scores were compared between the groups by means of Mann-Whitney U tests and linear mixed models. 284 of 4328 eligible PTs (7%) were included. The intervention (n = 133) was significantly more effective than no intervention (n = 151) concerning self-reported adherence and knowledge with mean differences in change scores (95% CI) at T1 and T2 being 1.4 (0.7-2.0) and 0.9 (0.2-1.7) for adherence and 6.8 (4.5-9.1) and 3.9 (1.7-6.2) for knowledge, (all p values knee osteoarthritis showed a small to moderate positive effect on self-reported guideline adherence and knowledge, whereas for perceived barriers an advantage was only seen on the longer term.

  5. Can we improve cognitive-behavioral therapy for chronic back pain treatment engagement and adherence? A controlled trial of tailored versus standard therapy.

    Science.gov (United States)

    Kerns, Robert D; Burns, John W; Shulman, Marc; Jensen, Mark P; Nielson, Warren R; Czlapinski, Rebecca; Dallas, Mary I; Chatkoff, David; Sellinger, John; Heapy, Alicia; Rosenberger, Patricia

    2014-09-01

    This study evaluated whether tailored cognitive-behavioral therapy (TCBT) that incorporated preferences for learning specific cognitive and/or behavioral skills and used motivational enhancement strategies would improve treatment engagement and participation compared with standard CBT (SCBT). We hypothesized that participants receiving TCBT would show a lower dropout rate, attend more sessions, and report more frequent intersession pain coping skill practice than those receiving SCBT. We also hypothesized that indices of engagement and adherence would correlate with pre- to posttreatment changes in outcome factors. One hundred twenty-eight of 161 consenting persons with chronic back pain who completed baseline measures were allocated to either TCBT or SCBT using a modified randomization procedure. Participants completed daily ratings of pain coping skill practice and goal accomplishment during treatment, as well as measures of pain severity, disability, and other key outcomes at the end of treatment. No significant differences between treatment groups were noted on measures of treatment engagement or adherence. However, these factors were significantly related to some pre- to posttreatment improvements in outcomes, regardless of treatment condition. Participants in this study evidenced a high degree of participation and adherence, but treatment tailored to take into account participant preferences, and that employed motivational enhancement strategies, failed to increase treatment participation over and above SCBT for chronic back pain. Evidence that participation and adherence were associated with positive outcomes supports continued clinical and research efforts focusing on these therapeutic processes. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  6. Cognitive cooperation groups mediated by computers and internet present significant improvement of cognitive status in older adults with memory complaints: a controlled prospective study

    Directory of Open Access Journals (Sweden)

    Rodrigo de Rosso Krug

    Full Text Available ABSTRACT Objective To estimate the effect of participating in cognitive cooperation groups, mediated by computers and the internet, on the Mini-Mental State Examination (MMSE percent variation of outpatients with memory complaints attending two memory clinics. Methods A prospective controlled intervention study carried out from 2006 to 2013 with 293 elders. The intervention group (n = 160 attended a cognitive cooperation group (20 sessions of 1.5 hours each. The control group (n = 133 received routine medical care. Outcome was the percent variation in the MMSE. Control variables included gender, age, marital status, schooling, hypertension, diabetes, dyslipidaemia, hypothyroidism, depression, vascular diseases, polymedication, use of benzodiazepines, exposure to tobacco, sedentary lifestyle, obesity and functional capacity. The final model was obtained by multivariate linear regression. Results The intervention group obtained an independent positive variation of 24.39% (CI 95% = 14.86/33.91 in the MMSE compared to the control group. Conclusion The results suggested that cognitive cooperation groups, mediated by computers and the internet, are associated with cognitive status improvement of older adults in memory clinics.

  7. Hypertension: adherence to treatment in rural Bangladesh – findings from a population-based study

    OpenAIRE

    Khanam, Masuma Akter; Lindeboom, Wietze; Koehlmoos, Tracey Lynn Perez; Alam, Dewan Shamsul; Niessen, Louis; Milton, Abul Hasnat

    2014-01-01

    Background: Poor adherence has been identified as the main cause of failure to control hypertension. Poor adherence to antihypertensive treatment is a significant cardiovascular risk factor, which often remains unrecognized. There are no previous studies that examined adherence with antihypertensive medication or the characteristics of the non-adherent patients in Bangladesh.Objective: This paper aims to describe hypertension and factors affecting adherence to treatment among hypertensive per...

  8. The effect of providing feedback on inhaler technique and adherence from an electronic audio recording device, INCA®, in a community pharmacy setting: study protocol for a randomised controlled trial.

    Science.gov (United States)

    O'Dwyer, Susan Mary; MacHale, Elaine; Sulaiman, Imran; Holmes, Martin; Hughes, Cian; D'Arcy, Shona; Rapcan, Viliam; Taylor, Terence; Boland, Fiona; Bosnic-Anticevich, Sinthia; Reilly, Richard B; Ryder, Sheila A; Costello, Richard W

    2016-05-04

    Poor adherence to inhaled medication may lead to inadequate symptom control in patients with respiratory disease. In practice it can be difficult to identify poor adherence. We designed an acoustic recording device, the INCA® (INhaler Compliance Assessment) device, which, when attached to an inhaler, identifies and records the time and technique of inhaler use, thereby providing objective longitudinal data on an individual's adherence to inhaled medication. This study will test the hypothesis that providing objective, personalised, visual feedback on adherence to patients in combination with a tailored educational intervention in a community pharmacy setting, improves adherence more effectively than education alone. The study is a prospective, cluster randomised, parallel-group, multi-site study conducted over 6 months. The study is designed to compare current best practice in care (i.e. routine inhaler technique training) with the use of the INCA® device for respiratory patients in a community pharmacy setting. Pharmacies are the unit of randomisation and on enrolment to the study they will be allocated by the lead researcher to one of the three study groups (intervention, comparator or control groups) using a computer-generated list of random numbers. Given the nature of the intervention neither pharmacists nor participants can be blinded. The intervention group will receive feedback from the acoustic recording device on inhaler technique and adherence three times over a 6-month period along with inhaler technique training at each of these times. The comparator group will also receive training in inhaler use three times over the 6-month study period but no feedback on their habitual performance. The control group will receive usual care (i.e. the safe supply of medicines and advice on their use). The primary outcome is the rate of participant adherence to their inhaled medication, defined as the proportion of correctly taken doses of medication at the correct

  9. Adherence to antidepressant treatment

    DEFF Research Database (Denmark)

    Hansen, Hanne Vibe; Kessing, Lars Vedel

    2007-01-01

    Depression is a common disorder with painful symptoms and, frequently, social impairment and decreased quality of life. The disorder has a tendency to be long lasting, often with frequent recurrence of symptoms. The risk of relapse and the severity of the symptoms may be reduced by correct...... of dependence of antidepressant medicine, have a great influence on adherence to treatment....

  10. adherence to antiretroviral regimens

    African Journals Online (AJOL)

    to macro- and microeconomic costs.' What soon became evident, however, was the vital importance of patient adherence with prescribed medication in order to garner the benefits that were so rapidly becoming available. As a result, much attention has recently been paid to this aspect of management. Both clinicians and ...

  11. Employment-based reinforcement of adherence to an FDA approved extended release formulation of naltrexone in opioid-dependent adults: a randomized controlled trial.

    Science.gov (United States)

    DeFulio, Anthony; Everly, Jeffrey J; Leoutsakos, Jeannie-Marie S; Umbricht, Annie; Fingerhood, Michael; Bigelow, George E; Silverman, Kenneth

    2012-01-01

    Naltrexone provides excellent opioid blockade, but its clinical utility is limited because opioid-dependent patients typically refuse it. An injectable suspension of naltrexone for extended release (XR-NTX) was recently approved by the FDA for treatment of opioid dependence. XR-NTX treatment may require concurrent behavioral intervention to maximize adherence and effectiveness, thus we sought to evaluate employment-based reinforcement as a method of improving adherence to XR-NTX in opiate dependent adults. Opioid-dependent adults (n=38) were detoxified and inducted onto oral naltrexone, then randomly assigned to contingency or prescription conditions. Participants received up to six doses of XR-NTX at four-week intervals. All participants could earn vouchers for attendance and performance at a therapeutic workplace. Contingency participants were required to accept XR-NTX injections to access the workplace and earn vouchers. Prescription participants could earn vouchers independent of their acceptance of XR-NTX injections. Contingency participants accepted significantly more naltrexone injections than prescription participants (87% versus 52%, p=.002), and were more likely to accept all injections (74% versus 26%, p=.004). Participants in the two conditions provided similar percentages of samples negative for opiates (72% versus 65%) and for cocaine (58% versus 54%). Opiate positivity was significantly more likely when samples were also cocaine positive, independent of naltrexone blockade (p=.002). Long-term adherence to XR-NTX in unemployed opiate dependent adults is low under usual care conditions. Employment-based reinforcement can maintain adherence to XR-NTX. Ongoing cocaine use appears to interfere with the clinical effectiveness of XR-NTX on opiate use. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  12. Regional technical cooperation model project, IAEA - RER/2/2004 ''quality control and quality assurance for nuclear analytical techniques'

    International Nuclear Information System (INIS)

    Arikan, P.

    2002-01-01

    An analytical laboratory should produce high quality analytical data through the use of analytical measurements that is accurate, reliable and adequate for the intended purpose. This objective can be accomplished in a cost-effective manner under a planned and documented quality system of activities. It is well-known that serious deficiencies can occur in laboratory operations when insufficient attention is given to the quality of the work. It requires not only a thorough knowledge of the laboratory's purpose and operation, but also the dedication of the management and operating staff to standards of excellence. Laboratories employing nuclear and nuclear-related analytical techniques are sometimes confronted with performance problems which prevent them from becoming accepted and respected by clients, such as industry, government and regulatory bodies, and from being eligible for contracts. The International Standard ISO 17025 has been produced as the result of extensive experience in the implementation of ISO/IEC Guide 25:1990 and EN 45001:1989, which replaces both of them now. It contains all of the requirements that testing and calibration laboratories must meet if they wish to demonstrate that they operate a quality system that is technically competent, and are able to generate technically valid results. The use of ISO 17025 should facilitate cooperation between laboratories and other bodies to assist in the exchange of information and experience, and in the harmonization of standards and procedures. IAEA model project RER/2/004 entitled 'Quality Assurance/Quality Control in Nuclear Analytical Techniques' was initiated in 1999 as a Regional TC project in East European countries to assist Member State laboratories in the region to install a complete quality system according to the ISO/IEC 17025 standard. 12 laboratories from 11 countries plus the Agency's Laboratories in Seibersdorf have been selected as participants to undergo exercises and training with the

  13. Efficacy of Pseudomonas fluorescens strain CL145A spray dried powder for controlling zebra mussels adhering to native unionid mussels within field enclosures

    Science.gov (United States)

    Luoma, James A.; Weber, Kerry L.; Severson, Todd J.; Mayer, Denise A.

    2015-01-01

    The efficacy of a commercially prepared spray dried powder (SDP) formulation of Pseudomonas fluorescens (strain CL145A) was evaluated for removing zebra mussels (Dreissena polymorpha) adhering to a population of unionid mussels in Lake Darling (Alexandria, Minnesota). Two groups of unionid mussels were used in the study. Unionid mussels were collected near the test area, weighed, photographed, individually tagged, and randomly allocated to one of nine test enclosures in equal proportions and then divided into two groups. The first group of unionid mussels (Group 1, n = 5 per test enclosure) were indiscriminately selected from each test enclosure and used to estimate the number of zebra mussels adhering to unionid mussels prior to exposure. The second group of unionid mussels (Group 2, n = 22 per test enclosure) were used to evaluate the efficacy of SDP for removal of adhering zebra mussels. Both Group 1 and Group 2 mussels were used to evaluate the effects of SDP exposure on unionid mussel survival.

  14. Motivation and Treatment Credibility Predicts Dropout, Treatment Adherence, and Clinical Outcomes in an Internet-Based Cognitive Behavioral Relaxation Program: A Randomized Controlled Trial.

    Science.gov (United States)

    Alfonsson, Sven; Olsson, Erik; Hursti, Timo

    2016-03-08

    In previous research, variables such as age, education, treatment credibility, and therapeutic alliance have shown to affect patients' treatment adherence and outcome in Internet-based psychotherapy. A more detailed understanding of how such variables are associated with different measures of adherence and clinical outcomes may help in designing more effective online therapy. The aims of this study were to investigate demographical, psychological, and treatment-specific variables that could predict dropout, treatment adherence, and treatment outcomes in a study of online relaxation for mild to moderate stress symptoms. Participant dropout and attrition as well as data from self-report instruments completed before, during, and after the online relaxation program were analyzed. Multiple linear and logistical regression analyses were conducted to predict early dropout, overall attrition, online treatment progress, number of registered relaxation exercises, posttreatment symptom levels, and reliable improvement. Dropout was significantly predicted by treatment credibility, whereas overall attrition was associated with reporting a focus on immediate consequences and experiencing a low level of intrinsic motivation for the treatment. Treatment progress was predicted by education level and treatment credibility, whereas number of registered relaxation exercises was associated with experiencing intrinsic motivation for the treatment. Posttreatment stress symptoms were positively predicted by feeling external pressure to participate in the treatment and negatively predicted by treatment credibility. Reporting reliable symptom improvement after treatment was predicted by treatment credibility and therapeutic bond. This study confirmed that treatment credibility and a good working alliance are factors associated with successful Internet-based psychotherapy. Further, the study showed that measuring adherence in different ways provides somewhat different results, which

  15. Cervical cancer screening and adherence to follow-up among Hispanic women study protocol: a randomized controlled trial to increase the uptake of cervical cancer screening in Hispanic women

    Directory of Open Access Journals (Sweden)

    Duggan Catherine

    2012-05-01

    Full Text Available Abstract Background In the US, Hispanic women have a higher incidence of, and mortality from, cervical cancer than non-Hispanic white women. The reason for this disparity may be attributable to both low rates of screening and poor adherence to recommended diagnostic follow-up after an abnormal Pap test. The 'Cervical Cancer Screening and Adherence to Follow-up Among Hispanic Women' study is a collaboration between a research institution and community partners made up of members from community based organizations, the Yakima Valley Farm Workers Clinic and the Breast, Cervical, and Colon Health Program of the Yakima District . The study will assess the efficacy of two culturally-appropriate, tailored educational programs designed to increase cervical cancer screening among Hispanic women, based in the Yakima Valley, Washington, US. Methods/design A parallel randomized-controlled trial of 600 Hispanic women aged 21–64, who are non-compliant with Papanicolau (Pap test screening guidelines. Participants will be randomized using block randomization to (1 a control arm (usual care; (2 a low-intensity information program, consisting of a Spanish-language video that educates women on the importance of cervical cancer screening; or (3 a high-intensity program consisting of the video plus a ‘promotora’ or lay-community health educator-led, home based intervention to encourage cervical cancer screening. Participants who attend cervical cancer screening, and receive a diagnosis of an abnormal Pap test will be assigned to a patient navigator who will provide support and information to promote adherence to follow-up tests, and any necessary surgery or treatment. Primary endpoint: Participants will be tracked via medical record review at community-based clinics, to identify women who have had a Pap test within 7 months of baseline assessment. Medical record reviewers will be blinded to randomization arm. Secondary endpoint: An evaluation of the patient

  16. Interorganizational Cooperation

    Science.gov (United States)

    2016-10-12

    Administrative Services Officer , Office of Congressional and Intergovernmental Affairs, Office of the Chief Financial Officer , Office of the Chief ...Nations. • Clarifies the role of the United States Agency for International Development (USAID) Office of Transition Initiatives and its relationship...Centralize interorganizational cooperation within the command group. Under this model, the chief of staff or a special staff officer within the command

  17. Trial Protocol: Using genotype to tailor prescribing of nicotine replacement therapy: a randomised controlled trial assessing impact of communication upon adherence

    Directory of Open Access Journals (Sweden)

    Prevost A Toby

    2010-11-01

    Full Text Available Abstract Background The behavioural impact of pharmacogenomics is untested; informing smokers of genetic test results for responsiveness to smoking cessation medication may increase adherence to this medication. The objective of this trial is to estimate the impact upon adherence to nicotine replacement therapy (NRT of informing smokers that their oral dose of NRT has been tailored to a DNA analysis. Hypotheses to be tested are as follows: IAdherence to NRT is greater among smokers informed that their oral dose of NRT is tailored to an analysis of DNA (genotype, compared to one tailored to nicotine dependence questionnaire score (phenotype. II Amongst smokers who fail to quit at six months, motivation to make another quit attempt is lower when informed that their oral dose of NRT was tailored to genotype rather than phenotype. Methods/Design An open label, parallel groups randomised trial in which 630 adult smokers (smoking 10 or more cigarettes daily using National Health Service (NHS stop smoking services in primary care are randomly allocated to one of two groups: i. NRT oral dose tailored by DNA analysis (OPRM1 gene (genotype, or ii. NRT oral dose tailored by nicotine dependence questionnaire score (phenotype The primary outcome is proportion of prescribed NRT consumed in the first 28 days following an initial quit attempt, with the secondary outcome being motivation to make another quit attempt, amongst smokers not abstinent at six months. Other outcomes include adherence to NRT in the first seven days and biochemically validated smoking abstinence at six months. The primary outcome will be collected on 630 smokers allowing sufficient power to detect a 7.5% difference in mean proportion of NRT consumed using a two-tailed test at the 5% level of significance between groups. The proportion of all NRT consumed in the first four weeks of quitting will be compared between arms using an independent samples t-test and by estimating the 95

  18. Patient adherence with COPD therapy

    Directory of Open Access Journals (Sweden)

    C. S. Rand

    2005-12-01

    Full Text Available Although there are very few published studies on adherence to treatment regimens in chronic obstructive pulmonary disease (COPD, the evidence that exists suggests that, as with asthma therapy, adherence is poor. Patient beliefs about COPD, as well as their motivation and expectations about the likelihood of success of medical interventions, can influence adherence rates. Other critical factors include the patient's understanding of their illness and therapy, and the complexity of the prescribed treatment regimen. Incorrect inhaler technique is also a common failing. When prescribing in primary or specialist care, healthcare professionals should address adherence as a vital part of the patient consultation. Improved patient education may also increase adherence rates.

  19. The Influence of Goal Setting on Exercise Adherence.

    Science.gov (United States)

    Cobb, Lawrence E.; Stone, William J.; Anonsen, Lori J.; Klein, Diane A.

    2000-01-01

    Assessed the influence of fitness- and health-related goal setting on exercise adherence. Students in a college fitness program participated in goal setting, reading, or control groups. No significant differences in exercise adherence were found. Students enrolled for letter grades had more fitness center visits and hours of activity than students…

  20. The impact of knowledge and attitudes on adherence to tuberculosis ...

    African Journals Online (AJOL)

    The impact of knowledge and attitudes on adherence to tuberculosis treatment: a case-control study in a Moroccan region. ... on TB especially among non adherent patients. This finding justifies the need to incorporate patient?s education into current TB case management. Pan African Medical Journal 2012; 12:52 ...

  1. Marketing co-operatives

    NARCIS (Netherlands)

    G.W.J. Hendrikse (George); C.P. Veerman (Cees)

    2000-01-01

    textabstractMarketing co-operatives (MCs) are analysed from an incomplete contracting perspective. The requirement of the domination of control by the members of a MC is a threat to the survival of a MC in markets where the level of asset specificity at the processing stage of production is

  2. Marketing Cooperatives and Financial Structure

    NARCIS (Netherlands)

    Hendrikse, G.W.J.; Veerman, C.P.

    1995-01-01

    The relationship between the financial structure of marketing cooperatives and the requirement of the domination of control by the members of the cooperative is analysed with an emphasis on incomplete contracts and system complementarities. It is argued that the disappearance of shortage markets in

  3. Providing patients with information about disease-modifying anti-rheumatic drugs: Individually or in groups? A pilot randomized controlled trial comparing adherence and satisfaction.

    Science.gov (United States)

    Homer, Dawn; Nightingale, Peter; Jobanputra, Paresh

    2009-06-01

    Communicating information about disease-modifying anti-rheumatic drugs (DMARDs) before patients start treatment is a key role for some rheumatology clinical nurse specialists. This is done in our unit to promote understanding of the risks and benefits of drug therapy and encourage timely and reliable use of DMARDs. Information is routinely provided individually but this can lead to delays in starting treatment because of limited nursing resources. In this randomized trial we tested the feasibility of giving patients, who were about to start on a DMARD, information about the drug in groups and compared this with information given individually. Adults with a clinical diagnosis of rheumatoid arthritis or psoriatic arthritis who were referred to the nursing team for counselling about starting on methotrexate, sulfasalazine or leflunomide were included. Patients who had previously taken a DMARD were not excluded and those consenting were randomized to receive drug information individually or in groups (of three to six patients). We provided all patients with written materials about the relevant drug and discussed the risks and benefits of drug use verbally. Patients allocated to group counselling received this intervention in a teaching room, with a slide presentation. The primary outcome was adherence with medication use, ascertained by pill counts, self-report diaries and prescription dispensation. Secondary outcomes included satisfaction with information about medicines (SIMS) by questionnaire; time taken to provide information; adherence to scheduled hospital appointments and blood monitoring schedules; and DMARD continuation rates at four and twelve months. Of 127 eligible patients referred for counselling about DMARDs, 62 consented to take part: 32 were randomized to receive drug information individually and 30 to receiving it in groups. Patients allocated to the two different interventions were comparable for age and diagnoses at baseline but more patients

  4. Co-operation agreement. The text of the agreement of 25 May 1998 between the International Atomic Energy Agency and the Brazilian-Argentine Agency for accounting and control of nuclear materials

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-06-25

    The document reproduces the text of the Co-operation Agreement between the International Atomic Energy Agency and the Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials which entered into force on 25 May 1998

  5. Co-operation agreement. The text of the agreement of 25 May 1998 between the International Atomic Energy Agency and the Brazilian-Argentine Agency for accounting and control of nuclear materials

    International Nuclear Information System (INIS)

    1998-01-01

    The document reproduces the text of the Co-operation Agreement between the International Atomic Energy Agency and the Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials which entered into force on 25 May 1998

  6. State and regional systems of accounting for and control of nuclear materials cooperation between international, regional and states safeguards organizations: An evolving issue

    International Nuclear Information System (INIS)

    Fernández Moreno, Sonia

    2011-01-01

    Cooperation between the IAEA, States and regional organizations is increasingly important to ensure effective accountancy and control of nuclear material in peaceful uses. The IAEA, SAGSI2 and institutions such INMM3 and ESARDA4 have recognized the relevance and the evolving role that SSAC5 and regional organizations play to this aim. In this context, it is important to take steps to ensure the effectiveness of the system and the optimal level of relationship between these organizations so as to maximize the benefits for each party, particularly in those cases where well developed systems exist. Moreover, expansion of nuclear energy requires concerted efforts towards building competence in safeguards in all relevant States. This is also important with respect to other aspects of nonproliferation. In this scenario there is agreement on the need to have effective state organizations that fulfill international safeguards and other security obligations. However, the roles and duties of SSAC and the possible scope of cooperation between the IAEA and SSAC are still under evolution. This paper discusses possible ways and means to build competence in safeguards and how the international community could be more proactive in establishing a framework including the various dimensions of the cooperation in safeguards and other security matters between all parties concerned. The establishment of a forum and a network of interested parties under the auspice of interested organizations could be one mechanism to exchange best practices and experiences. (authors)

  7. Analysis of the operation of the organs of internal control in the non agricultural cooperatives of the county of Pinar del Rio

    Directory of Open Access Journals (Sweden)

    Alexis del Llano Sobrino

    2016-12-01

    Full Text Available The achievement of a good operation of any entity, demands a high efficiency in the acting of its organs of internal control. It guarantees it that they are detected and prevent the internal deficiencies that affect the achievement of the objectives of the company, on time either material, social and financial without to wait to that coming organisms from the exterior of the entity are those that detect the same ones. At the present time the Non Agricultural Cooperatives in Cuba, are not isolated of this problem, being evidenced structural and functional inadequacies of the organs of internal control in the same ones that affect their inspection processes as well as the control of the execution of the agreements of their General Assembly of Associates. For what is necessary to propose a structure and functions for the organs of the Non Agricultural Cooperatives that it contributes to the improvement of their internal control and consequently the improvement of their economic and social administration.

  8. Does good medication adherence really save payers money?

    Science.gov (United States)

    Stuart, Bruce C; Dai, Mingliang; Xu, Jing; Loh, Feng-Hua E; S Dougherty, Julia

    2015-06-01

    Despite a growing consensus that better adherence with evidence-based medications can save payers money, assertions of cost offsets may be incomplete if they fail to consider additional drug costs and/or are biased by healthy adherer behaviors unobserved in typical medical claims-based analyses. The objective of this study was to determine whether controlling for healthy adherer bias (HAB) materially affected estimated medical cost offsets and additional drug spending associated with higher adherence. A total of 1273 Medicare beneficiaries with diabetes enrolled in Part D plans between 2006 and 2009. Using survey and claims data from the Medicare Current Beneficiary Survey, we measured medical and drug costs associated with good and poor adherence (proportion of days covered ≥ 80% and <80%, respectively) to oral antidiabetic drugs, ACE inhibitors/ARBs, and statins over 2 years. To test for HAB, we estimated pairs of regression models, one set containing variables typically controlled for in conventional claims analysis and a second set with survey-based variables selected to capture HAB effects. We found consistent evidence that controlling for HAB reduces estimated savings in medical costs from better adherence, and likewise, reduces estimates of additional adherence-related drug spending. For ACE inhibitors/ARBs we estimate that controlling for HAB reduced adherence-related medical cost offsets from $6389 to $4920 per person (P<0.05). Estimates of additional adherence-related drug costs were 26% and 14% lower in HAB-controlled models (P < 0.05). These results buttress the economic case for action by health care payers to improve medication adherence among insured persons with chronic disease. However, given the limitations of our research design, further research on larger samples with other disease states is clearly warranted.

  9. Movement Performance of Human-Robot Cooperation Control Based on EMG-Driven Hill-Type and Proportional Models for an Ankle Power-Assist Exoskeleton Robot.

    Science.gov (United States)

    Ao, Di; Song, Rong; Gao, JinWu

    2017-08-01

    Although the merits of electromyography (EMG)-based control of powered assistive systems have been certified, the factors that affect the performance of EMG-based human-robot cooperation, which are very important, have received little attention. This study investigates whether a more physiologically appropriate model could improve the performance of human-robot cooperation control for an ankle power-assist exoskeleton robot. To achieve the goal, an EMG-driven Hill-type neuromusculoskeletal model (HNM) and a linear proportional model (LPM) were developed and calibrated through maximum isometric voluntary dorsiflexion (MIVD). The two control models could estimate the real-time ankle joint torque, and HNM is more accurate and can account for the change of the joint angle and muscle dynamics. Then, eight healthy volunteers were recruited to wear the ankle exoskeleton robot and complete a series of sinusoidal tracking tasks in the vertical plane. With the various levels of assist based on the two calibrated models, the subjects were instructed to track the target displayed on the screen as accurately as possible by performing ankle dorsiflexion and plantarflexion. Two measurements, the root mean square error (RMSE) and root mean square jerk (RMSJ), were derived from the assistant torque and kinematic signals to characterize the movement performances, whereas the amplitudes of the recorded EMG signals from the tibialis anterior (TA) and the gastrocnemius (GAS) were obtained to reflect the muscular efforts. The results demonstrated that the muscular effort and smoothness of tracking movements decreased with an increase in the assistant ratio. Compared with LPM, subjects made lower physical efforts and generated smoother movements when using HNM, which implied that a more physiologically appropriate model could enable more natural and human-like human-robot cooperation and has potential value for improvement of human-exoskeleton interaction in future applications.

  10. Correlates of Pediatric CPAP Adherence

    Science.gov (United States)

    Hawkins, Stephen M.M.; Jensen, Emily L.; Simon, Stacey L.; Friedman, Norman R.

    2016-01-01

    Study Objectives: Obstructive sleep apnea (OSA) is a common pediatric condition characterized by recurrent partial or complete cessation of airflow during sleep, typically due to inadequate upper airway patency. Continuous positive airway pressure (CPAP) is a therapeutic option that reduces morbidity. Despite efforts to promote use, CPAP adherence is poor in both pediatric and adult populations. We sought to determine whether demographics, insurance status, OSA severity, therapeutic pressure, or comorbid conditions were associated with pediatric CPAP adherence. Methods: A retrospective review of adherence download data was performed on all pediatric patients with initiation or adjustment of CPAP treatment over a one-year period with documented in-laboratory CPAP titration. Patients were grouped as CPAP adherent or non-adherent, where adherence was defined as > 70% nightly use and average usage ≥ 4 hours per night. Differences between the groups were analyzed by χ2 test. Results: Overall, nearly half of participants were CPAP adherent (49%, 69/140). Of the demographic data collected (age, ethnicity, sex, insurance status), only female sex was associated with better adherence (60.9% vs 39.5% of males adherent; odds ratio [OR] = 2.41, 95%CI = 1.20–4.85; p = 0.01). Severity of OSA (diagnostic apnea-hypopnea index [AHI] and degree of hypoxemia), therapeutic pressure, and residual AHI did not impact CPAP adherence (p > 0.05). Patients with developmental delay (DD) were more likely to be adherent with CPAP than those without a DD diagnosis (OR = 2.55, 95%CI = 1.27–5.13; p = 0.007). Female patients with trisomy 21 tended to be more adherent, but this did not reach significance or account for the overall increased adherence associated with female sex. Conclusions: Our study demonstrates that adherence to CPAP therapy is poor but suggests that female sex and developmental delay are associated with better adherence. These findings support efforts to understand the

  11. Rationale and design of the Kanyini guidelines adherence with the polypill (Kanyini-GAP study: a randomised controlled trial of a polypill-based strategy amongst Indigenous and non Indigenous people at high cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Usherwood Tim

    2010-08-01

    Full Text Available Abstract Background The Kanyini Guidelines Adherence with the Polypill (Kanyini-GAP Study aims to examine whether a polypill-based strategy (using a single capsule containing aspirin, a statin and two blood pressure-lowering agents amongst Indigenous and non-Indigenous people at high risk of experiencing a cardiovascular event will improve adherence to guideline-indicated therapies, and lower blood pressure and cholesterol levels. Methods/Design The study is an open, randomised, controlled, multi-centre trial involving 1000 participants at high risk of cardiovascular events recruited from mainstream general practices and Aboriginal Medical Services, followed for an average of 18 months. The participants will be randomised to one of two versions of the polypill, the version chosen by the treating health professional according to clinical features of the patient, or to usual care. The primary study outcomes will be changes, from baseline measures, in serum cholesterol and systolic blood pressure and self-reported current use of aspirin, a statin and at least two blood pressure lowering agents. Secondary study outcomes include cardiovascular events, renal outcomes, self-reported barriers to indicated therapy, prescription of indicated therapy, occurrence of serious adverse events and changes in quality-of-life. The trial will be supplemented by formal economic and process evaluations. Discussion The Kanyini-GAP trial will provide new evidence as to whether or not a polypill-based strategy improves adherence to effective cardiovascular medications amongst individuals in whom these treatments are indicated. Trial Registration This trial is registered with the Australian New Zealand Clinical Trial Registry ACTRN126080005833347.

  12. Belonging to a peer support group enhance the quality of life and adherence rate in patients affected by breast cancer: A non-randomized controlled clinical trialFNx01

    Directory of Open Access Journals (Sweden)

    Afsaneh Malekpour Tehrani

    2011-01-01

    Full Text Available Background: Breast cancer is the most common cancer in women. It seems that breast cancer patients benefit from meeting someone who had a similar experience. This study evaluated the effect of two kinds of interventions (peer support and educational program on quality of life in breast cancer patients. Methods: This study was a controlled clinical trial on women with non-metastatic breast cancer. The patients studied in two experimental and control groups. Experimental group took part in peer support program and control group passed a routine educational program during 3 months. The authors administered SF-36 for evaluating the quality of life pre-and post intervention. Also, patient′s adherence was assessed by means of a simple checklist. Results: Two groups were similar with respect of age, age of onset of the disease, duration of having breast cancer, marital status, type of the treatment receiving now, and type of the received surgery. In the control group, there were statistically significant improvements in body pain, role-physical, role-emotional and social functioning. In experimental group, role-physical, vitality, social functioning, role-emotional and mental health showed significant improvement. Vitality score and mental health score in experimental group was significantly higher than that of the control group, both with p < 0.001. Also, it was shown that adherence was in high levels in both groups and no significant difference was seen after the study was done. Conclusions: According to the results of this study, supporting the patients with breast cancer by forming peer groups or by means of educational sessions could improve their life qualities.

  13. Adherence as a language game.

    Science.gov (United States)

    Kolberg, Espen Skarstein

    2017-04-01

    Non-adherence, i.e. medication intake behavior not corresponding with agreed recommendations, is associated with increased morbidity and death, and it has been estimated that as many as 50% of patients in developed countries are not taking their medications as prescribed. But even as efforts in improving medication adherence over the years have increased, results are inconsistent, with only a minority of clinical trials showing any improvement in both adherence and clinical outcome. Since patient education is central to promoting good medication adherence, and language is integral to education, perhaps an exploration of the meaning and use of language, using the philosophy of Ludwig Wittgenstein, is in order.

  14. Improving patient adherence to lifestyle advice (IMPALA: a cluster-randomised controlled trial on the implementation of a nurse-led intervention for cardiovascular risk management in primary care (protocol

    Directory of Open Access Journals (Sweden)

    Grol Richard

    2008-01-01

    Full Text Available Abstract Background Many patients at high risk of cardiovascular diseases are managed and monitored in general practice. Recommendations for cardiovascular risk management, including lifestyle change, are clearly described in the Dutch national guideline. Although lifestyle interventions, such as advice on diet, physical exercise, smoking and alcohol, have moderate, but potentially relevant effects in these patients, adherence to lifestyle advice in general practice is not optimal. The IMPALA study intends to improve adherence to lifestyle advice by involving patients in decision making on cardiovascular prevention by nurse-led clinics. The aim of this paper is to describe the design and methods of a study to evaluate an intervention aimed at involving patients in cardiovascular risk management. Methods A cluster-randomised controlled trial in 20 general practices, 10 practices in the intervention arm and 10 in the control arm, starting on October 2005. A total of 720 patients without existing cardiovascular diseases but eligible for cardiovascular risk assessment will be recruited. In both arms, the general practitioners and nurses will be trained to apply the national guideline for cardiovascular risk management. Nurses in the intervention arm will receive an extended training in risk assessment, risk communication, the use of a decision aid and adapted motivational interviewing. This communication technique will be used to support the shared decision-making process about risk reduction. The intervention comprises 2 consultations and 1 follow-up telephone call. The nurses in the control arm will give usual care after the risk estimation, according to the national guideline. Primary outcome measures are self-reported adherence to lifestyle advice and drug treatment. Secondary outcome measures are the patients' perception of risk and their motivation to change their behaviour. The measurements will take place at baseline and after 12 and 52

  15. Using a tailored health information technology- driven intervention to improve health literacy and medication adherence in a Pakistani population with vascular disease (Talking Rx) - study protocol for a randomized controlled trial.

    Science.gov (United States)

    Kamal, Ayeesha Kamran; Muqeet, Abdul; Farhat, Kashfa; Khalid, Wardah; Jamil, Anum; Gowani, Ambreen; Muhammad, Aliya Amin; Zaidi, Fabiha; Khan, Danyal; Elahi, Touseef; Sharif, Shahrukh; Raz, Sibtain; Zafar, Taha; Bokhari, Syedah Saira; Rahman, Nasir; Sultan, Fateh Ali Tipoo; Sayani, Saleem; Virani, Salim S

    2016-03-05

    Vascular disease, manifesting as myocardial infarction and stroke, is a major cause of morbidity and mortality, especially in low- and middle-income countries. Current estimates are that only one in six patients have good adherence to medications and very few have sufficient health literacy. Our aim is to explore the effectiveness and acceptability of Prescription Interactive Voice Response (IVR) Talking Prescriptions (Talking Rx) and SMS reminders in increasing medication adherence and health literacy in Pakistani patients with vascular disease. This is a randomized, controlled, single center trial. Adult participants, with access to a cell phone and a history of vascular disease, taking multiple risk-modifying medications (inclusive of anti-platelets and statins) will be selected from cerebrovascular and cardiovascular clinics. They will be randomized in a 1:1 ratio via a block design to the intervention or the control arm with both groups having access to a helpline number to address their queries in addition to standard of care as per institutional guidelines. Participants in the intervention group will also have access to Interactive Voice Response (IVR) technology tailored to their respective prescriptions in the native language (Urdu) and will have the ability to hear information about their medication dosage, correct use, side effects, mechanism of action and how and why they should use their medication, as many times as they like. Participants in the intervention arm will also receive scheduled SMS messages reminding them to take their medications. The primary outcome measure will be the comparison of the difference in adherence to anti-platelet and statin medication between baseline and at 3-month follow-up in each group measured by the Morisky Medication Adherence Scale. To ascertain the impact of our intervention on health literacy, we will also compare a local content-validated and modified version of Test of Health Literacy in Adults (TOFHLA) between

  16. Transboundary cooperation

    International Nuclear Information System (INIS)

    Rauber, D.

    2006-01-01

    The operation of nuclear power plants near national borders requires a close bilateral co-operation to cope with accidents having off-site radiological impacts. For example in 1978 such an agreement was signed by the German and Swiss government. The accident at the Chernobyl NPP changed the international co-operation in the framework of international consequence management. International conventions were agreed to insure a timely notification and international assistance in case of an accident with transboundary effects. In order to fulfill these conventions several procedures were introduced. In addition, bilateral agreements were signed also with countries which are not operating nuclear power plants near national borders. Since then no accident took place that would have required any notification. However, following the experience the expectations to these networks have changed considerably and hence sustainable development is required to cope with new challenges such as long term consequences management, new radiological threats, faster international assistance, media and public concerns, and technical evolution of communications systems. (author)

  17. Adherence to gout management recommendations of Chinese patients.

    Science.gov (United States)

    Sheng, Feng; Fang, Weigang; Zhang, Bingqing; Sha, Yue; Zeng, Xuejun

    2017-11-01

    Though efficacious and affordable treatments for gout are widely available, gout is still not well controlled in many countries of the world including China.To investigate patient adherence to gout management recommendations and potential barriers in Chinese male gout patients, a survey was carried out by telephone interview in male patients registered in the gout clinic at Peking Union Medical College Hospital. Adherence to dietary and medication recommendations was measured by a food frequency questionnaire and proportion of cumulative time adherent to chemical urate-lowering therapy (ULT), respectively. Dietary adherence was defined as consumption of alcohol, seafood and animal organs less than once per month, and reduced red meat after dietary counseling. Medication adherence was defined as ULT ≥80% of time in the past 12 months for patients with indications. Logistic regression models were used to identify patient characteristics associated with management adherence. Reasons for nonadherence were also sought by open-end questions.Dietary and medication adherence were 44.2% and 21.9%, respectively. Older age (odds ratio [OR] 7.90, 95% confidence interval [CI] 2.49-25.04 for age ≥60), higher serum uric acid (sUA) levels (OR 3.53, 95% CI 1.42-8.75 for the highest quartile), and tophi (OR 2.31, 95% CI 1.12-4.77) were associated with dietary adherence independently, while tophi (OR 14.05, 95% CI 2.67-74.08) and chronic kidney disease (OR 16.66, 95% CI 2.63-105.37) were associated with medication adherence independently. Reasons that patients reported for nonadherence to medication included remission after treatment (35.3%), concerns for potential side effects (22.7%), insufficient patient education (8.7%), and adverse events (8.2%).Patient adherence to gout management recommendations is poor in China. Older age, increased disease burden, and specific comorbidities were associated with management adherence.

  18. Socio-demographic and clinical factors affecting adherence to ...

    African Journals Online (AJOL)

    Socio-demographic and clinical factors affecting adherence to antihypertensive medications and blood pressure control among patients attending the family practice clinic in a tertiary hospital in northern Nigeria.

  19. Improved Adherence to Vision Self-monitoring with the Vision and Memory Stimulating (VMS) Journal for Non-neovascular Age-related Macular Degeneration during a Randomized Controlled Trial.

    Science.gov (United States)

    Bittner, Ava K; Torr-Brown, Sheryl; Arnold, Ellen; Nwankwo, Antonia; Beaton, Patricia; Rampat, Radhika; Dagnelie, Gislin; Roser, Mark

    2014-01-22

    An educational, interactive journal [Vision and Memory Stimulating (VMS) journal] was developed to boost patient confidence and promote long-term adherence with weekly vision self-monitoring in age-related macular degeneration (AMD) patients at risk for vision loss from new-onset neovascularization. In a multicenter randomized controlled trial, 198 subjects with intermediate stage, non-neovascular AMD received the VMS journal or followed usual care (e.g. their doctor's instructions for vision monitoring; Amsler grid). At 6 and/or 12 months post-enrollment, 157 subjects completed a questionnaire on vision self-monitoring. At 6 and 12 months, respectively, 85% and 80% of the VMS journal subjects reported vision monitoring at least weekly, which represent statistically significant 7.1 and 4.2 times greater odds than the 50% of controls who monitored weekly at both follow-up times (pself-monitoring. At 6 and 12 months, respectively, only 15% and 13% of the VMS journal subjects vs. 53% and 44% of the controls reported that they did not feel confident that they were taking care of their sight by self-monitoring (pself-monitoring between the groups (p=0.68), with 81% of all subjects reporting no change in frequency between 6 and 12 months. These findings support the efficacy of the VMS journal for increasing vision self-monitoring adherence and confidence, in addition to promoting persistence in weekly monitoring over the course of a year in AMD subjects at risk for exudative retinal changes.

  20. Improved Adherence to Vision Self-monitoring with the Vision and Memory Stimulating (VMS) Journal for Non-neovascular Age-related Macular Degeneration during a Randomized Controlled Trial

    Science.gov (United States)

    Bittner, Ava K; Torr-Brown, Sheryl; Arnold, Ellen; Nwankwo, Antonia; Beaton, Patricia; Rampat, Radhika; Dagnelie, Gislin; Roser, Mark

    2014-01-01

    Objective An educational, interactive journal [Vision and Memory Stimulating (VMS) journal] was developed to boost patient confidence and promote long-term adherence with weekly vision self-monitoring in age-related macular degeneration (AMD) patients at risk for vision loss from new-onset neovascularization. Methods In a multicenter randomized controlled trial, 198 subjects with intermediate stage, non-neovascular AMD received the VMS journal or followed usual care (e.g. their doctor’s instructions for vision monitoring; Amsler grid). At 6 and/or 12 months post-enrollment, 157 subjects completed a questionnaire on vision self-monitoring. Results At 6 and 12 months, respectively, 85% and 80% of the VMS journal subjects reported vision monitoring at least weekly, which represent statistically significant 7.1 and 4.2 times greater odds than the 50% of controls who monitored weekly at both follow-up times (psight by self-monitoring (p<0.001). Usual care controls had statistically significant 6.7 and 5.0 times greater odds of reporting non-confidence at 6 and 12 months, respectively. There was no statistically significant change in weekly vs. less frequent self-monitoring between the groups (p=0.68), with 81% of all subjects reporting no change in frequency between 6 and 12 months. Conclusions These findings support the efficacy of the VMS journal for increasing vision self-monitoring adherence and confidence, in addition to promoting persistence in weekly monitoring over the course of a year in AMD subjects at risk for exudative retinal changes. PMID:24791222

  1. Antihypertensive Medications Adherence Among Nigerian ...

    African Journals Online (AJOL)

    Hospital, Ogbomosho, 2Goshen Heart Clinic, Osogbo, 3Department of Economics, Osun State University, Osogbo, Nigeria ... significant impact of antihypertensive medication adherence.[13]. The level of information provided to patients may also impact ..... Muntner P. New medication adherence scale versus pharmacy.

  2. Does facial resemblance enhance cooperation?

    Directory of Open Access Journals (Sweden)

    Trang Giang

    Full Text Available Facial self-resemblance has been proposed to serve as a kinship cue that facilitates cooperation between kin. In the present study, facial resemblance was manipulated by morphing stimulus faces with the participants' own faces or control faces (resulting in self-resemblant or other-resemblant composite faces. A norming study showed that the perceived degree of kinship was higher for the participants and the self-resemblant composite faces than for actual first-degree relatives. Effects of facial self-resemblance on trust and cooperation were tested in a paradigm that has proven to be sensitive to facial trustworthiness, facial likability, and facial expression. First, participants played a cooperation game in which the composite faces were shown. Then, likability ratings were assessed. In a source memory test, participants were required to identify old and new faces, and were asked to remember whether the faces belonged to cooperators or cheaters in the cooperation game. Old-new recognition was enhanced for self-resemblant faces in comparison to other-resemblant faces. However, facial self-resemblance had no effects on the degree of cooperation in the cooperation game, on the emotional evaluation of the faces as reflected in the likability judgments, and on the expectation that a face belonged to a cooperator rather than to a cheater. Therefore, the present results are clearly inconsistent with the assumption of an evolved kin recognition module built into the human face recognition system.

  3. O Programa de Controle do Dengue em São José do Rio Preto, São Paulo, Brasil: dificuldades para a atuação dos agentes e adesão da população Dengue Control Program in São José do Rio Preto, São Paulo State, Brazil: problems with health agents' work and population adherence

    Directory of Open Access Journals (Sweden)

    Francisco Chiaravalloti Neto

    2007-07-01

    Full Text Available O objetivo do trabalho foi identificar aspectos que interferem na atuação dos agentes de controle de vetores e comunitários de saúde no Programa de Controle do Dengue e na adesão da população. Utilizou-se metodologia de grupos focais, nos quais foi discutida a relação agente-serviço-população. O controle e prevenção do dengue foram considerados atividades de menor importância, e o agente ideal seria aquele capaz de encaminhar todas as demandas e não só aquelas relacionadas ao dengue. Os agentes de controle de vetores apontaram para problemas como recusa e falta de adesão, identificação como coletores de lixo, diferenciação de status em relação aos agentes comunitários de saúde. Entre as mulheres, identificaram-se a relação de culpabilização entre vizinhos, a associação do problema do dengue à falta de higiene e a relação entre casa limpa e ausência de criadouros. Os aspectos destacados interferem negativamente na atuação dos agentes e são condicionados pela característica vertical do programa. Encaminhamentos possíveis: incorporação dos agentes de controle às Unidades de Saúde, investimento na integração intersetorial e criação de condições para que os agentes atuem sobre o meio ambiente.This study aimed to identify the aspects that interfere with the performance of vector control agents and community health workers and population adherence to dengue control programs. The focal group methodology was applied to discuss the relations between the program, health agents, and population. According to the results, dengue control and prevention were considered relatively unimportant activities, i.e., ideal community health workers would be capable of solving other (supposedly more important problems. Vector control agents emphasized the population's lack of adherence and the fact that they (the control agents were confused with garbage collectors (considered less important than community health workers

  4. Development of digital device based work verification system for cooperation between main control room operators and field workers in nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Min, E-mail: jewellee@kaeri.re.kr [Korea Atomic Energy Research Institute, 305-353, 989-111 Daedeok-daero, Yuseong-gu, Daejeon (Korea, Republic of); Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, 373-1, Guseong-dong, Yuseong-gu, Daejeon 305-701 (Korea, Republic of); Lee, Hyun Chul, E-mail: leehc@kaeri.re.kr [Korea Atomic Energy Research Institute, 305-353, 989-111 Daedeok-daero, Yuseong-gu, Daejeon (Korea, Republic of); Ha, Jun Su, E-mail: junsu.ha@kustar.ac.ae [Department of Nuclear Engineering, Khalifa University of Science Technology and Research, Abu Dhabi P.O. Box 127788 (United Arab Emirates); Seong, Poong Hyun, E-mail: phseong@kaist.ac.kr [Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, 373-1, Guseong-dong, Yuseong-gu, Daejeon 305-701 (Korea, Republic of)

    2016-10-15

    Highlights: • A digital device-based work verification and cooperation support system was developed. • Requirements were derived by interviewing field operators having experiences with mobile-based work support systems. • The usability of the proposed system was validated by conducting questionnaire surveys. • The proposed system will be useful if the manual or the set of guidelines is well constructed. - Abstract: Digital technologies have been applied in the nuclear field to check task results, monitor events and accidents, and transmit/receive data. The results of using digital devices have proven that these devices can provide high accuracy and convenience for workers, allowing them to obtain obvious positive effects by reducing their workloads. In this study, as one step forward, a digital device-based cooperation support system, the nuclear cooperation support and mobile documentation system (Nu-COSMOS), is proposed to support communication between main control room (MCR) operators and field workers by verifying field workers’ work results in nuclear power plants (NPPs). The proposed system consists of a mobile based information storage system to support field workers by providing various functions to make workers more trusted by MCR operators; also to improve the efficiency of meeting, and a large screen based information sharing system supports meetings by allowing both sides to share one medium. The usability of this system was estimated by interviewing field operators working in nuclear power plants and experts who have experience working as operators. A survey to estimate the usability of the suggested system and the suitability of the functions of the system for field working was conducted for 35 subjects who have experience in field works or with support system development-related research. The usability test was conducted using the system usability scale (SUS), which is widely used in industrial usability evaluation. Using questionnaires

  5. Development of digital device based work verification system for cooperation between main control room operators and field workers in nuclear power plants

    International Nuclear Information System (INIS)

    Lee, Seung Min; Lee, Hyun Chul; Ha, Jun Su; Seong, Poong Hyun

    2016-01-01

    Highlights: • A digital device-based work verification and cooperation support system was developed. • Requirements were derived by interviewing field operators having experiences with mobile-based work support systems. • The usability of the proposed system was validated by conducting questionnaire surveys. • The proposed system will be useful if the manual or the set of guidelines is well constructed. - Abstract: Digital technologies have been applied in the nuclear field to check task results, monitor events and accidents, and transmit/receive data. The results of using digital devices have proven that these devices can provide high accuracy and convenience for workers, allowing them to obtain obvious positive effects by reducing their workloads. In this study, as one step forward, a digital device-based cooperation support system, the nuclear cooperation support and mobile documentation system (Nu-COSMOS), is proposed to support communication between main control room (MCR) operators and field workers by verifying field workers’ work results in nuclear power plants (NPPs). The proposed system consists of a mobile based information storage system to support field workers by providing various functions to make workers more trusted by MCR operators; also to improve the efficiency of meeting, and a large screen based information sharing system supports meetings by allowing both sides to share one medium. The usability of this system was estimated by interviewing field operators working in nuclear power plants and experts who have experience working as operators. A survey to estimate the usability of the suggested system and the suitability of the functions of the system for field working was conducted for 35 subjects who have experience in field works or with support system development-related research. The usability test was conducted using the system usability scale (SUS), which is widely used in industrial usability evaluation. Using questionnaires

  6. Multidentate-Protected Colloidal Gold Nanocrystals: pH Control of Cooperative Precipitation and Surface Layer Shedding

    Science.gov (United States)

    Kairdolf, Brad A.; Nie, Shuming

    2011-01-01

    Colloidal gold nanocrystals with broad size tunability and unusual pH-sensitive properties have been synthesized by using multidentate polymer ligands. Containing both carboxylic functional groups and sterically hindered aliphatic chains, the multidentate ligands are able to both reduce gold precursors and to stabilize gold nanoclusters during nucleation and growth. The “as-synthesized” nanocrystals are protected by an inner coordinating layer and an outer polymer layer, and are soluble in water and polar solvents. When the solution pH is lowered by just 0.6 units (from pH 4.85 to 4.25), the particles undergo a dramatic cooperative transition from being soluble to insoluble, allowing rapid isolation, purification, and redispersion of the multidentate-protected nanocrystals. A surprise finding is that when a portion of the surface carboxylate groups is neutralized by protonation, the particles irreversibly shed their outer polymer layer and become soluble in nonpolar organic solvents. Further, the multidentate polymer coatings are permeable to small organic molecules, in contrast to tightly packed self-assembled monolayers of alkanethiols on gold. These insights are important towards the design of “smart” imaging and therapeutic nanoparticles that are activated by small pH changes in the tumor interstitial space or endocytic organelles. PMID:21510704

  7. Effects of Charitable Versus Monetary Incentives on the Acceptance of and Adherence to a Pedometer-Based Health Intervention: Study Protocol and Baseline Characteristics of a Cluster-Randomized Controlled Trial.

    Science.gov (United States)

    Kowatsch, Tobias; Kramer, Jan-Niklas; Kehr, Flavius; Wahle, Fabian; Elser, Niklas; Fleisch, Elgar

    2016-09-13

    Research has so far benefited from the use of pedometers in physical activity interventions. However, when public health institutions (eg, insurance companies) implement pedometer-based interventions in practice, people may refrain from participating due to privacy concerns. This might greatly limit the applicability of such interventions. Financial incentives have been successfully used to influence both health behavior and privacy concerns, and may thus have a beneficial effect on the acceptance of pedometer-based interventions. This paper presents the design and baseline characteristics of a cluster-randomized controlled trial that seeks to examine the effect of financial incentives on the acceptance of and adherence to a pedometer-based physical activity intervention offered by a health insurance company. More than 18,000 customers of a large Swiss health insurance company were allocated to a financial incentive, a charitable incentive, or a control group and invited to participate in a health prevention program. Participants used a pedometer to track their daily physical activity over the course of 6 months. A Web-based questionnaire was administered at the beginning and at the end of the intervention and additional data was provided by the insurance company. The primary outcome of the study will be the participation rate, secondary outcomes will be adherence to the prevention program, physical activity, and health status of the participants among others. Baseline characteristics indicate that residence of participants, baseline physical activity, and subjective health should be used as covariates in the statistical analysis of the secondary outcomes of the study. This is the first study in western cultures testing the effectiveness of financial incentives with regard to a pedometer-based health intervention offered by a large health insurer to their customers. Given that the incentives prove to be effective, this study provides the basis for powerful health

  8. Bacterial adherence to anodized titanium alloy

    International Nuclear Information System (INIS)

    Peremarch, C Perez-Jorge; Tanoira, R Perez; Arenas, M A; Matykina, E; Conde, A; De Damborenea, J J; Gomez Barrena, E; Esteban, J

    2010-01-01

    The aim of this study was to evaluate Staphylococcus sp adhesion to modified surfaces of anodized titanium alloy (Ti-6Al-4V). Surface modification involved generation of fluoride-containing titanium oxide nanotube films. Specimens of Ti-6Al-4V alloy 6-4 ELI-grade 23- meets the requirements of ASTM F136 2002A (AMS 2631B class A1) were anodized in a mixture of sulphuric/hydrofluoric acid at 20 V for 5 and 60 min to form a 100 nm-thick porous film of 20 nm pore diameter and 230 nm-thick nanotube films of 100 nm in diameter. The amount of fluorine in the oxide films was of 6% and of 4%, respectively. Collection strains and six clinical strains each of Staphylococcus aureus and Staphylococcus epidermidis were studied. The adherence study was performed using a previously published protocol by Kinnari et al. The experiments were performed in triplicates. As a result, lower adherence was detected for collection strains in modified materials than in unmodified controls. Differences between clinical strains were detected for both species (p<0.0001, Kruskal-Wallis test), although global data showed similar results to that of collection strains (p<0.0001, Kruskal-Wallis test). Adherence of bacteria to modified surfaces was decreased for both species. The results also reflect a difference in the adherence between S. aureus and S. epidermidis to the modified material. As a conclusion, not only we were able to confirm the decrease of adherence in the modified surface, but also the need to test multiple clinical strains to obtain more realistic microbiological results due to intraspecies differences.

  9. Adhered Supported Carbon Nanotubes

    International Nuclear Information System (INIS)

    Johnson, Dale F.; Craft, Benjamin J.; Jaffe, Stephen M.

    2001-01-01

    Carbon nanotubes (NTs) in excess of 200 μm long are grown by catalytic pyrolysis of hydrocarbon vapors. The nanotubes grow continuously without the typical extinction due to catalyst encapsulation. A woven metal mesh supports the nanotubes creating a metal supported nanotube (MSNT) structure. The 140 μm wide mesh openings are completely filled by 70 nm diameter multiwalled nanotubes (MWNTs). The MWNTs are straight, uniform and highly crystalline. Their wall thickness is about 10 nm (30 graphite layers). The adherent NTs are not removed from the support in a Scotch tape pull test. A 12.5 cm 2 capacitor made from two MSNT structures immersed in 1 M KCl has a capacitance of 0.35 F and an equivalent series resistance of 0.18 Ω. Water flows through the MSNT at a flow velocity of 1 cm/min with a pressure drop of 15 inches of water. With the support removed, the MWNTs naturally form a carbon nanocomposite (CNC) paper with a specific area of 80 m 2 /gm, a bulk density of 0.21 g/cm 3 , an open pore fraction of 0.81, and a resistivity of 0.16 Ω-cm

  10. Adherence of fluid interfaces and colloidal aggregation in emulsions

    International Nuclear Information System (INIS)

    Poulin, Philippe

    1995-01-01

    This research thesis addresses some aspects of the behaviour of emulsions in which droplets are adhesive, and are thus characterised by their ability to stick to one another or on surfaces. The objective is also to identify various adhesive systems while describing their behaviour in order to start to build up a rationale of these phenomena. The author mainly focuses on the adherence of single layers of adsorbed surfactants: by inducing and controlling this adherence, it is possible to make the droplets stick. After a brief presentation of the wetting phenomenon and of the adherence of emulsion droplets, the author presents theoretical backgrounds of adherence, and describes the thermodynamics of liquid films. He presents the general approach which has been adopted to search for and control adherence phenomena in emulsions, and outlines challenges and difficulties related to the use of adhesive particles in industrial applications. A method of measurement of the contact angle between droplets of some tens of microns is described. In the next part, the author reports the characterisation of adherence properties of different emulsions: measurement of adherence energy with respect to some parameters by using contact angle measurements, study of mixed systems (mixtures of surfactants) to illustrate the applicability to industrial formulas. In a last part, the author reports measurements of film thickness between stuck droplets by using experiments of small angle neutron scattering [fr

  11. Clustering based on adherence data.

    Science.gov (United States)

    Kiwuwa-Muyingo, Sylvia; Oja, Hannu; Walker, Sarah A; Ilmonen, Pauliina; Levin, Jonathan; Todd, Jim

    2011-03-08

    Adherence to a medical treatment means the extent to which a patient follows the instructions or recommendations by health professionals. There are direct and indirect ways to measure adherence which have been used for clinical management and research. Typically adherence measures are monitored over a long follow-up or treatment period, and some measurements may be missing due to death or other reasons. A natural question then is how to describe adherence behavior over the whole period in a simple way. In the literature, measurements over a period are usually combined just by using averages like percentages of compliant days or percentages of doses taken. In the paper we adapt an approach where patient adherence measures are seen as a stochastic process. Repeated measures are then analyzed as a Markov chain with finite number of states rather than as independent and identically distributed observations, and the transition probabilities between the states are assumed to fully describe the behavior of a patient. The patients can then be clustered or classified using their estimated transition probabilities. These natural clusters can be used to describe the adherence of the patients, to find predictors for adherence, and to predict the future events. The new approach is illustrated and shown to be useful with a simple analysis of a data set from the DART (Development of AntiRetroviral Therapy in Africa) trial in Uganda and Zimbabwe.

  12. Relationship among social support, treatment adherence and metabolic control of diabetes mellitus patients Relación entre apoyo social, adhesión al tratamiento y control metabólico de personas con Diabetes Mellitus Relação entre apoio social, adesão aos tratamentos e controle metabólico de pessoas com diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Lilian Cristiane Gomes-Villas Boas

    2012-02-01

    Full Text Available This cross-sectional and quantitative study aimed to analyze the relationship among social support, adherence to non-pharmacological (diet and physical exercise and pharmacological treatments (insulin and/or oral anti-diabetic medication and clinical and metabolic control of 162 type 2 diabetes mellitus patients. Data were collected through instruments validated for Brazil. Social support was directly correlated with treatment adherence. Adherence to non-pharmacological treatment was inversely correlated with body mass index, and medication adherence was inversely correlated with diastolic blood pressure. There were no associations between social support and clinical and metabolic control variables. Findings indicate that social support can be useful to achieve treatment adherence. Studies with other designs should be developed to broaden the analysis of relations between social support and other variables.El presente estudio objetivó analizar la relación entre apoyo social, adhesión a los tratamientos no medicamentoso (dieta y ejercicio físico y medicamentoso(insulina y/o antidiabéticos orales y control clínico-metabólico de 162 personas con diabetes mellitus tipo 2. Se trata de un estudio seccional, de abordaje cuantitativo. Los datos fueron recolectados por medio de instrumentos validados. El apoyo social tuvo correlación directa con la adhesión al tratamiento. Se observó correlación inversa entre adhesión al tratamiento no medicamentoso y índice de masa corporal, así como entre adhesión medicamentosa y presión arterial diastólica. No hubo asociaciones entre apoyo social y variables de control clínico-metabólico. Se concluye que el apoyo social podrá ser útil para obtener la adhesión a los tratamientos. Estudios con otros delineamientos deben ser desarrollados, a fin de ampliar el análisis de las relaciones entre apoyo social y otras variables.O presente estudo objetivou analisar a relação entre apoio social, ades

  13. Predicting Malawian Women's Intention to Adhere to Antiretroviral Therapy.

    Science.gov (United States)

    McKinney, Ogbochi; Modeste, Naomi N; Lee, Jerry W; Gleason, Peter C

    2015-07-16

    With the increase in scaling up of antiretroviral therapy (ART), knowledge of the need for adherence to ART is pivotal for successful treatment outcomes. A cross-sectional study was carried out between October and December 2013. We administered theory of planned behaviour (TPB) and adherence questionnaires to 358 women aged 18-49 years, from a rural and urban ART-clinics in southern Malawi. Hierarchical linear regression models were used to predict intentions to adhere to ART. Regression models show that attitude (β=0.47), subjective norm (β=0.31) and perceived behavioural control (β=0.12) explain 55% of the variance in intentions to adhere to ART. The relationship between both food insecurity and perceived side effects with intentions to adhere to ART is mediated by attitude, subjective norm, and perceived behavioural control. Household (r=0.20) and individual (r=0.21) food insecurity were positively and significantly correlated with perceived behavioural control. Household food insecurity had a negative correlation with perceived side effects (r=-0.11). Perceived side effects were positively correlated with attitude (r=0.25). There was no statistically significant relationship between intentions to adhere to ART in the future and one month self-report of past month adherence. These interactions suggest that attitude predicted adherence only when food insecurity is high or perception of side effects is strong. This study shows that modificat