Programmable dc motor controller

Science.gov (United States)

Hopwood, J. E.

1982-11-01

A portable programmable dc motor controller, with features not available on commercial instruments was developed for controlling fixtures during welding processes. The controller can be used to drive any dc motor having tachometer feedback and motor requirements not exceeding 30 volts, 3 amperes. Among the controller's features are delayed start time, upslope time, speed, and downslope time.

Animal trypanosomosis: Diagnosis and epidemiology. Results of a FAO/IAEA co-ordinated research programme on the use of immunoassay methods for improved diagnosis of trypanosomosis and monitoring tsetse and trypanosomosis control programmes

International Nuclear Information System (INIS)

2000-01-01

One of the tasks of the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture is to promote the use of nuclear techniques for improving disease diagnosis and monitoring disease control programmes in order to optimise animal production in developing countries. An applied research programme was initiated in 1987 with funding from the Government of the Netherlands to validate an ELISA to detect trypanosomal antigens developed by the International Laboratory for Research on Animal Diseases (ILRAD). The test was successfully validated in ten different laboratories in Africa through a Co-ordinated Research Programme (CRP) from 1987-1993 entitled ''Improving the diagnosis and control of trypanosomosis and other vector-borne diseases of African livestock using immunoassay methods''. Results indicated a reasonable, but at times variable sensitivity and specificity (published in IAEA-TECDOC-707). During an additional two-year period (1993-1995) the IAEA Department of Technical Co-operation and the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture provided support for a Regional Technical Co-operation Project (TCP) to strengthen disease diagnostic capabilities in the National Agricultural Research Systems (NARS) with a special emphasis on the diagnosis of trypanosomosis. Results of the TCP were published in IAEA-TECDOC-925 and were encouraging enough to request additional funding from the Government of the Netherlands for a five-year programme to enable application of the assay as a tool for monitoring disease control programmes in Africa. The results of the latter programme are reported in the present publication together with a number of review articles on the diagnostic and epidemiological aspects of the disease in African livestock

The management of cardiovascular disease in the Netherlands: analysis of different programmes

Directory of Open Access Journals (Sweden)

Jane M. Cramm

2013-08-01

Full Text Available Background: Disease management programmes are increasingly used to improve the efficacy and effectiveness of chronic care delivery.But, disease management programme development and implementation is a complex undertaking that requires effective decision-making.Choices made in the earliest phases of programme development are crucial, as they ultimately impact costs, outcomes and sustainability. Methods: To increase our understanding of the choices that primary healthcare practices face when implementing such programmes and to stimulate successful implementation and sustainability, we compared the early implementation of eight cardiovascular disease management programmes initiated and managed by healthcare practices in various regions of the Netherlands. Using a mixed-methods design, we identified differences in and challenges to programme implementation in terms of context, patient characteristics, disease management level, healthcare utilisation costs, development costs and health-related quality of life. Results: Shifting to a multidisciplinary, patient-centred care pathway approach to disease management is demanding for organisations, professionals and patients, and is especially vulnerable when sustainable change is the goal. Funding is an important barrier to sustainable implementation of cardiovascular disease management programmes, although development costs of the individual programmes varied considerably in relation to the length of the development period. The large number of professionals involved in combination with duration of programme development was the largest cost drivers. While Information and Communication Technology systems to support the new care pathways did not directly contribute to higher costs, delays in implementation indirectly did. Conclusions: Developing and implementing cardiovascular disease management programmes is time-consuming and challenging. Multidisciplinary, patient-centred care demands multifaceted changes

The management of cardiovascular disease in the Netherlands: analysis of different programmes

Directory of Open Access Journals (Sweden)

Jane M. Cramm

2013-08-01

Full Text Available Background: Disease management programmes are increasingly used to improve the efficacy and effectiveness of chronic care delivery.But, disease management programme development and implementation is a complex undertaking that requires effective decision-making.Choices made in the earliest phases of programme development are crucial, as they ultimately impact costs, outcomes and sustainability.Methods: To increase our understanding of the choices that primary healthcare practices face when implementing such programmes and to stimulate successful implementation and sustainability, we compared the early implementation of eight cardiovascular disease management programmes initiated and managed by healthcare practices in various regions of the Netherlands. Using a mixed-methods design, we identified differences in and challenges to programme implementation in terms of context, patient characteristics, disease management level, healthcare utilisation costs, development costs and health-related quality of life.Results: Shifting to a multidisciplinary, patient-centred care pathway approach to disease management is demanding for organisations, professionals and patients, and is especially vulnerable when sustainable change is the goal. Funding is an important barrier to sustainable implementation of cardiovascular disease management programmes, although development costs of the individual programmes varied considerably in relation to the length of the development period. The large number of professionals involved in combination with duration of programme development was the largest cost drivers. While Information and Communication Technology systems to support the new care pathways did not directly contribute to higher costs, delays in implementation indirectly did.Conclusions: Developing and implementing cardiovascular disease management programmes is time-consuming and challenging. Multidisciplinary, patient-centred care demands multifaceted changes in

The management of cardiovascular disease in the Netherlands: analysis of different programmes.

Science.gov (United States)

Cramm, Jane M; Tsiachristas, Apostolos; Walters, Bethany H; Adams, Samantha A; Bal, Roland; Huijsman, Robbert; Rutten-Van Mölken, Maureen P M H; Nieboer, Anna P

2013-01-01

Disease management programmes are increasingly used to improve the efficacy and effectiveness of chronic care delivery. But, disease management programme development and implementation is a complex undertaking that requires effective decision-making. Choices made in the earliest phases of programme development are crucial, as they ultimately impact costs, outcomes and sustainability. To increase our understanding of the choices that primary healthcare practices face when implementing such programmes and to stimulate successful implementation and sustainability, we compared the early implementation of eight cardiovascular disease management programmes initiated and managed by healthcare practices in various regions of the Netherlands. Using a mixed-methods design, we identified differences in and challenges to programme implementation in terms of context, patient characteristics, disease management level, healthcare utilisation costs, development costs and health-related quality of life. Shifting to a multidisciplinary, patient-centred care pathway approach to disease management is demanding for organisations, professionals and patients, and is especially vulnerable when sustainable change is the goal. Funding is an important barrier to sustainable implementation of cardiovascular disease management programmes, although development costs of the individual programmes varied considerably in relation to the length of the development period. The large number of professionals involved in combination with duration of programme development was the largest cost drivers. While Information and Communication Technology systems to support the new care pathways did not directly contribute to higher costs, delays in implementation indirectly did. Developing and implementing cardiovascular disease management programmes is time-consuming and challenging. Multidisciplinary, patient-centred care demands multifaceted changes in routine care. As care pathways become more complex, they

The management of cardiovascular disease in the Netherlands: analysis of different programmes

Science.gov (United States)

Cramm, Jane M.; Tsiachristas, Apostolos; Walters, Bethany H.; Adams, Samantha A.; Bal, Roland; Huijsman, Robbert; Rutten-Van Mölken, Maureen P.M.H.; Nieboer, Anna P.

2013-01-01

Background Disease management programmes are increasingly used to improve the efficacy and effectiveness of chronic care delivery. But, disease management programme development and implementation is a complex undertaking that requires effective decision-making. Choices made in the earliest phases of programme development are crucial, as they ultimately impact costs, outcomes and sustainability. Methods To increase our understanding of the choices that primary healthcare practices face when implementing such programmes and to stimulate successful implementation and sustainability, we compared the early implementation of eight cardiovascular disease management programmes initiated and managed by healthcare practices in various regions of the Netherlands. Using a mixed-methods design, we identified differences in and challenges to programme implementation in terms of context, patient characteristics, disease management level, healthcare utilisation costs, development costs and health-related quality of life. Results Shifting to a multidisciplinary, patient-centred care pathway approach to disease management is demanding for organisations, professionals and patients, and is especially vulnerable when sustainable change is the goal. Funding is an important barrier to sustainable implementation of cardiovascular disease management programmes, although development costs of the individual programmes varied considerably in relation to the length of the development period. The large number of professionals involved in combination with duration of programme development was the largest cost drivers. While Information and Communication Technology systems to support the new care pathways did not directly contribute to higher costs, delays in implementation indirectly did. Conclusions Developing and implementing cardiovascular disease management programmes is time-consuming and challenging. Multidisciplinary, patient-centred care demands multifaceted changes in routine care. As

The vector control operations in the onchocerciasis control programme in West Africa

International Nuclear Information System (INIS)

Hougard, Jean-Marc

2000-01-01

Onchocerciasis is a dermal filariasis transmitted to man by a blood sucking blackfly belonging to the Simulium genus. The most serious manifestations of the disease are blindness and debilitating skin lesions. Africa is by far the most affected continent both in terms of distribution and severity of the clinical manifestations of the disease. That is the reason why an ambitious regional onchocerciasis control project, the Onchocerciasis Control Programme in West Africa (OCP), was launched in 1974 (Molyneux 1995). The objective is to eliminate onchocerciasis as a public health problem and as an obstacle to socio-economic development and to ensure that the countries are in a position to maintain these achievements. Seven countries were concerned at the beginning of the programme), delimiting the 'initial area' (Benin, Burkina Faso, Cote d'Ivoire, Ghana, Mali, Niger and Togo). In 1988, the OCP began operations in the 'western extension', an additional four countries in the West (Guinea, Guinea Bissau, Senegal and Sierra Leone) and extended operations into the 'southeastern extension' (south Benin, Ghana and Togo). The rationale for these extensions related to findings that the vectors were able to migrate and hence re-invade controlled areas over several hundred kilometres (Garms et al. 1979). Until 1989, in the absence of a non-toxic drug which could be used on a wide scale to kill the adult worm, the vector control strategy was the only method to interrupt the transmission of the blinding form of the parasite until the adult worm in the human body was eliminated (the maximum duration of the adult worm is estimated to be about fourteen years). In the late 1980s, ivermectin, a microfilaricide which is the only drug available to date, became an integral part of the OCP control strategy (Webbe 1992). In the extension areas, larviciding is still going on with satisfaction, combined with the distribution of ivermectin. In pursuing this combined therapeutic and vector

Digital control programmer for temperature control

International Nuclear Information System (INIS)

Rajore, S.B.; Kumar, S.V.

1993-01-01

This report describes a PC based digital control programmer for controlling and programming temperature of a high vacuum resistance heating furnace and the software developed to control power using PID algorithm. It also describes the amplifier specially developed to suit the input requirement of the non-standard W5 thermocouple and the software and hardware protections introduced in the system. (author). 5 refs., 8 figs., 1 appendix

Programme documentation to control programme for Solar-tracker; Programdokumentation til styringsprogram til Solar-tracker

Energy Technology Data Exchange (ETDEWEB)

Rudbeck, C.

1995-07-01

The report contains the programme documentation partly for a programme to control of a tracking system and partly a programme, which uses this programme to make measurements of transmittance for covering layer. Both the transmittance measurement programme and the programme is built in Borland Pascal v7.0, and is compiled in Real mode for the use on a processor of the 80X86-family. The source code for the programme for transmittance measurements and the programmes (the positioning routines) are described in Appendix B. (EHS)

Disease management programmes for patients with coronary heart disease--an empirical study of German programmes.

Science.gov (United States)

Gapp, Oliver; Schweikert, Bernd; Meisinger, Christa; Holle, Rolf

2008-12-01

To evaluate healthcare and outcomes of disease management programmes (DMPs) for patients with coronary heart disease (CHD) in primary care, and to assess selection of enrollment for these programmes. A cross-sectional survey of 2330 statutorily insured patients with a history of acute myocardial infarction (AMI) was performed in 2006 by the population-based KORA Myocardial Infarction Register from the region of Augsburg, Germany. Patients enrolled in DMP-CHDs receive evidence-based care, with patients not enrolled receiving standard care. To control for selection bias, a propensity score approach was used. Main factors influencing DMP participation were age (OR 0.98, 95% CI 0.96-0.99), diabetes (OR 1.56, CI 1.25-1.95) and time since last heart attack (OR 0.98, CI 0.95-0.99). Significantly more patients enrolled in DMP-CHDs stated that they received medical counselling for smoking (OR 3.77, CI 1.07-13.34), nutrition (OR 2.15, 1.69-2.74) and for physical activity (OR 2.58, 1.99-3.35). Furthermore, prescription of statins (OR 1.58, CI 1.24-2.00), antiplatelets (OR 1.96, CI 1.43-2.69) and beta-blockers (not significant) were higher in the DMP group. With respect to outcomes, we did not see relevant differences in quality of life and body mass index, and only a minor reduction in smoking. Enrollment into DMPs for CHD exhibits systematic selection effects. Participants tend to experience--at least on a short to medium term and for AMI patients--better quality of healthcare services. However, since DMP-CHDs were initiated only 2 years ago, we were unable to identify significant improvements in health outcomes. Only the reduction in smoking provides a first indication of better quality outcomes following DMP-CHD. Thus, policy-makers must provide appropriate incentives to sickness funds and physicians in order to ensure initiation and continuation of high quality DMPs.

A disease management programme for patients with diabetes mellitus is associated with improved quality of care within existing budgets.

Science.gov (United States)

Steuten, L M G; Vrijhoef, H J M; Landewé-Cleuren, S; Schaper, N; Van Merode, G G; Spreeuwenberg, C

2007-10-01

To assess the impact of a disease management programme for patients with diabetes mellitus (Type 1 and Type 2) on cost-effectiveness, quality of life and patient self-management. By organizing care in accordance with the principles of disease management, it is aimed to increase quality of care within existing budgets. Single-group, pre-post design with 2-year follow-up in 473 patients. Substantial significant improvements in glycaemic control, health-related quality of life (HRQL) and patient self-management were found. No significant changes were detected in total costs of care. The probability that the disease management programme is cost-effective compared with usual care amounts to 74%, expressed in an average saving of 117 per additional life year at 5% improved HRQL. Introduction of a disease management programme for patients with diabetes is associated with improved intermediate outcomes within existing budgets. Further research should focus on long-term cost-effectiveness, including diabetic complications and mortality, in a controlled setting or by using decision-analytic modelling techniques.

[Evaluation of disease management programmes--assessing methods and initial outcomes from a health economic perspective].

Science.gov (United States)

Birnbaum, Dana Sophie; Braun, Sebastian

2010-01-01

Evaluation represents a substantial component of the concept of Disease Management Programmes. This and the fact that the implementation of Disease Management Programmes constitutes a major change in the German healthcare system require that the criteria established by the German Federal Social Insurance Authority (Bundesversicherungsamt) be carefully reviewed. The present paper focuses on the evaluation method and the economic data. The pre-/-post study design used in the evaluation is known to be vulnerable to threats to internal validity. The objective of this paper is to analyze whether these threats to internal validity which have been known theoretically are confirmed by the results of the final reports. A review of the final reports of health insurance companies like the AOK, Barmer and a group of the BKK in Westfalen-Lippe shows that this question can be answered in the affirmative. The pre-/-post design without control groups is unable to recognize the failure or success of the Disease Management concept. The reasons include a high drop-out rate as well as the lack of consideration of the characteristics of chronic disease. Hence the evaluation method has failed to prove the quality of Disease Management Programmes in Germany. This is why consistent further development is needed.

Cost Analysis of Chronic Disease Self-Management Programmes Being Delivered in South Florida

Science.gov (United States)

Page, Timothy F.; Palmer, Richard C.

2014-01-01

Background: Chronic disease accounts for the majority of healthcare costs. The Chronic Disease Self-Management Programme (CDSMP) has been shown to be effective in reducing the burden of chronic disease. Objectives: The objective of this study was to measure the cost of delivering the Chronic Disease Self-Management Programme (CDSMP) in order to…

Molecular characterization of foot-and-mouth disease virus: implications for disease control in Bangladesh.

Science.gov (United States)

Loth, L; Osmani, M G; Kalam, M A; Chakraborty, R K; Wadsworth, J; Knowles, N J; Hammond, J M; Benigno, C

2011-06-01

Foot-and-mouth disease (FMD) is endemic in Bangladesh, and to implement an effective FMD control programme, it is essential to understand the complex epidemiology of the disease. Here, we report on the characterization of FMD virus (FMDV) recovered from FMD outbreaks in Bangladesh in late 2009. All isolated viruses belonged to the FMDV serotype O. The phylogenetic reconstruction showed that all isolates belonged to the Middle East-South Asia (ME-SA) topotype, but fell into two distinct sublineages, one named Ind-2001 (the other has not been named). Within both sublineages, the 2009 Bangladesh isolates were most closely related to viruses from Nepal collected during 2008 and 2009. Additionally, both sublineages contained older viruses from India collected in 2000 and 2001. In South Asia, there is extensive cross-border cattle movement from Nepal and India to Bangladesh. Both these findings have implications for the control of FMD in Bangladesh. Because of the porous borders, a regional FMD control strategy should be developed. Further, animal identification and monitoring animal movements are necessary to identify the cross-border movements and market chain interactions of ruminants, leading to improved border and movement controls. Additionally, a vaccination strategy should be developed with the initial objective of protecting small-scale dairy herds from disease. For any successful FMD control programme, long-term Government commitment and adequate resources are necessary. A sustainable programme will also need farmer education, commitment and financial contributions. © 2011 Blackwell Verlag GmbH.

Controlling type I error rate for fast track drug development programmes.

Science.gov (United States)

Shih, Weichung J; Ouyang, Peter; Quan, Hui; Lin, Yong; Michiels, Bart; Bijnens, Luc

2003-03-15

The U.S. Food and Drug Administration (FDA) Modernization Act of 1997 has a Section (No. 112) entitled 'Expediting Study and Approval of Fast Track Drugs' (the Act). In 1998, the FDA issued a 'Guidance for Industry: the Fast Track Drug Development Programs' (the FTDD programmes) to meet the requirement of the Act. The purpose of FTDD programmes is to 'facilitate the development and expedite the review of new drugs that are intended to treat serious or life-threatening conditions and that demonstrate the potential to address unmet medical needs'. Since then many health products have reached patients who suffered from AIDS, cancer, osteoporosis, and many other diseases, sooner by utilizing the Fast Track Act and the FTDD programmes. In the meantime several scientific issues have also surfaced when following the FTDD programmes. In this paper we will discuss the concept of two kinds of type I errors, namely, the 'conditional approval' and the 'final approval' type I errors, and propose statistical methods for controlling them in a new drug submission process. Copyright 2003 John Wiley & Sons, Ltd.

Disease management programmes in Germany: a fundamental fault.

Science.gov (United States)

Felder, Stefan

2006-12-01

In 2001 Germany introduced disease management programmes (DMPs) in order to give sick funds an incentive to improve the treatment of the chronically ill. By 1 March 2005, a total of 3275 programmes had been approved, 2760 for diabetes, 390 for breast cancer and 125 for coronary heart disease, covering roughly 1 million patients. German DMPs show a major fault regarding financial incentives. Sick funds increase their transfers from the risk adjustment scheme when their clients enroll in DMPs. Since this money is a lump sum, sick funds do not necessarily foster treatment of the chronically ill. Similarly, reimbursement of physicians is also not well targeted to the needs of DMPs. Preliminary evidence points to poor performance of German DMPs.

Cost-effectiveness analysis of a state funded programme for control of severe asthma

Directory of Open Access Journals (Sweden)

Loureiro Sebastião

2007-05-01

Full Text Available Abstract Background Asthma is one of the most common chronic diseases and a major economical burden to families and health systems. Whereas efficacy of current therapeutical options has been clearly established, cost-effectiveness analysis of public health interventions for asthma control are scarce. Methods 81 patients with severe asthma (12–75 years joining a programme in a reference clinic providing free asthma medication were asked retrospectively about costs and events in the previous 12 months. During 12 months after joining the programme, information on direct and indirect costs, asthma control by lung function, symptoms and quality of life were collected. The information obtained was used to estimate cost-effectiveness of the intervention as compared to usual public health asthma management. Sensitivity analysis was conducted. Results 64 patients concluded the study. During the 12-months follow-up within the programme, patients had 5 fewer days of hospitalization and 68 fewer visits to emergency/non scheduled medical visits per year, on average. Asthma control scores improved by 50% and quality of life by 74%. The annual saving in public resources was US$387 per patient. Family annual income increased US$512, and family costs were reduced by US$733. Conclusion A programme for control of severe asthma in a developing country can reduce morbidity, improve quality of life and save resources from the health system and patients families.

Keeping health facilities safe: one way of strengthening the interaction between disease-specific programmes and health systems.

Science.gov (United States)

Harries, Anthony D; Zachariah, Rony; Tayler-Smith, Katie; Schouten, Erik J; Chimbwandira, Frank; Van Damme, Wim; El-Sadr, Wafaa M

2010-12-01

The debate on the interaction between disease-specific programmes and health system strengthening in the last few years has intensified as experts seek to tease out common ground and find solutions and synergies to bridge the divide. Unfortunately, the debate continues to be largely academic and devoid of specificity, resulting in the issues being irrelevant to health care workers on the ground. Taking the theme 'What would entice HIV- and tuberculosis (TB)-programme managers to sit around the table on a Monday morning with health system experts', this viewpoint focuses on infection control and health facility safety as an important and highly relevant practical topic for both disease-specific programmes and health system strengthening. Our attentions, and the examples and lessons we draw on, are largely aimed at sub-Saharan Africa where the great burden of TB and HIV ⁄ AIDS resides, although the principles we outline would apply to other parts of the world as well. Health care infections, caused for example by poor hand hygiene, inadequate testing of donated blood, unsafe disposal of needles and syringes, poorly sterilized medical and surgical equipment and lack of adequate airborne infection control procedures, are responsible for a considerable burden of illness amongst patients and health care personnel, especially in resource-poor countries. Effective infection control in a district hospital requires that all the components of a health system function well: governance and stewardship, financing,infrastructure, procurement and supply chain management, human resources, health information systems, service delivery and finally supervision. We argue in this article that proper attention to infection control and an emphasis on safe health facilities is a concrete first step towards strengthening the interaction between disease-specific programmes and health systems where it really matters – for patients who are sick and for the health care workforce who provide

Introducing new diagnostics into STI control programmes: the importance of programme science.

Science.gov (United States)

Peeling, Rosanna W; Mabey, David; Ballard, Ronald C

2013-03-01

Many innovative diagnostic technologies will become commercially available over the next 5-10 years. These tests can potentially transform the diagnosis of sexually transmitted infections but their introduction into control programmes can be hampered by health system constraints, and political, cultural, socioeconomic and behavioural factors. We used the introduction of syphilis rapid tests to illustrate the importance of programme science to address the gap between accruing evidence of acceptable test performance and the complexity of programme design, implementation and evaluation of test deployment to address public health needs and improve patient-important outcomes.

A scientometric evaluation of the Chagas disease implementation research programme of the PAHO and TDR.

Directory of Open Access Journals (Sweden)

Ana Laura Carbajal-de-la-Fuente

2013-11-01

Full Text Available The Special Programme for Research and Training in Tropical Diseases (TDR is an independent global programme of scientific collaboration cosponsored by the United Nations Children's Fund, the United Nations Development Program, the World Bank, and the World Health Organization. TDR's strategy is based on stewardship for research on infectious diseases of poverty, empowerment of endemic countries, research on neglected priority needs, and the promotion of scientific collaboration influencing global efforts to combat major tropical diseases. In 2001, in view of the achievements obtained in the reduction of transmission of Chagas disease through the Southern Cone Initiative and the improvement in Chagas disease control activities in some countries of the Andean and the Central American Initiatives, TDR transferred the Chagas Disease Implementation Research Programme (CIRP to the Communicable Diseases Unit of the Pan American Health Organization (CD/PAHO. This paper presents a scientometric evaluation of the 73 projects from 18 Latin American and European countries that were granted by CIRP/PAHO/TDR between 1997 and 2007. We analyzed all final reports of the funded projects and scientific publications, technical reports, and human resource training activities derived from them. Results about the number of projects funded, countries and institutions involved, gender analysis, number of published papers in indexed scientific journals, main topics funded, patents inscribed, and triatomine species studied are presented and discussed. The results indicate that CIRP/PAHO/TDR initiative has contributed significantly, over the 1997-2007 period, to Chagas disease knowledge as well as to the individual and institutional-building capacity.

Quality of care in patients with psoriasis: an initial clinical study of an international disease management programme.

Science.gov (United States)

de Korte, J; Van Onselen, J; Kownacki, S; Sprangers, M A G; Bos, J D

2005-01-01

Patients with psoriasis have to cope with their disease for many years or even throughout their entire life. To provide optimal care, a disease management programme was developed. This programme consisted of disease education, disease management training, and psychological support, together with topical treatment. To test a disease management programme in dermatological practice, to assess patients' satisfaction with this programme, and adherence to topical treatment. Additionally, disease severity and quality of life were assessed. An initial clinical investigation was conducted in 10 European treatment centres. A total of 330 patients were included. Patient satisfaction, adherence, disease severity and quality of life were measured with study-specific and standardized self-report questionnaires. Patients reported a high degree of satisfaction with the programme, and a high degree of adherence to topical treatment. Disease severity and quality of life significantly improved. The programme was well received by the participating professionals. The disease management programme was found to be a useful tool in the management of psoriasis, providing patients with relief from the burden of psoriasis in everyday life. A full-scale evaluation is recommended.

The effects of a community-based pulmonary rehabilitation programme on exercise tolerance and quality of life: a randomized controlled trial

NARCIS (Netherlands)

Cambach, W.; Chadwick-Straver, R.V.M.; Wagenaar, R.C.; van Keimpema, A.R.J.; Kemper, H.C.G.

1997-01-01

The present multicentre study evaluates the differences in efficacy between a 3 month rehabilitation programme including drug treatment, and a 3 month control period of drug treatment only, for asthmatic patients and patients with chronic obstructive pulmonary disease (COPD). The programme was run

Control and eradication of endemic infectious diseases in cattle

DEFF Research Database (Denmark)

Houe, Hans; Nielsen, Liza Rosenbaum; Nielsen, Søren Saxmose

"Control and eradication of endemic infectious diseases in cattle" provides the key elements that should be addressed in the establishment of bovine disease control and eradication programmes. The book aims to reach a broad group of readers, including: students; professionals in veterinary practice...... "disease profiling", which is governed by the characteristics of the agent and its interaction with the host and environment. This profile, along with due consideration of the socioeconomic circumstances, can be used to determine how best to address the problem....

Implementation of programmable logic controller for proposed new instrumentation and control system of RTP

International Nuclear Information System (INIS)

Mohd Khairulezwan Abdul Manan; Mohd Idris Taib; Mohd Dzul Aiman Aslan

2010-01-01

Reactor Monitoring System is one of very important part of Reactor Instrumentation and Control system. Current monitoring system is using analog system whereby all circuits are discrete circuit and all displays and indicators are not digitalized. The proposed new system will use using a Commercial Off-The-Shelf, state of the art, Supervisory Control and Data Acquisition system such as Programmable Logic Controller as well as Computer System. The implementations of Programmable Logic Controller are used for Data Acquisition System and as a sub-system for Computer System where all the activities involved are stored for operation record and report as well as use for research purposes. Programmable Logic Controller receives galvanised or optically isolated signal from Reactor Protection System. Programmable Logic Controller also receives signal from other parameters as a digital and analog input related to reactor system. (author)

WHO/IAEA joint research programme on trace elements in cardiovascular diseases

International Nuclear Information System (INIS)

1980-03-01

After several years of support by WHO and IAEA for the joint research programme on trace elements in cardiovascular diseases, a consultants' meeting was held (1) to examine the present status of the programme with a view to advising on actions necessary for its completion, and (2) to advise on the form, content and timing of a final report. The meeting was attended by the invited experts and other persons. The main work of this research programme is divided, as before, between two projects, (1) on Cd, Cr, Cu, Se, Zn and other elements in relation to ischaemic heart disease, and (2) on Cd, Se and Zn in relation to arterial hypertension

Description of a research reactor control system using a programmable controller

International Nuclear Information System (INIS)

Battle, R.E.

1986-01-01

This paper describes the design features, testing methods, and operational experience of a programmable controller (PC) installed as a neutron flux controller in the Oak Ridge Research Reactor (ORR) at Oak Ridge National Laboratory (ORNL). The PC was designed to control neutron flux from 1 to 105% for three selectable ranges. The PC generates a flux setpoint under operator control, calculates the reactor heat power from flow and temperature signals, calculates a neutron flux calibration factor based on the heat power, and positions a control rod based on the flux-setpoint difference. The programmable controller was tested by controlling an analog computer model of the ORR. The equipment was installed in August 1985, and except for some startup problems, the system has performed well

Programmable waveform controller

International Nuclear Information System (INIS)

Yeh, H.T.

1979-01-01

A programmable waveform controller (PWC) was developed for voltage waveform generation in the laboratory. It is based on the Intel 8080 family of chips. The hardware uses the modular board approach, sharing a common 44-pin bus. The software contains two separate programs: the first generates a single connected linear ramp waveform and is capable of bipolar operation, linear interpolation between input data points, extended time range, and cycling; the second generates four independent square waveforms with variable duration and amplitude

Nuclear and related techniques in the control of communicable diseases

International Nuclear Information System (INIS)

1991-07-01

The IAEA has a programme component entitled ''Nuclear Techniques in Communicable Diseases'', the aims of which are to encourage research in the development of new methods of controlling communicable diseases and to transfer the technology to institutes in endemic regions. Implementation of the programme component includes information exchange through publications, symposiums and seminars. The two most recent seminars were held in Bombay in November 1988 and Belo Horizonte in November 1989, and a selection of the papers presented have been published in this Technical Document. Refs, figs and tabs

Integrating an infectious disease programme into the primary health care service: a retrospective analysis of Chagas disease community-based surveillance in Honduras.

Science.gov (United States)

Hashimoto, Ken; Zúniga, Concepción; Nakamura, Jiro; Hanada, Kyo

2015-03-24

Integration of disease-specific programmes into the primary health care (PHC) service has been attempted mostly in clinically oriented disease control such as HIV/AIDS and tuberculosis but rarely in vector control. Chagas disease is controlled principally by interventions against the triatomine vector. In Honduras, after successful reduction of household infestation by vertical approach, the Ministry of Health implemented community-based vector surveillance at the PHC services (health centres) to prevent the resurgence of infection. This paper retrospectively analyses the effects and process of integrating a Chagas disease vector surveillance system into health centres. We evaluated the effects of integration at six pilot sites in western Honduras during 2008-2011 on; surveillance performance; knowledge, attitude and practice in schoolchildren; reports of triatomine bug infestation and institutional response; and seroprevalence among children under 15 years of age. The process of integration of the surveillance system was analysed using the PRECEDE-PROCEED model for health programme planning. The model was employed to systematically determine influential and interactive factors which facilitated the integration process at different levels of the Ministry of Health and the community. Overall surveillance performance improved from 46 to 84 on a 100 point-scale. Schoolchildren's attitude (risk awareness) score significantly increased from 77 to 83 points. Seroprevalence declined from 3.4% to 0.4%. Health centres responded to the community bug reports by insecticide spraying. As key factors, the health centres had potential management capacity and influence over the inhabitants' behaviours and living environment directly and through community health volunteers. The National Chagas Programme played an essential role in facilitating changes with adequate distribution of responsibilities, participatory modelling, training and, evaluation and advocacy. We found that Chagas

[The methods within the evaluation of disease management programmes in control-group designs using the example of diabetes mellitus - a systematic literature review].

Science.gov (United States)

Drabik, A; Sawicki, P T; Müller, D; Passon, A; Stock, S

2012-08-01

Disease management programmes (DMPs) were implemented in Germany in 2002. Their evaluation is required by law. Beyond the mandatory evaluation, a growing number of published studies evaluate the DMP for diabetes mellitus type 2 in a control-group design. As patients opt into the programme on a voluntary basis it is necessary to adjust the inherent selection bias between groups. The aim of this study is to review published studies which evaluate the diabetes DMP using a control-group design with respect to the methods used. A systematic literature review of electronic databases (PUBMED, Cochrane Library, EMBASE, MEDPILOT) and a hand search of reference lists of the relevant publications was conducted to identify studies evaluating the DMP diabetes mellitus in a control-group design. 8 studies were included in the systematic literature review. 4 studies gathered retrospective claims data from sickness funds, one from physician's records, one study used prospective data from ambulatory care, and 2 studies were based on one patient survey. Methods used for adjustment of selection bias included exact matching, matching using propensity score methods, age-adjusted and sex-separated analysis, and adjustment in a regression model/analysis of covariance. One study did not apply adjustment methods. The intervention period ranged from 1 day to 4 years. Considered outcomes of studies (surrogate parameter, diabetes complications, mortality, quality of life, and claim data) depended on the database. In the evaluation of the DMP diabetes mellitus based on a control-group design neither the database nor the methods used for selection bias adjustment were consistent in the available studies. Effectiveness of DMPs cannot be judged based on this review due to heterogeneity of study designs. To allow for a comprehensive programme evaluation standardised minimum requirements for the evaluation of DMPs in the control group design are required. © Georg Thieme Verlag KG Stuttgart · New

The results of a quality-control programme in mammography

International Nuclear Information System (INIS)

Ramsdale, M.L.; Hiles, P.A.

1989-01-01

With the introduction of a breast screening programme in the UK, quality assurance in mammography is of paramount importance in assuring optimum imaging performance with low dose. Quality control checks are an essential part of the quality-assurance system. A quality-control programme at a breast screening clinic is described. Daily checks include film sensitometry for X-ray processor control and radiography of a lucite phantom to monitor the consistency of the X-ray machine automatic exposure control. Weekly checks include additional measurements on the performance of the automatic exposure control for different breast thickness and an overall assessment of image quality using a prototype mammography test phantom. The test phantom measures low-contrast sensitivity, high-contrast resolution and small-detail visibility. The results of the quality-control programme are presented with particular attention paid to tolerances and limiting values. (author)

Assessment of a strategy for the control of respiratory diseases in children

Directory of Open Access Journals (Sweden)

Pereira Julio Cesar Rodrigues

1992-01-01

Full Text Available A programme for the control of respiratory diseases in children was conceived for the State of S. Paulo, Brazil, in 1986. Its progress thereafter and the epidemiology of the diseases concerned are examined. Apart from an inquiry into the 64 existing State local health authorities, a sample of 18,255 cases of children assisted by the programme at different levels, including both in-patient and outpatient care, is analysed. Each case record included information about identification (child, doctor and health facility, reasons for calling, diagnoses made and outcome of treatment. Further data were also sought from hospitals and from State mortality records. The programme was found to be poorly implemented in the State but, where implemented, it showed itself capable of resolving problems (only 0.5% of the cases could not be handled as also of changing ongoing trends (more than 50% reduction in hospital admission rates. Individual assessment of each item of the programme indicated its bottlenecks. Regarding the epidemiology of respiratory diseases, it is observed that the major burden to health services comes from children aged less than five, and that the most important diseases are wheezing illnesses and pneumonia. Morevoer, they were found to be significantly associated (p = 0.000 so that a child in the community presenting wheezing diseases is 5 times more likely to develop pneumonia than a child with any other respiratory diagnosis. Similarly, among the under five deaths it was found that the risk for pneumonia is 3 times greater for children who died presenting wheezing diseases than it is for children with any other sort of diagnosis. In conclusion, the programme is deemed to be efficient and effective but its efficacy is marred by administrative flaws. The successful control of respiratory problems in childhood is related to a proper appreciation of the importance of wheezing diseases.

PC (programmable controller) 'HISEC 04-M/D, DG for industrial plant control

International Nuclear Information System (INIS)

Takakura, Mitsuro; Tennichi, Yasuhiro; Kato, Takayoshi; Yamaoka, Hiromasa

1986-01-01

While the decentralization and total digitization of control system have advanced, programmable controllers that electric control engineers can easily handle have developed in their function and performance. Besides, recent control system became large scale and complex, on the other hand, the needs of improving product quality and productivity increased, accordingly, the programmable controllers which can meet higher function and rapid control and realize the minimum interface in both hardware and software have been demanded. Hitachi Ltd. has completed the programmable controller ''HISEC 04-M/OG'', in which the heightening of performance was planned, the multiple controller system having process input and output equipments in common can be made, and the economical efficiency was pursued by adopting optical multiple transmission system, so as to be able to build up an optimum decentralized system. In this report, the outline of HISEC 04-M/D, DG and the function, a typical system constitution, and the function of a programming and debugging tool are described. When high reliability is required, a tripled system is offered. In this case, a multiport process input/output equipment is connected to three CPUs. (Kako, I.)

Lifestyle modification programmes for patients with coronary heart disease: a systematic review and meta-analysis of randomized controlled trials

NARCIS (Netherlands)

Janssen, V.; Gucht, V. de; Dusseldorp, E.; Maes, S.

2012-01-01

Background: Lifestyle modification programmes for coronary heart disease patients have been shown to effectively improve risk factors and related health behaviours, quality of life, reincidence, and mortality. However, improvements in routine cardiac care over the recent years may offset the

Area-wide control of Chagas disease vectors in Latin America

International Nuclear Information System (INIS)

Schofield, C.J.

2000-01-01

Chagas disease (American trypanosomiasis) is now ranked by the World Bank as the most serious parasitic disease of the Americas, with a medical and economic impact far outranking even the combined effects of other parasitic diseases such as malaria and schistosomiasis (World Bank 1993). The infection is virtually impossible to cure and the disease is difficult and costly to treat. In contrast, transmission can be halted by eliminating the domestic insect vectors - large blood sucking reduviids of the subfamily Triatominae - and by improved screening of blood donors to minimise the risk of transfusional transmission (WHO 1991). Improved screening of blood banks requires appropriate legislation backed by a well-developed system of reference laboratories and standardised procedures, although to a large extent, this can be implemented in a progressive way from local to national levels (Schmunis 1991). By contrast, the key to success in Chagas disease vector control lies in the implementation of large-scale regional or international programmes coupled with long-term community-based vigilance. This is a classic intervention model beginning with a vertical intervention, the attack phase, in which all infested houses are sprayed by trained professionals, progressively backed by a more horizontal community-based system where householders themselves can report the presence of any residual infestations for retreatment where necessary. Elimination of domestic vectors of Chagas disease is facilitated by their slow reproductive rates and limited genetic variability, but is hampered by the ease of passive transport of the insects from one house to another, even across state and international boundaries (Schofield 1994). For this reason, international collaboration is particularly important in Chagas disease vector control. Since early trials in the 1940s, there have been many local and regional campaigns designed to control domestic populations of Triatominae, especially in

Control of neglected tropical diseases needs a long-term commitment

Directory of Open Access Journals (Sweden)

Mubila Likezo

2010-10-01

Full Text Available Abstract Background Neglected tropical diseases are widespread, particularly in sub-Saharan Africa, affecting over 2 billion individuals. Control of these diseases has gathered pace in recent years, with increased levels of funding from a number of governmental or non-governmental donors. Focus has currently been on five major 'tool-ready' neglected tropical diseases (lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiasis and trachoma, using a package of integrated drug delivery according to the World Health Organization guidelines for preventive chemotherapy. Discussion Success in controlling these neglected tropical diseases has been achieved in a number of countries in recent history. Experience from these successes suggests that long-term sustainable control of these diseases requires: (1 a long-term commitment from a wider range of donors and from governments of endemic countries; (2 close partnerships of donors, World Health Organization, pharmaceutical industries, governments of endemic countries, communities, and non-governmental developmental organisations; (3 concerted action from more donor countries to provide the necessary funds, and from the endemic countries to work together to prevent cross-border disease transmission; (4 comprehensive control measures for certain diseases; and (5 strengthened primary healthcare systems as platforms for the national control programmes and capacity building through implementation of the programmes. Conclusions The current level of funding for the control of neglected tropical diseases has never been seen before, but it is still not enough to scale up to the 2 billion people in all endemic countries. While more donors are sought, the stakeholders must work in a coordinated and harmonised way to identify the priority areas and the best delivery approaches to use the current funds to the maximum effect. Case management and other necessary control measures should be

The results of a quality-control programme in mammography

International Nuclear Information System (INIS)

Ramsdale, M.L.; Hiles, P.A.

1989-01-01

A quality-control programme at a breast screening clinic is described. Daily checks include film sensitometry for X-ray processor control and radiography of a lucite phantom to monitor the consistency of the X-ray machine automatic exposure control. Weekly checks include additional measurements on the performance of the automatic exposure control for different breast thickness and an overall assessment of image quality using a prototype mammography test phantom. The test phantom measures low-contrast sensitivity, high-control resolution and small-detail visibility. The results of the quality-control programme are presented with particular attention paid to tolerances and limiting values. (author)

Re-thinking global health sector efforts for HIV and tuberculosis epidemic control: promoting integration of programme activities within a strengthened health system.

Science.gov (United States)

Maher, Dermot

2010-07-05

The global financial crisis threatens global health, particularly exacerbating diseases of inequality, e.g. HIV/AIDS, and diseases of poverty, e.g. tuberculosis. The aim of this paper is to reconsider established practices and policies for HIV and tuberculosis epidemic control, aiming at delivering better results and value for money. This may be achieved by promoting greater integration of HIV and tuberculosis control programme activities within a strengthened health system. HIV and tuberculosis share many similarities in terms of their disease burden and the recommended stratagems for their control. HIV and tuberculosis programmes implement similar sorts of control activities, e.g. case finding and treatment, which depend for success on generic health system issues, including vital registration, drug procurement and supply, laboratory network, human resources, and financing. However, the current health system approach to HIV and tuberculosis control often involves separate specialised services. Despite some recent progress, collaboration between the programmes remains inadequate, progress in obtaining synergies has been slow, and results remain far below those needed to achieve universal access to key interventions. A fundamental re-think of the current strategic approach involves promoting integrated delivery of HIV and tuberculosis programme activities as part of strengthened general health services: epidemiological surveillance, programme monitoring and evaluation, community awareness of health-seeking behavior, risk behaviour modification, infection control, treatment scale-up (first-line treatment regimens), drug-resistance surveillance, containing and countering drug-resistance (second-line treatment regimens), research and development, global advocacy and global partnership. Health agencies should review policies and progress in HIV and tuberculosis epidemic control, learn mutual lessons for policy development and scaling up interventions, and identify ways

Re-thinking global health sector efforts for HIV and tuberculosis epidemic control: promoting integration of programme activities within a strengthened health system

Directory of Open Access Journals (Sweden)

Maher Dermot

2010-07-01

Full Text Available Abstract Background The global financial crisis threatens global health, particularly exacerbating diseases of inequality, e.g. HIV/AIDS, and diseases of poverty, e.g. tuberculosis. The aim of this paper is to reconsider established practices and policies for HIV and tuberculosis epidemic control, aiming at delivering better results and value for money. This may be achieved by promoting greater integration of HIV and tuberculosis control programme activities within a strengthened health system. Discussion HIV and tuberculosis share many similarities in terms of their disease burden and the recommended stratagems for their control. HIV and tuberculosis programmes implement similar sorts of control activities, e.g. case finding and treatment, which depend for success on generic health system issues, including vital registration, drug procurement and supply, laboratory network, human resources, and financing. However, the current health system approach to HIV and tuberculosis control often involves separate specialised services. Despite some recent progress, collaboration between the programmes remains inadequate, progress in obtaining synergies has been slow, and results remain far below those needed to achieve universal access to key interventions. A fundamental re-think of the current strategic approach involves promoting integrated delivery of HIV and tuberculosis programme activities as part of strengthened general health services: epidemiological surveillance, programme monitoring and evaluation, community awareness of health-seeking behavior, risk behaviour modification, infection control, treatment scale-up (first-line treatment regimens, drug-resistance surveillance, containing and countering drug-resistance (second-line treatment regimens, research and development, global advocacy and global partnership. Health agencies should review policies and progress in HIV and tuberculosis epidemic control, learn mutual lessons for policy

Temporal Analysis and Costs of Ruminant Brucellosis Control Programme in Egypt Between 1999 and 2011.

Science.gov (United States)

Eltholth, M M; Hegazy, Y M; El-Tras, W F; Bruce, M; Rushton, J

2017-08-01

Data for the prevalence of brucellosis in ruminants in Egypt are scarce; recent studies suggest the disease is endemic, with a high prevalence. The aim of this study was to assess the financial costs and the impact of the current control programme on the pattern of brucellosis among ruminants between 1999 and 2011. A univariate binary logistic regression model was used to compare between seropositive proportions for different years for each species. The proportion of seropositive cattle was significantly increased from 2000 to 2004 then significantly decreased from 2005 to 2011. The proportion of seropositive buffalo fluctuated year to year; however, there was a significant increase in 2008 (OR 3.13, 95% CI 2.69-3.66, P cost for the control programme including testing and compensation was more than US$3 million. The total cost for the control programme including testing and compensation for the period (13 years) between 1999 and 2011 was more than US$40 million, from which more than 56% for cattle. Further studies are required for the effectiveness of the current control strategies and alternative strategies should be considered. The socio-economic impact of brucellosis and its control measures should be investigated. © 2016 Blackwell Verlag GmbH.

A national programme for mastitis control in Australia: Countdown Downunder

Directory of Open Access Journals (Sweden)

Brightling PB

2009-04-01

Full Text Available Abstract In 1998, Countdown Downunder, Australia's national mastitis and cell count control programme, was created. With funding from the country's leading dairy organisation, Dairy Australia, this programme was originally intended to run for three years but is now in its tenth year. As it was the first time Australia had attempted a national approach to mastitis control on the farm, the first three years of the programme were largely concerned with the development of resources to be used by farmers and service providers. The second three years were devoted to training with both groups. Since that time, Countdown Downunder has entered into a second resource development phase. The goal of the programme was to achieve a reduction in the bulk milk somatic cell count from the Australian dairy herd. To achieve this, the programme had to develop resources with clear and consistent messages around mastitis and somatic cell count control on farms. It was determined that progress toward the goals would be made more rapidly if service providers were trained in the use of these resources prior to farmers. This paper reviews the Countdown Downunder programme from 1998 to 2007.

Effectiveness of a respiratory rehabilitation programme in patients with chronic obstructive pulmonary disease.

Science.gov (United States)

Prunera-Pardell, María Jesús; Padín-López, Susana; Domenech-Del Rio, Adolfo; Godoy-Ramírez, Ana

To evaluate the effectiveness of the multidisciplinary respiratory rehabilitation (RR) programme in patients with severe or very severe chronic obstructive pulmonary disease pre the RR programme, at the end of the programme and one year after the RR, measuring changes in ability to exercise (walking test), effort tolerance(forced expiratory volume (FEV1)) and health-related quality of life. Quasi-experimental single group design. We included patients diagnosed with severe or very severe chronic obstructive pulmonary disease (stages III and IV of the GOLD classification) who entered the rehabilitation programme for the years 2011 and 2012. Demographic data, questionnaires on general health-related quality of life (SF-36) and specific to respiratory patients (St George's Respiratory Questionnaire), FEV1% and exercise capacity test (running test 6minutes) were collected. Data were collected before the RR programme, at the end of the RR programme and a year after completing the program. No significant differences in FEV1% values were observed. Regarding exercise capacity, an increase in distance walked in the walking test was noted, which changed significantly after training, 377±59.7 to 415±79 m after one year (P<.01). A statistically significant improvement in mean scores of HRQoL was observed, except for the emotional role dimension of the SF-36 questionnaire. A pulmonary rehabilitation programme for 8 weeks improved the exercise capacity, dyspnoea and quality of life of patients with severe and very severe chronic obstructive pulmonary disease. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Exploring gender dimensions of treatment programmes for neglected tropical diseases in Uganda.

Directory of Open Access Journals (Sweden)

Heather Rilkoff

Full Text Available Gender remains a recognized but relatively unexamined aspect of the potential challenges for treatment programmes for Neglected Tropical Diseases (NTDs. We sought to explore the role of gender in access to treatment in the Uganda National Neglected Tropical Disease Control Programme.Quantitative and qualitative data was collected in eight villages in Buyende and Kamuli districts, Eastern Uganda. Quantitative data on the number of persons treated by age and gender was identified from treatment registers in each village. Qualitative data was collected through semi-structured interviews with sub-county supervisors, participant observation and from focus group discussions with community leaders, community medicine distributors (CMDs, men, women who were pregnant or breastfeeding at the time of mass-treatment, and adolescent males and females. Findings include the following: (i treatment registers are often incomplete making it difficult to obtain accurate estimates of the number of persons treated; (ii males face more barriers to accessing treatment than women due to occupational roles which keep them away from households or villages for long periods, and males may be more distrustful of treatment; (iii CMDs may be unaware of which medicines are safe for pregnant and breastfeeding women, resulting in women missing beneficial treatments.Findings highlight the need to improve community-level training in drug distribution which should include gender-specific issues and guidelines for treating pregnant and breastfeeding women. Accurate age and sex disaggregated measures of the number of community members who swallow the medicines are also needed to ensure proper monitoring and evaluation of treatment programmes.

Johne's disease: a successful eradication programme in a dairy goat herd.

Science.gov (United States)

Gavin, William G; Porter, Catherine A; Hawkins, Nathan; Schofield, Michael J; Pollock, John M

2018-04-28

This retrospective analysis and report describes the successful eradication and posteradication surveillance programme for Johne's disease ( Mycobacterium avium subspecies paratuberculosis (MAP)) in a closed herd of dairy goats. In 1994, MAP's presence in the goat herd was first suspected through individual annual serological screening and then subsequently confirmed through faecal culture and histopathology in 1997 when implementation of a more aggressive programme of testing and eradication of the diseased animals began. This programme included frequent serological screening of all adult goats using ELISA and agar gel immunodiffusion assays. Faecal cultures for bacteria were performed on suspect or positive animals and for all goats found dead or euthanased, and tissues were submitted for histopathology and acid-fast staining. Additional disease eradication measures included maintaining a closed herd and minimising faecal-oral transmission of MAP. Following a more aggressive testing regimen and euthanasia of goats with positive faecal culture, the herd was first considered free of MAP in 2003 and has remained free to the present day. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Self-management programmes for people living with chronic obstructive pulmonary disease: a call for a reconceptualisation.

Science.gov (United States)

Jonsdottir, Helga

2013-03-01

To synthesise findings from previously published studies on the effectiveness of self-management programmes for people with chronic obstructive pulmonary disease. Self-management is a widely valued concept to address contemporary issues of chronic health problems. Yet, findings of self-management programmes for people with chronic obstructive pulmonary disease are indecisive. Literature review of (1) previously published systematic reviews and (2) an integrative literature review. Synthesis of findings from previously published systematic reviews (n = 4) of the effectiveness of self-management programmes for people with chronic obstructive pulmonary disease and an integrated review that was performed on papers published between January 2007-June 2012 (n = 9). Findings demonstrate that there are few studies on the effectiveness of self-management programmes on people with chronic obstructive pulmonary disease despite more than a decade of research activities. Outcomes of the studies reveal some increase in health-related quality of life and reduction in use of healthcare resources. The methodological approaches vary, and the sample size is primarily small. Families are not acknowledged. Features of patient-centredness exist in self-management programmes, particularly in the more recent articles. The effectiveness of self-management programmes for people with chronic obstructive pulmonary disease remains indecisive. A reconceptualisation of self-management programmes is called for with attention to a family-centred, holistic and relational care focusing on living with and minimising the handicapping consequences of the health problems in their entirety. © 2013 Blackwell Publishing Ltd.

Power consumption of programmable controllers; Energieverbrauch von Prozesssteuerungen (SPS)

Energy Technology Data Exchange (ETDEWEB)

Schalcher, M.; Battaglia, U.; Busch, E.

2003-07-01

This final report for the Swiss Federal Office for Energy addresses the field of programmable logic controllers and thus investigates a topic that has been neglected up to now - the energy consumption of such controllers. The results of measurements made on programmable logic controllers in use both in operational industrial plants and in the Automation Laboratory at the University of Applied Science in Chur, Switzerland are presented, where a detailed analysis was made on a demonstration plant. Also, technical documentation (catalogues) were evaluated and discussed with experts who had practical experience at their disposal. The results of the study are discussed: these show that the power consumption of any particular programmable logic controller is low in comparison to the energy consumption of the processes that are being controlled. Additionally, it was found that the optimisation of newer devices has to a great extent already been realised and that standard solutions for energy optimisation are not easy to put into practice. It is suggested that savings can possibly be made in the controllers by improving the efficiency of their power supply units and by choosing power ratings to better suit the actual power needed.

Psychosocial behaviour management programme for home-dwelling people with dementia: A cluster-randomized controlled trial.

Science.gov (United States)

Nakanishi, Miharu; Endo, Kaori; Hirooka, Kayo; Granvik, Eva; Minthon, Lennart; Nägga, Katarina; Nishida, Atsushi

2018-03-01

Little is known about the effectiveness of a psychosocial behaviour management programme on home-dwelling people with dementia. We developed a Behaviour Analytics & Support Enhancement (BASE) programme for care managers and professional caregivers of home care services in Japan. We investigated the effects of BASE on challenging behaviour of home-dwelling people with dementia. A cluster-randomized controlled trial was conducted with home care providers from 3 different districts in Tokyo. Each provider recruited persons with dementia aged 65 years or older to receive home care in the BASE programme in August 2016. An online monitoring and assessment system was introduced to the intervention group for repeated measures of challenging behaviour with a total score of the Neuropsychiatric Inventory. Care professionals in both the intervention and control groups evaluated challenging behaviour of persons with dementia at baseline (September 2016) and follow-up (February 2017). A majority of persons with dementia had Alzheimer disease (59.3%). One-hundred and forty-one persons with dementia were included in the intervention group and 142 in the control group. Multilevel modelling revealed a significant reduction in challenging behaviour in the intervention group after 6 months (mean score, 18.3 to 11.2) compared with that of the control group (11.6 to 10.8; P dwelling people with dementia. Future research should examine the long-term effects of behaviour management programmes on behaviour, nursing home placement, and hospital admission of home-dwelling people with dementia. Copyright © 2017 John Wiley & Sons, Ltd.

GIS in Public Health: applications in the Legionnaires' disease prevention programme

Directory of Open Access Journals (Sweden)

Emiliano Aránguez Ruiz

2006-12-01

Full Text Available This experience has been developed by the Public Health Institute of the Community of Madrid in order to use the GIS tools in the Legionnaires’ disease prevention programme and specifically in three work areas: epidemiologic surveillance, cooling towers environmental control and plans of intervention in case of an outbreak of Legionnaires’ disease.After having considered different strategies with their advantages the selected model have been the use of map viewers in the intranet with a different configuration format depending on its goals: images map viewers for systematic non-outbreak cases and cooling towers surveillance, viewers that allow an easier and usual consultation and, in the other hand, layers map viewers, better adapted to more complex users’ necessities and so designed to work in emergency situations. Both models are implemented to decentralise the use of these indispensable tools and make them closer of the public health professionals.Some methodological proposals to study spatial association of Legionaires’disease outbreaks are also presented and discussed in this paper.

A community-based health education programme for bio-environmental control of malaria through folk theatre (Kalajatha in rural India

Directory of Open Access Journals (Sweden)

Tiwari Satyanarayan

2006-12-01

Full Text Available Abstract Background Health education is an important component in disease control programme. Kalajatha is a popular, traditional art form of folk theatre depicting various life processes of a local socio-cultural setting. It is an effective medium of mass communication in the Indian sub-continent especially in rural areas. Using this medium, an operational feasibility health education programme was carried out for malaria control. Methods In December 2001, the Kalajatha events were performed in the evening hours for two weeks in a malaria-affected district in Karnataka State, south India. Thirty local artists including ten governmental and non-governmental organizations actively participated. Impact of this programme was assessed after two months on exposed vs. non-exposed respondents. Results The exposed respondents had significant increase in knowledge and change in attitude about malaria and its control strategies, especially on bio-environmental measures (p Conclusion This study was carried out under the primary health care system involving the local community and various potential partners. Kalajatha conveyed the important messages on malaria control and prevention to the rural community. Similar methods of communication in the health education programme should be intensified with suitable modifications to reach all sectors, if malaria needs to be controlled.

Epidemiology and control of malaria and other arthropod born diseases

Directory of Open Access Journals (Sweden)

F. J. López-Antuñano

1992-01-01

Full Text Available Malaria and other arthropod born diseases remain a serious public health problem affecting the lives and health of certain social groups when the two basic strategies to control fail due to : (1 the lack of effective chemoprophylaxis/chemotherapy or the rapid development of drug resistance of the infectious agents and (2 the ineffectiveness of pesticides or the arthropod vectors develop resistance to them. These situations enhances the need for the design and implementation of other alternatives for sustainable health programmes. The application of the epidemiological methods is essential not only for analyzing the relevant data for the understanding of the biological characteristics of the infectious agents, their reservoirs and vectors and the methods for their control, but also for the assessment of the human behaviour, the environmental, social and economic factors involved in disease transmission and the capacity of the health systems to implement interventions for both changes in human behaviour and environmental management to purpose guaranteed prevention and control of malaria and other arthropod born diseases with efficiency, efficacy and equity. This paper discuss the evolution of the malaria arthropod diseases programmes in the American Region and the perspectives for their integration into health promotion programs and emphasis is made in the need to establish solid basis in the decision-making process for the selection of intervention strategies to remove the risk factors determining the probability to get sick or die from ABDs. The implications of the general planning and the polices to be adopted in an area should be analyzed in the light of programme feasibility at the local level, in the multisectoral context specific social groups and taking in consideration the principles of stratification and equity

The current screening programme for congenital transmission of Chagas disease in Catalonia, Spain.

Science.gov (United States)

Basile, L; Oliveira, I; Ciruela, P; Plasencia, A

2011-09-22

Due to considerable numbers of migrants from Chagas disease-endemic countries living in Catalonia, the Catalonian Health Department has recently implemented a screening programme for preventing congenital transmission, targeting Latin American pregnant women who attend antenatal consultations. Diagnosis of Trypanosoma cruzi infection in women is based on two positive serological tests. Screening of newborns from mothers with positive serology is based on a parasitological test during the first 48 hours of life and/or conventional serological analysis at the age of nine months. If either of these tests is positive, treatment with benznidazole is started following the World Health Organization's recommendations. The epidemiological surveillance of the programme is based on the Microbiological Reporting System of Catalonia, a well established network of laboratories. Once a positive case is reported, the responsible physician is asked to complete a structured epidemiological questionnaire. Clinical and demographic data are registered in the Voluntary Case Registry of Chagas Disease, a database administered by the Catalonian Health Department. It is expected that this programme will improve the understanding of the real burden of Chagas disease in the region. Furthermore, this initiative could encourage the implementation of similar programmes in other regions of Spain and even in other European countries.

OPTIMUM PROGRAMMABLE CONTROL OF UNMANNED FLYING VEHICLE

Directory of Open Access Journals (Sweden)

A. А. Lobaty

2012-01-01

Full Text Available The paper considers an analytical synthesis problem pertaining to programmable control of an unmanned flying vehicle while steering it to the fixed space point. The problem has been solved while applying a maximum principle which takes into account a final control purpose and its integral expenses. The paper presents an optimum law of controlling overload variation of a flying vehicle that has been obtained analytically

Programme for the control of African animal trypanosomiasis and related development

International Nuclear Information System (INIS)

Finelle, P.

1980-01-01

After a statement on the problems raised by African animal trypanosomiasis and its control, and the development of currently affected areas, the Programme is outlined describing the methodology for tsetse and trypanosomiasis control operations and the basic approach for implementation of related development. The activities carried out during the five-year preliminary phase are summarized. The operational phase of the Programme is now being launched. The possible use of the sterile male technique is mentioned marginally. No details of research programmes envisaged are presented. A series of Preliminary Assistance Missions to Governments for the evaluation and preparation of control schemes, development strategies and projects is being mounted

Calculation of optimum control rod operation programme for boiling water reactor

International Nuclear Information System (INIS)

Fehr, L.

1978-01-01

Control rod operation programmes are calculated based on a three dimensional Boiling Water Reactor situation model. The position of the control rods at variosu burn-ups is chosen by an optimisation so that the sum of the square deviations of the load density distribution from an optimum distribution ('Haling' distribution) are minimised. Other conditions are remaining critical and observing the thermal limits for central fuel element melting and critical heat surface loading. As an example, an optimum control rod operation programme for the first cycle in Lengen nuclear power station is calculated and is compared with the programme actually used. (orig.) 891 HP [de

Effects of an Ai Chi fall prevention programme for patients with Parkinson's disease.

Science.gov (United States)

Pérez-de la Cruz, S; García Luengo, A V; Lambeck, J

2016-04-01

One of the main symptoms of Parkinson's disease is the high incidence of falls occurring due to the decline of both static and dynamic balance. The aim of this study is to determine the effect of an Ai Chi programme designed to prevent falls in patients with Parkinson's disease by improving both functional independence and perception of physical pain. Fifteen patients diagnosed with Parkinson's disease (Hoehn and Yahr stages 1-3) participated in a 10-week Ai Chi programme consisting of 30 to 45-minute aquatic exercise sessions twice a week. The assessment measures used in this study were the pain visual analogue scale (VAS), the Tinetti gait and balance assessment tool, and the Timed Get up and Go test. The results were calculated by applying the Friedman test to 3 related measurements: patients at baseline, at post-treatment (at the end of the 10 week programme) and after one month of follow-up. The data obtained showed a significant improvement (p Parkinson's disease. Copyright © 2015 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

Universal Programmable Logic Controller Software

International Nuclear Information System (INIS)

Mohd Arif Hamzah; Azhar Shamsudin; Fadil Ismail; Muhammad Nor Atan; Anwar Abdul Rahman

2013-01-01

Programmable Logic Controller (PLC) is an electronic hardware which is widely used in manufacturing or processing industries. It is also serve as the main control system hardware to run the production and manufacturing process. There are more than ten (10) well known company producing PLC hardware, with their own specialties, including the method of programming and language used. Malaysia Nuclear Agency have various plant and equipment, runs and control by PLC, such as Mintex Sinagama Plant, Alurtron Plant, and few laboratory equipment. Since all the equipment and plant are equipped with various brand or different manufacture of PLC, it creates difficulties to the supporting staff to master the control program. The same problems occur for new application of this hardware, since there no policies to purchase only one specific brand of PLC. (author)

Index of tobacco control sustainability (ITCS): a tool to measure the sustainability of national tobacco control programmes.

Science.gov (United States)

Jackson-Morris, Angela; Latif, Ehsan

2017-03-01

To produce a tool to assess and guide sustainability of national tobacco control programmes. A two-stage process adapting the Delphi and Nominal group techniques. A series of indicators of tobacco control sustainability were identified in grantee/country advisor reports to The International Union Against Tuberculosis and Lung Disease under the Bloomberg Initiative to Reduce Tobacco Control (2007-2015). Focus groups and key informant interviews in seven low and middle-income countries (52 government and civil society participants) provided consensus ratings of the indicators' relative importance. Data were reviewed and the indicators were accorded relative weightings to produce the 'Index of Tobacco Control Sustainability' (ITCS). All 31 indicators were considered 'Critical' or 'Important' by the great majority of participants. There was consensus that a tool to measure progress towards tobacco control sustainability was important. The most critical indicators related to financial policies and allocations, a national law, a dedicated national tobacco control unit and civil society tobacco control network, a national policy against tobacco industry 'Corporate Social Responsibility' (CSR), national mortality and morbidity data, and national policy evaluation mechanisms. The 31 indicators were agreed to be 'critical' or 'important' factors for tobacco control sustainability. The Index comprises the weighted indicators as a tool to identify aspects of national tobacco control programmes requiring further development to augment their sustainability and to measure and compare progress over time. The next step is to apply the ITCS and produce tobacco control sustainability assessments. 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/.

Requirements for laboratory animals in health programmes*

OpenAIRE

Held, J. R.

1981-01-01

Laboratory animals are essential for the successful execution of many health programmes. A wide variety of animal models is used in the worldwide efforts to improve the control of various diseases, and in the basic research needed to improve health care. Biomedical programmes require specially-bred animals reared under controlled conditions, with close attention given to such factors as physical environment, nutrition, microbiological status, and genetic background. The need for a regular sup...

National infection prevention and control programmes: Endorsing quality of care.

Science.gov (United States)

Stempliuk, Valeska; Ramon-Pardo, Pilar; Holder, Reynaldo

2014-01-01

Core components Health care-associated infections (HAIs) are a major cause of morbidity and mortality. In addition to pain and suffering, HAIs increase the cost of health care and generates indirect costs from loss of productivity for patients and society as a whole. Since 2005, the Pan American Health Organization has provided support to countries for the assessment of their capacities in infection prevention and control (IPC). More than 130 hospitals in 18 countries were found to have poor IPC programmes. However, in the midst of many competing health priorities, IPC programmes are not high on the agenda of ministries of health, and the sustainability of national programmes is not viewed as a key point in making health care systems more consistent and trustworthy. Comprehensive IPC programmes will enable countries to reduce the mobility, mortality and cost of HAIs and improve quality of care. This paper addresses the relevance of national infection prevention and control (NIPC) programmes in promoting, supporting and reinforcing IPC interventions at the level of hospitals. A strong commitment from national health authorities in support of national IPC programmes is crucial to obtaining a steady decrease of HAIs, lowering health costs due to HAIs and ensuring safer care.

Control of zoonoses in emergency situations: lessons learned during recent outbreaks (gaps and weaknesses of current zoonoses control programmes

Directory of Open Access Journals (Sweden)

Darem Tabbaa

2008-12-01

Full Text Available In emergency situations, domestic animals and wildlife are, like people, exposed to infectious diseases and environmental contaminants in the air, soil, water and food. They can suffer from acute and/or chronic diseases from such exposure. Often animals serve as disease reservoirs or early warning systems for the community in regard to the spread of zoonotic diseases. Over 100 years of experience have shown that animal and human health are closely related. During the past few years, emergent disease episodes have increased; nearly all have involved zoonotic agents. As there is no way to predict when or where the next important new zoonotic pathogen will emerge or what its ultimate importance might be, investigation at the first sign of emergence of a new zoonotic disease is particularly important. Today, in many emerging situations, different activities involving zoonotic disease control are at risk because of failed investigative infrastructures or financial constraints. Considering that zoonotic diseases have their own characteristics, their prevention and control require unique strategies, based more on fundamental and applied research than on traditional approaches. Such strategies require cooperation and coordination between animal and public health sectors and the involvement of other disciplines and experts such as epidemiologists, entomologists, environmentalists and climatologists. Lessons learned from the avian influenza pandemic threat, the Crimean-Congo haemorrhagic fever and rabies outbreaks are presented and the gaps and weakness of current control programmes are discussed.

Financial incentives for disease management programmes and integrated care in German social health insurance.

Science.gov (United States)

Greb, Stefan; Focke, Axel; Hessel, Franz; Wasem, Jürgen

2006-10-01

As a result of recent health care reforms sickness funds and health care providers in German social health insurance face increased financial incentives for implementing disease management and integrated care. Sickness funds receive higher payments form the risk adjustment system if they set up certified disease management programmes and induce patients to enrol. If health care providers establish integrated care projects they are able to receive extra-budgetary funding. As a consequence, the number of certified disease management programmes and the number of integrated care contracts is increasing rapidly. However, contracts about disease management programmes between sickness funds and health care providers are highly standardized. The overall share of health care expenses spent on integrated care still is very low. Existing integrated care is mostly initiated by hospitals, is based on only one indication and is not fully integrated. However, opportunity to invest in integrated care may open up innovative processes, which generate considerable productivity gains. What is more, integrated care may serve as gateway for the introduction of more widespread selective contracting.

The radiation exposure control programme - its effect on design

International Nuclear Information System (INIS)

Simmons, R.B.V.

1975-01-01

The paper discusses how the Power Projects design organization has responded to the problem of operational exposure. This response took the form of an organized formal Programme developed during the Bruce G.S. design phase. This Radiation Exposure Control Programme considered: radiation conditions, number of items requiring attention, number of occasions item requires attention and manhours involved on each occasion. Analysis of these factors and comparison with target values enabled worthwhile reductions to be made in estimated operating exposure. Activity transport studies, reliability and design detail improvements have all received an impetus from the Programme. The Programme which has value both from the economic and the health physics points of view is now a continuing feature of the CANDU plant design process. (author)

Programming Programmable Logic Controller. High-Technology Training Module.

Science.gov (United States)

Lipsky, Kevin

This training module on programming programmable logic controllers (PLC) is part of the memory structure and programming unit used in a packaging systems equipment control course. In the course, students assemble, install, maintain, and repair industrial machinery used in industry. The module contains description, objectives, content outline,…

Gardening with Huntington's disease clients--creating a programme of winter activities.

Science.gov (United States)

Spring, Josephine Anne; Baker, Mark; Dauya, Loreane; Ewemade, Ivie; Marsh, Nicola; Patel, Prina; Scott, Adrienne; Stoy, Nicholas; Turner, Hannah; Viera, Marc; Will, Diana

2011-01-01

A programme of garden-related indoor activities was developed to sustain a gardening group for people with mid to late stage Huntington's disease during the winter. The activities were devised by the horticulturist, working empirically, involving the services occupational therapist, physiotherapist, occupational therapy art technician, computer room, recreation and leisure staff. The programme was strongly supported by the nursing and care staff. Feedback on the effectiveness of the activities was sought from the clients, team members and unit staff. The clients' interest in gardening was sustained by a multidisciplinary programme of indoor growing and using plant products in creative activities, computing and group projects. The clients enjoyed all activities except one that they said lacked contact with plants. The inexpensive programme of activities enabled creativity and self-expression, stimulated social contact and helped with therapeutic goals of the clients. In addition, it engaged the multi-disciplinary team and the unit staff, was practical and enhanced the environment.

Using intervention mapping (IM) to develop a self-management programme for employees with a chronic disease in the Netherlands

NARCIS (Netherlands)

Detaille, S.I.; van der Gulden, J.W.J.; Engels, J.A.; Heerkens, Y.F.; van Dijk, F.J.H.

2010-01-01

ABSTRACT: BACKGROUND: Employees with a chronic disease often encounter problems at work because of their chronic disease. The current paper describes the development of a self-management programme based on the Chronic Disease Self-Management Programme (CDSMP) of Stanford University to help employees

Quality control programme for radiotherapy

International Nuclear Information System (INIS)

Campos de Araujo, A.M.; Viegas, C.C.B.; Viamonte, A.M.

2002-01-01

A 3 years pilot programme started in January 2000 with 33 philanthropic cancer institutions that provides medical services to 60% of the patients from the national social security system. Brazil has today 161 radiotherapy services (144 operating with megavoltage equipment). These 33 institutions are distributed over 19 Brazilian states. The aim of this programme is: To create conditions to allow the participants to apply the radiotherapy with quality and efficacy; To promote up dating courses for the physicians, physicists and technicians of these 33 Institutions. With the following objectives: To recommend dosimetric and radiological protection procedures in order to guarantee the tumor prescribed dose and safe working conditions; To help in establishing and implementing these procedures. The main activities are: local quality control evaluations, postal TLD audits in reference conditions, postal TLD audits in off axis conditions and training. The local quality control program has already evaluated 22 institutions with 43 machines (25 Co-60 and 18 linear accelerators). In these visits we perform dosimetric, electrical, mechanical and safety tests. As foreseen, we found more problems among the old Co-60 machines i.e., field flatness, size, symmetry and relative output factors; lasers positioning system alignment; optical distance indicator; radiation and light field coincidence; optical and mechanical distance indicators agreement, than among the linear accelerators i.e., field flatness and size; lasers positioning system alignment; tray interlocking and wedge filter factors

Integrated control programmes for schistosomiasis and other helminth infections in P.R. China.

Science.gov (United States)

Xu, Jing; Xu, Jun-Fang; Li, Shi-Zhu; Zhang, Li-Juan; Wang, Qiang; Zhu, Hui-Hui; Zhou, Xiao-Nong

2015-01-01

The prevalence of human schistosomiasis and soil-transmitted helminthiasis (STH) has decreased significantly in the People's Republic of China (P.R. China), particularly after 2005 when the national control programmes were reinforced by forming of integrated control strategies. Furthermore, social-economic development also contributed to the decrease of schistosome and soil-transmitted helminth infections. The prevalence of the zoonotic helminthiasis, including clonorchiasis and echinococcosis, on the other hand, is either underestimated or has in fact increased due to changes in social and environmental factors. In comparison with the control strategies in force and their effects on those four kinds of helminthiasis, the challenges and control priorities for the potential transfer from control to elimination of each disease is reviewed, to provide evidence for policy-makers to act upon. Copyright © 2013 Elsevier B.V. All rights reserved.

Using intervention mapping (IM) to develop a self-management programme for employees with a chronic disease in the Netherlands.

NARCIS (Netherlands)

Detaille, S.I.; Gulden, J.W.J. van der; Engels, J.A.; Heerkens, Y.H.; Dijk, F.J. van

2010-01-01

BACKGROUND: Employees with a chronic disease often encounter problems at work because of their chronic disease. The current paper describes the development of a self-management programme based on the Chronic Disease Self-Management programme (CDSMP) of Stanford University to help employees with a

Using intervention mapping (IM) to develop a self-management programme for employees with a chronic disease in the Netherlands

NARCIS (Netherlands)

Detaille, Sarah I.; van der Gulden, Joost W. J.; Engels, Josephine A.; Heerkens, Yvonne F.; van Dijk, Frank J. H.

2010-01-01

Employees with a chronic disease often encounter problems at work because of their chronic disease. The current paper describes the development of a self-management programme based on the Chronic Disease Self-Management programme (CDSMP) of Stanford University to help employees with a chronic

Nurse-coordinated multidisciplinary, family-based cardiovascular disease prevention programme (EUROACTION) for patients with coronary heart disease and asymptomatic individuals at high risk of cardiovascular disease: a paired, cluster-randomised controlled trial.

Science.gov (United States)

Wood, D A; Kotseva, K; Connolly, S; Jennings, C; Mead, A; Jones, J; Holden, A; De Bacquer, D; Collier, T; De Backer, G; Faergeman, O

2008-06-14

Our aim was to investigate whether a nurse-coordinated multidisciplinary, family-based preventive cardiology programme could improve standards of preventive care in routine clinical practice. In a matched, cluster-randomised, controlled trial in eight European countries, six pairs of hospitals and six pairs of general practices were assigned to an intervention programme (INT) or usual care (UC) for patients with coronary heart disease or those at high risk of developing cardiovascular disease. The primary endpoints-measured at 1 year-were family-based lifestyle change; management of blood pressure, lipids, and blood glucose to target concentrations; and prescription of cardioprotective drugs. Analysis was by intention to treat. The trial is registered as ISRCTN 71715857. 1589 and 1499 patients with coronary heart disease in hospitals and 1189 and 1128 at high risk were assigned to INT and UC, respectively. In patients with coronary heart disease who smoked in the month before the event, 136 (58%) in the INT and 154 (47%) in the UC groups did not smoke 1 year afterwards (difference in change 10.4%, 95% CI -0.3 to 21.2, p=0.06). Reduced consumption of saturated fat (196 [55%] vs 168 [40%]; 17.3%, 6.4 to 28.2, p=0.009), and increased consumption of fruit and vegetables (680 [72%] vs 349 [35%]; 37.3%, 18.1 to 56.5, p=0.004), and oily fish (156 [17%] vs 81 [8%]; 8.9%, 0.3 to 17.5, p=0.04) at 1 year were greatest in the INT group. High-risk individuals and partners showed changes only for fruit and vegetables (p=0.005). Blood-pressure target of less than 140/90 mm Hg was attained by both coronary (615 [65%] vs 547 [55%]; 10.4%, 0.6 to 20.2, p=0.04) and high-risk (586 [58%] vs 407 [41%]; 16.9%, 2.0 to 31.8, p=0.03) patients in the INT groups. Achievement of total cholesterol of less than 5 mmol/L did not differ between groups, but in high-risk patients the difference in change from baseline to 1 year was 12.7% (2.4 to 23.0, p=0.02) in favour of INT. In the hospital group

One world health: socioeconomic burden and parasitic disease control priorities.

Science.gov (United States)

Torgerson, Paul R

2013-08-01

Parasitic diseases present a considerable socio-economic impact to society. Zoonotic parasites can result in a considerable burden of disease in people and substantive economic losses to livestock populations. Ameliorating the effects of these diseases may consist of attempts at eradicating specific diseases at a global level, eliminating them at a national or local level or controlling them to minimise incidence. Alternatively with some parasitic zoonoses it may only be possible to treat human and animal cases as they arise. The choice of approach will be determined by the potential effectiveness of a disease control programme, its cost and the cost effectiveness or cost benefit of undertaking the intervention. Furthermore human disease burden is being increasingly measured by egalitarian non-financial measures which are difficult to apply to livestock. This adds additional challenges to the assessment of socio-economic burdens of zoonotic diseases. Using examples from the group of neglected zoonotic diseases, information regarding the socio-economic effects is reviewed together with how this information is used in decision making with regard to disease control and treatment. Copyright © 2013 Elsevier B.V. All rights reserved.

Effect of multidisciplinary disease management for hospitalized heart failure under a national health insurance programme.

Science.gov (United States)

Mao, Chun-Tai; Liu, Min-Hui; Hsu, Kuang-Hung; Fu, Tieh-Cheng; Wang, Jong-Shyan; Huang, Yu-Yen; Yang, Ning-I; Wang, Chao-Hung

2015-09-01

Multidisciplinary disease management programmes (MDPs) for heart failure have been shown to be effective in Western countries. However, it is not known whether they improve outcomes in a high population density country with a national health insurance programme. In total, 349 patients hospitalized because of heart failure were randomized into control and MDP groups. All-cause death and re-hospitalization related to heart failure were analyzed. The median follow-up period was approximately 2 years. Mean patient age was 60 years; 31% were women; and 50% of patients had coronary artery disease. MDP was associated with fewer all-cause deaths [hazard ratio (HR) = 0.49, 95% confidence interval (CI) = 0.27-0.91, P = 0.02] and heart failure-related re-hospitalizations (HR = 0.44, 95% CI = 0.25-0.77, P = 0.004). MDP was still associated with better outcomes for all-cause death (HR = 0.53, 95% CI = 0.29-0.98, P = 0.04) and heart failure-related re-hospitalization (HR = 0.46, 95% CI = 0.26-0.81, P = 0.007), after adjusting for age, diuretics, diabetes mellitus, chronic kidney disease, hypertension, sodium, and albumin. However, MDPs' effect on all-cause mortality and heart failure-related re-hospitalization was significantly attenuated after adjusting for angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers or β-blockers. A stratified analysis showed that MDP combined with guideline-based medication had synergistic effects. MDP is effective in lowering all-cause mortality and re-hospitalization rates related to heart failure under a national health insurance programme. MDP synergistically improves the effectiveness of guidelines-based medications for heart failure.

Quality assurance programme and quality control

International Nuclear Information System (INIS)

Alvarez de Buergo, L.

1979-01-01

The paper analyses the requirements for the quality assurance and control in nuclear power plant projects which are needed to achieve safe, reliable and economic plants. The author describes the structure for the establishment of a nuclear programme at the national level and the participation of the different bodies involved in a nuclear power plant project. The paper ends with the study of a specific case in Spain. (NEA) [fr

Vaccine delivery to disease control: a paradigm shift in health policy.

Science.gov (United States)

John, T Jacob; Jain, Yogesh; Nadimpally, Sarojini; Jesani, Amar

2017-01-01

India's Universal Immunisation Programme (UIP) has resulted in the creation of infrastructure, human resources and systems for the procurement and delivery of vaccines. Recently, new vaccines have been added and there are plans for the introduction of more. However, the outcomes in terms of reduction of the diseases for which the vaccines are being administered remain ambiguous. This is evident from the persistent health issues that children continue to experience, despite immunisation. This situation raises a fundamental ethical question for public health: vaccinations are one of the tools of disease control, but are they properly aligned to the control of disease so as to produce the expected public health utility or benefit?

Stealth low-level manipulation of programmable logic controllers I/O by pin control exploitation

NARCIS (Netherlands)

Abbasi, A.; Hashemi, M.; Zambon, E.; Etalle, S.; Havarneanu, G.; Setola, R.; Nassopoulos, H.; Wolthusen, S.

2016-01-01

Input/OutputisthemechanismthroughwhichProgrammable Logic Controllers (PLCs) interact with and control the outside world. Particularly when employed in critical infrastructures, the I/O of PLCs has to be both reliable and secure. PLCs I/O like other embedded devices are controlled by a pin based

Integrated Programme Control Systems: Lessons Learned

Energy Technology Data Exchange (ETDEWEB)

Brown, C. W. [Babcock International Group PLC (formerly UKAEA Ltd) B21 Forss, Thurso, Caithness, Scotland (United Kingdom)

2013-08-15

Dounreay was the UK's centre of fast reactor research and development from 1955 until 1994 and is now Scotland's largest nuclear clean up and demolition project. After four decades of research, Dounreay is now a site of construction, demolition and waste management, designed to return the site to as near as practicable to its original condition. Dounreay has a turnover in the region of Pounds 150 million a year and employs approximately 900 people. It subcontracts work to 50 or so companies in the supply chain and this provides employment for a similar number of people. The plan for decommissioning the site anticipates all redundant buildings will be cleared in the short term. The target date to achieve interim end state by 2039 is being reviewed in light of Government funding constraints, and will be subject to change through the NDA led site management competition. In the longer term, controls will be put in place on the use of contaminated land until 2300. In supporting the planning, management and organisational aspects for this complex decommissioning programme an integrated programme controls system has been developed and deployed. This consists of a combination of commercial and bespoke tools integrated to support all aspects of programme management, namely scope, schedule, cost, estimating and risk in order to provide baseline and performance management data based upon the application of earned value management principles. Through system evolution and lessons learned, the main benefits of this approach are management data consistency, rapid communication of live information, and increased granularity of data providing summary and detailed reports which identify performance trends that lead to corrective actions. The challenges of such approach are effective use of the information to realise positive changes, balancing the annual system support and development costs against the business needs, and maximising system performance. (author)

Norwegian mastitis control programme

Directory of Open Access Journals (Sweden)

Østerås O

2009-04-01

Full Text Available Abstract This paper describes the methods and results of the Norwegian Mastitis Control Program implemented in 1982. The program has formed an integral part of the Norwegian Cattle Health Services (NCHS since 1995. The NCHS also have specific programs for milk fever, ketosis, reproduction and calf diseases. The goal of the program is to improve udder health by keeping the bulk milk somatic cell count (BMSCC low, to reduce the use of antibiotics, to keep the cost of mastitis low at herd level and improve the consumers' attitude to milk products. In 1996, a decision was made to reduce the use of antibiotics in all animal production enterprises in Norway by 25% within five years. Relevant data has been collected through the Norwegian Cattle Herd Recording System (NCHRS; including health records since 1975 and somatic cell count (SCC data since 1980. These data have been integrated within the NCHRS. Since 2000, mastitis laboratory data have also been included in the NCHRS. Data on clinical disease, SCC and mastitis bacteriology have been presented to farmers and advisors in monthly health periodicals since 1996, and on the internet since 2005. In 1996, Norwegian recommendations on the treatment of mastitis were implemented. Optimal milking protocols and milking machine function have been emphasised and less emphasis has been placed on dry cow therapy. A selective dry cow therapy program (SDCTP was implemented in 2006, and is still being implemented in new areas. Research demonstrates that the rate of clinical mastitis could be reduced by 15% after implementing SDCTP. The results so far show a 60% reduction in the clinical treatment of mastitis between 1994 and 2007, a reduction in BMSCC from 250,000 cells/ml to 114,000 cells/ml, and a total reduction in the mastitis cost from 0.23 NOK to 0.13 NOK per litre of milk delivered to the processors, corresponding to a fall from 9.2% to 1.7% of the milk price, respectively. This reduction is attributed to

Norwegian mastitis control programme

Science.gov (United States)

2009-01-01

This paper describes the methods and results of the Norwegian Mastitis Control Program implemented in 1982. The program has formed an integral part of the Norwegian Cattle Health Services (NCHS) since 1995. The NCHS also have specific programs for milk fever, ketosis, reproduction and calf diseases. The goal of the program is to improve udder health by keeping the bulk milk somatic cell count (BMSCC) low, to reduce the use of antibiotics, to keep the cost of mastitis low at herd level and improve the consumers' attitude to milk products. In 1996, a decision was made to reduce the use of antibiotics in all animal production enterprises in Norway by 25% within five years. Relevant data has been collected through the Norwegian Cattle Herd Recording System (NCHRS); including health records since 1975 and somatic cell count (SCC) data since 1980. These data have been integrated within the NCHRS. Since 2000, mastitis laboratory data have also been included in the NCHRS. Data on clinical disease, SCC and mastitis bacteriology have been presented to farmers and advisors in monthly health periodicals since 1996, and on the internet since 2005. In 1996, Norwegian recommendations on the treatment of mastitis were implemented. Optimal milking protocols and milking machine function have been emphasised and less emphasis has been placed on dry cow therapy. A selective dry cow therapy program (SDCTP) was implemented in 2006, and is still being implemented in new areas. Research demonstrates that the rate of clinical mastitis could be reduced by 15% after implementing SDCTP. The results so far show a 60% reduction in the clinical treatment of mastitis between 1994 and 2007, a reduction in BMSCC from 250,000 cells/ml to 114,000 cells/ml, and a total reduction in the mastitis cost from 0.23 NOK to 0.13 NOK per litre of milk delivered to the processors, corresponding to a fall from 9.2% to 1.7% of the milk price, respectively. This reduction is attributed to changes in attitude and

Impact of fruit fly control programmes using the sterile insect technique

International Nuclear Information System (INIS)

Enkerlin, W.R.

2005-01-01

Measuring the impact of area-wide integrated pest management (AW-IPM) programmes, that use the sterile insect technique (SIT) to control fruit fly pests of economic significance, is complex. These programmes affect practically the whole horticultural food chain. In this chapter, the impact of the programmes is assessed by focusing only on the benefits generated to producers and traders of horticultural products, the direct beneficiaries. This is done first by describing the types of benefits accrued from these programmes, second by explaining the factors that shape programme benefits, and finally by presenting several examples to illustrate how the SIT technology, when properly applied for eradication, containment, suppression, or prevention purposes, can generate substantial direct and indirect benefits to the horticulture industry. (author)

Gaining perspective on own illness - the lived experiences of a patient education programme for women with treated coeliac disease.

Science.gov (United States)

Ring Jacobsson, Lisa; Milberg, Anna; Hjelm, Katarina; Friedrichsen, Maria

2016-05-01

To explore the lived experiences of women with coeliac disease after attending a patient education programme, to gain a broader perspective of its influence. Adults, particularly women, with coeliac disease report suffering from poor well-being and reduced quality of life in terms of health. Patient education programmes might support and encourage them in the search for possible improvements in lifestyle and in their approach to the disease. A qualitative phenomenological study. Personal narrative interviews with 14 women suffering from coeliac disease who had participated in an educational programme. Data analysis in accordance with Giorgi was performed. The essential structure of women's lived experiences following their participation in the patient education programme was found to be an interaction with others with the same disease, which left the women feeling individually strengthened. The interaction enabled the participants to acquire a broader view of their life with coeliac disease. As a result, this realigned their sense of self in relation to their own disease. In coping with coeliac disease, it seems that women need interaction with others with the disease to experience togetherness within a group, get the opportunity to compare themselves with others and to exchange knowledge. The interaction appears to result in that women acquire an overview of life with the disease, develop a greater confidence and dare to try new things in life. When designing a patient education programme it seems important to consider the needs of persons to meet others with the same disease, and to ask them about their need for knowledge, rather than simply assuming that health care professionals know what they need. © 2016 John Wiley & Sons Ltd.

Information systems for administration, clinical documentation and quality assurance in an Austrian disease management programme.

Science.gov (United States)

Beck, Peter; Truskaller, Thomas; Rakovac, Ivo; Bruner, Fritz; Zanettin, Dominik; Pieber, Thomas R

2009-01-01

5.9% of the Austrian population is affected by diabetes mellitus. Disease Management is a structured treatment approach that is suitable for application to the diabetes mellitus area and often is supported by information technology. This article describes the information systems developed and implemented in the Austrian disease management programme for type 2 diabetes. Several workflows for administration as well as for clinical documentation have been implemented utilizing the Austrian e-Health infrastructure. De-identified clinical data is available for creating feedback reports for providers and programme evaluation.

The effectiveness of the Austrian disease management programme for type 2 diabetes: a cluster-randomised controlled trial

Directory of Open Access Journals (Sweden)

Klima Gert

2010-11-01

Full Text Available Abstract Background Disease management programmes (DMPs are costly and impose additional work load on general practitioners (GPs. Data on their effectiveness are inconclusive. We therefore conducted a cluster-randomised controlled trial to evaluate the effectiveness of the Austrian DMP for diabetes mellitus type 2 on HbA1c and quality of care for adult patients in primary care. Methods All GPs of Salzburg-province were invited to participate. After cluster-randomisation by district, all patients with diabetes type 2 were recruited consecutively from 7-11/2007. The DMP, consisting mainly of physician and patient education, standardised documentation and agreement on therapeutic goals, was implemented in the intervention group while the control group received usual care. We aimed to show superiority of the intervention regarding metabolic control and process quality. The primary outcome measure was a change in HbA1c after one year. Secondary outcomes were days in the hospital, blood pressure, lipids, body mass index (BMI, enrolment in patient education and regular guideline-adherent examination. Blinding was not possible. Results 92 physicians recruited 1489 patients (649 intervention, 840 control. After 401 ± 47 days, 590 intervention-patients and 754 controls had complete data. In the intention to treat analysis (ITT of all 1489 patients, HbA1c decreased 0.41% in the intervention group and 0.28% in controls. The difference of -0.13% (95% CI -0.24; -0.02 was significant at p = 0.026. Significance was lost in mixed models adjusted for baseline value and cluster-effects (adjusted mean difference -0.03 (95% CI -0.15; 0.09, p = 0.607. Of the secondary outcome measures, BMI and cholesterol were significantly reduced in the intervention group compared to controls in ITT after adjustments (-0.53 kg/m²; 95% CI -1.03;-0.02; p = 0.014 and -0.10 mmol/l; 95% CI -0.21; -0.003; p = 0.043. Additionally, more patients received patient education (49.5% vs. 20

Influence of media enlightenment programme on control and ...

African Journals Online (AJOL)

The study examined the influence of media enlightenment programmes on control and prevention of cerebrospinal meningitis among people of Ilorin metropolis, Kwara State, Nigeria. The study population comprised all the people within Ilorin metropolis, Kwara state. A descriptive research design of survey method was ...

Application of programmable logic controller in nuclear experiments

International Nuclear Information System (INIS)

Ponikvar, D.

1991-09-01

The applicability of programmable logic controller (PLC) in nuclear experiments was studied on an example that simulated the monitoring and control of an ion beam in an accelerator. Using infrared and laser light, a comparison was made between the complexity and suitability of PLC compared to a setup using a personal computer. The experiments are described in detail. The routines for registration of signals from appropriate sensors and for control of the stepper monitor were written in quick BASIC. (author). 5 figs

Effectiveness of a Peer Support Programme versus Usual Care in Disease Management of Diabetes Mellitus Type 2 regarding Improvement of Metabolic Control: A Cluster-Randomised Controlled Trial.

Science.gov (United States)

Johansson, Tim; Keller, Sophie; Winkler, Henrike; Ostermann, Thomas; Weitgasser, Raimund; Sönnichsen, Andreas C

2016-01-01

Testing the effectiveness of peer support additionally to a disease management programme (DMP) for type 2 diabetes patients. Unblinded cluster-randomised controlled trial (RCT) involving 49 general practices, province of Salzburg, Austria. All patients enrolled in the DMP were eligible, n = 337 participated (intervention: 148 in 19 clusters; control: 189 in 20 clusters). The peer support intervention ran over 24 months and consisted of peer supporter recruitment and training, and group meetings weekly for physical exercise and monthly for discussion of diabetes related topics. At two-year follow-up, adjusted analysis revealed a nonsignificant difference in HbA1c change of 0.14% (21.97 mmol/mol) in favour of the intervention (95% CI -0.08 to 0.36%, p = 0.22). Baseline values were 7.02 ± 1.25% in the intervention and 7.08 ± 1.25 in the control group. None of the secondary outcome measures showed significant differences except for improved quality of life (EQ-5D-VAS) in controls (4.3 points on a scale of 100; 95% CI 0.08 to 8.53, p = 0.046) compared to the intervention group. Our peer support intervention as an additional DMP component showed no significant effect on HbA1c and secondary outcome measures. Further RTCs with a longer follow-up are needed to reveal whether peer support will have clinically relevant effects. This trial has been registered with Current Controlled Trials Ltd. (ISRCTN10291077).

Including refugees in disease elimination: challenges observed from a sleeping sickness programme in Uganda.

Science.gov (United States)

Palmer, Jennifer J; Robert, Okello; Kansiime, Freddie

2017-01-01

Ensuring equity between forcibly-displaced and host area populations is a key challenge for global elimination programmes. We studied Uganda's response to the recent refugee influx from South Sudan to identify key governance and operational lessons for national sleeping sickness programmes working with displaced populations today. A refugee policy which favours integration of primary healthcare services for refugee and host populations and the availability of rapid diagnostic tests (RDTs) to detect sleeping sickness at this health system level makes Uganda well-placed to include refugees in sleeping sickness surveillance. Using ethnographic observations of coordination meetings, review of programme data, interviews with sleeping sickness and refugee authorities and group discussions with health staff and refugees (2013-2016), we nevertheless identified some key challenges to equitably integrating refugees into government sleeping sickness surveillance. Despite fears that refugees were at risk of disease and posed a threat to elimination, six months into the response, programme coordinators progressed to a sentinel surveillance strategy in districts hosting the highest concentrations of refugees. This meant that RDTs, the programme's primary surveillance tool, were removed from most refugee-serving facilities, exacerbating existing inequitable access to surveillance and leading refugees to claim that their access to sleeping sickness tests had been better in South Sudan. This was not intentionally done to exclude refugees from care, rather, four key governance challenges made it difficult for the programme to recognise and correct inequities affecting refugees: (a) perceived donor pressure to reduce the sleeping sickness programme's scope without clear international elimination guidance on surveillance quality; (b) a problematic history of programme relations with refugee-hosting districts which strained supervision of surveillance quality; (c) difficulties that

Enter B and W: two new meningococcal vaccine programmes launched.

Science.gov (United States)

Ladhani, Shamez N; Ramsay, Mary; Borrow, Ray; Riordan, Andrew; Watson, John M; Pollard, Andrew J

2016-01-01

In 2015, the UK became the first country in the world to have a comprehensive routine meningococcal vaccine programme targeting all of the main capsular groups of N. meningitidis. 1 An infant vaccine programme against meningococcal capsular group B Neisseria meningitidis (MenB) was launched from 1st September with an aim to reduce endemic MenB disease in early childhood. On 1st August 2015, an adolescent programme against groups A, C, W and Y meningococci (MenACWY) was rolled out to halt a growing outbreak of capsular group W disease (MenW) caused by a hypervirulent clone of N. meningitidis, in addition to maintaining control against MenC disease provided by the current adolescent programme. 2. 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/

A cluster randomised controlled trial evaluating the effectiveness of a structured pulmonary rehabilitation education programme for improving the health status of people with chronic obstructive pulmonary disease (COPD: The PRINCE Study protocol

Directory of Open Access Journals (Sweden)

Nichulain Martina

2011-01-01

Full Text Available Abstract Background A key strategy in improving care for people with chronic obstructive pulmonary disease (COPD is the provision of pulmonary rehabilitation programmes. Pulmonary rehabilitation programmes have been successful in improving patients' sense of dyspnoea and Health Related Quality of Life. However, the effectiveness of structured education pulmonary rehabilitation programmes delivered at the level of the general practice on the health status of people with COPD remains uncertain and there is a need for a robust and fair assessment of this. The PRINCE study will evaluate the effectiveness of a Structured Education Pulmonary Rehabilitation Programme (SEPRP, delivered at the level of the general practice, on the health status of people with COPD. Methods/Design The PRINCE Trial is a two-armed, single blind cluster randomised trial conducted in the primary care setting in Ireland. Randomisation to control and intervention is at the level of the General Practice. Participants in the intervention arm will receive a SEPRP and those allocated to the control arm will receive usual care. Delivery of the SEPRP will be by a practice nurse and physiotherapist in the General Practice (GP site. The primary outcome measure of the study will be health status as measured by the Chronic Respiratory Questionnaire (CRQ. Blinded outcome assessment will be undertaken at baseline and at twelve-fourteen weeks after completion of the programme. A comparison of outcomes between the intervention and control sites will be made to examine if differences exist and, if so, to what extent between control and experimental groups. Sample size calculations estimate that 32 practices with a minimum of 10 participants per practice are required, in total, to be randomised to control and intervention arms for power of at least 80% with alpha levels of 0.05, to determine a clinically significant change of 0.5 units in the CRQ. A cost effectiveness analysis will also be

A cluster randomised controlled trial evaluating the effectiveness of a structured pulmonary rehabilitation education programme for improving the health status of people with chronic obstructive pulmonary disease (COPD): The PRINCE Study protocol.

Science.gov (United States)

Murphy, Kathy; Casey, Dympna; Devane, Declan; Cooney, Adeline; McCarthy, Bernard; Mee, Lorraine; Nichulain, Martina; Murphy, Andrew W; Newell, John; O' Shea, Eamon

2011-01-18

A key strategy in improving care for people with chronic obstructive pulmonary disease (COPD) is the provision of pulmonary rehabilitation programmes. Pulmonary rehabilitation programmes have been successful in improving patients' sense of dyspnoea and Health Related Quality of Life. However, the effectiveness of structured education pulmonary rehabilitation programmes delivered at the level of the general practice on the health status of people with COPD remains uncertain and there is a need for a robust and fair assessment of this. The PRINCE study will evaluate the effectiveness of a Structured Education Pulmonary Rehabilitation Programme (SEPRP), delivered at the level of the general practice, on the health status of people with COPD. The PRINCE Trial is a two-armed, single blind cluster randomised trial conducted in the primary care setting in Ireland. Randomisation to control and intervention is at the level of the General Practice. Participants in the intervention arm will receive a SEPRP and those allocated to the control arm will receive usual care. Delivery of the SEPRP will be by a practice nurse and physiotherapist in the General Practice (GP) site. The primary outcome measure of the study will be health status as measured by the Chronic Respiratory Questionnaire (CRQ). Blinded outcome assessment will be undertaken at baseline and at twelve-fourteen weeks after completion of the programme. A comparison of outcomes between the intervention and control sites will be made to examine if differences exist and, if so, to what extent between control and experimental groups. Sample size calculations estimate that 32 practices with a minimum of 10 participants per practice are required, in total, to be randomised to control and intervention arms for power of at least 80% with alpha levels of 0.05, to determine a clinically significant change of 0.5 units in the CRQ. A cost effectiveness analysis will also be conducted. The results of this trial are directly

Home-based balance training programme using Wii Fit with balance board for Parkinsons's disease: a pilot study.

Science.gov (United States)

Esculier, Jean-Francois; Vaudrin, Joanie; Bériault, Patrick; Gagnon, Karine; Tremblay, Louis E

2012-02-01

To evaluate the effects of a home-based balance training programme using visual feedback (Nintendo Wii Fit game with balance board) on balance and functional abilities in subjects with Parkinson's disease, and to compare the effects with a group of paired healthy subjects. Ten subjects with moderate Parkinson's disease and 8 healthy elderly subjects. Subjects participated in a 6-week home-based balance training programme using Nintendo Wii Fit and balance board. Baseline measures were taken before training for the Sit-to-Stand test (STST), Timed-Up-and-Go (TUG), Tinetti Performance Oriented Mobility Assessment (POMA), 10-m walk test, Community Balance and Mobility assessment (CBM), Activities-specific Balance and Confidence scale (ABC), unipodal stance duration, and a force platform. All measurements were taken again after 3 and 6 weeks of training. The Parkinson's disease group significantly improved their results in TUG, STST, unipodal stance, 10-m walk test, CBM, POMA and force platform at the end of the 6-week training programme. The healthy subjects group significantly improved in TUG, STST, unipodal stance and CBM. This pilot study suggests that a home-based balance programme using Wii Fit with balance board could improve static and dynamic balance, mobility and functional abilities of people affected by Parkinson's disease.

ICMR programme on Antibiotic Stewardship, Prevention of Infection & Control (ASPIC).

Science.gov (United States)

Chandy, Sujith J; Michael, Joy Sarojini; Veeraraghavan, Balaji; Abraham, O C; Bachhav, Sagar S; Kshirsagar, Nilima A

2014-02-01

Antimicrobial resistance and hospital infections have increased alarmingly in India. Antibiotic stewardship and hospital infection control are two broad strategies which have been employed globally to contain the problems of resistance and infections. For this to succeed, it is important to bring on board the various stakeholders in hospitals, especially the clinical pharmacologists. The discipline of clinical pharmacology needs to be involved in themes such as antimicrobial resistance and hospital infection which truly impact patient care. Clinical pharmacologists need to collaborate with faculty in other disciplines such as microbiology to achieve good outcomes for optimal patient care in the hospital setting. The ASPIC programme was initiated by the Indian Council of Medical Research (ICMR) in response to the above need and was designed to bring together faculty from clinical pharmacology, microbiology and other disciplines to collaborate on initiating and improving antibiotic stewardship and concurrently curbing hospital infections through feasible infection control practices. This programme involves the participation of 20 centres per year throughout the country which come together for a training workshop. Topics pertaining to the above areas are discussed in addition to planning a project which helps to improve antibiotic stewardship and infection control practices in the various centres. It is hoped that this programme would empower hospitals and institutions throughout the country to improve antibiotic stewardship and infection control and ultimately contain antimicrobial resistance.

Brazilian programme for plasma physics and controlled thermonuclear fusion

International Nuclear Information System (INIS)

Chian, A.C.L.; Reusch, M.F.; Nascimento, I.C.; Pantuso-Sudano, J.

1992-01-01

A proposal for a National Programme of Plasma Physics and Controlled Thermonuclear Fusion in Brazil is presented, aimimg the dissemination of the researchers thought in plasma physics for the national authorities and the scientific community. (E.O.)

The FAO programme for the control of African animal trypanosomiasis and related development

International Nuclear Information System (INIS)

Hursey, B.S.

1990-01-01

The FAO proposal for a long-term Programme for the Control of African Animal Trypanosomiasis and Related Development was presented to the World Food Conference in November 1974. A recommendation was adopted that the programme should be implemented as a matter of urgency and should receive high priority in the FAO programme of work and budget. Following recommendations of support by FAO statutory bodies the preparatory phase, which led to implementation of a large-scale programme, was launched in 1980

The FAO programme for the control of African animal trypanosomiasis and related development

Energy Technology Data Exchange (ETDEWEB)

Hursey, B S [FAO, Rome (Italy)

1990-04-01

The FAO proposal for a long-term Programme for the Control of African Animal Trypanosomiasis and Related Development was presented to the World Food Conference in November 1974. A recommendation was adopted that the programme should be implemented as a matter of urgency and should receive high priority in the FAO programme of work and budget. Following recommendations of support by FAO statutory bodies the preparatory phase, which led to implementation of a large-scale programme, was launched in 1980.

Adaptive feedback analysis and control of programmable stimuli for assessment of cerebrovascular function

OpenAIRE

Fan, Lingke; Bush, Glen; Katsogridakis, Emmanuel; Simpson, David M.; Allen, Robert; Potter, John; Birch, Anthony A.; Panerai, Ronney B.

2013-01-01

The assessment of cerebrovascular regulatory mechanisms often requires flexibly controlled and precisely timed changes in arterial blood pressure (ABP) and/or inspired CO2. In this study, a new system for inducing variations in mean ABP was designed, implemented and tested using programmable sequences and programmable controls to induce pressure changes through bilateral thigh cuffs. The system is also integrated with a computer-controlled switch to select air or a CO2/air mixture to be provi...

United Nations International Drug Control Programme responds

Directory of Open Access Journals (Sweden)

Michael Platzer

2002-01-01

Full Text Available [First paragraph] We would like to reply to the article written by Axel Klein entitled, "Between the Death Penalty and Decriminalization: New Directions for Drug Control in the Commonwealth Caribbean" published in NWIG 75 (3&4 2001. We have noted a number of factual inaccuracies as well as hostile comments which portray the United Nations International Drug Control Programme in a negative light. This reply is not intended to be a critique of the article, which we find unbalanced and polemical, but rather an alert to the tendentious statements about UNDCP, which we feel should be corrected.

The WHO AFRO external quality assessment programme (EQAP): Linking laboratory networks through EQA programmes.

Science.gov (United States)

Boeras, Debrah I; Peeling, Rosanna W; Onyebujoh, Philip; Yahaya, Ali A; Gumede-Moeletsi, Hieronyma N; Ndihokubwayo, Jean B

2016-01-01

External Quality Assessment (EQA) surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO) revealed the need for the strengthening of public health microbiology laboratories, particularly for testing of epidemic-prone diseases in the African Region. These surveys revealed common issues such as supply chain management, skilled personnel, logistical support and overall lack of quality standards. For sustainable improvements to health systems as well as global health security, deficiencies identified need to be actively corrected through robust quality assurance programmes and implementation of laboratory quality management systems. Given all the pathogens of public health importance, an external quality assessment programme with a focus on vaccine-preventable diseases and emerging and re-emerging dangerous pathogens is important, and should not be stand-alone, but integrated within laboratory networks as seen in polio, measles, yellow fever and rubella. In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Prevention, the London School of Hygiene & Tropical Medicine and partners in a series of consultations with countries and national and regional EQA providers for the development of quality assurance models to support HIV point-of-care testing and monitoring. These consultations revealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forth its experience in implementing quality standards for health programmes, and also opened discussions on how lessons learned through such established programmes can be utilised to supporting and strengthening the introduction of early infant diagnosis of HIV and viral load point-of-care testing. An optimised external quality assessment programme will impact the ability of countries to meet core capacities, providing improved quality management systems, improving the confidence of diagnostic network services in Africa, and including capacities to detect events

The efficacy of a movement control exercise programme to reduce injuries in youth rugby: a cluster randomised controlled trial

Science.gov (United States)

Hislop, M D; Stokes, K A; Williams, S; McKay, C D; England, M; Kemp, S P T

2016-01-01

Background Injuries to youth rugby players have become an increasingly prominent health concern, highlighting the importance of developing and implementing appropriate preventive strategies. A growing body of evidence from other youth sports has demonstrated the efficacy of targeted exercise regimens to reduce injury risk. However, studies have yet to investigate the effect of such interventions in youth contact sport populations like rugby union. Objective To determine the efficacy of an evidence-based movement control exercise programme compared with a sham exercise programme to reduce injury risk in youth rugby players. Exercise programme compliance between trial arms and the effect of coach attitudes on compliance will also be evaluated. Setting School rugby coaches in England will be the target of the researcher intervention, with the effects of the injury prevention programmes being measured in male youth players aged 14–18 years in school rugby programmes over the 2015–2016 school winter term. Methods A cluster-randomised controlled trial with schools randomly allocated to either a movement control exercise programme or a sham exercise programme, both of which are coach-delivered. Injury measures will derive from field-based injury surveillance, with match and training exposure and compliance recorded. A questionnaire will be used to evaluate coach attitudes, knowledge, beliefs and behaviours both prior to and on the conclusion of the study period. Outcome measures Summary injury measures (incidence, severity and burden) will be compared between trial arms, as will the influence of coach attitudes on compliance and injury burden. Additionally, changes in these outcomes through using the exercise programmes will be evaluated. Trial registration number ISRTCNN13422001. PMID:27900148

The impact of a disease management programme for type 2 diabetes on health-related quality of life: multilevel analysis of a cluster-randomised controlled trial.

Science.gov (United States)

Panisch, Sigrid; Johansson, Tim; Flamm, Maria; Winkler, Henrike; Weitgasser, Raimund; Sönnichsen, Andreas C

2018-01-01

Type 2 diabetes is a chronic disease associated with poorer health outcomes and decreased health related quality of life (HRQoL). The aim of this analysis was to explore the impact of a disease management programme (DMP) in type 2 diabetes on HRQoL. A multilevel model was used to explain the variation in EQ-VAS. A cluster-randomized controlled trial-analysis of the secondary endpoint HRQoL. Our study population were general practitioners and patients in the province of Salzburg. The DMP "Therapie-Aktiv" was implemented in the intervention group, and controls received usual care. Outcome measure was a change in EQ-VAS after 12 months. For comparison of rates, we used Fisher's Exact test; for continuous variables the independent T test or Welch test were used. In the multilevel modeling, we examined various models, continuously adding variables to explain the variation in the dependent variable, starting with an empty model, including only the random intercept. We analysed random effects parameters in order to disentangle variation of the final EQ-VAS. The EQ-VAS significantly increased within the intervention group (mean difference 2.19, p = 0.005). There was no significant difference in EQ-VAS between groups (mean difference 1.00, p = 0.339). In the intervention group the improvement was more distinct in women (2.46, p = 0.036) compared to men (1.92, p = 0.063). In multilevel modeling, sex, age, family and work circumstances, any macrovascular diabetic complication, duration of diabetes, baseline body mass index and baseline EQ-VAS significantly influence final EQ-VAS, while DMP does not. The final model explains 28.9% (EQ-VAS) of the total variance. Most of the unexplained variance was found on patient-level (95%) and less on GP-level (5%). DMP "Therapie-Aktiv" has no significant impact on final EQ-VAS. The impact of DMPs in type 2 diabetes on HRQoL is still unclear and future programmes should focus on patient specific needs and predictors in

Control of human parasitic diseases: Context and overview.

Science.gov (United States)

Molyneux, David H

2006-01-01

The control of parasitic diseases of humans has been undertaken since the aetiology and natural history of the infections was recognized and the deleterious effects on human health and well-being appreciated by policy makers, medical practitioners and public health specialists. However, while some parasitic infections such as malaria have proved difficult to control, as defined by a sustained reduction in incidence, others, particularly helminth infections can be effectively controlled. The different approaches to control from diagnosis, to treatment and cure of the clinically sick patient, to control the transmission within the community by preventative chemotherapy and vector control are outlined. The concepts of eradication, elimination and control are defined and examples of success summarized. Overviews of the health policy and financing environment in which programmes to control or eliminate parasitic diseases are positioned and the development of public-private partnerships as vehicles for product development or access to drugs for parasite disease control are discussed. Failure to sustain control of parasites may be due to development of drug resistance or the failure to implement proven strategies as a result of decreased resources within the health system, decentralization of health management through health-sector reform and the lack of financial and human resources in settings where per capita government expenditure on health may be less than $US 5 per year. However, success has been achieved in several large-scale programmes through sustained national government investment and/or committed donor support. It is also widely accepted that the level of investment in drug development for the parasitic diseases of poor populations is an unattractive option for pharmaceutical companies. The development of partnerships to specifically address this need provides some hope that the intractable problems of the treatment regimens for the trypanosomiases and

Control and management of congenital Chagas disease in Europe and other non-endemic countries: current policies and practices.

Science.gov (United States)

Soriano-Arandes, Antoni; Angheben, Andrea; Serre-Delcor, Nuria; Treviño-Maruri, Begoña; Gómez I Prat, Jordi; Jackson, Yves

2016-05-01

Identifying pregnant women infected with Trypanosoma cruzi is one of the major challenges for preventing and controlling Chagas disease (CD) in non-endemic countries. The aim of this paper was to perform a policy evaluation of the current practices of congenital Chagas disease (CCD) control in non-endemic countries and to propose specific targets for enhanced interventions to tackle this emerging health problem outside the endemic areas of Latin America. We conducted a mixed method review of CCD policy strategies by searching the literature in the PubMed, Google Scholar and the World Health Organization (WHO) databases using the key terms 'CCD', 'paediatric Chagas disease' and 'non-endemic countries'; as free text and combined as one phrase to increase the search sensitivity. Reviews, recommendations, guidelines and control/surveillance programme reports were included. Of 427 CCD papers identified in non-endemic countries, 44 matched the inclusion. Although local programmes were launched in different countries with large numbers of Latin American immigrants, there were considerable disparities in terms of the programmes' distribution, delivery, integration and appropriated CCD control strategies. Moreover, Catalonia, Spain is the only region/country with an established systematic monitoring of CCD in pregnant women from Latin American countries. Given the worldwide dissemination of CD, the nature of its vertical transmission, and the gaps of the current strategies in non-endemic countries, there is an urgent need to standardise, expand and reinforce the control measures against CCD transmission. © 2016 John Wiley & Sons Ltd.

Antiretroviral therapy programme on control of HIV transmission in ...

African Journals Online (AJOL)

Antiretroviral therapy programme on control of HIV transmission in Morogoro municipality, Tanzania: A challenge for development. ... The government and partners should improve access to ART services to enable many PLHIV to access the services. Key words: Antiretroviral Therapy, Highly Active Antiretroviral Treatment, ...

The effectiveness of an emotion-focused educational programme in reducing diabetes distress in adults with Type 2 diabetes mellitus (VEMOFIT): a cluster randomized controlled trial.

Science.gov (United States)

Chew, B H; Vos, R C; Stellato, R K; Ismail, M; Rutten, G E H M

2018-06-01

To evaluate the effectiveness of a brief, value-based emotion-focused educational programme (VEMOFIT) in Malay adults with Type 2 diabetes mellitus compared with a programme of active listening to participants' emotional experiences, social support and their opinion on the health clinic diabetes care services (attention control). Malay adults with severe diabetes distress [Diabetes Distress Scale (DDS-17) mean score ≥ 3] were included. VEMOFIT consisted of four biweekly group sessions, a booster session after 3 months and a follow-up 6 months post intervention. The attention control programme consisted of three sessions over the same period. Outcomes included diabetes distress, depressive symptoms, self-efficacy and disease control. Required total sample size was 165. Participants (n = 124) were randomized to either VEMOFIT (n = 53) or the attention control programme (n = 71). Participants had a mean (sd) age of 55.7 (9.7) years, median diabetes duration of 7.0 (8.0) years and mean HbA 1c level of 82 mmol/mol (9.7%). The mean DDS-17 level decreased significantly in both the VEMOFIT and the attention control programmes (3.4 to 2.9 vs. 3.1 to 2.7, respectively). The adjusted between-group DDS-17 difference was not significant [-0.01, 95% confidence interval (CI) -0.38, 0.35]. The proportion of individuals with severe diabetes distress decreased in both groups, from 89% to 47% vs. 69% to 39% (odds ratio 0.88; 95% CI 0.26, 2.90). Other outcomes did not differ between groups. Both interventions decreased diabetes distress significantly. The theory-based VEMOFIT programme was not superior to the attention control programme. The latter approach is a simpler way to decrease severe diabetes distress (Trial registration: NCT02730078; NMRR-15-1144-24803). © 2018 Diabetes UK.

Promotion of physical activity and fitness in sedentary patients with Parkinson's disease: randomised controlled trial.

Science.gov (United States)

van Nimwegen, Marlies; Speelman, Arlène D; Overeem, Sebastiaan; van de Warrenburg, Bart P; Smulders, Katrijn; Dontje, Manon L; Borm, George F; Backx, Frank J G; Bloem, Bastiaan R; Munneke, Marten

2013-03-01

To evaluate whether a multifaceted behavioural change programme increases physical activities in patients with Parkinson's disease. Multicentre randomised controlled trial. 32 community hospitals in the Netherlands, collaborating in a nationwide network (ParkinsonNet). 586 sedentary patients with idiopathic Parkinson's disease aged between 40 and 75 years with mild to moderate disease severity (Hoehn and Yahr stage ≤ 3). Patients were randomly assigned to the ParkFit programme or a matched general physiotherapy intervention. ParkFit is a multifaceted behavioural change programme, designed specifically to achieve an enduring increase in the level of physical activity (coaches using motivational strategies; ambulatory feedback). The primary endpoint was the level of physical activity, measured every six months with a standardised seven day recall (LASA physical activity questionnaire-LAPAQ). Secondary endpoints included two other measures of physical activity (activity diary and ambulatory activity monitor), quality of life (Parkinson's disease questionnaire-PDQ-39), and fitness (six minute walk test). 540 (92.2%) patients completed the primary outcome. During follow-up, overall time spent on physical activities (LAPAQ) was comparable between the groups (adjusted group difference 7%, 95% confidence interval -3 to 17%; P=0.19). Analyses of three secondary outcomes indicated increased physical activity in ParkFit patients, as suggested by the activity diary (difference 30%; Pactivity monitor (difference 12%; Pphysical activity, as measured with the LAPAQ. The analysis of the secondary endpoints justifies further work into the possible merits of behavioural change programmes to increase physical activities in daily life in Parkinson's disease. Clinical trials NCT00748488.

Effectiveness of comprehensive tobacco control programmes in reducing teenage smoking in the USA

OpenAIRE

Wakefield, M.; Chaloupka, F.

2000-01-01

OBJECTIVE—To describe the extent to which comprehensive statewide tobacco control programmes in the USA have made progress toward reducing teenage smoking.
DATA SOURCES—Literature search of Medline for reviews of effectiveness of programme and policy elements, plus journal articles and personal request for copies of publicly released reports and working papers from evaluation staff in each of the state programmes of California, Massachusetts, Arizona, Oregon, and Florida.
STUDY SELECTION—All ...

How is the sustainability of chronic disease health programmes empirically measured in hospital and related healthcare services?—a scoping review

Science.gov (United States)

Francis, Linda; Dunt, David; Cadilhac, Dominique A

2016-01-01

Objectives Programmes to address chronic disease are a focus of governments worldwide. Despite growth in ‘implementation science’, there is a paucity of knowledge regarding the best means to measure sustainability. The aim of this review was to summarise current practice for measuring sustainability outcomes of chronic disease health programmes, providing guidance for programme planners and future directions for the academic field. Settings A scoping review of the literature spanning 1985–2015 was conducted using MEDLINE, CINAHL, PsychINFO and The Cochrane Library limited to English language and adults. Main search terms included chronic disease, acute care, sustainability, institutionalisation and health planning. A descriptive synthesis was required. Settings included primary care, hospitals, mental health centres and community health. Participants Programmes included preventing or managing chronic conditions including diabetes, heart disease, depression, respiratory disease, cancer, obesity, dental hygiene and multiple chronic diseases. Primary and secondary outcome measures Outcome measures included clarifying a sustainability definition, types of methodologies used, timelines for assessment, criteria levels to determine outcomes and how methodology varies between intervention types. Results Among 153 abstracts retrieved, 87 were retained for full article review and 42 included in the qualitative synthesis. Five definitions for sustainability outcome were identified with ‘maintenance of programme activities’ most frequent. Achieving sustainability was dependent on inter-relationships between various organisational and social contexts supporting a broad scale approach to evaluation. An increasing trend in use of mixed methods designs over multiple time points to determine sustainability outcomes was found. Conclusions Despite the importance and investment in chronic disease programmes, few studies are undertaken to measure sustainability. Methods to

The WHO AFRO external quality assessment programme (EQAP: Linking laboratory networks through EQA programmes

Directory of Open Access Journals (Sweden)

Debrah I. Boeras

2016-10-01

Full Text Available External Quality Assessment (EQA surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO revealed the need for the strengthening of publichealth microbiology laboratories, particularly for testing of epidemic-prone diseases in theAfrican Region. These surveys revealed common issues such as supply chain managementskilled personnel, logistical support and overall lack of quality standards. For sustainableimprovements to health systems as well as global health security, deficiencies identified needto be actively corrected through robust quality assurance programmes and implementation oflaboratory quality management systems. Given all the pathogens of public health importance, an external quality assessment programmewith a focus on vaccine-preventable diseases and emerging and re-emerging dangerouspathogens is important, and should not be stand-alone, but integrated within laboratorynetworks as seen in polio, measles, yellow fever and rubella. In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Preventionthe London School of Hygiene & Tropical Medicine and partners in a series of consultationswith countries and national and regional EQA providers for the development of qualityassurance models to support HIV point-of-care testing and monitoring. These consultationsrevealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forthits experience in implementing quality standards for health programmes, and also openeddiscussions on how lessons learned through such established programmes can be utilised tosupporting and strengthening the introduction of early infant diagnosis of HIV and viralload point-of-care testing. An optimised external quality assessment programme will impact the ability of countries tomeet core capacities, providing improved quality management systems, improving theconfidence of diagnostic network services in Africa, and including capacities to detect eventsof

Application of programmable controllers to oil fired boiler light-off system

International Nuclear Information System (INIS)

Copeland, H.C.; Gallaway, E.N.

1978-01-01

A programmable controller has been used to improve the reliability of an oil-fired boiler burner control system. An outdated and failing Germanium discrete transistor logic control system was replaced with a modern solid state large scale integrated circuit programmable controller. The ease of making this conversion at a modest expenditure during a limited boiler outage is explained, as well as pitfalls and problems encountered. Light-off reliability with fuel savings were prime objectives. The boiler, rated at 575,000 lb/hr at 450 psig, is used as a backup steam supply for the dual purpose N Reactor at Hanford, Washington, which supplies 860 MWe to the Bonneville Power Administration and weapons grade Plutonium for the Department of Energy. High reliability in light-off and load ascension from standby is required of the boiler which serves as the backup power supply for the reactor

How is the sustainability of chronic disease health programmes empirically measured in hospital and related healthcare services?-a scoping review.

Science.gov (United States)

Francis, Linda; Dunt, David; Cadilhac, Dominique A

2016-05-31

Programmes to address chronic disease are a focus of governments worldwide. Despite growth in 'implementation science', there is a paucity of knowledge regarding the best means to measure sustainability. The aim of this review was to summarise current practice for measuring sustainability outcomes of chronic disease health programmes, providing guidance for programme planners and future directions for the academic field. A scoping review of the literature spanning 1985-2015 was conducted using MEDLINE, CINAHL, PsychINFO and The Cochrane Library limited to English language and adults. Main search terms included chronic disease, acute care, sustainability, institutionalisation and health planning. A descriptive synthesis was required. Settings included primary care, hospitals, mental health centres and community health. Programmes included preventing or managing chronic conditions including diabetes, heart disease, depression, respiratory disease, cancer, obesity, dental hygiene and multiple chronic diseases. Outcome measures included clarifying a sustainability definition, types of methodologies used, timelines for assessment, criteria levels to determine outcomes and how methodology varies between intervention types. Among 153 abstracts retrieved, 87 were retained for full article review and 42 included in the qualitative synthesis. Five definitions for sustainability outcome were identified with 'maintenance of programme activities' most frequent. Achieving sustainability was dependent on inter-relationships between various organisational and social contexts supporting a broad scale approach to evaluation. An increasing trend in use of mixed methods designs over multiple time points to determine sustainability outcomes was found. Despite the importance and investment in chronic disease programmes, few studies are undertaken to measure sustainability. Methods to evaluate sustainability are diverse with some emerging patterns in measurement found. Use of mixed

Using intervention mapping (IM to develop a self-management programme for employees with a chronic disease in the Netherlands

Directory of Open Access Journals (Sweden)

Heerkens Yvonne F

2010-06-01

Full Text Available Abstract Background Employees with a chronic disease often encounter problems at work because of their chronic disease. The current paper describes the development of a self-management programme based on the Chronic Disease Self-Management programme (CDSMP of Stanford University to help employees with a chronic somatic disease cope with these problems at work. The objective of this article is to present the systematic development and content of this programme. Methods The method of intervention mapping (Bartholomew 2006 was used to tailor the original CDSMP for employees with a chronic somatic disease. This paper describes the process of adjusting the CDSMP for this target group. A needs assessment has been carried out by a literature review and qualitative focus groups with employees with a chronic disease and involved health professionals. On the basis of the needs assessment, the relevant determinants of self-management behaviour at work have been identified for the target population and the objectives of the training have been formulated. Furthermore, techniques have been chosen to influence self-management and the determinants of behaviour and a programme plan has been developed. Results The intervention was designed to address general personal factors such as lifestyle, disease-related factors (for example coping with the disease and work-related personal factors (such as self-efficacy at work. The course consists of six sessions of each two and a half hour and intents to increase the self management and empowerment of employees with a chronic somatic disease. Conclusion Intervention mapping has been found to be a useful tool for tailoring in a systematic way the original CDSMP for employees with a chronic somatic disease. It might be valuable to use IM for the development or adjusting of interventions in occupational health care.

Are cardiovascular disease risk assessment and management programmes cost effective? A systematic review of the evidence.

Science.gov (United States)

Lee, John Tayu; Lawson, Kenny D; Wan, Yizhou; Majeed, Azeem; Morris, Stephen; Soljak, Michael; Millett, Christopher

2017-06-01

The World Health Organization recommends that countries implement population-wide cardiovascular disease (CVD) risk assessment and management programmes. The aim of this study was to conduct a systematic review to evaluate whether this recommendation is supported by cost-effectiveness evidence. Published economic evaluations were identified via electronic medical and social science databases (including Medline, Web of Science, and the NHS Economic Evaluation Database) from inception to March 2016. Study quality was evaluated using a modified version of the Consolidated Health Economic Evaluation Reporting Standards. Fourteen economic evaluations were included: five studies based on randomised controlled trials, seven studies based on observational studies and two studies using hypothetical modelling synthesizing secondary data. Trial based studies measured CVD risk factor changes over 1 to 3years, with modelled projections of longer term events. Programmes were either not, or only, cost-effective under non-verified assumptions such as sustained risk factor changes. Most observational and hypothetical studies suggested programmes were likely to be cost-effective; however, study deigns are subject to bias and subsequent empirical evidence has contradicted key assumptions. No studies assessed impacts on inequalities. In conclusion, recommendations for population-wide risk assessment and management programmes lack a robust, real world, evidence basis. Given implementation is resource intensive there is a need for robust economic evaluation, ideally conducted alongside trials, to assess cost effectiveness. Further, the efficiency and equity impact of different delivery models should be investigated, and also the combination of targeted screening with whole population interventions recognising that there multiple approaches to prevention. Copyright © 2017. Published by Elsevier Inc.

Toward Automating Web Protocol Configuration for a Programmable Logic Controller Emulator

Science.gov (United States)

2014-06-19

Security Risks for Industrial Control Systems ,” VDE 2004 Congress, Berlin, Germany, October 2004, pp. 1-7. [Cis12] Cisco, NetFlow Configuration Guide...Date 29 May 2014 Date AFIT-ENG-T-14-J-4 Abstract Industrial Control Systems (ICS) remain vulnerable through attack vectors that exist within programmable...5 2.2 Industrial Control Systems

Adherence challenges encountered in an intervention programme to combat chronic non-communicable diseases in an urban black community, Cape Town

Directory of Open Access Journals (Sweden)

Nasheetah Solomons

2017-10-01

Full Text Available Background: Chronic non-communicable diseases (CNCD have become the greatest contributor to the mortality rate worldwide. Despite attempts by Governments and various non-governmental organisations to prevent and control the epidemic with various intervention strategies, the number of people suffering from CNCD is increasing at an alarming rate in South Africa and worldwide. Objectives: Study's objectives were to explore perceived challenges with implementation of, and adherence to health messages disseminated as part of a CNCD intervention programme; to gain an understanding of participants' expectations of CNCD intervention programmes;, and to explore the acceptability and preference of health message dissemination methods. In addition, participants' awareness of, and willingness to participate inCNCDs intervention programmes in their community was explored. Methods: Participants were recruited from the existing urban Prospective Urban Rural Epidemiology study site in Langa, Cape Town. Focus group discussions were conducted with 47participants using a question guide. Summative content analysis was used to analyse the data. Results: Four themes emerged from the data analysis: practical aspects of implementation and adherence to intervention programmes; participants' expectations of intervention programmes; aspects influencing participants' acceptance of interventions; and their preferences for health message dissemination. The results of this study will be used to inform CNCDs intervention programmes. Conclusions: Our findings revealed that although participants found current methods of health message dissemination in CNCDs intervention acceptable, they faced real challenges with implementing and adhering to CNCDs to these messages.

Roles of programmable logic controllers in fuel reprocessing plants

International Nuclear Information System (INIS)

Mishra, Hrishikesh; Balakrishnan, V.P.; Pandya, G.J.

1999-01-01

Fuel charging facility is another application of Programmable Logic Controllers (PLC) in fuel reprocessing plants, that involves automatic operation of fuel cask dolly, charging motor, pneumatic doors, clutches, clamps, stepper motors and rod pushers in a pre-determined sequence. Block diagram of ACF system is given for underlining the scope of control and interlocks requirements involved for automation of the fuel charging system has been provided for the purpose at KARP Plant, Kalpakkam

A new joint training programme in infectious diseases and medical microbiology.

Science.gov (United States)

Cohen, J; Roberts, C

2000-01-01

The increasing overlap between the disciplines of medical microbiology and infectious diseases prompted the Joint Royal Colleges Committee on Infection and Tropical Medicine to set up a working party to examine how trainees could obtain certification in both subjects. Following widespread consultations, a scheme was developed that entails six years of training and leads to the award of CCSTs in both microbiology and infectious diseases. Both Royal Colleges and the Specialist Training Authority have approved the scheme. Joint training will be demanding and will not be suitable for everyone; it represents an alternative approach to training in the infection disciplines that will run alongside the existing monospecialty training programmes.

Development and evaluation of a dietary self-management programme for older adults with low literacy and heart disease: pilot study of feasibility and acceptability.

Science.gov (United States)

Shao, Jung-Hua; Chen, Su-Hui

2016-12-01

To develop a dietary self-management programme for salt-, fluid-, fat- and cholesterol-intake behaviours for older adults with low literacy and heart disease and evaluate the feasibility and acceptability of the programme. Eating behaviours such as fluid, salt, fat and cholesterol intake are an important factor related to heart disease outcomes. People with low literacy have difficulty following recommended health behaviours, but limited research has investigated intervention programmes for this population. Programme development and pilot testing its feasibility and acceptability. Recommendations were also collected from participants and the research assistant for future large-scale interventions. The study had two phases. Phase I consisted of programme development based on previous qualitative findings, a systematic review of the literature, clinical practice experience and expert opinion. In Phase II, we pilot tested the programme from January - June 2014 in a convenience sample of 10 older adults with low literacy, heart disease and recruited from a medical centre in northern Taiwan. Pilot testing showed that our programme was feasible and acceptable to older adults with low literacy and heart disease. Moreover, the final version of the programme was revised based on participants' and the research assistant's recommendations. Our study results suggest that with guidance and assistance, older adults with low literacy and heart disease can be motivated to take action for their health and are empowered by learning how to self-manage their heart-healthy eating behaviours. © 2016 John Wiley & Sons Ltd.

Programmable logic control applied to a coal preparation plant complex

Energy Technology Data Exchange (ETDEWEB)

Krahenbil, L W

1979-02-01

The programmable Logic Controller (PLC), at its present stage of evolution, is now considered as a mature control system. The PLC combines the solid-state reliability of hard-wired logic and computer control systems with the simplicity of a relay ladder logic. Relay symbolic programming through a function-oriented keyboard provides a means which plant personnel can easily become accoustomed to work with. In a large coal facility, it is shown that the control engineer can provide improved control flexibility with the advanced capabilities of the PLC.

Emergency Diesel: Safety-related instrumentation and control with programmable logic controllers

International Nuclear Information System (INIS)

Breidenich, G.; Luedtke, M.

2004-01-01

This report presents a new concept for the design of emergency diesel equipment protection circuits as a part of the safety related instrumentation in the nuclear power plant Biblis, units A and B. The concept was implemented with state of the art SIMATIC S7/316 programmable logic controllers (PLCs) and can be adapted to any system with high availability requirements (e.g. power plant turbines, aircraft engines, mining pumps etc). (orig.)

Foot-and-mouth disease control and eradication in the Bicol Surveillance Buffer Zone of the Philippines.

Science.gov (United States)

Windsor, P A; Freeman, P G; Abila, R; Benigno, C; Verin, B; Nim, V; Cameron, A

2011-10-01

Following the onset of an epidemic of foot and mouth disease (FMD) commencing in 1994 and affecting mainly pigs in the Philippines, a National Plan for the Control and Eradication of the disease was initiated. A disease surveillance buffer zone in the southern Luzon region of Bicol was established to protect the Visayas and Mindanao from infection and enable eventual elimination of the disease in Luzon. With achievement of Office International Epizooties (OIE)-certified FMD freedom with vaccination in the Philippines now imminent, the four components of the disease control strategy are reviewed, including quarantine and animal movement controls, strategic vaccination, surveillance and disease investigation, and enhanced public awareness with school on the air radio programmes. Although numbers of outbreaks declined following widespread vaccination, evaluation of serological responses in vaccinates suggested low levels of immune protection. The cessation of outbreaks was considered more likely a result of animal movement controls, improved surveillance and emergency response capability, and reduction in FMD-risk behaviours by livestock owners, particularly through efforts to enhance public awareness of biosecurity measures by the training of traders, livestock industry personnel and both commercial and smallholder farmers. A two-stage random sampling serosurveillance strategy enabled identification of residual infection that was not detected through opportunistic sampling and negative incident reporting. Intensive investigations of FMD outbreaks, particularly in Albay province in 1999, enabled improved understanding of the risk factors involved in disease transmission and implementation of appropriate interventions. The findings from this review are offered to assist development of FMD control and eradication programmes in other countries in south-east Asia that are now being encouraged to support the OIE goal of FMD freedom with vaccination by 2020. © 2011

Nurse- and peer-led self-management programme for patients with an implantable cardioverter defibrillator; a feasibility study

Directory of Open Access Journals (Sweden)

van Eijk Jacques

2007-09-01

Full Text Available Abstract Background The prevalence of cardiovascular disease is increasing. Improved treatment options increase survival after an acute myocardial infarction or sudden cardiac arrest, although patients often have difficulty adjusting and regaining control in daily life. In particular, patients who received an implantable cardioverter defibrillator (ICD experience physical and psychological problems. Interventions to enhance perceived control and acceptance of the device are therefore necessary. This paper describes a small-scale study to explore the feasibility and the possible benefits of a structured nurse- and peer-led self-management programme ('Chronic Disease Self-Management Program' – CDSMP among ICD patients. Methods Ten male ICD patients (mean age = 65.5 years participated in a group programme, consisting of six sessions, led by a team consisting of a nurse specialist and a patient with cardiovascular disease. Programme feasibility was evaluated among patients and leaders by measuring performance of the intervention according to protocol, attendance and adherence of the participating ICD patients, and patients' and leaders' opinions about the programme. In addition, before and directly after attending the intervention, programme benefits (e.g. perceived control, symptoms of anxiety and depression, and quality of life were assessed. Results The programme was conducted largely according to protocol. Eight patients attended at least four sessions, and adherence ranged from good to very good. On average, the patients reported to have benefited very much from the programme, which they gave an overall report mark of 8.4. The leaders considered the programme feasible as well. Furthermore, improvements were identified for general self-efficacy expectancies, symptoms of anxiety, physical functioning, social functioning, role limitations due to physical problems, and pain. Conclusion This study suggests that a self-management programme led by a

Costs and cost-effectiveness of the nursing programme 'Coping with itch' for patients with chronic pruritic skin disease

NARCIS (Netherlands)

van Os-Medendorp, H.; Guikers, C. L. H.; Eland-de Kok, P. C. M.; Ros, W. J. G.; Bruijnzeel-Koomen, C. A. F. M.; Buskens, E.

Background Itch, a major symptom of many skin diseases, has a great impact on quality of life. The nursing programme 'Coping with itch' aims at reducing itch and at helping patients to cope with itch. Objectives To explore costs and cost-effectiveness of the programme. Methods A randomized

Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial.

Science.gov (United States)

Mash, Bob; Levitt, Naomi; Steyn, Krisela; Zwarenstein, Merrick; Rollnick, Stephen

2012-12-24

Diabetes is an important contributor to the burden of disease in South Africa and prevalence rates as high as 33% have been recorded in Cape Town. Previous studies show that quality of care and health outcomes are poor. The development of an effective education programme should impact on self-care, lifestyle change and adherence to medication; and lead to better control of diabetes, fewer complications and better quality of life. Pragmatic cluster randomized controlled trialParticipants: Type 2 diabetic patients attending 45 public sector community health centres in Cape TownInterventions: The intervention group will receive 4 sessions of group diabetes education delivered by a health promotion officer in a guiding style. The control group will receive usual care which consists of ad hoc advice during consultations and occasional educational talks in the waiting room. To evaluate the effectiveness of the group diabetes education programmeOutcomes: diabetes self-care activities, 5% weight loss, 1% reduction in HbA1c. self-efficacy, locus of control, mean blood pressure, mean weight loss, mean waist circumference, mean HbA1c, mean total cholesterol, quality of lifeRandomisation: Computer generated random numbersBlinding: Patients, health promoters and research assistants could not be blinded to the health centre's allocationNumbers randomized: Seventeen health centres (34 in total) will be randomly assigned to either control or intervention groups. A sample size of 1360 patients in 34 clusters of 40 patients will give a power of 80% to detect the primary outcomes with 5% precision. Altogether 720 patients were recruited in the intervention arm and 850 in the control arm giving a total of 1570. The study will inform policy makers and managers of the district health system, particularly in low to middle income countries, if this programme can be implemented more widely. Pan African Clinical Trial Registry PACTR201205000380384.

Methods for estimating population coverage of mass distribution programmes: a review of practices in relation to trachoma control.

Science.gov (United States)

Cromwell, Elizabeth A; Ngondi, Jeremiah; McFarland, Deborah; King, Jonathan D; Emerson, Paul M

2012-10-01

In the context of trachoma control, population coverage with mass drug administration (MDA) using antibiotics is measured using routine data. Due to the limitations of administrative records as well as the potential for bias from incomplete or incorrect records, a literature review of coverage survey methods applied in neglected tropical disease control programmes and immunisation outreach was conducted to inform the design of coverage surveys for trachoma control. Several methods were identified, including the '30 × 7' survey method for the Expanded Programme on Immunization (EPI 30×7), other cluster random sampling (CRS) methods, lot quality assurance sampling (LQAS), purposive sampling and routine data. When compared against one another, the EPI and other CRS methods produced similar population coverage estimates, whilst LQAS, purposive sampling and use of administrative data did not generate estimates consistent with CRS. In conclusion, CRS methods present a consistent approach for MDA coverage surveys despite different methods of household selection. They merit use until standard guidelines are available. CRS methods should be used to verify population coverage derived from LQAS, purposive sampling methods and administrative reports. Copyright © 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

Evaluation of a structured goal planning and tailored follow-up programme in rehabilitation for patients with rheumatic diseases: protocol for a pragmatic, stepped-wedge cluster randomized trial

Science.gov (United States)

2014-01-01

Background Comprehensive rehabilitation, involving health professionals from various disciplines, is widely used as an adjunct to pharmacological and surgical treatment in people with rheumatic diseases. However, the evidence for the clinical- and cost-effectiveness of such interventions is limited, and the majority of those who receive rehabilitation are back to their initial health status six to 12 months after discharge. Methods/design To evaluate the goal attainment, health effects and cost-effectiveness of a new rehabilitation programme compared to current traditional rehabilitation programmes for people with rheumatic diseases, a stepped-wedge cluster randomized trial will be performed. Patients admitted for rehabilitation at six centres in the south-eastern part of Norway will be invited to participate. In the trial, six participating centres will switch from a control (current rehabilitation programme) to an intervention phase (the new rehabilitation programme) in a randomized order. Supported by recent research, the new programme will be a supplement to the existing programme at each centre, and will comprise four elements designed to enhance and support lifestyle changes introduced in the rehabilitation period: structured goal-planning, motivational interviewing, a self-help booklet and four follow-up telephone calls during the first five months following discharge. The primary outcome will be health-related quality of life and goal attainment, as measured by the Patient Generated Index directly before and after the rehabilitation stay, as well as after six and 12 months. Secondary outcomes will include self-reported pain, fatigue, a global assessment of disease activity and motivation for change (measured on 11-point numeric ratings scales), health-related quality of life as measured by the Short Form 36 Health Survey (SF-36) and utility assessed by the SF6D utility index. The main analysis will be on an intention to treat basis and will assess the

Management of Industrial Processes with Programmable Logic Controller

Directory of Open Access Journals (Sweden)

Marius Tufoi

2009-10-01

Full Text Available In a modern economy, automation (the control is primarily to raise the competitiveness of a product, either directly through price or quality, or indirectly through the improvement of working conditions of staff productive. The control of industrial processes involves the management of dynamic systems that have continuous states. These systems are described by differential equations and, in general, analog inputs and outputs. Management of these systems is achieved, in general, with classical automation, by automation or with analog computers which contains modules with input / output analog performance. If states, inputs and outputs of a system can be modeled using binary variables, then these systems can be driven with Programmable Logic Controller.

Parental experiences with a hospital-based bead programme for children with congenital heart disease.

Science.gov (United States)

Wilson, Valerie; Chando, Shingisai

2015-02-01

To present survey findings on parental experiences with a hospital-based bead programme for children with congenital heart disease. The Heart Beads programme commenced at a paediatric hospital in Australia in 2008. Children enrolled in the programme are awarded a distinctive bead for every procedure/treatment they have while in hospital. A previous evaluation study on the programme revealed that the beads are therapeutic for the child and parents; however, due to a small sample size, the results were representative of the experiences of a small number of families who participated in the programme. This was an evaluation study which employed a nonexperimental descriptive design. Surveys were mailed to all eligible families who enrolled in the programme. Data collection occurred between July-December 2012. Questions on parental experiences with the Heart Beads programme were divided into three categories: understanding, acknowledgement and quality. Descriptive statistics were obtained and analysed. One hundred and sixty-two mothers and 136 fathers responded to the survey. Heart Beads assisted mothers (83%) and fathers (80%) with understanding their child's condition and helped them with communication (mothers 80%, fathers 58%). The majority of fathers felt that their experience was acknowledged by nursing staff (64%) and medical staff (62%), while mothers indicated a higher response from nurses (76%) compared to medical staff (67%). Overall, parents rated the programme positively; however, there was some concern that children at times missed out on beads. Understanding how mothers and fathers experience the programme differently can guide staff in their communication with parents and inform future initiatives. The Heart Beads help nurses understand how parents are experiencing care and ways in which they can provide support and acknowledgement of the parent's experience. © 2014 John Wiley & Sons Ltd.

Home exercise programmes supported by video and automated reminders compared with standard paper-based home exercise programmes in patients with stroke: a randomized controlled trial.

Science.gov (United States)

Emmerson, Kellie B; Harding, Katherine E; Taylor, Nicholas F

2017-08-01

To determine whether patients with stroke receiving rehabilitation for upper limb deficits using smart technology (video and reminder functions) demonstrate greater adherence to prescribed home exercise programmes and better functional outcomes when compared with traditional paper-based exercise prescription. Randomized controlled trial comparing upper limb home exercise programmes supported by video and automated reminders on smart technology, with standard paper-based home exercise programmes. A community rehabilitation programme within a large metropolitan health service. Patients with stroke with upper limb deficits, referred for outpatient rehabilitation. Participants were randomly assigned to the control (paper-based home exercise programme) or intervention group (home exercise programme filmed on an electronic tablet, with an automated reminder). Both groups completed their prescribed home exercise programme for four weeks. The primary outcome was adherence using a self-reported log book. Secondary outcomes were change in upper limb function and patient satisfaction. A total of 62 participants were allocated to the intervention ( n = 30) and control groups ( n = 32). There were no differences between the groups for measures of adherence (mean difference 2%, 95% CI -12 to 17) or change in the Wolf Motor Function Test log transformed time (mean difference 0.02 seconds, 95% CI -0.1 to 0.1). There were no between-group differences in how participants found instructions ( p = 0.452), whether they remembered to do their exercises ( p = 0.485), or whether they enjoyed doing their exercises ( p = 0.864). The use of smart technology was not superior to standard paper-based home exercise programmes for patients recovering from stroke. This trial design was registered prospectively with the Australian and New Zealand Clinical Trials Register, ID: ACTRN 12613000786796. http://www.anzctr.org.au/trialSearch.aspx.

Towards livestock disease diagnosis and control in the 21st century. Proceedings of an international symposium

International Nuclear Information System (INIS)

1998-01-01

Livestock diseases remain a key constraint to livestock production in developing countries. Diseases like rinderpest, foot-and-mouth disease, brucellosis, trypanosomosis, tick borne diseases such as anaplasmosis, heartwater and East Coast fever, contagious bovine pleuropneumonia and Newcastle disease have caused great economic losses in various parts of the world. The control, and ultimate eradication where possible, of these and other diseases is important for the economies of many nations. It is for this reason that both the IAEA and the FAO have put great emphasis on the control and eradication of livestock diseases. The success of any disease control or eradication programme relies heavily on the robustness and efficacy of tile diagnosis, surveillance or seromonitoring method or methods being used. Nuclear based and related techniques such as enzyme linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) have played and continue to play a vital role in this regard. The aim of this symposium is to review existing and emerging techniques used in disease diagnosis and control and to carefully put them in context for use in developing countries in the future

AHP Expert Programme As A Tool For Unsealed Sources Contamination Control Of The Environment

International Nuclear Information System (INIS)

Amin, E.T.; Ibrahim, M.S.; Hussein, A.Z.

2007-01-01

Unsealed sources of radionuclides are widely used in hot laboratories of medical centers and hospitals which can be easily dispersed and may be taken undue into the body. The presence of radioactive substances inside the human body generates risk of internal intakes of radionuclides and organ's tissue retention. In order to make control for any contamination occurring from unsealed sources, an AHP programme (PC programme) has been developed so that it includes all data of most unsealed sources used in the hot laboratories of nuclear medicine units at hospitals/medical centers. Sequence of questions are retrieved by the programme in relevance to the place address, uses, activity and half life of the unsealed radioisotopes that may cause contamination. The programme will also give information output about the hospital that use the unsealed source and its location which facilitate emergency planning and contamination control to the environment

Programmer`s manual for CAMCON: Compliance Assessment Methodology CONtroller

Energy Technology Data Exchange (ETDEWEB)

Rechard, R.P. [Sandia National Labs., Albuquerque, NM (United States); Gilkey, A.P.; Rudeen, D.K.; Byle, K.A. [New Mexico Engineering Research Inst., Albuquerque, NM (United States); Iuzzolino, H.J. [Geo-Centers, Inc., Albuquerque, NM (United States)

1993-05-01

CAMCON, the Compliance Assessment Methodology CONtroller, is an analysis system that assists in assessing the compliance of the Waste Isolation Pilot Plant (WIPP) with applicable long-term regulations of the US Environmental Protection Agency, including Subpart B of the Environmental Standards for the Management and Disposal of spent Nuclear Fuel, High-Level and Transuranic Radioactive Wastes, 40 CFR 191 and 40CFR268.6, which is the portion of the Land Disposal Restrictions implementing the Resource, Conservative, and Recovery Act of 1976, as amended that states the conditions for disposal of hazardous chemical wastes. This manual provides an architectural overview of the CAMCON system. Furthermore this manual presents guidelines and presents suggestions for programmers developing the many different types of software necessary to investigate various events and physical processes of the WIPP. These guidelines include user interface requirements, minimum quality assurance requirements, coding style suggestions, and the use of numerous software libraries developed specifically for or adapted for the CAMCON system.

Structured education programme for women with polycystic ovary syndrome: a randomised controlled trial

Directory of Open Access Journals (Sweden)

Hamidreza Mani

2017-12-01

Full Text Available Objective: To evaluate the effectiveness of a structured education programmes in women with polycystic ovary syndrome (PCOS. Methods: Single-centre, randomised controlled trial, testing a single exposure to a group-based, face-to-face, structured education programme. Inclusion criteria were women with PCOS, aged 18–49 years inclusive and body mass index ≥23 kg/m2 for black and minority ethnicities or ≥25 kg/m2 for white Europeans. Primary outcome was step-count/day at 12 months. Secondary outcomes included indices of physical activity, cardiovascular risk factors, quality of life (QoL and illness perception (IP. Results: 161 women were included (78 control, 83 intervention; 69% white; mean age 33.4 (s.d. 7.6 years, of whom 100 (48 intervention; 52 control attended their 12-month visit (38% attrition. 77% of the intervention arm attended the education programme. No significant change in step-count was observed at 12 months (mean difference: +351 steps/day (95% confidence interval −481, +1183; P = 0.40. No differences were found in biochemical or anthropometric outcomes. The education programme improved participants’ IP in 2 dimensions: understanding their PCOS (P < 0.001 and sense of control (P < 0.01 and improved QoL in 3 dimensions: emotions (P < 0.05, fertility (P < 0.05, weight (P < 0.01 and general mental well-being (P < 0.01. Discussion: A single exposure to structured education programme did not increase physical activity or improve biochemical markers in overweight and obese women with PCOS. However, providing a structured education in parallel to routine medical treatment can be beneficial for participants’ understanding of their condition, reducing their anxiety and improving their QoL.

Chitosan (biochikol 020 PC) in the control of some ornamental foliage diseases.

Science.gov (United States)

Wojdyła, A T

2004-01-01

Chitosan, (Biochikol 020 PC) a potential elicitor of plant defence and also an active inhibitor of fungal growth was used in experiments. The compound was used at concentrations 0.01 to 0.2% as a plant spray for rose protection against Sphaerotheca pannosa var. rosae, Peronospora sparsa and Diplocarpon rosae, Oidium chrysanthemi and Puccinia horiana on chrysanthemum, against Melampsora epitea on willow. Myrothecium roridum on dieffenbachia and against Lophodermium spp on Scots pine. Effectiveness of this product, applied curatively 2-times at 7-day-intervals after appearance of rose powdery mildew symptoms on most of plant parts, was about 32%. When compound was applied just after the first disease symptoms appearance, after 2-week-protection its effectiveness was about 43-60%. After 4 weeks, effectiveness of chitosan (Biochikol 020 PC) increased and ranged from 67 to 77%. In the control of P. sparsa on rose shrubs, growing in plastic tunnel, chitosan at conc. 0.025% was applied 4 times at weekly intervals. Effectiveness of chitosan against this pathogen was over 72%, similar as standard fungicide. Increase of chitosan (Biochikol 020 PC) concentration resulted in decrease of its effectiveness. In case of D. rosae control, chitosan used 9 times at weekly intervals was applied after first disease symptoms. After 3-week-protection effectiveness of the compound varied from 18 to 60% according to used concentration. After 9 weeks of protection effectiveness of tested product ranged from 16 to 23% and was connected with used concentration. Increase of chitosan concentration resulted in better protection of rose shrubs. Effectiveness of chitosan (Biochikol 020 PC) used 4-times at conc. 0.01 to 0.05% as chrysanthemum spray in the control of Oidium chrysanthemi ranged from 69 to 79%, whereas against Puccinia horiana from 54-97%. Two-time-spraying of willow with rust symptoms (Melampsora epitea) with chitosan at conc. 01-0.04% caused decrease of disease severity from 26 to

Effectiveness of rotavirus pentavalent vaccine under a universal immunization programme in Israel, 2011-2015: a case-control study.

Science.gov (United States)

Muhsen, K; Anis, E; Rubinstein, U; Kassem, E; Goren, S; Shulman, L M; Ephros, M; Cohen, D

2018-01-01

The use of rotavirus pentavalent vaccine (RotaTeq ® ) as a sole vaccine within rotavirus universal immunization programmes remains limited. We examined the effectiveness of RotaTeq in preventing rotavirus gastroenteritis (RVGE) hospitalization in Israel, after the introduction of universal immunization against the disease. A test-negative case-control study included age-eligible children for universal RotaTeq immunization (aged 2-59 months, born in 2011-2015). Cases (n = 98) were patients who tested positive for rotavirus by immunochromatography; those who tested negative (n = 628) comprised the control group. Information on rotavirus immunization history was obtained through linkage with a national immunization registry. Vaccination status was compared between cases and controls, adjusted odds ratios (aORs) were obtained from logistic regression models, and vaccine effectiveness calculated as (1 - aOR)*100. Immunization with RotaTeq was less frequent in RVGE cases (73.5%) than in controls (90.1%), p < 0.001; this association persisted after controlling for potential confounders. Effectiveness of the complete vaccine series was estimated at 77% (95% confidence interval (CI): 49-90) in children aged 6-59 months, and 86% (95% CI: 65-94) in children aged 6-23 months; whereas for the incomplete series, the respective estimates were 72% (95% CI: 28-89) and 75% (95% CI: 30-91). Vaccine effectiveness was estimated at 79% (95% CI: 45-92) against G1P[8]-associated RVGE hospitalizations and 69% (95% CI: 11-89) against other genotype-RVGE hospitalizations. High effectiveness of RotaTeq as the sole rotavirus vaccine in a universal immunization programme was demonstrated in a high-income country. Although partial vaccination conferred protection, completing the vaccine series is warranted to maximize the benefit. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Norms concerning the programmable automatic control devices

International Nuclear Information System (INIS)

Fourmentraux, G.

1995-01-01

This presentation is a report of the studies carried out by the Work Group on Functioning Safety of Programmable Automatic Control Devices and by the Group for Prevention Studies (GEP) from the CEA. The objective of these groups is to evaluate the methods which could be used to estimate the functioning safety of control and instrumentation systems involved in the Important Elements for Safety (EIS) of the Basic Nuclear Installations (INB) of the CEA, and also to carry out a qualification of automatic control devices. Norms, protocols and tools for the evaluation are presented. The problem comprises two aspects: the evaluation of fault avoidance techniques and the evaluation of fault control techniques used during the conceiving. For the fault avoidance techniques, the quality assurance organization, the environment tests, and the software quality plans are considered. For the fault control techniques, the different available tools and fault injection models are analysed. The results of an analysis carried out with the DEF.I tool from the National Institute for Research and Safety (INRS) are reported. (J.S.). 23 refs

The impact of Chagas disease control in Latin America: a review.

Science.gov (United States)

Dias, J C P; Silveira, A C; Schofield, C J

2002-07-01

Discovered in 1909, Chagas disease was progressively shown to be widespread throughout Latin America, affecting millions of rural people with a high impact on morbidity and mortality. With no vaccine or specific treatment available for large-scale public health interventions, the main control strategy relies on prevention of transmission, principally by eliminating the domestic insect vectors and control of transmission by blood transfusion. Vector control activities began in the 1940s, initially by means of housing improvement and then through insecticide spraying following successful field trials in Brazil (Bambui Research Centre), with similar results soon reproduced in São Paulo, Argentina, Venezuela and Chile. But national control programmes only began to be implemented after the 1970s, when technical questions were overcome and the scientific demonstration of the high social impact of Chagas disease was used to encourage political determination in favour of national campaigns (mainly in Brazil). Similarly, large-scale screening of infected blood donors in Latin America only began in the 1980s following the emergence of AIDS. By the end of the last century it became clear that continuous control in contiguous endemic areas could lead to the elimination of the most highly domestic vector populations - especially Triatoma infestans and Rhodnius prolixus - as well as substantial reductions of other widespread species such as T. brasiliensis, T. sordida, and T. dimidiata, leading in turn to interruption of disease transmission to rural people. The social impact of Chagas disease control can now be readily demonstrated by the disappearance of acute cases and of new infections in younger age groups, as well as progressive reductions of mortality and morbidity rates in controlled areas. In economic terms, the cost-benefit relationship between intervention (insecticide spraying, serology in blood banks) and the reduction of Chagas disease (in terms of medical and

The impact of Chagas disease control in Latin America: a review

Directory of Open Access Journals (Sweden)

JCP Dias

2002-07-01

Full Text Available Discovered in 1909, Chagas disease was progressively shown to be widespread throughout Latin America, affecting millions of rural people with a high impact on morbidity and mortality. With no vaccine or specific treatment available for large-scale public health interventions, the main control strategy relies on prevention of transmission, principally by eliminating the domestic insect vectors and control of transmission by blood transfusion. Vector control activities began in the 1940s, initially by means of housing improvement and then through insecticide spraying following successful field trials in Brazil (Bambui Research Centre, with similar results soon reproduced in São Paulo, Argentina, Venezuela and Chile. But national control programmes only began to be implemented after the 1970s, when technical questions were overcome and the scientific demonstration of the high social impact of Chagas disease was used to encourage political determination in favour of national campaigns (mainly in Brazil. Similarly, large-scale screening of infected blood donors in Latin America only began in the 1980s following the emergence of AIDS. By the end of the last century it became clear that continuous control in contiguous endemic areas could lead to the elimination of the most highly domestic vector populations - especially Triatoma infestans and Rhodnius prolixus - as well as substantial reductions of other widespread species such as T. brasiliensis, T. sordida, and T. dimidiata, leading in turn to interruption of disease transmission to rural people. The social impact of Chagas disease control can now be readily demonstrated by the disappearance of acute cases and of new infections in younger age groups, as well as progressive reductions of mortality and morbidity rates in controlled areas. In economic terms, the cost-benefit relationship between intervention (insecticide spraying, serology in blood banks and the reduction of Chagas disease (in terms

Programmable Logic Controllers for Systems of Automatic of the Level Crossing

Directory of Open Access Journals (Sweden)

Mieczyslaw Kornaszewski

2006-01-01

Full Text Available The railway crossings are vulnerable to incidence of high number of accidents often deadly. In order to face this problem, the modern systems of automatic of the level crossing have been introduced. These systems are based on Programmable Logic Controllers, which allow the designers to exploit self-control mechanisms, events acquiring, technical diagnostic which in turn enable remote control and acquisition of faults.

Application of programmable controllers to vacuum system interlocks

International Nuclear Information System (INIS)

Lee, G.; Moore, D.

1979-11-01

This paper describes the Doublet III Vacuum Control System in which all input signals and output loads are connected to a programmable controller (PC) for logical interfacing. Input signals derived from CAMAC, control panels, limit switches, etc., are implemented as output signals to CAMAC, vacuum valves, pump motors, etc., according to a logic program stored in the PC memory. The memory can be easily programmed by anyone familar with either Boolean algebra or relay-ladder network diagrams. The program data is entered with the aid of a calculator like, keyboard instrument with LED readout displays. The PC system contains a 1024 word RAM memory with a battery backup system to provide 72 hours protection of contents in case of power failure

PID Neural Network Based Speed Control of Asynchronous Motor Using Programmable Logic Controller

Directory of Open Access Journals (Sweden)

MARABA, V. A.

2011-11-01

Full Text Available This paper deals with the structure and characteristics of PID Neural Network controller for single input and single output systems. PID Neural Network is a new kind of controller that includes the advantages of artificial neural networks and classic PID controller. Functioning of this controller is based on the update of controller parameters according to the value extracted from system output pursuant to the rules of back propagation algorithm used in artificial neural networks. Parameters obtained from the application of PID Neural Network training algorithm on the speed model of the asynchronous motor exhibiting second order linear behavior were used in the real time speed control of the motor. Programmable logic controller (PLC was used as real time controller. The real time control results show that reference speed successfully maintained under various load conditions.

The Programmable Logic Controller and its application in nuclear reactor systems

International Nuclear Information System (INIS)

Palomar, J.; Wyman, R.

1993-09-01

This document provides recommendations to guide reviewers in the application of Programmable Logic Controllers (PLCS) to the control, monitoring and protection of nuclear reactors. The first topics addressed are system-level design issues, specifically including safety. The document then discusses concerns about the PLC manufacturing organization and the protection system engineering organization. Supplementing this document are two appendices. Appendix A summarizes PLC characteristics. Specifically addressed are those characteristics that make the PLC more suitable for emergency shutdown systems than other electrical/electronic-based systems, as well as characteristics that improve reliability of a system. Also covered are PLC characteristics that may create an unsafe operating environment. Appendix B provides an overview of the use of programmable logic controllers in emergency shutdown systems. The intent is to familiarize the reader with the design, development, test, and maintenance phases of applying a PLC to an ESD system. Each phase is described in detail and information pertinent to the application of a PLC is pointed out

The Programmable Logic Controller and its application in nuclear reactor systems

Energy Technology Data Exchange (ETDEWEB)

Palomar, J.; Wyman, R. [Lawrence Livermore National Lab., CA (United States)

1993-09-01

This document provides recommendations to guide reviewers in the application of Programmable Logic Controllers (PLCS) to the control, monitoring and protection of nuclear reactors. The first topics addressed are system-level design issues, specifically including safety. The document then discusses concerns about the PLC manufacturing organization and the protection system engineering organization. Supplementing this document are two appendices. Appendix A summarizes PLC characteristics. Specifically addressed are those characteristics that make the PLC more suitable for emergency shutdown systems than other electrical/electronic-based systems, as well as characteristics that improve reliability of a system. Also covered are PLC characteristics that may create an unsafe operating environment. Appendix B provides an overview of the use of programmable logic controllers in emergency shutdown systems. The intent is to familiarize the reader with the design, development, test, and maintenance phases of applying a PLC to an ESD system. Each phase is described in detail and information pertinent to the application of a PLC is pointed out.

Effects of a Worksite Weight-Control Programme in Obese Male Workers: A Randomized Controlled Crossover Trial

Science.gov (United States)

Iriyama, Yae; Murayama, Nobuko

2014-01-01

Objective: We conducted a randomized controlled crossover trial to evaluate the effects of a new worksite weight-control programme designed for men with or at risk of obesity using a combination of nutrition education and nutrition environmental interventions. Subjects and methods: Male workers with or at risk of obesity were recruited for this…

Programmable lighting control: do-it-yourself energy savings

Energy Technology Data Exchange (ETDEWEB)

1982-04-01

At C-E Power Systems, an operating group of Combustion Engineering, Inc., Windsor, CT, the lighting and HVAC in six of 24 buildings are now under microprocessor control, and the necessary equipment to convert two additional buildings before the year end has been ordered. The initial analysis of the economic benefits of a /100,000 investment for the first six buildings showed the system will pay for itself in electricity savings in 30 months or less. In the programmable lighting system, a microprocessor-based central controller is /left double quote/softwired/right double quote/ to a single-chip microcomputer-based local transceiver. The data line provides a high integrity communications channel carrying multiplex commands from the central controllers as well as status and switch override message from the remote transceivers. The controller has the capacity to direct as many as 500 transceivers controlling 8,000 relays.

The role of vaccination in risk mitigation and control of Newcastle disease in poultry.

Science.gov (United States)

Mayers, Jo; Mansfield, Karen L; Brown, Ian H

2017-10-20

Newcastle disease is regarded as one of the most important avian diseases throughout the world and continues to be a threat and economic burden to the poultry industry. With no effective treatment, poultry producers rely primarily on stringent biosecurity and vaccination regimens to control the spread of this devastating disease. This concise review provides an historical perspective of Newcastle disease vaccination and how fundamental research has paved the way for the development of instrumental techniques which are still in use today. Although vaccination programmes have reduced the impact of clinical disease, they have historically been ineffective in controlling the spread of virulent viruses and therefore do not always offer an adequate solution to the world's food security problems. However, the continued development of novel vaccine technology and improved biosecurity measures through education may offer a solution to help reduce the global threat of Newcastle disease on the poultry industry. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Reducing musculoskeletal injury and concussion risk in schoolboy rugby players with a pre-activity movement control exercise programme: a cluster randomised controlled trial.

Science.gov (United States)

Hislop, Michael D; Stokes, Keith A; Williams, Sean; McKay, Carly D; England, Mike E; Kemp, Simon P T; Trewartha, Grant

2017-08-01

Injury risk in youth rugby has received much attention, highlighting the importance of establishing evidence-based injury reduction strategies. To determine the efficacy of a movement control exercise programme in reducing injuries in youth rugby players and to investigate the effect of programme dose on injury measures. In a cluster-randomised controlled trial, 40 independent schools (118 teams, 3188 players aged 14-18 years) were allocated to receive either the intervention or a reference programme, both of which were to be delivered by school coaches. The intervention comprised balance training, whole-body resistance training, plyometric training, and controlled rehearsal of landing and cutting manoeuvres. Time-loss (>24 hours) injuries arising from school rugby matches were recorded by coaches and medical staff. 441 time-loss match injuries (intervention, 233; control, 208) were reported across 15 938 match exposure-hours (intervention, 9083; control, 6855). Intention-to-treat results indicated unclear effects of trial arm on overall match injury incidence (rate ratio (RR)=0.85, 90% confidence limits 0.61 to 1.17), although clear reductions were evident in the intervention arm for concussion incidence (RR=0.71, 0.48 to 1.05). When trial arm comparisons were limited to teams who had completed three or more weekly programme sessions on average, clear reductions in overall match injury incidence (RR=0.28, 0.14 to 0.51) and concussion incidence (RR=0.41, 0.17 to 0.99) were noted in the intervention group. A preventive movement control exercise programme can reduce match injury outcomes, including concussion, in schoolboy rugby players when compared with a standardised control exercise programme, although to realise the greatest effects players should complete the programme at least three times per week. © 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

Can we control all-cause meningococcal disease in Europe?

Science.gov (United States)

Sadarangani, M; Pollard, A J

2016-12-01

Invasive disease caused by Neisseria meningitidis is potentially devastating, with a case fatality rate of 5-15% and high rates of significant sequelae among survivors after septicaemia or meningitis. Capsular group C (MenC) conjugate vaccines have been highly successful in achieving control of MenC disease across Europe, and some countries have also introduced quadrivalent MenACWY conjugate vaccines to reduce disease caused by groups A, W and Y in addition to C. These vaccines putatively elicit protective levels of bactericidal antibodies in all age groups, induce immunologic memory and reduce nasopharyngeal carriage, thereby leading to herd protection. Protein-based meningococcal vaccines based on subcapsular components, and designed primarily to target capsular group B (MenB) disease, have recently been licensed. These vaccines are highly immunogenic in infants and adolescents, inducing bactericidal antibodies against strains expressing high levels of vaccine antigens which are identical to the variants present in the vaccines. Effectiveness of these vaccines at a population level will be determined by whether vaccine-induced antibodies provide cross-protection against variants of the vaccine antigens present on the surface of the diverse collection of circulating invasive strains. The level of serum bactericidal activity induced against strains also seems to depend on the level of expression of the vaccine antigens. The duration of protection and the impact on carriage of meningococci will have a major bearing on the overall effectiveness of the programme. In September 2015 the UK became the first country to introduce the multicomponent meningococcal serogroup B vaccine (4CMenB) into a national routine immunization schedule, and data on the effectiveness of this programme are anticipated in the next few years. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Cost-benefit evaluation in a quality control programme for conventional radiodiagnosis

International Nuclear Information System (INIS)

Gallini, R.; Belletti, S.; Giugni, U.

1985-01-01

A comparison is being made between the cost of the staff and equipment in a quality control programme of conventional radiodiagnosis and the benefit obtained in the reduction of spoilt films and in the reduction of dose to patients and workers. For over two years the programme has followed a protocol verified on about 50 X-ray tubes, 25 radiological devices and four automatic processors. The present research, based on previous data, works on a limited but representative sample of radiological X-ray tubes and accessories. The control procedures are carried out periodically to improve and make constant the efficiency of the radiological devices. An evaluation of the cost of these procedures is made. In the meantime the dose to the patients undergoing radiodiagnostic examinations is evaluated by a transmission chamber. Comparison between the values obtained before and after the control enables the benefits to be evaluated. Rejection of radiographic films is evaluated before and after the control to obtain the cost reduction. During the one year control period, there were no variations in the technical characteristics of the personnel, in the operational procedures or in the work-load. (author)

Effect of Sex Education Programme on at-risk sexual behaviour of school-going adolescents in Ilorin, Nigeria.

Science.gov (United States)

Esere, Mary Ogechi

2008-06-01

Adolescents display sexual behaviours and developmental characteristics that place them at risk for Sexually Transmitted Diseases (STDs). Because young people experiment sexually and because of the consequences of indiscriminate sexual activities on the youth, there is the need to mount sex education programmes that are geared towards enlightenment and appropriate education about sex and sexuality. To determine whether Sex Education Intervention Programme would reduce at-risk sexual behaviours of school-going adolescents. Pre-test, post-test control group quasi-experimental design. A randomly selected co-educational school in Ilorin Metropolis, Nigeria. 24 school-going adolescents aged 13-19 years. Sex Education Programme (treatment group) versus Control programme (placebo). Self-reported exposure to sexually transmitted diseases, multiple sex partners, anal sex, oral sex, non use of condom. When the treatment (intervention) group was compared with the control group in an intention to treat analysis, there were significant differences in at-risk sexual behaviours of the two groups. Those in the intervention group reported less at-risk sexual behaviours than their counterparts in the control group. The treatment group evaluated the intervention programme positively and their knowledge of sexual health improved. Lack of behavioural effect on the control group could be linked to differential quality of delivery of intervention. Compared with the control group, this specially designed intervention sex education programme reduced at-risk sexual behaviour in adolescents. Based on this finding, it was recommended that sex education be introduced into the curriculum of secondary school education in Nigeria.

Programmable controllers replace relays in MFTF-B personnel-safety interlocks

International Nuclear Information System (INIS)

Branum, J.D.

1981-01-01

This paper describes a new approach for implementing personnel safety interlocks logic using industrial-type programmable controllers. The logic for all personnel safety interlocks except those totally internal to a subsystem is implemented in two non-redundant controllers. A high degree of fail-safe reliability is achieved by augmenting the protective features intrinsic to each controller with those provided by a small amount of external support hardware. The controllers are interfaced to the host computer system via fiber optic data links to enable display of interlock and overall system status on the control room graphic displays. When fully implemented, the controllers will perform the equivalent of over 2000 discreet relay functions

Surveillance programme for uncompensated work-related diseases in France.

Science.gov (United States)

Valenty, M; Homère, J; Lemaitre, A; Plaine, J; Ruhlman, M; Cohidon, C; Imbernon, E

2015-11-01

The surveillance programme for uncompensated work-related diseases (UWRDs) in France relies on a network of occupational physicians (OPs) who volunteer to report all UWRDs diagnosed during a biannual 2-week observation period. To describe this programme and the usefulness of its results. During the observation period, OPs record job title and employment sector for each worker. For each potential UWRD, they complete a one-page report form. Between 2007 and 2012, the number of reporting OPs ranged from 705 to 965 and they saw between 78884 and 114154 employees annually. The UWRD incidence rate reports varied from 5 to 5.3% for men and from 6.5 to 7.7% for women, with musculoskeletal disorders (MSDs) being most frequent, followed by mental ill-health. Incidence rates, except for hearing loss, were higher for women than men in all categories and, in 2012, were twice as high for women (3.1%) as for men (1.4%) for mental ill-health. Incidence rates in every category increased with age up to 54 years. The highest rates for MSDs were observed among blue-collar workers (6.9% in women and 4% in men in 2012) and the lowest rates in professionals/managers (1.1 and 0.4%, respectively). Conversely, the latter had the highest incidence of mental health disorders (5.9 and 3.3%). This 'Fortnight' protocol provides useful data on the frequency of diseases linked to employment and allows us to estimate the incidence of UWRDs, whether recognized as compensable or not, as well as their trends over time. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Efficacy of a movement control injury prevention programme in adult men’s community rugby union: a cluster randomised controlled trial

Science.gov (United States)

Attwood, Matthew J; Roberts, Simon P; Trewartha, Grant; England, Mike E; Stokes, Keith A

2018-01-01

Background Exercise programmes aimed at reducing injury have been shown to be efficacious for some non-collision sports, but evidence in adult men’s collision sports such as rugby union is lacking. Objective To evaluate the efficacy of a movement control injury prevention exercise programme for reducing match injuries in adult men’s community rugby union players. Methods 856 clubs were invited to participate in this prospective cluster randomised (single-blind) controlled trial where clubs were the unit of randomisation. 81 volunteered and were randomly assigned (intervention/control). A 42-week exercise programme was followed throughout the season. The control programme reflected ‘normal practice’ exercises, whereas the intervention focused on proprioception, balance, cutting, landing and resistance exercises. Outcome measures were match injury incidence and burden for: (1) all ≥8 days time-loss injuries and (2) targeted (lower limb, shoulder, head and neck, excluding fractures and lacerations) ≥8 days time-loss injuries. Results Poisson regression identified no clear effects on overall injury outcomes. A likely beneficial difference in targeted injury incidence (rate ratio (RR), 90% CI=0.6, 0.4 to 1.0) was identified, with a 40% reduction in lower-limb incidence (RR, 90% CI=0.6, 0.4 to 1.0) and a 60% reduction in concussion incidence (RR, 90% CI=0.4, 0.2 to 0.7) in the intervention group. Comparison between arms for clubs with highest compliance (≥median compliance) demonstrated very likely beneficial 60% reductions in targeted injury incidence (RR, 90% CI=0.4, 0.2 to 0.8) and targeted injury burden (RR, 90% CI=0.4, 0.2 to 0.7). Conclusions The movement control injury prevention programme resulted in likely beneficial reductions in lower-limb injuries and concussion. Higher intervention compliance was associated with reduced targeted injury incidence and burden. PMID:29055883

Effectiveness of comprehensive tobacco control programmes in reducing teenage smoking in the USA.

Science.gov (United States)

Wakefield, M; Chaloupka, F

2000-06-01

To describe the extent to which comprehensive statewide tobacco control programmes in the USA have made progress toward reducing teenage smoking. Literature search of Medline for reviews of effectiveness of programme and policy elements, plus journal articles and personal request for copies of publicly released reports and working papers from evaluation staff in each of the state programmes of California, Massachusetts, Arizona, Oregon, and Florida. All studies, reports, and commentaries that provided information on aspects of programme implementation and evaluation. Statewide comprehensive programmes show high levels of advertising recall and generally positive improvement in smoking related beliefs and attitudes among teenagers. More fully funded programmes lead to increased mass media campaign advertising and community initiatives; a greater capacity to implement school based smoking prevention programmes; and an increase in the passage of local ordinances that create smoke free indoor environments and reduce cigarette sales to youth. The combination of programme activity and increased tobacco tax reduce cigarette consumption more than expected as a result of price increases alone, and these effects seem to apply to adolescents as well as adults. Programmes are associated with a decline in adult smoking prevalence, with these effects observed to date in California, Massachusetts, and Oregon. Arizona and Florida have yet to examine change in adult prevalence associated with programme exposure. California and Massachusetts have demonstrated relative beneficial effects in teenage smoking prevalence, and Florida has reported promising indications of reduced prevalence. Arizona has yet to report follow up data, and Oregon has found no change in teenage smoking, but has only two years of follow up available. One of the most critical factors in programme success is the extent of programme funding, and consequent level of programme implementation, and the degree to

A framework for evaluating community-based physical activity promotion programmes in Latin America.

Science.gov (United States)

Schmid, Thomas L; Librett, John; Neiman, Andrea; Pratt, Michael; Salmon, Art

2006-01-01

A growing interest in promoting physical activity through multi-sectoral community-based programmes has highlighted the need for effective programme evaluation. Meeting in Rio de Janeiro, an international workgroup of behavioural, medical, public health and other scientists and practitioners endorsed the principle of careful evaluation of all programmes and in a consensus process developed the Rio de Janeiro Recommendations for Evaluation of Physical Activity Interventions". Among these recommendations and principles were that when possible, evaluation should 'built into' the programme from the beginning. The workgroup also called for adequate funding for evaluation, setting a goal of about 10% of programme resources for evaluation. The group also determined that evaluations should be developed in conjunction with and the results shared with all appropriate stakeholders in the programme; evaluations should be guided by ethical standards such as those proposed by the American Evaluation Association and should assess programme processes as well as outcomes; evaluation outcomes should be used to revise and refine ongoing programmes and guide decisions about programme continuation or expansion. It was also recognised that additional training in programme evaluation is needed and the Centers for Disease Control and Prevention's Physical Activity Evaluation Handbook could be easily adapted for use in culturally diverse communities, especially in Latin America. This paper describes a 6-step evaluation process and provides the full set of recommendations from the Rio de Janeiro Workgroup. The handbook has been translated and additional case studies from Colombia and Brazil have been added. Spanish and Portuguese language editions of the Evaluation Handbook are available from the Centers for Disease Control and Prevention, Physical Activity and Health Branch.

Programmable logic controllers in Heavy Water Project, Manuguru (Paper No. 3.4)

International Nuclear Information System (INIS)

Gupta, S.C.; Bhaskar, R.; Maiti, A.; Venkatesu, G.; Satish, P.; Goel, R.K.

1992-01-01

Enhancement to plant operational flexibility has been achieved in Heavy Water Project, Manuguru by installing programmable logic controllers for its control equipment. The earlier sulfide based Heavy Water Plant, Kota is using relay logic and diode based program-matrix for binary controls. Performance improvement and advantages of PLC and experience in its operation are described. (author). 3 refs

Efficacy of a movement control injury prevention programme in adult men's community rugby union: a cluster randomised controlled trial.

Science.gov (United States)

Attwood, Matthew J; Roberts, Simon P; Trewartha, Grant; England, Mike E; Stokes, Keith A

2018-03-01

Exercise programmes aimed at reducing injury have been shown to be efficacious for some non-collision sports, but evidence in adult men's collision sports such as rugby union is lacking. To evaluate the efficacy of a movement control injury prevention exercise programme for reducing match injuries in adult men's community rugby union players. 856 clubs were invited to participate in this prospective cluster randomised (single-blind) controlled trial where clubs were the unit of randomisation. 81 volunteered and were randomly assigned (intervention/control). A 42-week exercise programme was followed throughout the season. The control programme reflected 'normal practice' exercises, whereas the intervention focused on proprioception, balance, cutting, landing and resistance exercises.Outcome measures were match injury incidence and burden for: (1) all ≥8 days time-loss injuries and (2) targeted (lower limb, shoulder, head and neck, excluding fractures and lacerations) ≥8 days time-loss injuries. Poisson regression identified no clear effects on overall injury outcomes. A likely beneficial difference in targeted injury incidence (rate ratio (RR), 90% CI=0.6, 0.4 to 1.0) was identified, with a 40% reduction in lower-limb incidence (RR, 90% CI=0.6, 0.4 to 1.0) and a 60% reduction in concussion incidence (RR, 90% CI=0.4, 0.2 to 0.7) in the intervention group. Comparison between arms for clubs with highest compliance (≥median compliance) demonstrated very likely beneficial 60% reductions in targeted injury incidence (RR, 90% CI=0.4, 0.2 to 0.8) and targeted injury burden (RR, 90% CI=0.4, 0.2 to 0.7). The movement control injury prevention programme resulted in likely beneficial reductions in lower-limb injuries and concussion. Higher intervention compliance was associated with reduced targeted injury incidence and burden. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is

Assessment of nutrition and physical activity education programmes in children.

Science.gov (United States)

Burke, V; Beilin, L J; Milligan, R; Thompson, C

1995-03-01

1. Studies in children relating blood lipids to the extent of atherosclerosis at post-mortem suggest a link between risk factors for cardiovascular disease in childhood and adult life. Tracking of blood pressure (BP) and cholesterol from childhood also supports this association. However, prospective studies have not yet established the outcome in children with increased levels of risk factors. 2. In a controlled trial in Perth, Western Australia, involving over 1000 10-12 year old children, fitness was improved by physical activity programmes which were associated with a greater fall in diastolic BP and triceps skinfolds in girls compared with controls. Sugar intake decreased in boys and fat intake fell in girls, mainly affecting participants in home nutrition programmes. 3. In higher risk children, identified by cluster analysis, major benefits were associated with the fitness and home nutrition programmes. Physical activity combined with involvement of the family in nutrition education is likely to be the most successful approach to modifying lifestyle in children, including those with higher levels of risk. 4. Undernutrition by too rigid restriction of fat intake must be avoided in young children who need calorie-dense foods. Undernutrition, in itself, may predispose to cardiovascular disease in later life. Programmes should aim to establish a prudent diet appropriate to the age of the child combined with physical activity. As regular activity and a healthy diet in adult life will reduce risks of cardiovascular disease it is likely that childhood education will establish lifestyle habits of potential long-term benefit.

Recent food shortage is associated with leprosy disease in Bangladesh: a case-control study.

Directory of Open Access Journals (Sweden)

Sabiena G Feenstra

Full Text Available BACKGROUND: Leprosy is remaining prevalent in the poorest areas of the world. Intensive control programmes with multidrug therapy (MDT reduced the number of registered cases in these areas, but transmission of Mycobacterium leprae continues in most endemic countries. Socio-economic circumstances are considered to be a major determinant, but uncertainty exists regarding the association between leprosy and poverty. We assessed the association between different socio-economic factors and the risk of acquiring clinical signs of leprosy. METHODS AND FINDINGS: We performed a case-control study in two leprosy endemic districts in northwest Bangladesh. Using interviews with structured questionnaires we compared the socio-economic circumstances of recently diagnosed leprosy patients with a control population from a random cluster sample in the same area. Logistic regression was used to compare cases and controls for their wealth score as calculated with an asset index and other socio-economic factors. The study included 90 patients and 199 controls. A recent period of food shortage and not poverty per se was identified as the only socio-economic factor significantly associated with clinical manifestation of leprosy disease (OR 1.79 (1.06-3.02; p = 0.030. A decreasing trend in leprosy prevalence with an increasing socio-economic status as measured with an asset index is apparent, but not statistically significant (test for a trend: OR 0.85 (0.71-1.02; p = 0.083. CONCLUSIONS: Recent food shortage is an important poverty related predictor for the clinical manifestation of leprosy disease. Food shortage is seasonal and poverty related in northwest Bangladesh. Targeted nutritional support for high risk groups should be included in leprosy control programmes in endemic areas to reduce risk of disease.

Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial

Directory of Open Access Journals (Sweden)

Mash Bob

2012-12-01

Full Text Available Abstract Background Diabetes is an important contributor to the burden of disease in South Africa and prevalence rates as high as 33% have been recorded in Cape Town. Previous studies show that quality of care and health outcomes are poor. The development of an effective education programme should impact on self-care, lifestyle change and adherence to medication; and lead to better control of diabetes, fewer complications and better quality of life. Methods Trial design: Pragmatic cluster randomized controlled trial Participants: Type 2 diabetic patients attending 45 public sector community health centres in Cape Town Interventions: The intervention group will receive 4 sessions of group diabetes education delivered by a health promotion officer in a guiding style. The control group will receive usual care which consists of ad hoc advice during consultations and occasional educational talks in the waiting room. Objective: To evaluate the effectiveness of the group diabetes education programme Outcomes: Primary outcomes: diabetes self-care activities, 5% weight loss, 1% reduction in HbA1c. Secondary outcomes: self-efficacy, locus of control, mean blood pressure, mean weight loss, mean waist circumference, mean HbA1c, mean total cholesterol, quality of life Randomisation: Computer generated random numbers Blinding: Patients, health promoters and research assistants could not be blinded to the health centre’s allocation Numbers randomized: Seventeen health centres (34 in total will be randomly assigned to either control or intervention groups. A sample size of 1360 patients in 34 clusters of 40 patients will give a power of 80% to detect the primary outcomes with 5% precision. Altogether 720 patients were recruited in the intervention arm and 850 in the control arm giving a total of 1570. Discussion The study will inform policy makers and managers of the district health system, particularly in low to middle income countries, if this programme can

Identification and Control of Cladobotryum spp., Causal Agents of Cobeweb Disease of Cultivated Mushroom

Directory of Open Access Journals (Sweden)

Ivana Potočnik

2009-01-01

Full Text Available Cladobotryum spp. are causal agents of cobweb disease, one of the most serious diseases of cultivated mushroom (Agaricus bisporus (Lange Imbach in Serbia and worldwide, which affects product quality and yield. The disease symptoms are: cottony fluffy white oryellowish to pink colonies on mushroom casing, rapid colonization of casing surface, covering of host basidiomata by mycelia, and their decay. Prochloraz-Mn has been officially recommended for mushroom cultivation in EU countries. However, inefficiency of prochloraz-Mn has been noted at a level of spotting symptoms of cobweb disease. With regard to cases of resistance evolution and a general threat to the environment and human health, special attention should be focused on good programmes of hygiene, and inventing and developing alternative methods of disease control.

A research agenda for helminth diseases of humans: intervention for control and elimination.

Directory of Open Access Journals (Sweden)

Roger K Prichard

Full Text Available Recognising the burden helminth infections impose on human populations, and particularly the poor, major intervention programmes have been launched to control onchocerciasis, lymphatic filariasis, soil-transmitted helminthiases, schistosomiasis, and cysticercosis. The Disease Reference Group on Helminth Infections (DRG4, established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR, was given the mandate to review helminthiases research and identify research priorities and gaps. A summary of current helminth control initiatives is presented and available tools are described. Most of these programmes are highly dependent on mass drug administration (MDA of anthelmintic drugs (donated or available at low cost and require annual or biannual treatment of large numbers of at-risk populations, over prolonged periods of time. The continuation of prolonged MDA with a limited number of anthelmintics greatly increases the probability that drug resistance will develop, which would raise serious problems for continuation of control and the achievement of elimination. Most initiatives have focussed on a single type of helminth infection, but recognition of co-endemicity and polyparasitism is leading to more integration of control. An understanding of the implications of control integration for implementation, treatment coverage, combination of pharmaceuticals, and monitoring is needed. To achieve the goals of morbidity reduction or elimination of infection, novel tools need to be developed, including more efficacious drugs, vaccines, and/or antivectorial agents, new diagnostics for infection and assessment of drug efficacy, and markers for possible anthelmintic resistance. In addition, there is a need for the development of new formulations of some existing anthelmintics (e.g., paediatric formulations. To achieve ultimate elimination of helminth parasites, treatments for the above mentioned helminthiases, and for taeniasis

Computer programmes for the control and data manipulation of a sequential x-ray-fluorescence spectrometer

International Nuclear Information System (INIS)

Spimpolo, G.F.

1984-01-01

Two computer programmes have been written for use on a fully automated Siemens SRS200 sequential X-ray-fluorescence spectrometer. The first of these is used to control the spectrometer via an LC200 logic controller using a Data General Nova IV minicomputer; the second is used for the on-line evaluation of the intensity results and the printout of the analytical results. This system is an alternative to the systems offered by Siemens Ltd, which consist of a Process PR310 or Digital DEC PDP1103 computer and the Siemens Spectra 310 software package. The multibatch capabilities of the programmes, with the option of measuring one sample or a tray of samples before the results are calculated, give the new programmes a major advantage over the dedicated software and, together with the elimination of human error in calculation, have resulted in increased efficiency and quality in routine analyses. A description is given of the two programmes, as well as instruction and guidelines to the user

Field-programmable beam reconfiguring based on digitally-controlled coding metasurface

Science.gov (United States)

Wan, Xiang; Qi, Mei Qing; Chen, Tian Yi; Cui, Tie Jun

2016-02-01

Digital phase shifters have been applied in traditional phased array antennas to realize beam steering. However, the phase shifter deals with the phase of the induced current; hence, it has to be in the path of each element of the antenna array, making the phased array antennas very expensive. Metamaterials and/or metasurfaces enable the direct modulation of electromagnetic waves by designing subwavelength structures, which opens a new way to control the beam scanning. Here, we present a direct digital mechanism to control the scattered electromagnetic waves using coding metasurface, in which each unit cell loads a pin diode to produce binary coding states of “1” and “0”. Through data lines, the instant communications are established between the coding metasurface and the internal memory of field-programmable gate arrays (FPGA). Thus, we realize the digital modulation of electromagnetic waves, from which we present the field-programmable reflective antenna with good measurement performance. The proposed mechanism and functional device have great application potential in new-concept radar and communication systems.

A test system and supervisory control and data acquisition application with programmable logic controller for thermoelectric generators

International Nuclear Information System (INIS)

Ahiska, Rasit; Mamur, Hayati

2012-01-01

Highlights: ► A new TEG test measurement system with the PLC has been carried out. ► A new SCADA program has been written and tested for the test measurement system. ► An operator panel has been used for monitoring to the instant TEG data. ► All of the measurement data of TEG have been aggregated in the system. - Abstract: In this study, a new test measurement system and supervisory control and data acquisition application with programmable logic controller has been carried out to be enable the collection of the data of thermoelectric generator for the usage of thermoelectric modules as thermoelectric generator. During the production of the electric energy from the thermoelectric generator, the temperatures of the surfaces of the thermoelectric generator, current–voltage values obtained from output of the thermoelectric generator, hot and cold flows have been measured by the newly established system instantly. All these data have been monitored continuously from the computer and recorded by a supervisory control and data acquisition program. At the same time, in environments where there was no computer, an operator panel with the ability to communicate with the programmable logic controller has been added for the monitoring of the instant thermoelectric generator data. All of the measurement data of the thermoelectric generator have been aggregated in the new test measurement and supervisory control and data acquisition system. The setup test measurement system has been implemented on the thermoelectric generator system with about 10 W. Thermoelectric generators, Altec-GM-1 brand-coded have been examined by the new proposed test measurement system and the values of maximum power and thermoelectric generator efficiency were calculated by the programmable logic controller. When the obtained results were compared with the datasheets, the relative error for the maximum power was around 4% and the value for efficiency was below 3%.

Up-Beat UK: A programme of research into the relationship between coronary heart disease and depression in primary care patients

Directory of Open Access Journals (Sweden)

Pariante Carmine M

2011-05-01

Full Text Available Abstract Background Coronary heart disease and depression are both common health problems and by 2020 will be the two leading causes of disability worldwide. Depression has been found to be more common in patients with coronary heart disease but the nature of this relationship is uncertain. In the United Kingdom general practitioners are now being remunerated for case-finding for depression in patients with coronary heart disease, however it is unclear how general practitioners should manage these patients. We aim to explore the relationship between coronary heart disease and depression in a primary care population and to develop an intervention for patients with coronary heart disease and depression. Methods/design This programme of research will consist of 4 inter-related studies. A 4 year prospective cohort study of primary care patients with coronary heart disease will be conducted to explore the relationship between coronary heart disease and depression. Within this, a nested case-control biological study will investigate genetic and blood-biomarkers as predictors of depression in this sample. Two qualitative studies, one of patients' perspectives of treatments for coronary heart disease and co-morbid depression and one of primary care professionals' views on the management of patients with coronary heart disease and depression will inform the development of an intervention for this patient group. A feasibility study for a randomised controlled trial will then be conducted. Discussion This study will provide information on the relationship between coronary heart disease and depression that will allow health services to determine the efficiency of case-finding for depression in this patient group. The results of the cohort study will also provide information on risk factors for depression. The study will provide evidence on the efficacy and feasibility of a joint patient and professional led intervention and data necessary to plan a

Establishment and development of the National Tuberculosis Control Programme in Vietnam

NARCIS (Netherlands)

Huong, N. T.; Duong, B. D.; Co, N. V.; Quy, H. T.; Tung, L. B.; Bosman, M.; Gebhardt, A.; Velema, J. P.; Broekmans, J. F.; Borgdorff, M. W.

2005-01-01

OBJECTIVE: To describe the establishment and development of the National Tuberculosis Control Programme (NTP) of Vietnam. METHODS: Data were obtained from the surveillance system established by the new NTP in 1986 and based on the principles now described as the WHO DOTS strategy. RESULTS: The

The current and potential health benefits of the National Health Service Health Check cardiovascular disease prevention programme in England: A microsimulation study.

Science.gov (United States)

Mytton, Oliver T; Jackson, Christopher; Steinacher, Arno; Goodman, Anna; Langenberg, Claudia; Griffin, Simon; Wareham, Nick; Woodcock, James

2018-03-01

The National Health Service (NHS) Health Check programme was introduced in 2009 in England to systematically assess all adults in midlife for cardiovascular disease risk factors. However, its current benefit and impact on health inequalities are unknown. It is also unclear whether feasible changes in how it is delivered could result in increased benefits. It is one of the first such programmes in the world. We sought to estimate the health benefits and effect on inequalities of the current NHS Health Check programme and the impact of making feasible changes to its implementation. We developed a microsimulation model to estimate the health benefits (incident ischaemic heart disease, stroke, dementia, and lung cancer) of the NHS Health Check programme in England. We simulated a population of adults in England aged 40-45 years and followed until age 100 years, using data from the Health Survey of England (2009-2012) and the English Longitudinal Study of Aging (1998-2012), to simulate changes in risk factors for simulated individuals over time. We used recent programme data to describe uptake of NHS Health Checks and of 4 associated interventions (statin medication, antihypertensive medication, smoking cessation, and weight management). Estimates of treatment efficacy and adherence were based on trial data. We estimated the benefits of the current NHS Health Check programme compared to a healthcare system without systematic health checks. This counterfactual scenario models the detection and treatment of risk factors that occur within 'routine' primary care. We also explored the impact of making feasible changes to implementation of the programme concerning eligibility, uptake of NHS Health Checks, and uptake of treatments offered through the programme. We estimate that the NHS Health Check programme prevents 390 (95% credible interval 290 to 500) premature deaths before 80 years of age and results in an additional 1,370 (95% credible interval 1,100 to 1,690) people

Epidemiological Concepts Regarding Disease Monitoring and Surveillance

Directory of Open Access Journals (Sweden)

Christensen Jette

2001-03-01

Full Text Available Definitions of epidemiological concepts regarding disease monitoring and surveillance can be found in textbooks on veterinary epidemiology. This paper gives a review of how the concepts: monitoring, surveillance, and disease control strategies are defined. Monitoring and surveillance systems (MO&SS involve measurements of disease occurrence, and the design of the monitoring determines which types of disease occurrence measures can be applied. However, the knowledge of the performance of diagnostic tests (sensitivity and specificity is essential to estimate the true occurrence of the disease. The terms, disease control programme (DCP or disease eradication programme (DEP, are defined, and the steps of DCP/DEP are described to illustrate that they are a process rather than a static MO&SS.

Control Systems of Rubber Dryer Machinery Components Using Programmable Logic Control (PLC)

Science.gov (United States)

Hendra; Yulianto, A. S.; Indriani, A.; Hernadewita; Hermiyetti

2018-02-01

Application of programmable logic control (PLC) is widely used on the control systems in the many field engineering such as automotive, aviation, food processing and other industries [1-2]. PLC is simply program to control many automatic activity, easy to use, flexible and others. PLC using the ladder program to solve and regulated the control system component. In previous research, PLC was used for control system of rotary dryer machine. In this paper PLC are used for control system of motion component in the rubber dryer machinery. Component of rubber dryer machine is motors, gearbox, sprocket, heater, drying chamber and bearing. Principle working of rubber dryer machinery is wet rubber moving into the drying chamber by sprocket. Sprocket is driven by motors that conducted by PLC to moving and set of wet rubber on the drying chamber. Drying system uses greenhouse effect by making hanger dryer design in the form of line path. In this paper focused on motion control system motors and sensors drying rubber using PLC. The results show that control system of rubber dryer machinery can work in accordance control input and the time required to dry the rubber.

The association between individual counselling and health behaviour change: the See Kidney Disease (SeeKD) targeted screening programme for chronic kidney disease

OpenAIRE

Galbraith, Lauren; Hemmelgarn, Brenda; Manns, Braden; Samuel, Susan; Kappel, Joanne; Valk, Nadine; Ronksley, Paul

2016-01-01

Background Health behaviour change is an important component of management for patients with chronic kidney disease (CKD); however, the optimal method to promote health behaviour change for self-management of CKD is unknown. The See Kidney Disease (SeeKD) targeted screening programme screened Canadians at risk for CKD and promoted health behaviour change through individual counselling and goal setting. Objectives The objectives of this study are to determine the effectiveness of individual co...

Evaluation of an occupational health intervention programme on whole‐body vibration in forklift truck drivers: a controlled trial

Science.gov (United States)

Hulshof, C T J; Verbeek, J H A M; Braam, I T J; Bovenzi, M; van Dijk, F J H

2006-01-01

Objectives To evaluate process and outcome of a multifaceted occupational health intervention programme on whole‐body vibration (WBV) in forklift truck drivers. Methods An experimental pretest/post‐test control group study design. The authors trained occupational health services (OHS) in the experimental group in the use of the programme. OHS in the control group were asked to deliver care as usual. In total, 15 OHS, 32 OHS professionals, 26 companies, and 260 forklift drivers were involved. Post‐test measurements were carried out one year after the start of the programme. Results Baseline data before the start of the programme showed no difference between experimental and control group. Results of the outcome evaluation indicate a slight, although not statistically significant, reduction of WBV exposure in the experimental group (p = 0.06). Process evaluation revealed a positive influence on company policy toward WBV, attitude and intended behaviour of forklift drivers, and a trend towards an increase in knowledge of OHS professionals and company managers. The number of observed control measures with a major impact (levelling of surface and reduction of speed) was rather low. In those cases where control measures had been taken, there was a significant reduction in WBV exposure. This limited effect of the programme might be caused by the short period of follow up and the dropout of participants. The feasibility and the usefulness of the programme within the OHS setting were rated good by the participants. Conclusions This programme to decrease WBV exposure was partially effective. Significant effects on intermediate objectives were observed. More research on the effectiveness of intervention in the field of WBV is needed. PMID:16551762

Mobile phone short message service messaging for behaviour modification in a community-based weight control programme in Korea.

Science.gov (United States)

Joo, Nam-Seok; Kim, Bom-Taeck

2007-01-01

We conducted a community-based anti-obesity programme using mobile phone short message service (SMS) messaging. A total of 927 participants were recruited and visited a public health centre for initial assessment. Mobile phones were used to deliver short messages about diet, exercise and behaviour modification once a week. After a 12-week anti-obesity programme they visited the public health centre again. Four hundred and thirty-three subjects (47%) successfully completed their weight control programme. There were mean reductions of weight, waist circumference and body mass index of 1.6 kg (P behaviour modification in weight control and anti-obesity health education programmes when promoted by community health centres.

Design lessons from using programmable controllers in the MFTF-B personnel safety and interlocks system

International Nuclear Information System (INIS)

Branum, J.D.

1983-01-01

Applying programmable controllers in critical applications such as personnel safety and interlocks systems requires special considerations in the design of both hardware and software. All modern programmable controller systems feature extensive internal diagnostic capabilities to protect against problems such as program memory errors; however most, if not all present designs lack an intrinsic capability for detecting and countering failures on the field-side of their I/O modules. Many of the most common styles of I/O modules can also introduce potentially dangerous sneak circuits, even without component failure. This paper presents the most significant lessons learned to date in the design of the MFTF-B Personnel Safety and Interlocks System, which utilizes two non-redundant programmable controllers with over 800 I/O points each. Specific problems recognized during the design process as well as those discovered during initial testing and operation are discussed along with their specific solutions in hardware and software

A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

OpenAIRE

Thomas, K. S.; Batchelor, J. M.; Bath-Hextall, F.; Chalmers, J. R.; Clarke, T.; Crowe, S.; Delamere, F. M.; Eleftheriadou, V.; Evans, N.; Firkins, L.; Greenlaw, N.; Lansbury, L.; Lawton, S.; Layfield, C.; Leonardi-Bee, J.

2016-01-01

BACKGROUND: Skin diseases are very common and can have a large impact on the quality of life of patients and caregivers. This programme addressed four diseases: (1) eczema, (2) vitiligo, (3) squamous cell skin cancer (SCC) and (4) pyoderma gangrenosum (PG). OBJECTIVE: To set priorities and reduce uncertainties for the treatment and prevention of skin disease in our four chosen diseases. DESIGN: Mixed methods including eight systematic reviews, three prioritisation exercises, tw...

An effect of the outpatient rehabilitation programme in patients with chronic respiratory diseases

Directory of Open Access Journals (Sweden)

Jakub Zatloukal

2013-12-01

Full Text Available BACKGROUND: Pulmonary rehabilitation is a common type of complex treatment especially in patients with chronic obstructive pulmonary disease (COPD. By contrast, only few rehabilitation centres in the Czech Republic provide pulmonary rehabilitation programme to non-COPD patients. OBJECTIVE: To find out if the rehabilitation programme has a similar effect in patient with obstructive and restrictive ventilatory disorder. METHODS: Twenty-eight patients with either COPD or pulmonary sarcoidosis (PS have been enrolled for the 6-week rehabilitation programme. Lung functions, maximal inspiratory (MIP and expiratory (MEP mouth pressures, chest expansion at the level of the 4th intercostal space (IC and at the level of the xiphoid process (XP, six-minute walk test, health-related quality of life using the St. George’s Questionnaire (SGRQ and fatigue occurrence using the Multidimensional Assessment of Fatigue scale (MAF were tested at the baseline and after 6 weeks. The rehabilitation programme consisted of exercise training, ventilatory muscle training, respiratory physiotherapy and soft-tissue techniques. RESULTS: Patients with COPD improved significantly (p < .05 in MIP by 17% (10.5 cm H2O, MEP by 18% (16.8 cm H2O, IC by 65% (1.7 cm, XP by 90% (1.9 cm, six-minute walk distance (6MWD by 15% (64.1 m and SGRQ by –28% (–12.3 points. Patients with PS improved significantly (p < .05 in MIP by 25% (20.1 cm H2O, IC by 29% (1.3 cm, XP by 29% (1.3 cm and 6MWD by 6% (31.6 m. The change in lung functions and MAF in both groups; MEP and SGRQ in PS group were insignificant after the 6-week rehabilitation programme. CONCLUSIONS: The 6-week rehabilitation programme produces similar responses in functional health status of patients with either obstructive or restrictive ventilatory disorder. However, patients with restrictive ventilatory disorder in particular should be encouraged to continue in the programme to enhance the health

Evaluation of a large scale implementation of disease management programmes in various Dutch regions: a study protocol

Science.gov (United States)

2011-01-01

Background Disease management programmes (DMPs) have been developed to improve effectiveness and economic efficiency within chronic care delivery by combining patient-related, professional-directed, and organisational interventions. The benefits of DMPs within different settings, patient groups, and versions remain unclear. In this article we propose a protocol to evaluate a range of current DMPs by capturing them in a single conceptual framework, employing comparable structure, process, and outcome measures, and combining qualitative and quantitative research methods. Methods To assess DMP effectiveness a practical clinical trial will be conducted. Twenty-two disease management experiments will be studied in various Dutch regions consisting of a variety of collaborations between organisations and/or professionals. Patient cohorts include those with cardiovascular diseases, chronic obstructive pulmonary disease, diabetes, stroke, depression, psychotic diseases, and eating disorders. Our methodological approach combines qualitative and quantitative research methods to enable a comprehensive evaluation of complex programmes. Process indicators will be collected from health care providers' data registries and measured via physician and staff questionnaires. Patient questionnaires include health care experiences, health care utilisation, and quality of life. Qualitative data will be gathered by means of interviews and document analysis for an in depth description of project interventions and the contexts in which DMPs are embedded, and an ethnographic process evaluation in five DMPs. Such a design will provide insight into ongoing DMPs and demonstrate which elements of the intervention are potentially (cost)-effective for which patient populations. It will also enable sound comparison of the results of the different programmes. Discussion The study will lead to a better understanding of (1) the mechanisms of disease management, (2) the feasibility, and cost

Evaluation of a large scale implementation of disease management programmes in various Dutch regions: a study protocol.

Science.gov (United States)

Lemmens, Karin M M; Rutten-Van Mölken, Maureen P M H; Cramm, Jane M; Huijsman, Robbert; Bal, Roland A; Nieboer, Anna P

2011-01-10

Disease management programmes (DMPs) have been developed to improve effectiveness and economic efficiency within chronic care delivery by combining patient-related, professional-directed, and organisational interventions. The benefits of DMPs within different settings, patient groups, and versions remain unclear. In this article we propose a protocol to evaluate a range of current DMPs by capturing them in a single conceptual framework, employing comparable structure, process, and outcome measures, and combining qualitative and quantitative research methods. To assess DMP effectiveness a practical clinical trial will be conducted. Twenty-two disease management experiments will be studied in various Dutch regions consisting of a variety of collaborations between organisations and/or professionals. Patient cohorts include those with cardiovascular diseases, chronic obstructive pulmonary disease, diabetes, stroke, depression, psychotic diseases, and eating disorders. Our methodological approach combines qualitative and quantitative research methods to enable a comprehensive evaluation of complex programmes. Process indicators will be collected from health care providers' data registries and measured via physician and staff questionnaires. Patient questionnaires include health care experiences, health care utilisation, and quality of life. Qualitative data will be gathered by means of interviews and document analysis for an in depth description of project interventions and the contexts in which DMPs are embedded, and an ethnographic process evaluation in five DMPs. Such a design will provide insight into ongoing DMPs and demonstrate which elements of the intervention are potentially (cost)-effective for which patient populations. It will also enable sound comparison of the results of the different programmes. The study will lead to a better understanding of (1) the mechanisms of disease management, (2) the feasibility, and cost-effectiveness of a disease management

Evaluation of a large scale implementation of disease management programmes in various Dutch regions: a study protocol

Directory of Open Access Journals (Sweden)

Bal Roland A

2011-01-01

Full Text Available Abstract Background Disease management programmes (DMPs have been developed to improve effectiveness and economic efficiency within chronic care delivery by combining patient-related, professional-directed, and organisational interventions. The benefits of DMPs within different settings, patient groups, and versions remain unclear. In this article we propose a protocol to evaluate a range of current DMPs by capturing them in a single conceptual framework, employing comparable structure, process, and outcome measures, and combining qualitative and quantitative research methods. Methods To assess DMP effectiveness a practical clinical trial will be conducted. Twenty-two disease management experiments will be studied in various Dutch regions consisting of a variety of collaborations between organisations and/or professionals. Patient cohorts include those with cardiovascular diseases, chronic obstructive pulmonary disease, diabetes, stroke, depression, psychotic diseases, and eating disorders. Our methodological approach combines qualitative and quantitative research methods to enable a comprehensive evaluation of complex programmes. Process indicators will be collected from health care providers' data registries and measured via physician and staff questionnaires. Patient questionnaires include health care experiences, health care utilisation, and quality of life. Qualitative data will be gathered by means of interviews and document analysis for an in depth description of project interventions and the contexts in which DMPs are embedded, and an ethnographic process evaluation in five DMPs. Such a design will provide insight into ongoing DMPs and demonstrate which elements of the intervention are potentially (cost-effective for which patient populations. It will also enable sound comparison of the results of the different programmes. Discussion The study will lead to a better understanding of (1 the mechanisms of disease management, (2 the

Knowledge gaps that hamper prevention and control of Mycobacterium avium subspecies paratuberculosis infection

DEFF Research Database (Denmark)

Barkema, H W; Orsel, K; Nielsen, S S

2018-01-01

In the last decades, many regional and country-wide control programmes for Johne's disease (JD) were developed due to associated economic losses, or because of a possible association with Crohn's disease. These control programmes were often not successful, partly because management protocols were...... programmes are typically evaluated in a limited number of herds and the duration of the study is less than 5 year, making it difficult to adequately assess the efficacy of control programmes. In this manuscript, we identify the most important gaps in knowledge hampering JD prevention and control programmes......, including vaccination and diagnostics. Secondly, we discuss directions that research should take to address those knowledge gaps....

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.

Educational benefits of Internet and computer-based programmes for prostate cancer patients: a systematic review.

Science.gov (United States)

Salonen, Anne; Ryhänen, Anne M; Leino-Kilpi, Helena

2014-01-01

This study aims to review systematically the available literature on Internet and computer-based patient education programmes, assess the quality of these studies and analyze the benefit of these programmes for prostate cancer patients. Complete databases were searched. Studies were included if they concerned patient education of prostate cancer patients, were qualitative or quantitative and examined Internet or interactive CD-ROM use. Eighteen studies met the inclusion criteria. The majority of the studies reported a significant increase in the knowledge of the disease, satisfaction with treatment options and support for men. The benefit of the programmes was that the patients felt more empowered and obtained a heightened sense of control over their disease. The Internet or computer-based programmes had a positive impact on prostate cancer patient education. Most papers reported that the programmes were beneficial, but few presented data from studies with rigorous research methodologies to support these claims. Internet and computer-based programmes can be useful tools in prostate cancer patient education. In order to improve the benefits of the programmes, more Internet and computer-based programmes need to be developed and studied. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

Integrated plant automation using programmable logic controllers

International Nuclear Information System (INIS)

Qureshi, S.A.

2002-01-01

In the world of automation the Programmable Logic Controller (PLC) has became for control. It now not only replaces the earlier relay logic controls but also has taken over many additional control functions. Initially the PLC was used to replace relay logic, but is ever-increasing range of functions means that it is found in many and more complex applications. As the structure of the PLC is based on the same principles as those employed in computer architecture, it is capable of performance not only relay switching tasks, but also other applications such as counting, calculating, comparing and the processing of analogue signals. Due to the simplicity of entering and modifying the programmed instructions to suit the requirements of the process under control, the PLC is truly a versatile and flexible device that can be employed easily and efficiently to repeatedly control tasks that vary in nature and complexes. A photograph of the Siemens S-5 95U. To illustrate the advantage of using a PLC over a traditional relay logic system, consider a control system with 20 input/output points. This assembly could comprise 60-80 relays, some counter/timers and a great deal of wiring. This assembly would be cumbersome with a power consumption of 30-40VA. A considerable time would be required to design, test and commission the assembly and once it is in full working order any desired modification, even of minor nature, could require major hardware changes. (author)

Development of control system for multi-converter high voltage power supply using programmable SoC

International Nuclear Information System (INIS)

Dave, Rasesh; Singh, N.P.; Thakar, Aruna; Dhola, Hitesh; Gajjar, Sandip; Parmar, Darshan Kumar; Baruah, Ujjwal Kumar; Dharangutti, Jagruti; Zaveri, Tanish

2015-01-01

Multi-converter based High Voltage Power Supplies (HVPSs) find application in multi-megawatt accelerators, RF systems. Control system for HVPS must be a combination of superior parallel processing, real time performance, fast computation and versatile connectivity. The hardware platform is expected to be robust, easily scalable for future developments without any cost overhead. Typical HVPS control mechanism involves communication, generation of precise control signals/pulses for few hundred Nos of chopper and closed loop control in microsecond range for regulated output. Such kind of requirements can be met with Zynq All Programmable SoC, which is a combination of Dual core ARM Cortex A-9 Processing System (PS) and Xilinx 7 series FPGA based Programmable Logic (PL). Deterministic functions of power supply control system such as generation of control signals with precise inter-channel delay of nanosecond range and communication with individual chopper at 100kbps can be implemented on PL. PS should implement corrective tasks based on field feedback received from individual chopper, user interface and OS management that allows to take full advantage of system capabilities. PS and PL are connected with on-chip AXI-4 interface with low latency and higher bandwidth through 9 AXI ports. Typically PS boots first, this ensures secure booting and prevents external environment from tampering PL. This paper describes development of control system on Zynq All Programmable SoC for HVPS. (author)

Development of control system for multi-converter High voltage Power supply using programmable SoC

Science.gov (United States)

Dave, Rasesh; Dharangutti, Jagruti; Singh, N. P.; Thakar, Aruna; Dhola, Hitesh; Gajjar, Sandip; Parmar, Darshan; Zaveri, Tanish; Baruah, Ujjwal

2017-04-01

Multi-converter based High Voltage Power Supplies (HVPSs) find application in multi-megawatt accelerators, RF systems. Control system for HVPS must be a combination of superior parallel processing, real time performance, fast computation and versatile connectivity. The hardware platform is expected to be robust, easily scalable for future developments with minimal overheads. This paper describes development of control system on Zynq All Programmable SoC (System on Chip) for HVPS. Typical HVPS control mechanism involves communication, generation of precise control signals/pulses for few hundred numbers of chopper and closed loop control in microsecond range for regulated output. Such kind of requirements can be met with Zynq All Programmable SoC, which is a combination of Dual core ARM Cortex A-9 Processing System (PS) and Xilinx 7 series FPGA based Programmable Logic (PL). Deterministic functions of power supply control system such as generation of control signals with precise inter-channel delay of nanosecond range and communication with individual chopper at 100kbps can be implemented on PL. PS should implement corrective tasks based on field feedback received from individual chopper, user interface and OS management that allows to take full advantage of system capabilities. PS and PL are connected with on-chip AXI-4 interface with low latency and higher bandwidth through 9 AXI ports. Typically PS boots first, this ensures secure booting and prevents external environment from tampering PL.

Programmable logic controller based synchronous motor excitation system

Directory of Open Access Journals (Sweden)

Janda Žarko

2011-01-01

Full Text Available This paper presents a 3.5 MW synchronous motor excitation system reconstruction. In the proposed solution programmable logic controller is used to control motor, which drives the turbo compressor. Comparing to some other solutions that are used in similar situations, the proposed solution is superior due to its flexibility and usage of mass-production hardware. Moreover, the implementation of PLC enables easy integration of the excitation system with the other technological processes in the plant as well as in the voltage regulation of 'smart grid' system. Also, implementation of various optimization algorithms can be done comfortably and it does not require additional investment in hardware. Some experimental results that depict excitation current during motor start-up, as well as, measured static characteristics of the motor, were presented.

6-PACK programme to decrease fall injuries in acute hospitals: cluster randomised controlled trial.

Science.gov (United States)

Barker, Anna L; Morello, Renata T; Wolfe, Rory; Brand, Caroline A; Haines, Terry P; Hill, Keith D; Brauer, Sandra G; Botti, Mari; Cumming, Robert G; Livingston, Patricia M; Sherrington, Catherine; Zavarsek, Silva; Lindley, Richard I; Kamar, Jeannette

2016-01-26

To evaluate the effect of the 6-PACK programme on falls and fall injuries in acute wards. Cluster randomised controlled trial. Six Australian hospitals. All patients admitted to 24 acute wards during the trial period. Participating wards were randomly assigned to receive either the nurse led 6-PACK programme or usual care over 12 months. The 6-PACK programme included a fall risk tool and individualised use of one or more of six interventions: "falls alert" sign, supervision of patients in the bathroom, ensuring patients' walking aids are within reach, a toileting regimen, use of a low-low bed, and use of a bed/chair alarm. The co-primary outcomes were falls and fall injuries per 1000 occupied bed days. During the trial, 46 245 admissions to 16 medical and eight surgical wards occurred. As many people were admitted more than once, this represented 31 411 individual patients. Patients' characteristics and length of stay were similar for intervention and control wards. Use of 6-PACK programme components was higher on intervention wards than on control wards (incidence rate ratio 3.05, 95% confidence interval 2.14 to 4.34; Pcontrol wards. Positive changes in falls prevention practice occurred following the introduction of the 6-PACK programme. However, no difference was seen in falls or fall injuries between groups. High quality evidence showing the effectiveness of falls prevention interventions in acute wards remains absent. Novel solutions to the problem of in-hospital falls are urgently needed. Australian New Zealand Clinical Trials Registry ACTRN12611000332921. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Effectiveness of programmes as part of primary prevention demonstrated on the example of cardiovascular diseases and the metabolic syndrome.

Science.gov (United States)

Korczak, Dieter; Dietl, Markus; Steinhauser, Gerlinde

2011-04-01

The HTA-report (HTA = Health Technology Assessment) deals with the primary prevention of cardiovascular diseases and diabetes mellitus type 2. In 2009 approximately 356,000 people died in Germany due to cardiovascular diseases. According to estimations about 6.3 million people are suffering from diabetes mellitus type 2. The interventions that are subsidized by the public health insurance are mainly focused on sufficient physical activities, healthy nutrition, stress management and the reduction of the consumption of addictive drugs and luxury food. Which lifestyle-related measures and/or programmes for primary prevention of cardiovascular diseases and of the metabolic syndrome are effective? To what extent will the health status be improved by these offers? To what extent will existing health resources and skills be strengthened by these offers? Are there any differences regarding the effectiveness among the interventions with respect to different settings or subgroups? Which lifestyle-related interventions and/or programmes for primary prevention of cardiovascular diseases and of the metabolic syndrome are sustainable and cost-effective? Which outcome parameters are in the view of the contributors decisive for the evaluation of the effectiveness? In the view of the contributor are there different values between the outcome parameters? In the view of the payers and other actors are there different values between the outcome parameters? Which ethical and juridical factors have to be considered? Which social and/or socio-economic parameters influence the use of the services and effectiveness? A systematic literature research is done in 35 databases. For the period 2005 to 2010, reviews, epidemiological and clinical studies as well as economical evaluations which deal with primary prevention programmes regarding cardiovascular diseases or the metabolic syndrome are included. 44 publications meet the inclusion criteria. These studies confirm the effectiveness of the

Effectiveness of programmes as part of primary prevention demonstrated on the example of cardiovascular diseases and the metabolic syndrome

Directory of Open Access Journals (Sweden)

Korczak, Dieter

2011-01-01

Full Text Available Background: The HTA-report (HTA = Health Technology Assessment deals with the primary prevention of cardiovascular diseases and diabetes mellitus type 2. In 2009 approximately 356,000 people died in Germany due to cardiovascular diseases. According to estimations about 6.3 million people are suffering from diabetes mellitus type 2. The interventions that are subsidized by the public health insurance are mainly focused on sufficient physical activities, healthy nutrition, stress management and the reduction of the consumption of addictive drugs and luxury food. Objectives: Which lifestyle-related measures and/or programmes for primary prevention of cardiovascular diseases and of the metabolic syndrome are effective? To what extent will the health status be improved by these offers? To what extent will existing health resources and skills be strengthened by these offers? Are there any differences regarding the effectiveness among the interventions with respect to different settings or subgroups? Which lifestyle-related interventions and/or programmes for primary prevention of cardiovascular diseases and of the metabolic syndrome are sustainable and cost-effective? Which outcome parameters are in the view of the contributors decisive for the evaluation of the effectiveness? In the view of the contributor are there different values between the outcome parameters? In the view of the payers and other actors are there different values between the outcome parameters? Which ethical and juridical factors have to be considered? Which social and/or socio-economic parameters influence the use of the services and effectiveness? Methods: A systematic literature research is done in 35 databases. For the period 2005 to 2010, reviews, epidemiological and clinical studies as well as economical evaluations which deal with primary prevention programmes regarding cardiovascular diseases or the metabolic syndrome are included. Results: 44 publications meet the

Monitoring the efficacy of drugs for neglected tropical diseases controlled by preventive chemotherapy.

Science.gov (United States)

Albonico, M; Levecke, B; LoVerde, P T; Montresor, A; Prichard, R; Vercruysse, J; Webster, J P

2015-12-01

In the last decade, pharmaceutical companies, governments and global health organisations under the leadership of the World Health Organization (WHO) have pledged large-scale donations of anthelmintic drugs, including ivermectin (IVM), praziquantel (PZQ), albendazole (ALB) and mebendazole (MEB). This worldwide scale-up in drug donations calls for strong monitoring systems to detect any changes in anthelmintic drug efficacy. This review reports on the outcome of the WHO Global Working Group on Monitoring of Neglected Tropical Diseases Drug Efficacy, which consists of three subgroups: (i) soil-transmitted helminthiases (ALB and MEB); (ii) onchocerciasis and lymphatic filariasis (IVM); and (iii) schistosomiasis (PZQ). Progress of ongoing work, challenges and research needs for each of the four main drugs used in helminthic preventive chemotherapy (PC) are reported, laying the ground for appropriate implementation of drug efficacy monitoring programmes under the co-ordination and guidelines of the WHO. Best practices for monitoring drug efficacy should be made available and capacity built as an integral part of neglected tropical disease (NTD) programme monitoring. Development of a disease-specific model to predict the impact of PC programmes, to detect outliers and to solicit responses is essential. Research studies on genetic polymorphisms in relation to low-efficacy phenotypes should be carried out to identify markers of putative resistance against all NTD drugs and ultimately to develop diagnostic assays. Development of combination and co-administration of NTD drugs as well as of new drug entities to boost the armamentarium of the few drugs available for NTD control and elimination should be pursued in parallel. Copyright © 2015 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

Effect of an education programme for patients with osteoarthritis in primary care - a randomized controlled trial

Directory of Open Access Journals (Sweden)

Bjärnung Åsa

2010-10-01

Full Text Available Abstract Background Osteoarthritis (OA is a degenerative disease, considered to be one of the major public health problems. Research suggests that patient education is feasible and valuable for achieving improvements in quality of life, in function, well-being and improved coping. Since 1994, Primary Health Care in Malmö has used a patient education programme directed towards OA. The aim of this study was to evaluate the effects of this education programme for patients with OA in primary health care in terms of self-efficacy, function and self-perceived health. Method The study was a single-blind, randomized controlled trial (RCT in which the EuroQol-5D and Arthritis self-efficacy scale were used to measure self-perceived health and self-efficacy and function was measured with Grip Ability Test for the upper extremity and five different functional tests for the lower extremity. Results We found differences between the intervention group and the control group, comparing the results at baseline and after 6 months in EuroQol-5D (p Conclusion This study has shown that patient education for patients with osteoarthritis is feasible in a primary health care setting and can improve self-perceived health as well as function in some degree, but not self-efficacy. Further research to investigate the effect of exercise performance on function, as well as self-efficacy is warranted. Trial registration The trial is registered with ClinicalTrials.gov. Registration number: NCT00979914

Fungal/mycotic diseases of poultry-diagnosis, treatment and control: a review.

Science.gov (United States)

Dhama, Kuldeep; Chakraborty, Sandip; Verma, Amit Kumar; Tiwari, Ruchi; Barathidasan, Rajamani; Kumar, Amit; Singh, Shambhu Dayal

2013-12-01

Fungal/mycotic diseases cause significant economic losses to the poultry industry either due to their direct infectious nature or due to production of mycotoxins, the secondary fungal metabolites produced in grains or poultry feed. Several fungi have created havoc in the poultry industry and some of them cause direct harm to human health due to their zoonotic implications. They are responsible for high morbidity and mortality, especially in young birds and cause stunted growth and diarrhea; and fatal encephalitis. Mycotic dermatitis is a possible health hazard associated with poultry houses. Mycotoxins are the leading cause of producing immunosuppression in birds, which makes them prone to several bacterial and viral infections leading to huge economic losses to the poultry industry. In comparison to bacterial and viral diseases, advances in diagnosis, treatment, prevention and control of fungal diseases in poultry has not taken much attention. Recently, molecular biological tools have been explored for rapid and accurate diagnosis of important fungal infections. Effective prevention and control measures include: appropriate hygiene, sanitation and disinfection, strict biosecurity programme and regular surveillance/monitoring of fungal infections as well as following judicious use of anti-fungal drugs. Precautionary measures during crop production, harvesting and storing and in feed mixing plants can help to check the fungal infections including health hazards of mycotoxins/mycotoxicosis. The present review describes the fungal pathogens causing diseases in poultry/birds, especially focusing to their diagnosis, prevention and control measures, which would help in formulating appropriate strategies to have a check and control on these unwanted troubles to the poultry producers/farmers.

Use of advanced programmable controllers in LCTF

International Nuclear Information System (INIS)

Thompson, D.H.; Baylor, L.R.; Patek, D.R.; Fletcher, W.M.

1983-01-01

The present generation of industrial programmable logic controllers (PLCs) offers a variety of features that are ideal for use in large-scale fusion experiments. Among these features are computational capabilities, communication interfaces, ease of programming, and, most importantly, high reliability. In the Large Coil Test Facility (LCTF), three PLCs control all of the major systems, including liquid helium, liquid nitrogen, vacuum, vapor-cooled leads, coil protection, power supplies, and personnel protection. The PLC control system for LCTF is divided into three functional blocks. The first is the vacuum PLC that monitors all tank functions and has a graphic display panel on the Master Control Console (MCC). A second PLC monitors all time-critical coil protection functions and has the capability to initiate a dump of the stored energy in the coils when a setpoint is exceeded in coil or vapor-cooled lead monitoring instruments. The third PLC, which is designated the facility PLC, monitors and controls the bulk of the LCTF facility systems and serves as a redundant coil protection PLC. The facility PLC is a Modicon 584, level-IV 32K word machine with enhanced software features that include Proportional Integral Derivative (PID) control loops, block functions, and table lookups. A low-cost, color computer graphics terminal located in the MCC is attached to the Modbus link of the facility PLC and has the capability of displaying alarms and operating valves. A hard-copy terminal driven directly by the PLC logs all alarms and valve operations. Twenty-two process loops, including vapor-cooled lead flow, are controlled via the PID functions

Physiotherapy programme reduces fatigue in patients with advanced cancer receiving palliative care: randomized controlled trial.

Science.gov (United States)

Pyszora, Anna; Budzyński, Jacek; Wójcik, Agnieszka; Prokop, Anna; Krajnik, Małgorzata

2017-09-01

Cancer-related fatigue (CRF) is a common and relevant symptom in patients with advanced cancer that significantly decreases their quality of life. The aim of this study was to evaluate the effect of a physiotherapy programme on CRF and other symptoms in patients diagnosed with advanced cancer. The study was designed as a randomized controlled trial. Sixty patients diagnosed with advanced cancer receiving palliative care were randomized into two groups: the treatment group (n = 30) and the control group (n = 30). The therapy took place three times a week for 2 weeks. The 30-min physiotherapy session included active exercises, myofascial release and proprioceptive neuromuscular facilitation (PNF) techniques. The control group did not exercise. The outcomes included Brief Fatigue Inventory (BFI), Edmonton Symptom Assessment Scale (ESAS) and satisfaction scores. The exercise programme caused a significant reduction in fatigue scores (BFI) in terms of severity of fatigue and its impact on daily functioning. In the control group, no significant changes in the BFI were observed. Moreover, the physiotherapy programme improved patients' general well-being and reduced the intensity of coexisting symptoms such as pain, drowsiness, lack of appetite and depression. The analysis of satisfaction scores showed that it was also positively evaluated by patients. The physiotherapy programme, which included active exercises, myofascial release and PNF techniques, had beneficial effects on CRF and other symptoms in patients with advanced cancer who received palliative care. The results of the study suggest that physiotherapy is a safe and effective method of CRF management.

Preliminary measurements of the establishment of a quality control programme for the activimeter calibration reference system

International Nuclear Information System (INIS)

Martins, Elaine W.; Potiens, Maria da Penha A.

2009-01-01

The nuclear medicine techniques efficiency and safety depends on, beside other factors, a quality control programme, mainly regards to the nuclides activimeter utilization. The Calibration Laboratory of IPEN uses as a work standard, a tertiary standard system Capintec, calibrated at the Accredited Dosimetry Calibration Laboratory of the Medical radiation Research Center - University of Wisconsin. In this work, as preliminary measurements to establish a quality control programme for the activimeter calibration procedures, initially the repeatability and reproducibility (long term stability) tests were performed using a sealed check source of 133 Ba. Later on, to complete this quality control programme other check sources ( 137 Cs, 57 Co, 60 Co) will be used to perform the same tests. A series of 80 experiments of 10 measurements each has been carried out. The reference system showed a good behaviour to the repeatability test, considering the tolerance limits of 5%. The percent deviations of all tested sources in the activity measurements were lower 1% to 133 Ba. (author)

Evaluation of tuberculosis control programme in Khartoum State for the year 2006

DEFF Research Database (Denmark)

Ahmed Suleiman, M M; Aro, Arja R.; Sodemann, M

2009-01-01

BACKGROUND: Tuberculosis (TB) is among the top ten causes of global mortality. Sudan is among the countries with high TB prevalence; with an estimated incidence of 90/100,000 smear-positive cases. In 1993, the Khartoum State tuberculosis control programme was established. Since its establishment,...

Professional commitment to changing chronic illness care: results from disease management programmes.

Science.gov (United States)

Lemmens, Karin; Strating, Mathilde; Huijsman, Robbert; Nieboer, Anna

2009-08-01

The aim of this exploratory study was to investigate to what extent primary care professionals are able to change their systems for delivering care to chronic obstructive pulmonary disease (COPD) patients and what professional and organizational factors are associated with the degree of process implementation. Quasi-experimental design with 1 year follow-up after intervention. Three regional COPD management programmes in the Netherlands, in which general practices cooperated with regional hospitals. All participating primary care professionals (n = 52). COPD management programme. Professional commitment, organizational context and degree of process implementation. Professionals significantly changed their systems for delivering care to COPD patients, namely self-management support, decision support, delivery system design and clinical information systems. Associations were found between organizational factors, professional commitment and changes in processes of care. Group culture and professional commitment appeared to be, to a moderate degree, predictors of process implementation. COPD management was effective; all processes improved significantly. Moreover, theoretically expected associations between organizational context and professional factors with the implementation of COPD management were indeed confirmed to some extent. Group culture and professional commitment are important facilitators.

Effectiveness of job rotation for preventing work-related musculoskeletal diseases: a cluster randomised controlled trial.

Science.gov (United States)

Comper, Maria Luiza Caires; Dennerlein, Jack Tigh; Evangelista, Gabriela Dos Santos; Rodrigues da Silva, Patricia; Padula, Rosimeire Simprini

2017-08-01

Job rotation is an organisational strategy widely used on assembly lines in manufacturing industries to mitigate workers' exposure so as to prevent musculoskeletal disorders. This study aimed to evaluate the effectiveness of job rotation for reducing working hours lost due to sick leave resulting from musculoskeletal diseases. The design consisted of a 1-year cluster randomised controlled trial with a blinded assessor. Production sectors of the textile industry were randomised to intervention and control groups. Both groups received ergonomic training. The intervention group performed a job rotation programme. The primary outcome measure was number of working hours lost due to sick leave as a result of musculoskeletal disease (ICD-10). The secondary outcome measures were musculoskeletal symptoms (Yes/No), risk factors for musculoskeletal diseases (0-10), psychosocial factors and fatigue (0-100), general health (0-100), and productivity (0-10). All secondary outcomes were measured at baseline and 12-month follow-up. At the 12-month follow-up, both groups showed an increase in the number of working hours lost due to sick leave for musculoskeletal disease. There was no significant difference between the job rotation intervention group (mean deviation -5.6 hours, 95% CI -25.0 to 13.8) at the 12-month follow-up and the control group. There were no significant differences between groups for the secondary outcomes (p>0.05). The job rotation programme was not effective in reducing the number of working hours lost due to sick leave, decreasing the prevalence of musculoskeletal symptoms, or improving perception of musculoskeletal pain and workplace risk factors, psychosocial risk factors and productivity. NCT01979731. 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/.

Knowledge gaps that hamper prevention and control of Mycobacterium avium subspecies paratuberculosis infection

NARCIS (Netherlands)

Barkema, H.W.; Orsel, K.; Nielsen, S.; Koets, Ad; Rutten, V.P.M.G.; Bannantine, J.P.; Keefe, G.P.; Kelton, D.F.; Wells, S.J.; Whittington, R.J.; Mackintosh, C.G.; Manning, E.J.; Weber, M.F.; Heuer, C.; Forde, T.L.; Ritter, C.; Roche, S.; Corbett, C.S.; Wolf, R.; Griebel, P.J.; Kastelic, J.P.; Buck, De J.

2017-01-01

In the last decades, many regional and country-wide control programmes for Johne's disease (JD) were developed due to associated economic losses, or because of a possible association with Crohn's disease. These control programmes were often not successful, partly because management protocols were

Evaluating disease management programme effectiveness: an introduction to instrumental variables.

Science.gov (United States)

Linden, Ariel; Adams, John L

2006-04-01

This paper introduces the concept of instrumental variables (IVs) as a means of providing an unbiased estimate of treatment effects in evaluating disease management (DM) programme effectiveness. Model development is described using zip codes as the IV. Three diabetes DM outcomes were evaluated: annual diabetes costs, emergency department (ED) visits and hospital days. Both ordinary least squares (OLS) and IV estimates showed a significant treatment effect for diabetes costs (P = 0.011) but neither model produced a significant treatment effect for ED visits. However, the IV estimate showed a significant treatment effect for hospital days (P = 0.006) whereas the OLS model did not. These results illustrate the utility of IV estimation when the OLS model is sensitive to the confounding effect of hidden bias.

A parenting programme to prevent abuse of adolescents in South Africa: study protocol for a randomised controlled trial.

Science.gov (United States)

Cluver, Lucie; Meinck, Franziska; Shenderovich, Yulia; Ward, Catherine L; Romero, Rocio Herrero; Redfern, Alice; Lombard, Carl; Doubt, Jenny; Steinert, Janina; Catanho, Ricardo; Wittesaele, Camille; De Stone, Sachin; Salah, Nasteha; Mpimpilashe, Phelisa; Lachman, Jamie; Loening, Heidi; Gardner, Frances; Blanc, Daphnee; Nocuza, Mzuvekile; Lechowicz, Meryn

2016-07-19

An estimated one billion children experience child abuse each year, with the highest rates in low- and middle-income countries. The Sinovuyo Teen programme is part of Parenting for Lifelong Health, a WHO/UNICEF initiative to develop and test violence-prevention programmes for implementation in low-resource contexts. The objectives of this parenting support programme are to prevent the abuse of adolescents, improve parenting and reduce adolescent behavioural problems. This trial aims to evaluate the effectiveness of Sinovuyo Teen compared to an attention-control group of a water hygiene programme. This is a pragmatic cluster randomised controlled trial, with stratified randomisation of 37 settlements (rural and peri-urban) with 40 study clusters in the Eastern Cape of South Africa. Settlements receive either a 14-session parenting support programme or a 1-day water hygiene programme. The primary outcomes are child abuse and parenting practices, and secondary outcomes include adolescent behavioural problems, mental health and social support. Concurrent process evaluation and qualitative research are conducted. Outcomes are reported by both primary caregivers and adolescents. Brief follow-up measures are collected immediately after the intervention, and full follow-up measures collected at 3-8 months post-intervention. A 15-24-month follow-up is planned, but this will depend on the financial and practical feasibility given delays related to high levels of ongoing civil and political violence in the research sites. This is the first known trial of a parenting programme to prevent abuse of adolescents in a low- or middle-income country. The study will also examine potential mediating pathways and moderating factors. Pan-African Clinical Trials Registry PACTR201507001119966. Registered on 27 April 2015. It can be found by searching for the key word 'Sinovuyo' on their website or via the following link: http://www.pactr.org/ATMWeb/appmanager/atm/atmregistry?_nfpb=true&_windowLabel=BasicSearchUpdateController

Use of advanced programmable controllers in LCTF

International Nuclear Information System (INIS)

Thompson, D.H.; Baylor, L.R.; Fletcher, W.M.; Patek, D.R.

1983-01-01

The present generation of industrial programmable logic controllers (PLCs) offers a variety of features that are ideal for use in largescale fusion experiments. Among these features are computational capabilities, communication interfaces, ease of programming, and, most importantly, high reliability. In the Large Coil Test Facility (LCTF), three PLCs control all of the major systems, including liquid helium, liquid nitrogen, vacuum, vapor-cooled leads, coil protection, power supplies, and personnel protection. The PLC control system for LCTF is divided into three functional blocks. The first is the vacuum PLC that monitors all tank functions and has a graphic display panel on the Master Control Console (MCC). A second PLC monitors all time-critical coil protection functions and has the capability to initiate a dump of the stored energy in the coils when a setpoint is exceeded in coil or vapor-cooled lead monitoring instruments. The third PLC, which is designated the facility PLC, monitors and controls the bulk of the LCTF facility systems and serves as a redundant coil protection PLC. The facility PLC is a Modicon 584, level-IV 32K word machine with enhanced software features that include Proportional Integral Derivative (PID) control loops, block functions, and table lookups. A low-cost, color computer graphics terminal located in the MCC is attached to the Modbus link of the facility PLC and has the capability of displaying alarms and operating valves. A hard-copy terminal driven directly by the PLC logs all alarms and valve operations. Twenty-two process loops, including vapor-cooled lead flow, are controlled via the PID functions. The PLC-based control system in LCTF is the result of a philosophy that reliable control needs to be separate from data acquisition. This has resulted in a control system with maximum flexibility constructed entirely of off-the-shelf components and minimal software effort

African Programme For Onchocerciasis Control 1995-2015: model-estimated health impact and cost.

Science.gov (United States)

Coffeng, Luc E; Stolk, Wilma A; Zouré, Honorat G M; Veerman, J Lennert; Agblewonu, Koffi B; Murdoch, Michele E; Noma, Mounkaila; Fobi, Grace; Richardus, Jan Hendrik; Bundy, Donald A P; Habbema, Dik; de Vlas, Sake J; Amazigo, Uche V

2013-01-01

Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015. With data on pre-control prevalence of infection and population coverage of mass treatment, we simulated trends in infection, blindness, visual impairment, and severe itch using the micro-simulation model ONCHOSIM, and estimated disability-adjusted life years (DALYs) lost due to onchocerciasis. We assessed financial costs for APOC, beneficiary governments, and non-governmental development organizations, excluding cost of donated drugs. We estimated that between 1995 and 2010, mass treatment with ivermectin averted 8.2 million DALYs due to onchocerciasis in APOC areas, at a nominal cost of about US$257 million. We expect that APOC will avert another 9.2 million DALYs between 2011 and 2015, at a nominal cost of US$221 million. Our simulations suggest that APOC has had a remarkable impact on population health in Africa between 1995 and 2010. This health impact is predicted to double during the subsequent five years of the program, through to 2015. APOC is a highly cost-effective public health program. Given the anticipated elimination of onchocerciasis from some APOC areas, we expect even more health gains and a more favorable cost-effectiveness of mass treatment with ivermectin in the near future.

African Programme For Onchocerciasis Control 1995-2015: model-estimated health impact and cost.

Directory of Open Access Journals (Sweden)

Luc E Coffeng

Full Text Available Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015.With data on pre-control prevalence of infection and population coverage of mass treatment, we simulated trends in infection, blindness, visual impairment, and severe itch using the micro-simulation model ONCHOSIM, and estimated disability-adjusted life years (DALYs lost due to onchocerciasis. We assessed financial costs for APOC, beneficiary governments, and non-governmental development organizations, excluding cost of donated drugs. We estimated that between 1995 and 2010, mass treatment with ivermectin averted 8.2 million DALYs due to onchocerciasis in APOC areas, at a nominal cost of about US$257 million. We expect that APOC will avert another 9.2 million DALYs between 2011 and 2015, at a nominal cost of US$221 million.Our simulations suggest that APOC has had a remarkable impact on population health in Africa between 1995 and 2010. This health impact is predicted to double during the subsequent five years of the program, through to 2015. APOC is a highly cost-effective public health program. Given the anticipated elimination of onchocerciasis from some APOC areas, we expect even more health gains and a more favorable cost-effectiveness of mass treatment with ivermectin in the near future.

Programmable logic controller optical fibre sensor interface module

Science.gov (United States)

Allwood, Gary; Wild, Graham; Hinckley, Steven

2011-12-01

Most automated industrial processes use Distributed Control Systems (DCSs) or Programmable Logic Controllers (PLCs) for automated control. PLCs tend to be more common as they have much of the functionality of DCSs, although they are generally cheaper to install and maintain. PLCs in conjunction with a human machine interface form the basis of Supervisory Control And Data Acquisition (SCADA) systems, combined with communication infrastructure and Remote Terminal Units (RTUs). RTU's basically convert different sensor measurands in to digital data that is sent back to the PLC or supervisory system. Optical fibre sensors are becoming more common in industrial processes because of their many advantageous properties. Being small, lightweight, highly sensitive, and immune to electromagnetic interference, means they are an ideal solution for a variety of diverse sensing applications. Here, we have developed a PLC Optical Fibre Sensor Interface Module (OFSIM), in which an optical fibre is connected directly to the OFSIM located next to the PLC. The embedded fibre Bragg grating sensors, are highly sensitive and can detect a number of different measurands such as temperature, pressure and strain without the need for a power supply.

Efficacy of an infection control programme in reducing nosocomial bloodstream infections in a Senegalese neonatal unit.

Science.gov (United States)

Landre-Peigne, C; Ka, A S; Peigne, V; Bougere, J; Seye, M N; Imbert, P

2011-10-01

Neonatal nosocomial infections are public health threats in the developing world, and successful interventions are rarely reported. A before-and-after study was conducted in the neonatal unit of the Hôpital Principal de Dakar, Senegal to assess the efficacy of a multi-faceted hospital infection control programme implemented from March to May 2005. The interventions included clustering of nursing care, a simple algorithm for empirical therapy of suspected early-onset sepsis, minimal invasive care and promotion of early discharge of neonates. Data on nosocomial bloodstream infections, mortality, bacterial resistance and antibiotic use were collected before and after implementation of the infection control programme. One hundred and twenty-five infants were admitted immediately before the programme (Period 1, January-February 2005) and 148 infants were admitted immediately after the programme (Period 2, June-July 2005). The two groups of infants were comparable in terms of reason for admission and birth weight. After implementation of the infection control programme, the overall rate of nosocomial bloodstream infections decreased from 8.8% to 2.0% (P=0.01), and the rate of nosocomial bloodstream infections/patient-day decreased from 10.9 to 2.9/1000 patient-days (P=0.03). Overall mortality rates did not differ significantly. The proportion of neonates who received antimicrobial therapy for suspected early-onset sepsis decreased significantly from 100% to 51% of at-risk infants (Punit, simple, low-cost and sustainable interventions led to the control of a high incidence of bacterial nosocomial bloodstream infections, and the efficacy of these interventions was long-lasting. Such interventions could be extended to other low-income countries. Copyright © 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Genetics of animal health and disease in cattle

Directory of Open Access Journals (Sweden)

Berry Donagh P

2011-03-01

Full Text Available Abstract There have been considerable recent advancements in animal breeding and genetics relevant to disease control in cattle, which can now be utilised as part of an overall programme for improved cattle health. This review summarises the contribution of genetic makeup to differences in resistance to many diseases affecting cattle. Significant genetic variation in susceptibility to disease does exist among cattle suggesting that genetic selection for improved resistance to disease will be fruitful. Deficiencies in accurately recorded data on individual animal susceptibility to disease are, however, currently hindering the inclusion of health and disease resistance traits in national breeding goals. Developments in 'omics' technologies, such as genomic selection, may help overcome some of the limitations of traditional breeding programmes and will be especially beneficial in breeding for lowly heritable disease traits that only manifest themselves following exposure to pathogens or environmental stressors in adulthood. However, access to large databases of phenotypes on health and disease will still be necessary. This review clearly shows that genetics make a significant contribution to the overall health and resistance to disease in cattle. Therefore, breeding programmes for improved animal health and disease resistance should be seen as an integral part of any overall national disease control strategy.

A Scoping Review of Economic Evaluations Alongside Randomised Controlled Trials of Home Monitoring in Chronic Disease Management.

Science.gov (United States)

Kidholm, Kristian; Kristensen, Mie Borch Dahl

2018-04-01

Many countries have considered telemedicine and home monitoring of patients as a solution to the demographic challenges that health-care systems face. However, reviews of economic evaluations of telemedicine have identified methodological problems in many studies as they do not comply with guidelines. The aim of this study was to examine economic evaluations alongside randomised controlled trials of home monitoring in chronic disease management and hereby to explore the resources included in the programme costs, the types of health-care utilisation that change as a result of home monitoring and discuss the value of economic evaluation alongside randomised controlled trials of home monitoring on the basis of the studies identified. A scoping review of economic evaluations of home monitoring of patients with chronic disease based on randomised controlled trials and including information on the programme costs and the costs of equipment was carried out based on a Medline (PubMed) search. Nine studies met the inclusion criteria. All studies include both costs of equipment and use of staff, but there is large variation in the types of equipment and types of tasks for the staff included in the costs. Equipment costs constituted 16-73% of the total programme costs. In six of the nine studies, home monitoring resulted in a reduction in primary care or emergency contacts. However, in total, home monitoring resulted in increased average costs per patient in six studies and reduced costs in three of the nine studies. The review is limited by the small number of studies found and the restriction to randomised controlled trials, which can be problematic in this area due to lack of blinding of patients and healthcare professionals and the difficulty of implementing organisational changes in hospital departments for the limited period of a trial. Furthermore, our results may be based on assessments of older telemedicine interventions.

The design of programme-controlled gain and linear pulse amplifier

International Nuclear Information System (INIS)

Guan Xuemei; Chen Chunkai; Northeast Normal Univ., Changchun; Qiao Shuang; Zhou Chuansheng

2006-01-01

The authors have designed a kind of new-style programme-controlled gain and linear pulse amplifier with accurate gausses of CR-RC-CR shaping circuit structure. The use of non-volatile digital electric potential device and accurate operational amplifier makes the circuit structure simple greatly, makes the ability stronger that resists assault. It can realize multistage gain in succession and make the drift of temperature low and make the linearity of pulse well. (authors)

Communicable diseases in the Eastern Mediterranean Region: prevention and control 2010-2011.

Science.gov (United States)

Haq, Z; Mahjour, J; Khan, W

2013-10-01

One-third of all morbidities and mortalities in the Eastern Mediterranean Region are attributed to communicable diseases. A continued situation of war and conflict, and growing political unrest in the Region, coupled with factors such as travel and migration, and insufficient infrastructure and inadequate technical and managerial capacity ofthe programmes are the major challenges. Despite these challenges, the Region continued making progress towards the elimination of specific diseases such as lymphatic filariasis, measles, malaria, schistosomiasis and dracunculiasis during 2010-11. Coverage for vaccine-preventable diseases was enhanced. Preparedness and response to emerging (e.g. dengue fever in Pakistan and Yemen) and re-emerging (e.g. cholera in Sudan) infections was improved. The Region has continued its efforts for controlling tuberculosis and curbing HIV/AIDS. Looking ahead, the Region aims to improve surveillance and response capacities, legislation issues, coordination, bio-risk and bio-security and quality management in the coming years.

The high level programmer and user interface of the NSLS control system

International Nuclear Information System (INIS)

Tang, Y.N.; Smith, J.D.; Sathe, S.

1993-01-01

This paper presents the major components of the high level software in the NSLS upgraded control system. Both programmer and user interfaces are discussed. The use of the high-speed work stations, fast network communications, UNIX system, X-window and Motif have greatly changed and improved these interfaces

The impact of an employee wellness programme in clothing/textile manufacturing companies: a randomised controlled trial

Directory of Open Access Journals (Sweden)

Edries Naila

2013-01-01

Full Text Available Abstract Background The prevalence of health risk behaviours is growing amongst South African employees. Health risk behaviours have been identified as a major contributor to reduced health related quality of life (HRQoL and the increased prevalence of non-communicable diseases. Worksite wellness programmes promise to promote behaviour changes amongst employees and to improve their HRQoL. The aim of this study was to evaluate the short-term effects of an employee wellness programme on HRQoL, health behaviour change, body mass index (BMI and absenteeism amongst clothing and textile manufacturing employees. Methods The study used a randomised control trial design. The sample consisted of 80 subjects from three clothing manufacturing companies in Cape Town, South Africa. The experimental group was subjected to a wellness programme based on the principles of cognitive behaviour therapy (CBT as well as weekly supervised exercise classes over six weeks. The control group received a once-off health promotion talk and various educational pamphlets, with no further intervention. Measurements were recorded at baseline and at six weeks post-intervention. Outcome measures included the EQ-5D, Stanford Exercise Behaviours Scale, body mass index and absenteeism. Data was analysed with the Statistica-8 software program. Non-parametric tests were used to evaluate the differences in the medians between the two groups and to determine the level of significance. The Sign test was used to determine the within group changes. The Mann–Whitney U test was used to determine the difference between the two groups. Results At six weeks post intervention the experimental group (39 subjects demonstrated improvement in almost every parameter. In contrast, apart from an overall decrease in time off work and a reduction in BMI for all study participants, there was no significant change noted in the behaviour of the control group (41 subjects. Seventy percent of the

The effect of motivational interviewing on glycaemic control and perceived competence of diabetes self-management in patients with type 1 and type 2 diabetes mellitus after attending a group education programme: a randomised controlled trial

DEFF Research Database (Denmark)

Rosenbek Minet, L K; Wagner, L; Lønvig, E M

2011-01-01

education programme, 349 patients were randomised to either a usual care control group or an intervention group, which received up to five individual counselling sessions in 1 year based on MI, in addition to usual care. A randomised parallel design was used and open-label allocation was done by random...... diabetes mellitus, were over 18 years of age and had participated in a 4 day group education programme offered at a diabetes clinic at a university hospital in Denmark. Exclusion criteria included pregnancy, severe debilitating disease and cognitive deficit. Out of 469 patients who attended the group...... diabetes self-care, compared with usual care. RESULTS: Out of the 176 included in the control group and 173 in the intervention group, 153 and 145 were analysed in the groups, respectively. When using the baseline value as covariate there were no significant differences in change score between the two...

Establishing an independent mobile health programme for chronic disease self-management support in Bolivia

Directory of Open Access Journals (Sweden)

John D Piette

2014-08-01

Full Text Available Background: Mobile health (m-health work in low and middle-income countries (LMICs mainly consists of pilot programmes with an unclear path to scaling and dissemination. We describe the deployment and testing of an m-health platform for non-communicable disease (NCD self-management support in Bolivia. Methods: 364 primary care patients in La Paz with diabetes or hypertension completed surveys about their use of mobile phones, health and access to care. 165 of those patients then participated in a 12-week demonstration of automated telephone monitoring and self-management support. Weekly Interactive Voice Response (IVR calls were made from a platform established at a university in La Paz, under the direction of the regional health ministry. Results: 37% of survey respondents spoke indigenous languages at home, and 38% had six or fewer years of education. 82% had a mobile phone; half (45% used text messaging with a standard phone, and 9% had a smartphone. Smartphones were least common among patients who were older, spoke indigenous languages, or had less education. IVR programme participants completed 1007 self-management support calls, with an overall response rate of 51%. IVR call completion was lower among older adults, but was not related to patients’ ethnicity, health status or healthcare access. IVR health and self-care reports were consistent with information reported during baseline interviews. Patients’ likelihood of reporting excellent, very good, or good health (versus fair or poor health via IVR increased during programme participation, and was associated with better medication adherence. Patients completing follow-up interviews were satisfied with the programme, with 19/20 (95% reporting that they would recommend it to a friend. Conclusions: By collaborating with LMICs, m-health programmes can be transferred from higher-resource centres to LMICs and implemented in ways that improve access to self-management support among people

Performance Testing Methodology for Safety-Critical Programmable Logic Controller

International Nuclear Information System (INIS)

Kim, Chang Ho; Oh, Do Young; Kim, Ji Hyeon; Kim, Sung Ho; Sohn, Se Do

2009-01-01

The Programmable Logic Controller (PLC) for use in Nuclear Power Plant safety-related applications is being developed and tested first time in Korea. This safety-related PLC is being developed with requirements of regulatory guideline and industry standards for safety system. To test that the quality of the developed PLC is sufficient to be used in safety critical system, document review and various product testings were performed over the development documents for S/W, H/W, and V/V. This paper provides the performance testing methodology and its effectiveness for PLC platform conducted by KOPEC

Effects of Hybrid Cycle and Handcycle Exercise on Cardiovascular Disease Risk Factors in People with Spinal Cord Injury : A Randomized Controlled Trial

NARCIS (Netherlands)

Bakkum, Arjan J. T.; Paulson, Thomas A. W.; Bishop, Nicolette C.; Goosey-Tolfrey, Victoria L.; Stolwijk-Swuste, Janneke M.; van Kuppevelt, Dirk J.; de Groot, Sonja; Janssen, Thomas W. J.

Objective: To examine the effects of a 16-week exercise programme, using either a hybrid cycle or a handcycle, on cardiovascular disease risk factors in people with spinal cord injury. Participants: Nineteen individuals with spinal cord injury >= 8 years. Design: Multicentre randomized controlled

Cost-effectiveness of tobacco control policies and programmes targeting adolescents: a systematic review

NARCIS (Netherlands)

Leão, Teresa; Kunst, Anton E.; Perelman, Julian

2018-01-01

Consistent evidence shows the importance of preventing smoking at young ages, when health behaviours are formed, with long-term consequences on health and survival. Although tobacco control policies and programmes targeting adolescents are widely promoted, the cost-effectiveness of such

Perception of young adults with sickle cell disease or sickle cell trait about participation in the CHOICES randomized controlled trial.

Science.gov (United States)

Hershberger, Patricia E; Gallo, Agatha M; Molokie, Robert; Thompson, Alexis A; Suarez, Marie L; Yao, Yingwei; Wilkie, Diana J

2016-06-01

To gain an in-depth understanding of the perceptions of young adults with sickle cell disease and sickle cell trait about parenthood and participating in the CHOICES randomized controlled trial that used computer-based, educational programmes. In the USA, there is insufficient education to assure that all young adults with sickle cell disease or sickle cell trait understand genetic inheritance risks and reproductive options to make informed reproductive decisions. To address this educational need, we developed a computer-based, multimedia program (CHOICES) and reformatted usual care into a computer-based (e-Book) program. We then conducted a two-year randomized controlled trial that included a qualitative component that would deepen understanding of young adults' perceptions of parenthood and use of computer-based, educational programmes. A qualitative descriptive approach completed after a randomized controlled trial. Sixty-eight men and women of childbearing age participated in semi-structured interviews at the completion of the randomized controlled trial from 2012-2013. Thematic content analysis guided the qualitative description. Three main themes were identified: (1) increasing knowledge and new ways of thinking and behaving; (2) rethinking parenting plans; and (3) appraising the program design and delivery. Most participants reported increased knowledge and rethinking of their parenting plans and were supportive of computer-based learning. Some participants expressed difficulty in determining individual transmission risks. Participants perceived the computer programs as beneficial to their learning. Future development of an Internet-based educational programme is warranted, with emphasis on providing tailored education or memory boosters about individual transmission risks. © 2015 John Wiley & Sons Ltd.

EPIC Trial: education programme impact on serum phosphorous control in CKD 5D patients on hemodialysis

Directory of Open Access Journals (Sweden)

Carmen Tzanno Branco Martins

Full Text Available Abstract Introduction: In stage 5D chronic kidney disease (CKD 5D patients, the encouragement of treatment adherence by health professionals is a significant clinical challenge. Objectives: This study evaluates the impact of a nutritional education programme on hyperphosphatemia, utilizing the transtheoretical model of behavior change (TMBC. Subjects and Methods: A prospective interventional study comprising 179 CKD 5D patients with hypophosphatemia. The 4-month educational programme took place during dialysis sessions. Demographic and laboratory data were evaluated, whilst the TMBC was utilized both pre- and post-intervention. Results: 132 patients showed a positive change and significant reduction in phosphate levels, whilst 47 patients showed a negative change and little reduction in phosphate levels. Positive changes were identified at different levels of literacy. 117/179 participants had ongoing treatment with sevelamer throughout the trial period. 61 patients with intact parathyroid hormone (iPTH 300 pg/ml also showed a decrease in phosphate levels. Conclusions: Nutritional education programmes can achieve excellent results when appropriately applied. An education programme may be effective across different literacy levels.

The emergence of insecticide resistance in central Mozambique and potential threat to the successful indoor residual spraying malaria control programme

Directory of Open Access Journals (Sweden)

Wilding Craig S

2011-05-01

Full Text Available Abstract Background Malaria vector control by indoor residual spraying was reinitiated in 2006 with DDT in Zambézia province, Mozambique. In 2007, these efforts were strengthened by the President's Malaria Initiative. This manuscript reports on the monitoring and evaluation of this programme as carried out by the Malaria Decision Support Project. Methods Mosquitoes were captured daily through a series of 114 window exit traps located at 19 sentinel sites, identified to species and analysed for sporozoites. Anopheles mosquitoes were collected resting indoors and tested for insecticide resistance following the standard WHO protocol. Annual cross sectional household parasite surveys were carried out to monitor the impact of the control programme on prevalence of Plasmodium falciparum in children aged 1 to 15 years. Results A total of 3,769 and 2,853 Anopheles gambiae s.l. and Anopheles funestus, respectively, were captured from window exit traps throughout the period. In 2010 resistance to the pyrethroids lambda-cyhalothrin and permethrin and the carbamate, bendiocarb was detected in An. funestus. In 2006, the sporozoite rate in An. gambiae s.s. was 4% and this reduced to 1% over 4 rounds of spraying. The sporozoite rate for An. funestus was also reduced from 2% to 0 by 2008. Of the 437 Anopheles arabiensis identified, none were infectious. Overall prevalence of P. falciparum in the sentinel sites fell from 60% to 32% between October 2006 and October 2008. Conclusion Both An. gambiae s.s. and An. funestus were controlled effectively with the DDT-based IRS programme in Zambézia, reducing disease transmission and burden. However, the discovery of pyrethroid resistance in the province and Mozambique's policy change away from DDT to pyrethroids for IRS threatens the gains made here.

Evaluation of a nurse-led dementia education and knowledge translation programme in primary care: A cluster randomized controlled trial.

Science.gov (United States)

Wang, Yao; Xiao, Lily Dongxia; Ullah, Shahid; He, Guo-Ping; De Bellis, Anita

2017-02-01

The lack of dementia education programmes for health professionals in primary care is one of the major factors contributing to the unmet demand for dementia care services. To determine the effectiveness of a nurse-led dementia education and knowledge translation programme for health professionals in primary care; participants' satisfaction with the programme; and to understand participants' perceptions of and experiences in the programme. A cluster randomized controlled trial was used as the main methodology to evaluate health professionals' knowledge, attitudes and care approach. Focus groups were used at the end of the project to understand health professionals' perceptions of and experiences in the programme. Fourteen community health service centres in a province in China participated in the study. Seven centres were randomly assigned to the intervention or control group respectively and 85 health professionals in each group completed the programme. A train-the-trainer model was used to implement a dementia education and knowledge translation programme. Outcome variables were measured at baseline, on the completion of the programme and at 3-month follow-up. A mixed effect linear regression model was applied to compare the significant differences of outcome measures over time between the two groups. Focus groups were guided by four semi-structured questions and analysed using content analysis. Findings revealed significant effects of the education and knowledge translation programme on participants' knowledge, attitudes and a person-centred care approach. Focus groups confirmed that the programme had a positive impact on dementia care practice. A dementia education and knowledge translation programme for health professionals in primary care has positive effects on their knowledge, attitudes, care approach and care practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

Integration of microbiology and infectious disease teaching courses in an interdisciplinary training programme (Master level) centred on the 'One world, one health' WHO concept.

Science.gov (United States)

Eveillard, Matthieu; Ruvoen, Nathalie; Lepelletier, Didier; Fradet, Stéphanie; Couvreur, Sébastien; Krempf, Michel; Magras, Catherine

2016-05-01

This report describes the integration of the microbiology and infectious diseases teaching courses in an international Master's level interdisciplinary programme based on the 'One world, one health' WHO concept, and reports the students and teachers' evaluation related to their feelings of about this innovative programme. The integration was evaluated by recording the positioning of these two topics in the five teaching units constituting the programme, and by identifying their contribution in the interactions between the different teaching units. The satisfaction of students was assessed by a quantitative survey, whereas the feelings of students and teachers were assessed by interviews. The study demonstrated that microbiology and infectious diseases were widely involved in interactions between the teaching units, constituting a kind of cement for the programme. The students assigned a mean score of 3.7 to the topics dealing with microbiology and infectious diseases. According to the qualitative data, students and teachers considered that the interdisciplinary approach provided new insights but reported problems of communication, probably inherent to the multiculturalism of the class. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effects of Hybrid Cycle and Handcycle Exercise on Cardiovascular Disease Risk Factors in People with Spinal Cord Injury: a Randomized Controlled Trial

NARCIS (Netherlands)

Bakkum, A.J.T.; Paulson, T.A.W.; Bishop, N.C.; Goosey-Tolfrey, V.L.; Stolwijk-Swuste, J.M.; van Kuppevelt, D.J.; de Groot, S.; Janssen, T.W.J.

2015-01-01

Objective: To examine the effects of a 16-week exercise programme, using either a hybrid cycle or a handcycle, on cardiovascular disease risk factors in people with spinal cord injury. Participants: Nineteen individuals with spinal cord injury ≥ 8 years. Design: Multicentre randomized controlled

The Incredible Years Parent-Toddler Programme and parental language: a randomised controlled trial.

Science.gov (United States)

Gridley, N; Hutchings, J; Baker-Henningham, H

2015-01-01

Parental language is associated with children's later language development. Parenting programmes, based on social learning theory, enhance a range of parenting behaviours, yet there is limited evidence for their effect on parental language. To assess the benefits of a behavioural-based parenting programme, which features components of language and communication, to enhance parental language. Parents of toddlers, aged 12 to 36 months, were recruited from eight Flying Start early intervention centres across Wales. Participants were randomised 2:1 either to a parenting programme (n = 60) or to a wait-list control group (n = 29). Researchers were blind to participant allocation throughout the trial. Fifteen-minute video-recorded observations of parents and children interacting during free-play, both at a pre-intervention and at 6-month follow-up, provided the data for the study. Five observed measures of parental language were assessed; quantity and variety, encouraging, critical, child-led and parent led interactions. The Incredible Years Parent-Toddler Programme (IYPTP) is a 12-week group-based behavioural intervention that teaches effective relationship and behavioural management skills including social, emotional and persistence coaching to enable parents to better support their children's development. Of 89 dyads that completed pre-intervention assessments 81 (54 intervention and 27 control) met the criteria for the current study. Intention to treat analysis indicated that child-led language interactions significantly benefited from the intervention [regression coefficient (B) = -1.44, 95% confidence intervals (CI) = -2.59 to -0.29, P = 0.015, effect size (ES) = 0.47] and a positive trend for encouraging language in favour of the intervention sample was evident. Per-protocol sample analysis replicated these findings with encouraging language reaching statistical significance (B = 1.07, 95% CI = 0.11 to 2.03, P = 0.03, ES = 0.52). No further benefits were evident

Enhancing biological control of basal stem rot disease (Ganoderma boninense) in oil palm plantations.

Science.gov (United States)

Susanto, A; Sudharto, P S; Purba, R Y

2005-01-01

Basal Stem Rot (BSR) disease caused by Ganoderma boninense is the most destructive disease in oil palm, especially in Indonesia and Malaysia. The available control measures for BSR disease such as cultural practices and mechanical and chemical treatment have not proved satisfactory due to the fact that Ganoderma has various resting stages such as melanised mycelium, basidiospores and pseudosclerotia. Alternative control measures to overcome the Ganoderma problem are focused on the use of biological control agents and planting resistant material. Present studies conducted at Indonesian Oil Palm Research Institute (IOPRI) are focused on enhancing the use of biological control agents for Ganoderma. These activities include screening biological agents from the oil palm rhizosphere in order to evaluate their effectiveness as biological agents in glasshouse and field trials, testing their antagonistic activities in large scale experiments and eradicating potential disease inoculum with biological agents. Several promising biological agents have been isolated, mainly Trichoderma harzianum, T. viride, Gliocladium viride, Pseudomonas fluorescens, and Bacillus sp. A glasshouse and field trial for Ganoderma control indicated that treatment with T. harzianum and G. viride was superior to Bacillus sp. A large scale trial showed that the disease incidence was lower in a field treated with biological agents than in untreated fields. In a short term programme, research activities at IOPRI are currently focusing on selecting fungi that can completely degrade plant material in order to eradicate inoculum. Digging holes around the palm bole and adding empty fruit bunches have been investigated as ways to stimulate biological agents.

The effectiveness of a preconditioning programme on preventing running-related injuries in novice runners: a randomised controlled trial.

Science.gov (United States)

Bredeweg, Steef W; Zijlstra, Sjouke; Bessem, Bram; Buist, Ida

2012-09-01

There is no consensus on the aetiology and prevention of running-related injuries in runners. Preconditioning studies among different athlete populations show positive effects on the incidence of sports injuries. A 4-week preconditioning programme in novice runners will reduce the incidence of running-related injuries. Randomised controlled clinical trial; level of evidence, 1. Novice runners (N=432) prepared for a four-mile recreational running event. Participants were allocated to the 4-week preconditioning (PRECON) group (N=211) or the control group (N=221). The PRECON group started a 4-week training programme, prior to the running programme, with walking and hopping exercises. After the 4-week period both groups started a 9-week running programme. In both groups information was registered on running exposure and running-related injuries (RRIs) using an internet-based running log. Primary outcome measure was RRIs per 100 runners. An RRI was defined as any musculoskeletal complaint of the lower extremity or lower back causing restriction of running for at least a week. The incidence of RRIs was 15.2% in the PRECON group and 16.8% in the control group. The difference in RRIs between the groups was not significant (χ(2)=0.161, df=1, p=0.69). This prospective study demonstrated that a 4-week PRECON programme with walking and hopping exercises had no influence on the incidence of RRIs in novice runners.

Challenges of implementing an Integrated Disease Surveillance and ...

African Journals Online (AJOL)

Tanzania adopted an Integrated Disease Surveillance and Response (IDSR) strategy in 1998 in order to strengthen its infectious disease surveillance system. During that time, the country had 5 separate surveillance systems to monitor infectious disease trends and disease control programmes. The systems included the ...

Project-Based Learning in Programmable Logic Controller

Science.gov (United States)

Seke, F. R.; Sumilat, J. M.; Kembuan, D. R. E.; Kewas, J. C.; Muchtar, H.; Ibrahim, N.

2018-02-01

Project-based learning is a learning method that uses project activities as the core of learning and requires student creativity in completing the project. The aims of this study is to investigate the influence of project-based learning methods on students with a high level of creativity in learning the Programmable Logic Controller (PLC). This study used experimental methods with experimental class and control class consisting of 24 students, with 12 students of high creativity and 12 students of low creativity. The application of project-based learning methods into the PLC courses combined with the level of student creativity enables the students to be directly involved in the work of the PLC project which gives them experience in utilizing PLCs for the benefit of the industry. Therefore, it’s concluded that project-based learning method is one of the superior learning methods to apply on highly creative students to PLC courses. This method can be used as an effort to improve student learning outcomes and student creativity as well as to educate prospective teachers to become reliable educators in theory and practice which will be tasked to create qualified human resources candidates in order to meet future industry needs.

School-based suicide prevention programmes: the SEYLE cluster-randomised, controlled trial.

Science.gov (United States)

Wasserman, Danuta; Hoven, Christina W; Wasserman, Camilla; Wall, Melanie; Eisenberg, Ruth; Hadlaczky, Gergö; Kelleher, Ian; Sarchiapone, Marco; Apter, Alan; Balazs, Judit; Bobes, Julio; Brunner, Romuald; Corcoran, Paul; Cosman, Doina; Guillemin, Francis; Haring, Christian; Iosue, Miriam; Kaess, Michael; Kahn, Jean-Pierre; Keeley, Helen; Musa, George J; Nemes, Bogdan; Postuvan, Vita; Saiz, Pilar; Reiter-Theil, Stella; Varnik, Airi; Varnik, Peeter; Carli, Vladimir

2015-04-18

Suicidal behaviours in adolescents are a major public health problem and evidence-based prevention programmes are greatly needed. We aimed to investigate the efficacy of school-based preventive interventions of suicidal behaviours. The Saving and Empowering Young Lives in Europe (SEYLE) study is a multicentre, cluster-randomised controlled trial. The SEYLE sample consisted of 11,110 adolescent pupils, median age 15 years (IQR 14-15), recruited from 168 schools in ten European Union countries. We randomly assigned the schools to one of three interventions or a control group. The interventions were: (1) Question, Persuade, and Refer (QPR), a gatekeeper training module targeting teachers and other school personnel, (2) the Youth Aware of Mental Health Programme (YAM) targeting pupils, and (3) screening by professionals (ProfScreen) with referral of at-risk pupils. Each school was randomly assigned by random number generator to participate in one intervention (or control) group only and was unaware of the interventions undertaken in the other three trial groups. The primary outcome measure was the number of suicide attempt(s) made by 3 month and 12 month follow-up. Analysis included all pupils with data available at each timepoint, excluding those who had ever attempted suicide or who had shown severe suicidal ideation during the 2 weeks before baseline. This study is registered with the German Clinical Trials Registry, number DRKS00000214. Between Nov 1, 2009, and Dec 14, 2010, 168 schools (11,110 pupils) were randomly assigned to interventions (40 schools [2692 pupils] to QPR, 45 [2721] YAM, 43 [2764] ProfScreen, and 40 [2933] control). No significant differences between intervention groups and the control group were recorded at the 3 month follow-up. At the 12 month follow-up, YAM was associated with a significant reduction of incident suicide attempts (odds ratios [OR] 0·45, 95% CI 0·24-0·85; p=0·014) and severe suicidal ideation (0·50, 0·27-0·92; p=0·025

African Programme for Onchocerciasis Control 1995–2015: Model-Estimated Health Impact and Cost

Science.gov (United States)

Coffeng, Luc E.; Stolk, Wilma A.; Zouré, Honorat G. M.; Veerman, J. Lennert; Agblewonu, Koffi B.; Murdoch, Michele E.; Noma, Mounkaila; Fobi, Grace; Richardus, Jan Hendrik; Bundy, Donald A. P.; Habbema, Dik; de Vlas, Sake J.; Amazigo, Uche V.

2013-01-01

Background Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015. Methods and Findings With data on pre-control prevalence of infection and population coverage of mass treatment, we simulated trends in infection, blindness, visual impairment, and severe itch using the micro-simulation model ONCHOSIM, and estimated disability-adjusted life years (DALYs) lost due to onchocerciasis. We assessed financial costs for APOC, beneficiary governments, and non-governmental development organizations, excluding cost of donated drugs. We estimated that between 1995 and 2010, mass treatment with ivermectin averted 8.2 million DALYs due to onchocerciasis in APOC areas, at a nominal cost of about US$257 million. We expect that APOC will avert another 9.2 million DALYs between 2011 and 2015, at a nominal cost of US$221 million. Conclusions Our simulations suggest that APOC has had a remarkable impact on population health in Africa between 1995 and 2010. This health impact is predicted to double during the subsequent five years of the program, through to 2015. APOC is a highly cost-effective public health program. Given the anticipated elimination of onchocerciasis from some APOC areas, we expect even more health gains and a more favorable cost-effectiveness of mass treatment with ivermectin in the near future. PMID:23383355

Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women.

OpenAIRE

Campbell, A. J.; Robertson, M. C.; Gardner, M. M.; Norton, R. N.; Tilyard, M. W.; Buchner, D. M.

1997-01-01

OBJECTIVE: To assess the effectiveness of a home exercise programme of strength and balance retraining exercises in reducing falls and injuries in elderly women. DESIGN: Randomised controlled trial of an individually tailored programme of physical therapy in the home (exercise group, n = 116) compared with the usual care and an equal number of social visits (control group, n = 117). SETTING: 17 general practices in Dunedin, New Zealand. SUBJECTS: Women aged 80 years and older living in the co...

Socio-ecological dynamics and challenges to the governance of Neglected Tropical Disease control.

Science.gov (United States)

Michael, Edwin; Madon, Shirin

2017-02-06

The current global attempts to control the so-called "Neglected Tropical Diseases (NTDs)" have the potential to significantly reduce the morbidity suffered by some of the world's poorest communities. However, the governance of these control programmes is driven by a managerial rationality that assumes predictability of proposed interventions, and which thus primarily seeks to improve the cost-effectiveness of implementation by measuring performance in terms of pre-determined outputs. Here, we argue that this approach has reinforced the narrow normal-science model for controlling parasitic diseases, and in doing so fails to address the complex dynamics, uncertainty and socio-ecological context-specificity that invariably underlie parasite transmission. We suggest that a new governance approach is required that draws on a combination of non-equilibrium thinking about the operation of complex, adaptive, systems from the natural sciences and constructivist social science perspectives that view the accumulation of scientific knowledge as contingent on historical interests and norms, if more effective control approaches sufficiently sensitive to local disease contexts are to be devised, applied and managed. At the core of this approach is an emphasis on the need for a process that assists with the inclusion of diverse perspectives, social learning and deliberation, and a reflexive approach to addressing system complexity and incertitude, while balancing this flexibility with stability-focused structures. We derive and discuss a possible governance framework and outline an organizational structure that could be used to effectively deal with the complexity of accomplishing global NTD control. We also point to examples of complexity-based management structures that have been used in parasite control previously, which could serve as practical templates for developing similar governance structures to better manage global NTD control. Our results hold important wider

Modelling risk aversion to support decision-making for controlling zoonotic livestock diseases.

Science.gov (United States)

van Asseldonk, M A P M; Bergevoet, R H M; Ge, L

2013-12-01

Zoonotic infectious livestock diseases are becoming a significant burden for both animal and human health and are rapidly gaining the attention of decision-makers who manage public health programmes. If control decisions have only monetary components, governments are generally regarded as being risk-neutral and the intervention strategy with the highest expected benefit (lowest expected net costs) should be preferred. However, preferences will differ and alternative intervention plans will prevail if (human) life and death outcomes are involved. A rational decision framework must therefore consider risk aversion in the decision-maker and controversial values related to public health. In the present study, risk aversion and its impact on both the utility for the monetary component and the utility for the non-monetary component is shown to be an important element when dealing with emerging zoonotic infectious livestock diseases and should not be ignored in the understanding and support of decision-making. The decision framework was applied to several control strategies for the reduction of human cases of brucellosis (Brucella melitensis) originating from sheep in Turkey.

Microwave metamaterials—from passive to digital and programmable controls of electromagnetic waves

Science.gov (United States)

Cui, Tie Jun

2017-08-01

Since 2004, my group at Southeast University has been carrying out research into microwave metamaterials, which are classified into three catagories: metamaterials based on the effective medium model, plasmonic metamaterials for spoof surface plasmon polaritons (SPPs), and coding and programmable metamaterials. For effective-medium metamaterials, we have developed a general theory to accurately describe effective permittivity and permeability in semi-analytical forms, from which we have designed and realized a three dimensional (3D) wideband ground-plane invisibility cloak, a free-space electrostatic invisibility cloak, an electromagnetic black hole, optical/radar illusions, and radially anisotropic zero-index metamaterial for omni-directional radiation and a nearly perfect power combination of source array, etc. We have also considered the engineering applications of microwave metamaterials, such as a broadband and low-loss 3D transformation-optics lens for wide-angle scanning, a 3D planar gradient-index lens for high-gain radiations, and a random metasurface for reducing radar cross sections. In the area of plasmonic metamaterials, we proposed an ultrathin, narrow, and flexible corrugated metallic strip to guide SPPs with a small bending loss and radiation loss, from which we designed and realized a series of SPP passive devices (e.g. power divider, coupler, filter, and resonator) and active devices (e.g. amplifier and duplexer). We also showed a significant feature of the ultrathin SPP waveguide in overcoming the challenge of signal integrity in traditional integrated circuits, which will help build a high-performance SPP wireless communication system. In the area of coding and programmable metamaterials, we proposed a new measure to describe a metamaterial from the viewpoint of information theory. We have illustrated theoretically and experimentally that coding metamaterials composed of digital units can be controlled by coding sequences, leading to different

Rabies prevention and management of cats in the context of trap-neuter-vaccinate-release programmes.

Science.gov (United States)

Roebling, A D; Johnson, D; Blanton, J D; Levin, M; Slate, D; Fenwick, G; Rupprecht, C E

2014-06-01

Domestic cats are an important part of many Americans' lives, but effective control of the 60-100 million feral cats living throughout the country remains problematic. Although trap-neuter-vaccinate-return (TNVR) programmes are growing in popularity as alternatives to euthanizing feral cats, their ability to adequately address disease threats and population growth within managed cat colonies is dubious. Rabies transmission via feral cats is a particular concern as demonstrated by the significant proportion of rabies post-exposure prophylaxis associated with exposures involving cats. Moreover, TNVR has not been shown to reliably reduce feral cat colony populations because of low implementation rates, inconsistent maintenance and immigration of unsterilized cats into colonies. For these reasons, TNVR programmes are not effective methods for reducing public health concerns or for controlling feral cat populations. Instead, responsible pet ownership, universal rabies vaccination of pets and removal of strays remain integral components to control rabies and other diseases. © 2013 Blackwell Verlag GmbH.

APPLICATION OF LOT QUALITY ASSURANCE SAMPLING FOR ASSESSING DISEASE CONTROL PROGRAMMES - EXAMINATION OF SOME METHODOLOGICAL ISSUES

OpenAIRE

T. R. RAMESH RAO

2011-01-01

Lot Quality Assurance Sampling (LQAS), a statistical tool in industrial setup, has been in use since 1980 for monitoring and evaluation of programs on disease control / immunization status among children / health workers performance in health system. While conducting LQAS in the field, there are occasions, even after due care of design, there are practical and methodological issues to be addressed before it is recommended for implementation and intervention. LQAS is applied under the assumpti...

A research agenda for helminth diseases of humans: health research and capacity building in disease-endemic countries for helminthiases control.

Directory of Open Access Journals (Sweden)

Mike Y Osei-Atweneboana

Full Text Available Capacity building in health research generally, and helminthiasis research particularly, is pivotal to the implementation of the research and development agenda for the control and elimination of human helminthiases that has been proposed thematically in the preceding reviews of this collection. Since helminth infections affect human populations particularly in marginalised and low-income regions of the world, they belong to the group of poverty-related infectious diseases, and their alleviation through research, policy, and practice is a sine qua non condition for the achievement of the United Nations Millennium Development Goals. Current efforts supporting research capacity building specifically for the control of helminthiases have been devised and funded, almost in their entirety, by international donor agencies, major funding bodies, and academic institutions from the developed world, contributing to the creation of (not always equitable North-South "partnerships". There is an urgent need to shift this paradigm in disease-endemic countries (DECs by refocusing political will, and harnessing unshakeable commitment by the countries' governments, towards health research and capacity building policies to ensure long-term investment in combating and sustaining the control and eventual elimination of infectious diseases of poverty. The Disease Reference Group on Helminth Infections (DRG4, established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR, was given the mandate to review helminthiases research and identify research priorities and gaps. This paper discusses the challenges confronting capacity building for parasitic disease research in DECs, describes current capacity building strategies with particular reference to neglected tropical diseases and human helminthiases, and outlines recommendations to redress the balance of alliances and partnerships for health research between the developed countries of

[General conditions concerning the implementation of an outpatient education programme--characteristics and distinctions from an inpatient training programme].

Science.gov (United States)

Brandes, I; Wunderlich, B; Niehues, C

2011-04-01

The aim of the EVA study was to develop an outpatient education programme for women with endometriosis with a view to permanent transfer into routine care. Implementation of the programme generated several problems and obstacles that are not, or not to this extent, present in the inpatient setting of a rehabilitation clinic. The patient education programme was developed in line with an existing inpatient programme, taking into account the criteria for evaluating such training programmes. Several adjustments to process, structure and content level had to be made to achieve the conditions of the outpatient setting. Since May 2008, 17 training courses took place in various outpatient and acute inpatient settings, and a total of 156 women with diagnosed endometriosis participated. The problems and obstacles that emerged affected similarly the process, structure and content of the training programme. On the structural level, especially problems with availability of rooms, technical equipment and trainers occurred, leading to significant time pressures. The main problem on the procedural level was the recruitment of participants, since--in contrast to the inpatient setting and to disease management programmes--no assignment by physicians or insurers takes place. Furthermore, gainful activity of the participants and the resulting shift of the training beyond the usual working and opening hours are important barriers for implementation. The unavailability of trainers in these settings requires creative solutions. Regarding the contents of the training it has to be taken into consideration that--unlike the inpatient setting--no aftercare intervention and no individual psychological consultation are possible. The training programme has to be designed in such a way that all problems that have occurred could be dealt with appropriately. In summary, the permanent implementation of an outpatient training programme is possible but is more time-consuming than inpatient trainings

Buruli Ulcer in Cameroon: The Development and Impact of the National Control Programme.

Directory of Open Access Journals (Sweden)

Earnest Njih Tabah

2016-01-01

Full Text Available Cameroon is endemic for Buruli ulcer (BU and organised institutional BU control began in 2002. The objective was to describe the evolution, achievements and challenges of the national BU control programme (NBUCP and to make suggestions for scaling up the programme.We analysed collated data on BU from 2001 to 2014 and reviewed activity reports NBUCP in Cameroon. Case-detection rates and key BU control indicators were calculated and plotted on a time scale to determine trends in performance. A linear regression analysis of BU detection rate from 2005-2014 was done. The regression coefficient was tested statistically for the significance in variation of BU detection rate.In 14 years of BU control, 3700 cases were notified. The BU detection rate dropped significantly from 3.89 to 1.45 per 100 000 inhabitants. The number of BU endemic health districts rose from two to 64. Five BU diagnostic and treatment centres are functional and two more are planned for 2015. The health system has been strengthened and BU research and education has gained more interest in Cameroon.Although institutional BU control Cameroon only began 30 years after the first cases were reported in 1969, a number of milestones have been attained. These would serve as stepping stones for charting the way forward and improving upon control activities in the country if the major challenge of resource allocation is dealt with.

Economic evaluation of a pre-ESRD pay-for-performance programme in advanced chronic kidney disease patients.

Science.gov (United States)

Hsieh, Hui-Min; Lin, Ming-Yen; Chiu, Yi-Wen; Wu, Ping-Hsun; Cheng, Li-Jeng; Jian, Feng-Shiuan; Hsu, Chih-Cheng; Hwang, Shang-Jyh

2017-07-01

The National Health Insurance Administration in Taiwan initiated a nationwide pre-end-stage renal disease (ESRD) pay-for-performance (P4P) programme at the end of 2006 to improve quality of care for chronic kidney disease (CKD) patients. This study aimed to examine this programme's effect on patients' clinical outcomes and its cost-effectiveness among advanced CKD patients. We conducted a longitudinal observational matched cohort study using two nationwide population-based datasets. The major outcomes of interests were incidence of dialysis, all-cause mortality, direct medical costs, life years (LYs) and incremental cost-effectiveness ratio comparing matched P4P and non-P4P advanced CKD patients. Competing-risk analysis, general linear regression and bootstrapping statistical methods were used for the analysis. Subdistribution hazard ratio (95% confidence intervals) for advanced CKD patients enrolled in the P4P programme, compared with those who did not enrol, were 0.845 (0.779-0.916) for incidence of dialysis and 0.792 (0.673-0.932) for all-cause mortality. LYs for P4P and non-P4P patients who initiated dialysis were 2.83 and 2.74, respectively. The adjusted incremental CKD-related costs and other-cause-related costs were NT$114 704 (US$3823) and NT$32 420 (US$1080) for P4P and non-P4P patients who initiated dialysis, respectively, and NT$-3434 (US$114) and NT$45 836 (US$1572) for P4P and non-P4P patients who did not initiate dialysis, respectively, during the 3-year follow-up period. P4P patients had lower risks of both incidence of dialysis initiation and death. In addition, our empirical findings suggest that the P4P pre-ESRD programme in Taiwan provided a long-term cost-effective use of resources and cost savings for advanced CKD patients. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

A control system based on field programmable gate array for papermaking sewage treatment

International Nuclear Information System (INIS)

Zhang, Zi Sheng; Xie, Chang; Xiong, Yan Qing; Liu, Zhi Qiang; Li, Qing

2013-01-01

A sewage treatment control system is designed to improve the efficiency of papermaking wastewater treatment system. The automation control system is based on Field Programmable Gate Array (FPGA), coded with Very-High-Speed Integrate Circuit Hardware Description Language (VHDL), compiled and simulated with Quartus. In order to ensure the stability of the data used in FPGA, the data is collected through temperature sensors, water level sensor and online PH measurement system. The automatic control system is more sensitive, and both the treatment efficiency and processing power are increased. This work provides a new method for sewage treatment control.

Effect of a group-based rehabilitation programme on glycaemic control and cardiovascular risk factors in type 2 diabetes patients: The Copenhagen Type 2 Diabetes Rehabilitation Project

DEFF Research Database (Denmark)

Vadstrup, Eva Soelberg; Frølich, Anne; Perrild, Hans Jørgen Duckert

2011-01-01

To compare the effectiveness of a group-based rehabilitation programme with an individual counselling programme at improving glycaemic control and cardiovascular risk factors among patients with type 2 diabetes.......To compare the effectiveness of a group-based rehabilitation programme with an individual counselling programme at improving glycaemic control and cardiovascular risk factors among patients with type 2 diabetes....

Determinants of risk factor control in subjects with coronary heart disease : a report from the EUROASPIRE III investigators.

LENUS (Irish Health Repository)

Cooney, Marie Therese

2012-04-18

The EUROASPIRE audits of risk factor control have indicated that, even in those with established coronary heart disease, risk factor control remains poor. We therefore analysed the EUROASPRE III data set to establish the factors associated with success or failure in risk factor control in order to inform future risk factor management strategies. University education, attendance at a specialist cardiology clinic, and participation in a cardiac rehabilitation programme were associated with improved risk factor control. Risk factor control was poorer in women, those with diabetes, and those undergoing coronary artery bypass surgery as opposed to medical therapy or percutaneous coronary intervention. Increasing age, depression, and anxiety were not associated with poorer risk factor control.

Control of foot and mouth disease: the experience of the Americas.

Science.gov (United States)

Correa Melo, E; López, A

2002-12-01

Foot and mouth disease (FMD) was first recognised in South America in 1870, almost simultaneously in the province of Buenos Aires (Argentina), in the central region of Chile, in Uruguay, in southern Brazil and coincidentally, on the northeastern coast of the United States of America. The epidemiology of the disease was unknown and no government action was taken following the initial outbreaks. This resulted in the disease spreading to other areas of Chile, as well as to Peru, Bolivia and Paraguay, reaching Venezuela and Colombia in the 1950s, and Ecuador in 1961. The entire continent was affected in the 1960s when national FMD control programmes were initiated, with the exception of Guyana, Surinam, French Guiana and Patagonia. In the 1970s, steps were taken to implement a regional control and eradication strategy in view of the impact of production and trade on the persistence of the virus. The Plan Hemisférico de Erradicación de la Fiebre Aftosa (PHEFA: Hemispheric FMD Eradication Plan), public- and private-sector policies, new diagnostic tools, the oil-adjuvanted FMD vaccine and regional strategies played a part in improving the epidemiological situation during the 1990s. A setback was encountered in 2000 and 2001, with outbreaks due to virus types A and 0 recorded in Argentina, Uruguay and Brazil.

Chronic Disease Management Programmes: an adequate response to patients’ needs?

Science.gov (United States)

Rijken, Mieke; Bekkema, Nienke; Boeckxstaens, Pauline; Schellevis, François G.; De Maeseneer, Jan M.; Groenewegen, Peter P.

2012-01-01

Abstract Background  Inspired by American examples, several European countries are now developing disease management programmes (DMPs) to improve the quality of care for patients with chronic diseases. Recently, questions have been raised whether the disease management approach is appropriate to respond to patient‐defined needs. Objective  In this article we consider the responsiveness of current European DMPs to patients’ needs defined in terms of multimorbidity, functional and participation problems, and self‐management. Method  Information about existing DMPs was derived from a survey among country‐experts. In addition, we made use of international scientific literature. Results  Most European DMPs do not have a solid answer yet to the problem of multimorbidity. Methods of linking DMPs, building extra modules to deal with the most prevalent comorbidities and integration of case management principles are introduced. Rehabilitation, psychosocial and reintegration support are not included in all DMPs, and the involvement of the social environment of the patient is uncommon. Interventions tailored to the needs of specific social or cultural patient groups are mostly not available. Few DMPs provide access to individualized patient information to strengthen self‐management, including active engagement in decision making. Conclusion  To further improve the responsiveness of DMPs to patients’ needs, we suggest to monitor ‘patient relevant outcomes’ that might be based on the ICF‐model. To address the needs of patients with multimorbidity, we propose a generic comprehensive model, embedded in primary care. A goal‐oriented approach provides the opportunity to prioritize goals that really matter to patients. PMID:22712877

The effectiveness of the cardiovascular disease prevention programme 'KardioPro' initiated by a German sickness fund: a time-to-event analysis of routine data.

Directory of Open Access Journals (Sweden)

Sabine Witt

Full Text Available Cardiovascular disease is the leading cause of morbidity and mortality in the developed world. To reduce this burden of disease, a German sickness fund ('Siemens-Betriebskrankenkasse', SBK initiated the prevention programme 'KardioPro' including primary (risk factor reduction and secondary (screening prevention and guideline-based treatment. The aim of this study was to assess the effectiveness of 'KardioPro' as it is implemented in the real world.The study is based on sickness fund routine data. The control group was selected from non-participants via propensity score matching. Study analysis was based on time-to-event analysis via Cox proportional hazards regression with the endpoint 'all-cause mortality, acute myocardial infarction (MI and ischemic stroke (1', 'all-cause mortality (2' and 'non-fatal acute MI and ischemic stroke (3'.A total of 26,202 insurants were included, 13,101 participants and 13,101 control subjects. 'KardioPro' enrollment was associated with risk reductions of 23.5% (95% confidence interval (CI 13.0-32.7% (1, 41.7% (95% CI 30.2-51.2% (2 and 3.5% (hazard ratio 0.965, 95% CI 0.811-1.148 (3. This corresponds to an absolute risk reduction of 0.29% (1, 0.31% (2 and 0.03% (3 per year.The prevention programme initiated by a German statutory sickness fund appears to be effective with regard to all-cause mortality. The non-significant reduction in non-fatal events might result from a shift from fatal to non-fatal events.

A EUropean study on effectiveness and sustainability of current Cardiac Rehabilitation programmes in the Elderly: Design of the EU-CaRE randomised controlled trial.

Science.gov (United States)

Prescott, Eva; Meindersma, Esther P; van der Velde, Astrid E; Gonzalez-Juanatey, Jose R; Iliou, Marie Christine; Ardissino, Diego; Zoccai, Giuseppe Biondi; Zeymer, Uwe; Prins, Leonie F; Van't Hof, Arnoud Wj; Wilhelm, Matthias; de Kluiver, Ed P

2016-10-01

Cardiac rehabilitation (CR) is an evidence-based intervention to increase survival and quality of life. Yet studies consistently show that elderly patients are less frequently referred to CR, show less uptake and more often drop out of CR programmes. The European study on effectiveness and sustainability of current cardiac rehabilitation programmes in the elderly (EU-CaRE) project consists of an observational study and an open prospective, investigator-initiated multicentre randomised controlled trial (RCT) involving mobile telemonitoring guided CR (mCR). The aim of EU-CaRE is to map the efficiency of current CR of the elderly in Europe, and to investigate whether mCR is an effective alternative in terms of efficacy, adherence and sustainability. The EU-CaRE study includes patients aged 65 years or older with ischaemic heart disease or who have undergone heart valve surgery. A total of 1760 patients participating in existing CR programmes in eight regions of Europe will be included. Of patients declining regular CR, 238 will be included in the RCT and randomised in two study arms. The experimental group (mCR) will receive a personalised home-based programme while the control group will receive no advice or coaching throughout the study period. Outcomes will be assessed after the end of CR and at 12 months follow-up. The primary outcome is VO 2peak and secondary outcomes include variables describing CR uptake, adherence, efficacy and sustainability. The study will provide important information to improve CR in the elderly. The EU-CaRE RCT is the first European multicentre study of mCR as an alternative for elderly patients not attending usual CR. © The European Society of Cardiology 2016.

Product quality control, irradiation and shipping procedures for mass-reared tephritid fruit flies for sterile insect release programmes

International Nuclear Information System (INIS)

1999-05-01

This document represents the recommendations, reached by consensus of an international group of quality control experts, on the standard procedures for product quality control (QC) for mass reared tephritid flies that are to be used in Sterile Insect Technique (SIT) programs. In addition, the manual describes recommended methods of handling and packaging pupae during irradiation and shipment. Most of the procedures were designed specifically for use with Mediterranean fruit flies, Ceratitis capitata (Wied.), but they are applicable, with minor modification in some cases, for other tephritid species such as Caribbean fruit fly Anastrepha suspense, Mexican fruit fly A. ludens, and various Bactrocera species. The manual is evolving and subject to periodic updates. The future additions will include other fruit flies as the need is identified. If followed, procedures described in this manual will help ensure that the quality of mass-produced flies is measured accurately in a standardised fashion, allowing comparisons of quality over time and across rearing facilities and field programmes. Problems in rearing, irradiation and handling procedures, and strain quality can be identified and hopefully corrected before control programmes are affected. Tests and procedures described in this document are only part of a total quality control programme for tephritid fly production. The product QC evaluations included in this manual are, unless otherwise noted, required to be conducted during SIT programmes by the Field programme staff not the production staff. Additional product QC tests have been developed and their use is optional (see ancillary test section). Production and process QC evaluations (e.g., analysis of diet components, monitoring the rearing environment, yield of larvae, development rate, etc.) are not within the scope of this document. Quality specifications are included for minimum and mean acceptability of conventional strains of C. capitata, A. ludens, and A

A model to evaluate quality and effectiveness of disease management.

Science.gov (United States)

Lemmens, K M M; Nieboer, A P; van Schayck, C P; Asin, J D; Huijsman, R

2008-12-01

Disease management has emerged as a new strategy to enhance quality of care for patients suffering from chronic conditions, and to control healthcare costs. So far, however, the effects of this strategy remain unclear. Although current models define the concept of disease management, they do not provide a systematic development or an explanatory theory of how disease management affects the outcomes of care. The objective of this paper is to present a framework for valid evaluation of disease-management initiatives. The evaluation model is built on two pillars of disease management: patient-related and professional-directed interventions. The effectiveness of these interventions is thought to be affected by the organisational design of the healthcare system. Disease management requires a multifaceted approach; hence disease-management programme evaluations should focus on the effects of multiple interventions, namely patient-related, professional-directed and organisational interventions. The framework has been built upon the conceptualisation of these disease-management interventions. Analysis of the underlying mechanisms of these interventions revealed that learning and behavioural theories support the core assumptions of disease management. The evaluation model can be used to identify the components of disease-management programmes and the mechanisms behind them, making valid comparison feasible. In addition, this model links the programme interventions to indicators that can be used to evaluate the disease-management programme. Consistent use of this framework will enable comparisons among disease-management programmes and outcomes in evaluation research.

An integrated programme after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: effect on emotional and functional dimensions of quality of life.

Science.gov (United States)

Moullec, G; Ninot, G

2010-02-01

To assess whether a maintenance integrated health care programme is effective in improving functional and emotional dimensions of quality of life in patients with chronic obstructive pulmonary disease (COPD) after a first pulmonary rehabilitation. Prospective controlled trial. Three rehabilitation centres and three patient self-help associations within a health care network in France. Forty patients with moderate to severe COPD. After a first four-week inpatient pulmonary rehabilitation programme, patients took part in a maintenance integrated health care programme or usual care for 12 months. The primary outcomes were the change in functional and emotional dimensions of quality of life measured by the St George's Respiratory Questionnaire (SGRQ), the brief World Health Organization Quality of Life questionnaire (Brief-WHOQOL) and six specific questions using a 10-cm visual analogue scale. Secondary outcomes were change in exercise tolerance measured by six-minute walking test and cycle exercise. At one year, the maintenance intervention (n = 11) produced improvements in functional and emotional dimensions scores of quality of life and exercise tolerance. Patients in the usual aftercare group (n = 16) exhibited maintenance of functional dimension scores of quality of life, but a clinically relevant decline in emotional scores of quality of life and in six-minute walking distance one year after the pulmonary rehabilitation. Patient self-help association seems to be an innovative and efficient organizational structure to support patients with COPD after pulmonary rehabilitation in real-life settings. A distinction between emotional and functional dimensions of quality of life may improve the design and evaluation of integrated health care programmes in patients with COPD.

Cost-effectiveness of tobacco control policies and programmes targeting adolescents: a systematic review.

Science.gov (United States)

Leão, Teresa; Kunst, Anton E; Perelman, Julian

2018-02-01

Consistent evidence shows the importance of preventing smoking at young ages, when health behaviours are formed, with long-term consequences on health and survival. Although tobacco control policies and programmes targeting adolescents are widely promoted, the cost-effectiveness of such interventions has not been systematically documented. We performed a systematic review on the cost-effectiveness of policies and programmes preventing tobacco consumption targeting adolescents. We systematically reviewed literature on the (i) cost and effectiveness of (ii) prevention policies targeting (iii) smoking by (iv) adolescents. PubMed, Web of Science, Cochrane, CEA-TUFTS, Health Economic Evaluations, Wiley Online Library, Centre for Reviews and Dissemination Database, the National Institute for Health and Care Excellence and Google Scholar databases were used, and Google search engine was used for other grey literature review. We obtained 793 full-text papers and 19 grey literature documents, from which 16 studies fulfilled the inclusion criteria. Of these, only one was published in the last 5 years, and 15 were performed in high-income countries. Eight analyzed the cost-effectiveness of school-based programmes, five focused on media campaigns and three on legal bans. Policies and programmes were found to be cost-effective in all studies, and both effective and cost-saving in about half of the studies. Evidence is scarce and relatively obsolete, and rarely focused on the evaluation of legal bans. Moreover, no comparisons have been made between different interventions or across different contexts and implementation levels. However, all studies conclude that smoking prevention policies and programmes amongst adolescents are greatly worth their costs. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association.

Preventing Australian football injuries with a targeted neuromuscular control exercise programme: comparative injury rates from a training intervention delivered in a clustered randomised controlled trial.

Science.gov (United States)

Finch, Caroline F; Twomey, Dara M; Fortington, Lauren V; Doyle, Tim L A; Elliott, Bruce C; Akram, Muhammad; Lloyd, David G

2016-04-01

Exercise-based training programmes are commonly used to prevent sports injuries but programme effectiveness within community men's team sport is largely unknown. To present the intention-to-treat analysis of injury outcomes from a clustered randomised controlled trial in community Australian football. Players from 18 male, non-elite, community Australian football clubs across two states were randomly allocated to either a neuromuscular control (NMC) (intervention n=679 players) or standard-practice (control n=885 players) exercise training programme delivered as part of regular team training sessions (2× weekly for 8-week preseason and 18-week regular-season). All game-related injuries and hours of game participation were recorded. Generalised estimating equations, adjusted for clustering (club unit), were used to compute injury incidence rates (IIRs) for all injuries, lower limb injuries (LLIs) and knee injuries sustained during games. The IIRs were compared across groups with cluster-adjusted Injury Rate Ratios (IRRs). Overall, 773 game injuries were recorded. The lower limb was the most frequent body region injured, accounting for 50% of injuries overall, 96 (12%) of which were knee injuries. The NMC players had a reduced LLI rate compared with control players (IRR: 0.78 (95% CI 0.56 to 1.08), p=0.14.) The knee IIR was also reduced for NMC compared with control players (IRR: 0.50 (95% CI 0.24 to 1.05), p=0.07). These intention-to-treat results indicate that positive outcomes can be achieved from targeted training programmes for reducing knee and LLI injury rates in men's community sport. While not statistically significant, reducing the knee injury rate by 50% and the LLI rate by 22% is still a clinically important outcome. Further injury reductions could be achieved with improved training attendance and participation in the programme. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

The IAEA’s Role in Nutrition Programmes

International Nuclear Information System (INIS)

2016-01-01

The International Atomic Energy Agency (IAEA) programme on nutrition enhances countries’ capabilities to combat malnutrition for better health throughout life. It complements the work of other United Nations (UN) agencies, non-governmental organizations (NGOs) and interested stakeholders in the field of nutrition and health, by encouraging the use of accurate nuclear techniques (including stable isotopes) to design and evaluate interventions aimed at addressing malnutrition in all its forms with specific focus on: infant and young child feeding; maternal and adolescent nutrition; diet quality; prevention and control of non-communicable diseases (NCDs); and healthy ageing.

Effects of an exercise programme for chronically ill and mobility-restricted elderly with structured support by the general practitioner's practice (HOMEfit - study protocol of a randomised controlled trial

Directory of Open Access Journals (Sweden)

Hinrichs Timo

2011-12-01

Full Text Available Abstract Background Exercise programmes can be administered successfully as therapeutic agents to patients with a number of chronic diseases and help to improve physical functioning in older adults. Usually, such programmes target either healthy and mobile community-dwelling seniors or elderly individuals living in nursing institutions or special residences. Chronically ill or mobility-restricted individuals, however, are difficult to reach when they live in their own homes. A pilot study has shown good feasibility of a home-based exercise programme that is delivered to this target group through cooperation between general practitioners and exercise therapists. A logical next step involves evaluation of the effects of the programme. Methods/design The study is designed as a randomised controlled trial. We plan to recruit 210 patients (≥ 70 years in about 15 general practices. The experimental intervention (duration 12 weeks-a multidimensional home-based exercise programme-is delivered to the participant by an exercise therapist in counselling sessions at the general practitioner's practice and on the telephone. It is based on methods and strategies for facilitating behaviour change according to the Health Action Process Approach (HAPA. The control intervention-baseline physical activities-differs from the experimental intervention with regard to content of the counselling sessions as well as to content and frequency of the promoted activities. Primary outcome is functional lower body strength measured by the "chair-rise" test. Secondary outcomes are: physical function (battery of motor tests, physical activity (step count, health-related quality of life (SF-8, fall-related self-efficacy (FES-I, and exercise self-efficacy (SSA-Scale. The hypothesis that there will be differences between the two groups (experimental/control with respect to post-interventional chair-rise time will be tested using an ANCOVA with chair-rise time at baseline

Feeling safe and motivated to achieve better health: Experiences with a partnership-based nursing practice programme for in-home patients with chronic obstructive pulmonary disease.

Science.gov (United States)

Leine, Marit; Wahl, Astrid Klopstad; Borge, Christine Råheim; Hustavenes, Magne; Bondevik, Hilde

2017-09-01

To explore chronic obstructive pulmonary disease patients' experiences with a partnership-based nursing practice programme in the home setting. Patients with chronic obstructive pulmonary disease suffer from psychological and physiological problems, especially when they return home after hospitalisation from exacerbation. Many express a need for information and knowledge about chronic obstructive pulmonary disease. Partnership as practice is a patient-centred framework providing an individualised practice for each patient. This study intends to achieve a nuanced and improved understanding of chronic obstructive pulmonary disease patients' experiences with a partnership-based nursing practice programme comprising home visits from a respiratory nurse after hospital discharge, alongside interdisciplinary collaboration. This study has a qualitative design with interviews. Six individual semi-structured interviews collected in 2012-2013 constitute the material. Interviews were recorded, transcribed to written text and analysed using systematic text condensation. Three key themes were identified: to be seen, talked with and understood; healthcare support at home-continuity, practical support and facilitation; and exchange of knowledge. However, there were two generic themes that permeated the material: feeling safe and comforted, and motivation to achieve better health. Patients with chronic obstructive pulmonary disease can experience feeling safe and comforted, and be motivated to make changes in order to achieve better health after participating in a partnership-based nursing practice programme that includes home visits from a respiratory nurse and interdisciplinary cooperation after hospital discharge. To feel safe is of great importance, and how this relates to the patient's ability to cope with illness should be explored in further research. The results suggest that the partnership-based nursing practice programme that includes home visits and interdisciplinary

Tailored educational supportive care programme on sleep quality and psychological distress in patients with heart failure: A randomised controlled trial.

Science.gov (United States)

Chang, Yia-Ling; Chiou, Ai-Fu; Cheng, Shu-Meng; Lin, Kuan-Chia

2016-09-01

Up to 74% of patients with heart failure report poor sleep in Taiwan. Poor symptom management or sleep hygiene may affect patients' sleep quality. An effective educational programme was important to improve patients' sleep quality and psychological distress. However, research related to sleep disturbance in patients with heart failure is limited in Taiwan. To examine the effects of a tailored educational supportive care programme on sleep disturbance and psychological distress in patients with heart failure. randomised controlled trial. Eighty-four patients with heart failure were recruited from an outpatient department of a medical centre in Taipei, Taiwan. Patients were randomly assigned to the intervention group (n=43) or the control group (n=41). Patients in the intervention group received a 12-week tailored educational supportive care programme including individualised education on sleep hygiene, self-care, emotional support through a monthly nursing visit at home, and telephone follow-up counselling every 2 weeks. The control group received routine nursing care. Data were collected at baseline, the 4th, 8th, and 12th weeks after patients' enrollment. Outcome measures included sleep quality, daytime sleepiness, anxiety, and depression. The intervention group exhibited significant improvement in the level of sleep quality and daytime sleepiness after 12 weeks of the supportive nursing care programme, whereas the control group exhibited no significant differences. Anxiety and depression scores were increased significantly in the control group at the 12th week (p.05). Compared with the control group, the intervention group had significantly greater improvement in sleep quality (β=-2.22, pquality and psychological distress in patients with heart failure. We suggested that this supportive nursing care programme should be applied to clinical practice in cardiovascular nursing. Copyright © 2016 Elsevier Ltd. All rights reserved.

Programmes design for Bohunice NPP personnel other than control room operators

International Nuclear Information System (INIS)

Kalincik, L.

2002-01-01

This paper deals with project development of training programmes for non-licenced NPP personnel-masters, field operators, maintenance and technical supporting personnel. The programme development focuses on the part stage and on the job training at NPP. Bohunice NPP belongs to plants with higher specific number of personnel per installed power capacity. This factor also influenced the choice of programmes design. Undermentioned procedure is one of various approaches to SAT exploitation for training programmes design. (author)

Saltwell PIC Skid Programmable Logic Controller (PLC) Software Configuration Management Plan

International Nuclear Information System (INIS)

KOCH, M.R.

1999-01-01

This document provides the procedures and guidelines necessary for computer software configuration management activities during the operation and maintenance phases of the Saltwell PIC Skids as required by LMH-PRO-309/Rev. 0, Computer Software Quality Assurance, Section 2.6, Software Configuration Management. The software configuration management plan (SCMP) integrates technical and administrative controls to establish and maintain technical consistency among requirements, physical configuration, and documentation for the Saltwell PIC Skid Programmable Logic Controller (PLC) software during the Hanford application, operations and maintenance. This SCMP establishes the Saltwell PIC Skid PLC Software Baseline, status changes to that baseline, and ensures that software meets design and operational requirements and is tested in accordance with their design basis

Implementation of Adaptive Digital Controllers on Programmable Logic Devices

Science.gov (United States)

Gwaltney, David A.; King, Kenneth D.; Smith, Keary J.; Monenegro, Justino (Technical Monitor)

2002-01-01

Much has been made of the capabilities of FPGA's (Field Programmable Gate Arrays) in the hardware implementation of fast digital signal processing. Such capability also makes an FPGA a suitable platform for the digital implementation of closed loop controllers. Other researchers have implemented a variety of closed-loop digital controllers on FPGA's. Some of these controllers include the widely used proportional-integral-derivative (PID) controller, state space controllers, neural network and fuzzy logic based controllers. There are myriad advantages to utilizing an FPGA for discrete-time control functions which include the capability for reconfiguration when SRAM-based FPGA's are employed, fast parallel implementation of multiple control loops and implementations that can meet space level radiation tolerance requirements in a compact form-factor. Generally, a software implementation on a DSP (Digital Signal Processor) or microcontroller is used to implement digital controllers. At Marshall Space Flight Center, the Control Electronics Group has been studying adaptive discrete-time control of motor driven actuator systems using digital signal processor (DSP) devices. While small form factor, commercial DSP devices are now available with event capture, data conversion, pulse width modulated (PWM) outputs and communication peripherals, these devices are not currently available in designs and packages which meet space level radiation requirements. In general, very few DSP devices are produced that are designed to meet any level of radiation tolerance or hardness. The goal of this effort is to create a fully digital, flight ready controller design that utilizes an FPGA for implementation of signal conditioning for control feedback signals, generation of commands to the controlled system, and hardware insertion of adaptive control algorithm approaches. An alternative is required for compact implementation of such functionality to withstand the harsh environment

How to adapt the pulmonary rehabilitation programme to patients with chronic respiratory disease other than COPD

Directory of Open Access Journals (Sweden)

Anne E. Holland

2013-12-01

Full Text Available Dyspnoea, fatigue, reduced exercise tolerance, peripheral muscle dysfunction and mood disorders are common features of many chronic respiratory disorders. Pulmonary rehabilitation successfully treats these manifestations in chronic obstructive pulmonary disease (COPD and emerging evidence suggests that these benefits could be extended to other chronic respiratory conditions, although adaptations to the standard programme format may be required. Whilst the benefits of exercise training are well established in asthma, pulmonary rehabilitation can also provide evidence-based interventions including breathing techniques and self-management training. In interstitial lung disease, a small number of trials show improved exercise capacity, symptoms and quality of life following pulmonary rehabilitation, which is a positive development for patients who may have few treatment options. In pulmonary arterial hypertension, exercise training is safe and effective if patients are stable on medical therapy and close supervision is provided. Pulmonary rehabilitation for bronchiectasis, including exercise training and airway clearance techniques, improves exercise capacity and quality of life. In nonsmall cell lung cancer, a comprehensive interdisciplinary approach is required to ensure the success of pulmonary rehabilitation following surgery. Pulmonary rehabilitation programmes provide important and underutilised opportunities to improve the integrated care of people with chronic respiratory disorders other than COPD.

Schistosomiasis control in Brazil

Directory of Open Access Journals (Sweden)

Katz Naftale

1998-01-01

Full Text Available In 1975 the Special Programme for Schistosomiasis Control was introduced in Brazil with the objective of controlling this parasitic disease in six northeastern states. The methodology applied varied largely from state to state, but was based mainly on chemotherapy, This Programme was modified about ten years after it beginning with the main goals including control of morbidity and the blockage of establishment of new foci in non-endemic areas. In two states, Bahia and Minas Gerais, the schistosomiasis control programme started in 1979 and 1983, respectively. The recently made evaluation of those two programmes is the main focus of this paper. It must also be pointed out, that the great majority of the studies performed by different researchers in Brazil, at different endemic areas, consistently found significant decrease on prevalence and incidence, when control measures are repeatedly used for several years. Significant decrease of hepatosplenic forms in the studied areas is well documented in Brazil. After more than 20 years of schistosomiasis control programmes in our country, chemotherapy has shown to be a very important tool for the control of morbidity and to decrease prevalence and incidence in endemic areas. Nevertheless, in medium and long terms, sanitation, water supply, sewage draining and health education seem to be the real tools when the aim is persistent and definitive schistosomiasis control.

Effects of a lifestyle programme on ambulatory blood pressure and drug dosage in treated hypertensive patients: a randomized controlled trial.

Science.gov (United States)

Burke, Valerie; Beilin, Lawrie J; Cutt, Hayley E; Mansour, Jacqueline; Wilson, Amy; Mori, Trevor A

2005-06-01

To assess effects of multifactorial lifestyle modification on antihypertensive drug needs in treated hypertensive individuals. Randomized controlled trial. Research studies unit. Overweight hypertensive patients, receiving one or two antihypertensive drugs, were recruited by advertising, and allocated randomly to a usual care group (controls; n = 118) or a lifestyle modification group (programme group; n = 123). A 4-month programme of weight loss, a low-sodium 'Dietary Approaches to Stop Hypertension'-type diet with added fish, physical activity and moderation of alcohol intake. After 4 months, if mean 24-h ambulatory blood pressure (ABP) was less than 135/85 mmHg, antihypertensive drugs were withdrawn over 4 weeks and long-term home blood pressure monitoring was begun. Antihypertensive drug requirements, ABP, weight, waist girth at 4 months and 1-year follow-up. Ninety control group and 102 programme group participants completed the study. Mean 24-h ABP changed after 4 months by -1.0/-0.3 +/- 0.5/0.4 mmHg in controls and -4.1/-2.1 +/- 0.7/0.5 mmHg with the lifestyle programme (P lifestyle modification in patients with treated hypertension reduced blood pressure in the short-term. Decreased central obesity persisted 1 year later and could reduce overall cardiovascular risk.

An evaluation of two guidance programmes to promote breast-feeding

Directory of Open Access Journals (Sweden)

M. Steyn

1989-09-01

Full Text Available During the past ten years a comprehensive research project has been undertaken to develop a guidance programme in three adjacent communities in the South- Western Cape with the aim o f lowering the high incidence o f coronary heart disease. The purpose o f this substudy was to determine whether the guidance provided in the different communities had any influence on the knowledge o f and attitudes towards the nutrition o f pregnant women, babies and infants as well as breast-feeding practices o f the women who gave birth during the period 1980 to 1986. In the first community guidance was provided by means o f small mass media and interpersonal communication whereas only the small mass media were employed in the second. The third served as the control community. The findings suggest that the combined interpersonal and mass media programme was more successful than the mass media programme alone.

Optical programmable metamaterials

Science.gov (United States)

Gong, Cheng; Zhang, Nan; Dai, Zijie; Liu, Weiwei

2018-02-01

We suggest and demonstrate the concept of optical programmable metamaterials which can configure the device's electromagnetic parameters by the programmable optical stimuli. In such metamaterials, the optical stimuli produced by a FPGA controlled light emitting diode array can switch or combine the resonance modes which are coupled in. As an example, an optical programmable metamaterial terahertz absorber is proposed. Each cell of the absorber integrates four meta-rings (asymmetric 1/4 rings) with photo-resistors connecting the critical gaps. The principle and design of the metamaterials are illustrated and the simulation results demonstrate the functionalities for programming the metamaterial absorber to change its bandwidth and resonance frequency.

Neglected Tropical Diseases and the Millennium Development Goals-why the "other diseases" matter: reality versus rhetoric

Directory of Open Access Journals (Sweden)

Molyneux David H

2011-12-01

Full Text Available Abstract Since 2004 there has been an increased recognition of the importance of Neglected Tropical Diseases (NTDs as impediments to development. These diseases are caused by a variety of infectious agents - viruses, bacteria and parasites - which cause a diversity of clinical conditions throughout the tropics. The World Health Organisation (WHO has defined seventeen of these conditions as core NTDs. The objectives for the control, elimination or eradication of these conditions have been defined in World Health Assembly resolutions whilst the strategies for the control or elimination of individual diseases have been defined in various WHO documents. Since 2005 there has been a drive for the expanded control of these diseases through an integrated approach of mass drug administration referred to as Preventive Chemotherapy via community-based distribution systems and through schools. This has been made possible by donations from major pharmaceutical companies of quality and efficacious drugs which have a proven track record of safety. As a result of the increased commitment of endemic countries, bilateral donors and non-governmental development organisations, there has been a considerable expansion of mass drug administration. In particular, programmes targeting lymphatic filariasis, onchocerciasis, schistosomiasis, trachoma and soil transmitted helminth infections have expanded to treat 887. 8 million people in 2009. There has been significant progress towards guinea worm eradication, and the control of leprosy and human African trypanosomiasis. This paper responds to what the authors believe are inappropriate criticisms of these programmes and counters accusations of the motives of partners made in recently published papers. We provide a detailed response and update the information on the numbers of global treatments undertaken for NTDs and list the success stories to date. The paper acknowledges that in undertaking any health programme in

Administrative Aspects of the Criticality Controls Used in Programmes for Basic Criticality Research, Reactor Development and Materials Processing

Energy Technology Data Exchange (ETDEWEB)

Wood, D. P.; Giessing, D. F. [Operational Safety Division, USAEC Albuquerque Operations Office, NM (United States)

1966-05-15

This paper describes the administrative and procedural aspects of criticality controls used by a field office of the United States Atomic Energy Commission in programmes that include reactor criticals, research and materials testing reactors, and power reactor development. Situations encountered include handling, storing, and processing large quantities of uranium-235 and plutonium-239 of various configurations and compositions in laboratories and operations which gather basic criticality data, processing of fissile material, and varied reactor research and development, programmes including fuel materials. Similar situations exist for uranium-233 and plutonium-238 on a smaller laboratory scale. The administrative controls and interactions of the USAEC field office and the operating contractors, who operate these installations for the USAEC, are outlined. Also, the purpose and scope of the direct examination by USAEC personnel of these contractor facilities are analysed. The programme has been in effect for three years and is believed to be successful in maintaining efficient operations and an acceptable low level of risk of inadvertent criticality. Success of this programme is in good measure due to the close working relationship between the staffs of the USAEC field office and the operating contractors. (author)

Efficacy of infant simulator programmes to prevent teenage pregnancy: a school-based cluster randomised controlled trial in Western Australia.

Science.gov (United States)

Brinkman, Sally A; Johnson, Sarah E; Codde, James P; Hart, Michael B; Straton, Judith A; Mittinty, Murthy N; Silburn, Sven R

2016-11-05

Infant simulator-based programmes, which aim to prevent teenage pregnancy, are used in high-income as well as low-income and middle-income countries but, despite growing popularity, no published evidence exists of their long-term effect. The aim of this trial was to investigate the effect of such a programme, the Virtual Infant Parenting (VIP) programme, on pregnancy outcomes of birth and induced abortion in Australia. In this school-based pragmatic cluster randomised controlled trial, eligible schools in Perth, Western Australia, were enrolled and randomised 1:1 to the intervention and control groups. Randomisation using a table of random numbers without blocking, stratification, or matching was done by a researcher who was masked to the identity of the schools. Between 2003 and 2006, the VIP programme was administered to girls aged 13-15 years in the intervention schools, while girls of the same age in the control schools received the standard health education curriculum. Participants were followed until they reached 20 years of age via data linkage to hospital medical and abortion clinic records. The primary endpoint was the occurrence of pregnancy during the teenage years. Binomial and Cox proportional hazards regression was used to test for differences in pregnancy rates between study groups. This study is registered as an international randomised controlled trial, number ISRCTN24952438. 57 (86%) of 66 eligible schools were enrolled into the trial and randomly assigned 1:1 to the intervention (28 schools) or the control group (29 schools). Then, between Feb 1, 2003, and May 31, 2006, 1267 girls in the intervention schools received the VIP programme while 1567 girls in the control schools received the standard health education curriculum. Compared with girls in the control group, a higher proportion of girls in the intervention group recorded at least one birth (97 [8%] of 1267 in the intervention group vs 67 [4%] of 1567 in the control group) or at least one

A dual-task home-based rehabilitation programme for improving balance control in patients with acquired brain injury: a single-blind, randomized controlled pilot study.

Science.gov (United States)

Peirone, Eliana; Goria, Paolo Filiberto; Anselmino, Arianna

2014-04-01

To evaluate the safety, feasibility and effectiveness of a dual-task home-based rehabilitation programme on balance impairments among adult patients with acquired brain injury. Single-blind, randomized controlled pilot study. Single rehabilitation centre. Sixteen participants between 12 and 18 months post-acquired brain injury with balance impairments and a score task home-based programme six days a week for seven weeks. The primary outcome measure was the Balance Evaluation System Test; secondary measures were the Activities-specific Balance Confidence Scale and Goal Attainment Scaling. At the end of the pilot study, the intervention group showed significantly greater improvement in Balance Evaluation System Test scores (17.87, SD 6.05) vs. the control group (5.5, SD 3.53; P = 0.008, r = 0.63). There was no significant difference in improvement in Activities-specific Balance Confidence Scale scores between the intervention group (25.25, SD 25.51) and the control group (7.00, SD 14.73; P = 0.11, r = 0.63). There was no significant improvement in Goal Attainment Scaling scores in the intervention (19.37, SD 9.03) vs. the control group (16.28, SD 6.58; P = 0.093, r = 0.63). This pilot study shows the safety, feasibility and short-term benefit of a dual-task home-based rehabilitation programme to improve balance control in patients with acquired brain injury. A sample size of 26 participants is required for a definitive study.

Cluster randomised controlled trial of 'whole school' child maltreatment prevention programme in primary schools in Northern Ireland: study protocol for Keeping Safe.

Science.gov (United States)

McElearney, Aisling; Brennan-Wilson, Aoibheann; Murphy, Christina; Stephenson, Phyllis; Bunting, Brendan

2018-05-03

Child maltreatment has a pervasive, detrimental impact on children's wellbeing. Despite a growing focus on prevention through school based education, few programmes adopt a whole- school approach, are multi-component, seek to address all forms of maltreatment, or indeed have been robustly evaluated. This paper describes a cluster randomised controlled trial designed to evaluate a school based child maltreatment prevention programme: 'Keeping Safe' in primary schools in Northern Ireland. The intervention has been designed by a non-profit agency. Programme resources include 63 lessons taught incrementally to children between four and 11 years old, and is premised on three core themes: healthy relationships, my body, and being safe. There are programme resources to engage parents and to build the capacity and skills of school staff. A cluster Randomised Controlled Trial (RCT) will be conducted with children in 80 schools over a two-year period. The unit of randomisation is the school. Schools will be allocated to intervention or wait-list control groups using a computer-generated list. Data will be collected at three time points: baseline, end of year one, and end of year two of programme implementation. Primary outcomes will include: children's understanding of key programme concepts, self-efficacy to keep safe in situations of maltreatment, anxiety arising from programme participation, and disclosure of maltreatment. Secondary outcomes include teachers' comfort and confidence in teaching the programme and parents' confidence in talking to their children about programme concepts. This RCT will address gaps in current practice and evidence regarding school based child maltreatment prevention programmes. This includes the use of a whole- school approach and multi-component programme that addresses all maltreatment concepts, a two-year period of programme implementation, and the tracking of outcomes for children, parents, and teachers. Methodologically, it will extend

Programmable multi-node quantum network design and simulation

Science.gov (United States)

Dasari, Venkat R.; Sadlier, Ronald J.; Prout, Ryan; Williams, Brian P.; Humble, Travis S.

2016-05-01

Software-defined networking offers a device-agnostic programmable framework to encode new network functions. Externally centralized control plane intelligence allows programmers to write network applications and to build functional network designs. OpenFlow is a key protocol widely adopted to build programmable networks because of its programmability, flexibility and ability to interconnect heterogeneous network devices. We simulate the functional topology of a multi-node quantum network that uses programmable network principles to manage quantum metadata for protocols such as teleportation, superdense coding, and quantum key distribution. We first show how the OpenFlow protocol can manage the quantum metadata needed to control the quantum channel. We then use numerical simulation to demonstrate robust programmability of a quantum switch via the OpenFlow network controller while executing an application of superdense coding. We describe the software framework implemented to carry out these simulations and we discuss near-term efforts to realize these applications.

Costs analysis of a population level rabies control programme in Tamil Nadu, India.

Directory of Open Access Journals (Sweden)

Syed Shahid Abbas

2014-02-01

Full Text Available The study aimed to determine costs to the state government of implementing different interventions for controlling rabies among the entire human and animal populations of Tamil Nadu. This built upon an earlier assessment of Tamil Nadu's efforts to control rabies. Anti-rabies vaccines were made available at all health facilities. Costs were estimated for five different combinations of animal and human interventions using an activity-based costing approach from the provider perspective. Disease and population data were sourced from the state surveillance data, human census and livestock census. Program costs were extrapolated from official documents. All capital costs were depreciated to estimate annualized costs. All costs were inflated to 2012 Rupees. Sensitivity analysis was conducted across all major cost centres to assess their relative impact on program costs. It was found that the annual costs of providing Anti-rabies vaccine alone and in combination with Immunoglobulins was $0.7 million (Rs 36 million and $2.2 million (Rs 119 million, respectively. For animal sector interventions, the annualised costs of rolling out surgical sterilisation-immunization, injectable immunization and oral immunizations were estimated to be $ 44 million (Rs 2,350 million, $23 million (Rs 1,230 million and $ 11 million (Rs 590 million, respectively. Dog bite incidence, health systems coverage and cost of rabies biologicals were found to be important drivers of costs for human interventions. For the animal sector interventions, the size of dog catching team, dog population and vaccine costs were found to be driving the costs. Rabies control in Tamil Nadu seems a costly proposition the way it is currently structured. Policy makers in Tamil Nadu and other similar settings should consider the long-term financial sustainability before embarking upon a state or nation-wide rabies control programme.

Costs analysis of a population level rabies control programme in Tamil Nadu, India.

Science.gov (United States)

Abbas, Syed Shahid; Kakkar, Manish; Rogawski, Elizabeth Tacket

2014-02-01

The study aimed to determine costs to the state government of implementing different interventions for controlling rabies among the entire human and animal populations of Tamil Nadu. This built upon an earlier assessment of Tamil Nadu's efforts to control rabies. Anti-rabies vaccines were made available at all health facilities. Costs were estimated for five different combinations of animal and human interventions using an activity-based costing approach from the provider perspective. Disease and population data were sourced from the state surveillance data, human census and livestock census. Program costs were extrapolated from official documents. All capital costs were depreciated to estimate annualized costs. All costs were inflated to 2012 Rupees. Sensitivity analysis was conducted across all major cost centres to assess their relative impact on program costs. It was found that the annual costs of providing Anti-rabies vaccine alone and in combination with Immunoglobulins was $0.7 million (Rs 36 million) and $2.2 million (Rs 119 million), respectively. For animal sector interventions, the annualised costs of rolling out surgical sterilisation-immunization, injectable immunization and oral immunizations were estimated to be $ 44 million (Rs 2,350 million), $23 million (Rs 1,230 million) and $ 11 million (Rs 590 million), respectively. Dog bite incidence, health systems coverage and cost of rabies biologicals were found to be important drivers of costs for human interventions. For the animal sector interventions, the size of dog catching team, dog population and vaccine costs were found to be driving the costs. Rabies control in Tamil Nadu seems a costly proposition the way it is currently structured. Policy makers in Tamil Nadu and other similar settings should consider the long-term financial sustainability before embarking upon a state or nation-wide rabies control programme.

LA sprouts randomized controlled nutrition, cooking and gardening programme reduces obesity and metabolic risk in Hispanic/Latino youth.

Science.gov (United States)

Gatto, N M; Martinez, L C; Spruijt-Metz, D; Davis, J N

2017-02-01

Many programmes for children that involve gardening and nutrition components exist; however, none include experimental designs allowing more rigorous evaluation of their impact on obesity. The objective of this study is to explore the effects of a novel 12-week gardening, nutrition and cooking intervention {'LA Sprouts'} on dietary intake, obesity parameters and metabolic disease risk among low-income, primarily Hispanic/Latino youth in Los Angeles.. This study used a randomized control trial involving four elementary schools [two randomized to intervention {172, 3rd-5th grade students}; two randomized to control {147, 3rd-5th grade students}]. Classes were taught in 90-min sessions once per week for 12 weeks. Data collected at pre-intervention and post-intervention included dietary intake via food frequency questionnaire, anthropometric measures {body mass index, waist circumference}, body fat, and fasting blood samples. LA Sprouts participants compared with controls had significantly greater reductions in body mass index z-scores {-0.1 vs. -0.04, respectively; p = 0.01} and waist circumference {-1.2 vs. 0.1 cm; p obesity and metabolic risk; however, additional larger and longer-term studies are warranted. © 2016 World Obesity Federation.

Costs and outcomes of the German disease management programme (DMP) for chronic obstructive pulmonary disease (COPD)-A large population-based cohort study.

Science.gov (United States)

Achelrod, Dmitrij; Welte, Tobias; Schreyögg, Jonas; Stargardt, Tom

2016-09-01

To curb costs and improve health outcomes in chronic obstructive pulmonary disease (COPD), a nationwide disease management programme (DMP) was introduced in Germany in 2005. Yet, its effectiveness has not been comprehensively evaluated. To examine the effects of the German COPD DMP over three years on costs and health resource utilisation from the payer perspective, process quality, morbidity and mortality. A retrospective, population-based cohort study design is applied, using administrative data. After eliminating differences in observable characteristics between the DMP and the control group with entropy balancing, difference-in-difference estimators were computed to account for time-invariant unobservable heterogeneity. 215,104 individuals were included into the analysis of whom 25,269 were enrolled in the DMP. DMP patients had a reduced mortality hazard ratio (0.89, 95%CI: 0.84-0.94) but incurred excess costs of €553 per year. DMP enrolees reveal higher healthcare utilisation with larger shares of individuals being hospitalised (3.14%), consulting an outpatient clinic due to exacerbations (11.13%) and pharmaceutical prescriptions (2.78). However, average length of hospitalisation due to COPD fell by 0.49 days, adherence to medication guidelines as well as indicators for morbidity improved. The German COPD DMP achieved significant improvements in mortality, morbidity and process quality, but at higher costs. Given the low ICER per life year gained, DMP COPD may constitute a cost-effective option to promote COPD population health. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Data acquisition and control system with a programmable logic controller (PLC) for a pulsed chemical oxygen-iodine laser

Science.gov (United States)

Yu, Haijun; Li, Guofu; Duo, Liping; Jin, Yuqi; Wang, Jian; Sang, Fengting; Kang, Yuanfu; Li, Liucheng; Wang, Yuanhu; Tang, Shukai; Yu, Hongliang

2015-02-01

A user-friendly data acquisition and control system (DACS) for a pulsed chemical oxygen -iodine laser (PCOIL) has been developed. It is implemented by an industrial control computer，a PLC, and a distributed input/output (I/O) module, as well as the valve and transmitter. The system is capable of handling 200 analogue/digital channels for performing various operations such as on-line acquisition, display, safety measures and control of various valves. These operations are controlled either by control switches configured on a PC while not running or by a pre-determined sequence or timings during the run. The system is capable of real-time acquisition and on-line estimation of important diagnostic parameters for optimization of a PCOIL. The DACS system has been programmed using software programmable logic controller (PLC). Using this DACS, more than 200 runs were given performed successfully.

Independent evaluation of a canine Echinococcosis Control Programme in Hobukesar County, Xinjiang, China.

Science.gov (United States)

van Kesteren, Freya; Qi, Xinwei; Tao, Jiang; Feng, Xiaohui; Mastin, Alexander; Craig, Philip S; Vuitton, Dominique A; Duan, Xinyu; Chu, Xiangdong; Zhu, Jinlong; Wen, Hao

2015-05-01

The Xinjiang Uyghur Autonomous Region in northwest China is one of the world's most important foci for cystic echinococcosis. Domestic dogs are the main source for human infection, and previous studies in Xinjiang have found a canine Echinococcus spp. coproELISA prevalence of between 36% and 41%. In 2010 the Chinese National Echinococcosis Control Programme was implemented in Xinjiang, and includes regular dosing of domestic dogs with praziquantel. Six communities in Hobukesar County, northwest Xinjiang were assessed in relation to the impact of this control programme through dog necropsies, dog Echinococcus spp. coproantigen surveys based on Lot Quality Assurance Sampling (LQAS) and dog owner questionnaires. We found that 42.1% of necropsied dogs were infected with Echinococcus granulosus, and coproELISA prevalences were between 15% and 70% in the communities. Although approximately half of all dog owners reported dosing their dogs within the 12 months prior to sampling, coproELISA prevalence remained high. Regular praziquantel dosing of owned dogs in remote and semi-nomadic communities such as those in Hobukesar County is logistically very difficult and additional measures should be considered to reduce canine echinococcosis. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

'The Anglo-Saxon disease': a pilot study of the barriers to and facilitators of the use of randomised controlled trials of social programmes in an international context.

Science.gov (United States)

Roberts, Helen; Petticrew, Mark; Liabo, Kristin; Macintyre, Sally

2012-11-01

There appears to be considerable variation between different national jurisdictions and between different sectors of public policy in the use of evidence and particularly the use of randomised controlled trials (RCTs) to evaluate non-healthcare sector programmes. As part of a wider study attempting to identify RCTs of public policy sector programmes and the reasons for variation between countries and sectors in their use, we carried out a pilot study which interviewed 10 policy makers and researchers in six countries to elicit views on barriers to and facilitators of the use of RCTs for social programmes. While in common with earlier studies, those interviewed expressed a need for unambiguous findings, timely results and significant effect sizes, users could, in fact, be ambivalent about robust methods and robust answers about what works, does not work or makes no difference, particularly where investment or a policy announcement was planned. Different national and policy sector cultures varied in their use of and support for RCTs. In order to maximise the use of robust evaluations of public programmes across the world it would be useful to examine, systematically, cross-national and cross-sectoral variations in the use of different methods including RCTs and barriers to and facilitators of their use. Sound research methods, whatever their scientific value, are no guarantee that findings will be useful or used. 'Stories' have been shown to influence policy; those advocating the use of RCTs may need to provide convincing narratives to avoid repetition about their value.

Disruptive technology for vector control: the Innovative Vector Control Consortium and the US Military join forces to explore transformative insecticide application technology for mosquito control programmes.

Science.gov (United States)

Knapp, Jennifer; Macdonald, Michael; Malone, David; Hamon, Nicholas; Richardson, Jason H

2015-09-26

Malaria vector control technology has remained largely static for decades and there is a pressing need for innovative control tools and methodology to radically improve the quality and efficiency of current vector control practices. This report summarizes a workshop jointly organized by the Innovative Vector Control Consortium (IVCC) and the Armed Forces Pest Management Board (AFPMB) focused on public health pesticide application technology. Three main topics were discussed: the limitations with current tools and techniques used for indoor residual spraying (IRS), technology innovation to improve efficacy of IRS programmes, and truly disruptive application technology beyond IRS. The group identified several opportunities to improve application technology to include: insuring all IRS programmes are using constant flow valves and erosion resistant tips; introducing compression sprayer improvements that help minimize pesticide waste and human error; and moving beyond IRS by embracing the potential for new larval source management techniques and next generation technology such as unmanned "smart" spray systems. The meeting served to lay the foundation for broader collaboration between the IVCC and AFPMB and partners in industry, the World Health Organization, the Bill and Melinda Gates Foundation and others.

Hazard analysis of critical control points assessment as a tool to respond to emerging infectious disease outbreaks.

Directory of Open Access Journals (Sweden)

Kelly L Edmunds

Full Text Available Highly pathogenic avian influenza virus (HPAI strain H5N1 has had direct and indirect economic impacts arising from direct mortality and control programmes in over 50 countries reporting poultry outbreaks. HPAI H5N1 is now reported as the most widespread and expensive zoonotic disease recorded and continues to pose a global health threat. The aim of this research was to assess the potential of utilising Hazard Analysis of Critical Control Points (HACCP assessments in providing a framework for a rapid response to emerging infectious disease outbreaks. This novel approach applies a scientific process, widely used in food production systems, to assess risks related to a specific emerging health threat within a known zoonotic disease hotspot. We conducted a HACCP assessment for HPAI viruses within Vietnam's domestic poultry trade and relate our findings to the existing literature. Our HACCP assessment identified poultry flock isolation, transportation, slaughter, preparation and consumption as critical control points for Vietnam's domestic poultry trade. Introduction of the preventative measures highlighted through this HACCP evaluation would reduce the risks posed by HPAI viruses and pressure on the national economy. We conclude that this HACCP assessment provides compelling evidence for the future potential that HACCP analyses could play in initiating a rapid response to emerging infectious diseases.

Comparing Two Exercise Programmes for the Management of Lateral Elbow Tendinopathy (Tennis Elbow/Lateral Epicondylitis—A Controlled Clinical Trial

Directory of Open Access Journals (Sweden)

Dimitrios Stasinopoulos

2013-09-01

Full Text Available Aim: To compare the effectiveness of supervised exercise programme as proposed by Stasinopoulos and colleagues with home exercise programme as proposed by Pienimaki and his coworkers in the treatment of lateral elbow tendinopathy. Design: Controlled clinical trial. Setting: Physiotherapy and rehabilitation centre. Participants: This trial was carried out with 60 patients, who had lateral elbow tendinopathy. Intervention: Group A (n = 30 had received supervised exercise programme, once per day for 4 weeks. Group B (n = 30 was treated with home exercise programme four to six times daily for 8 weeks. Outcome measures: pain, using a visual analogue scale, function, using a visual analogue scale for elbow function and the pain-free grip strength. Patients were evaluated at baseline, at the end of treatment (week 12, and 3 months (week 24 after the end of treatment. Results: Both the supervised and home exercise programme were found to be significantly effective in the reduction of pain and in the improvement of functional status. The supervised exercise programme resulted in significantly different improvement in comparison to those who received home exercise programme. Conclusion: A specific supervised exercise programme is superior to a specific home exercise programme in reducing pain and improving function in patients with LET at the end of the treatment and at the 3 month follow-up. Further research is needed to confirm our results.

Ultrasonically nebulised electrolysed oxidising water: a promising new infection control programme for impressions, metals and gypsum casts used in dental hospitals.

Science.gov (United States)

Wu, G; Yu, X; Gu, Z

2008-04-01

Controlling the transmission of infectious diseases by impressions, metals and dental casts in dental hospitals remains a challenge. Current disinfection methods have various drawbacks. This study introduced and provided a preliminary evaluation of the feasibility of using ultrasonically nebulised, electrolysed oxidising water (UNEOW) as a new infection control programme. UNEOW was produced from freshly generated electrolysed oxidising water (EOW). Samples of impressions, titanium and gypsum were subjected to the following treatments: (1) immersion in 1% sodium hypochlorite for 10min; (2) immersion in EOW for 10min; (3) exposure to UNEOW for 15, 30 and 45min; (4) no disinfection (control). Bactericidal efficacy was examined using Staphylococcus aureus and Bacillus subtilis var. niger spores as indicators. Dimensional accuracy, surface quality, and effect of corrosion were also evaluated for the different samples. Results showed that except for B. subtilis var. niger spores on gypsum casts, the bacterial reduction log(10) values after 30-45min treatment with UNEOW were all above 4. The impression dimensional changes showed no difference between control and UNEOW groups, but both were significantly lower than the EOW and sodium hypochlorite groups (Pimpressions and gypsum casts. No assessable corrosion was found on the titanium surface after a 45min treatment with UNEOW. The findings indicated that use of UNEOW is a feasible and promising approach for controlling the transmission of infectious diseases by impressions, gypsum casts and denture metals in dental facilities.

The cost-effectiveness of a structured education pulmonary rehabilitation programme for chronic obstructive pulmonary disease in primary care: the PRINCE cluster randomised trial.

Science.gov (United States)

Gillespie, Paddy; O'Shea, Eamon; Casey, Dympna; Murphy, Kathy; Devane, Declan; Cooney, Adeline; Mee, Lorraine; Kirwan, Collette; McCarthy, Bernard; Newell, John

2013-11-25

To assess the cost-effectiveness of a structured education pulmonary rehabilitation programme (SEPRP) for chronic obstructive pulmonary disease (COPD) relative to usual practice in primary care. The programme consisted of group-based sessions delivered jointly by practice nurses and physiotherapists over 8 weeks. Cost-effectiveness and cost-utility analysis alongside a cluster randomised controlled trial. 32 general practices in Ireland. 350 adults with COPD, 69% of whom were moderately affected. Intervention arm (n=178) received a 2 h group-based SEPRP session per week over 8 weeks delivered jointly by a practice nurse and physiotherapist at the practice surgery or nearby venue. The control arm (n=172) received the usual practice in primary care. Incremental costs, Chronic Respiratory Questionnaire (CRQ) scores, quality-adjusted life years (QALYs) gained estimated using the generic EQ5D instrument, and expected cost-effectiveness at 22 weeks trial follow-up. The intervention was associated with an increase of €944 (95% CIs 489 to 1400) in mean healthcare cost and €261 (95% CIs 226 to 296) in mean patient cost. The intervention was associated with a mean improvement of 1.11 (95% CIs 0.35 to 1.87) in CRQ Total score and 0.002 (95% CIs -0.006 to 0.011) in QALYs gained. These translated into incremental cost-effectiveness ratios of €850 per unit increase in CRQ Total score and €472 000 per additional QALY gained. The probability of the intervention being cost-effective at respective threshold values of €5000, €15 000, €25 000, €35 000 and €45 000 was 0.980, 0.992, 0.994, 0.994 and 0.994 in the CRQ Total score analysis compared to 0.000, 0.001, 0.001, 0.003 and 0.007 in the QALYs gained analysis. While analysis suggests that SEPRP was cost-effective if society is willing to pay at least €850 per one-point increase in disease-specific CRQ, no evidence exists when effectiveness was measured in QALYS gained. Current Controlled Trials ISRCTN52 403 063.

Digital Instrumentation and Control working group (DICWG) - MDEP DICWG Programme Plan 2012 2013

International Nuclear Information System (INIS)

2012-02-01

The Multinational Design Evaluation Programme (MDEP) Digital Instrumentation and Controls Working Group (DICWG) was approved by MDEP's Policy Group in March 2008 and meets approximately 3 times a year. All MDEP members and the IAEA are invited to participate in this working group's activities. The DICWG's main objectives are as follows: - to document common positions in the DI and C safety systems design areas; - to harmonise and converge national codes, standards and regulatory requirements and practices in this area while recognising the sovereign rights and responsibilities of national regulators in carrying out their safety reviews of new reactor designs (see the DICWG programme plan for more details of the group's work). The DICWG interacts regularly with the following organisations: - IEC (International Electro-technical Commission) Subcommittee 45A, Instrumentation and Control of Nuclear Facilities; - IEEE (Institute of Electric and Electronics Engineers); - other organisations involved in the design of digital I and C safety systems for nuclear power plants. The DICWG reports its status to the MDEP Steering Technical Committee at the latter's thrice annual meetings. This document presents the 2012 and 2013 programme plan and its products: the Generic Common Position DICWG-02 on Software Tools; the Generic Common Position DICWG-03 on Verification and Validation throughout the Life Cycle of Safety Systems Using Digital Computers; the Generic Common Position DICWG-04 on Communication Independence; the Generic Common Position DICWG-05 on Treatment of Hardware Description Language (HDL) Programmed Devices for Use in Nuclear Safety Systems; the Generic Common Position DICWG-06 on Simplicity in Design; the Generic Common Position DICWG-08 on Impact of Cyber Security Features on Digital I and C Safety Systems

Political epidemiology: strengthening socio-political analysis for mass immunisation - lessons from the smallpox and polio programmes.

Science.gov (United States)

Taylor, S

2009-01-01

Control and reduction of infectious diseases is a key to attaining the Millennium Development Goals. An important element of this work is the successful immunisation, especially in resource-poor countries. Mass immunisation, most intensively in the case of eradication, depends on a combination of reliable demand (e.g. public willingness to comply with the vaccine protocol) and effective supply (e.g. robust, generally state-led, vaccine delivery). This balance of compliance and enforceability is, quintessentially, socio-political in nature - conditioned by popular perceptions of disease and risk, wider conditions of economic development and poverty, technical aspects of vaccine delivery, and the prevailing international norms regarding power relations between states and peoples. In the past 100 years, three out of six disease eradication programmes have failed. The explanations for failure have focused on biotechnical and managerial or financial issues. Less attention is paid to socio-political aspects. Yet socio-political explanations are key. Eradication is neither inherently prone to failure, nor necessarily doomed in the case of polio. However, eradication, and similar mass immunisation initiatives, which fail to address social and political realities of intervention may be. A comparison of the smallpox and polio eradication programmes illustrates the importance of disease-specific socio-political analysis in programme conceptualisation, design, and management.

How to promote joint participation of the public and private sectors in the organisation of animal health programmes.

Science.gov (United States)

Melo, E Correa; Saraiva, V

2003-08-01

It is generally accepted that the first recorded outbreaks of foot and mouth disease (FMD) in South America occurred around 1870. The disease emerged almost simultaneously in the province of Buenos Aires (Argentina), in the central region of Chile, in Uruguay and in southern Brazil, due to the introduction of livestock from Europe. Argentina set up an agency for the control and eradication of FMD in 1961, Brazil began disease-control activities in Rio Grande do Sul in 1965, Paraguay and Uruguay initiated similar programmes in 1967, Chile in 1970 and Colombia in 1972. A common characteristic was observed in all early national FMD programmes, namely, they were developed, financed, operated and evaluated by the public sector, without major participation from the private sector, except when buying vaccines and abiding by the regulations. In 1987, the Hemispheric Foot and Mouth Disease Eradication Plan (PHEFA: Plan Hemisférico para la Erradicación de la Fiebre Aftosa) was launched and the private sector played a prominent role in achieving the eradication and control of FMD in several countries. However, this model of co-participation between the public and private sectors has suffered setbacks and a new approach is being developed to find ways in which local structures and activities can be self-sustaining.

Health-social partnership intervention programme for community-dwelling older adults: a research protocol for a randomized controlled trial.

Science.gov (United States)

Wong, Kwan Ching; Wong, Frances Kam Yuet; Chang, Katherine Ka Pik

2015-11-01

This paper aims to describe the research protocol that will be used to determine the effectiveness of a health-social partnership intervention programme among community-dwelling older adults. Ageing in place is a preferred option for overcoming challenges of the increasing prevalence of chronic diseases and the risk for hospitalization associated with the ageing population. Nevertheless, our knowledge of how to implement this concept is limited. The integrated efforts of health and social services may help to enable older adults to live with a sense of control over their daily life and to be independent to the fullest extent possible in the community. This is a randomized, controlled trial. Participants are community-dwelling older adults referred from a community centre. Sample size calculation was based on power analysis. The intervention group will receive the programme with the standard protocols guided by a comprehensive assessment-intervention-evaluation framework. Home visits and telephones follow-up will be employed as means of conducting the interventions and monitoring their progress. The customary care group will receive placebo social calls. The duration of the interventions will be 3 months. The study was funded by the School of Nursing in Hong Kong. Research Ethics Committee approval was obtained in September 2014. The results of this research are expected to enable older adults to stay in the community with optimal health and well-being. Health and social sciences are integrated into the practice in this research protocol. The scarce literature on this topic means that this study can also provide an opportunity to bridge the caring gap among older adults. © 2015 John Wiley & Sons Ltd.

Impact on quality of life of a nursing intervention programme for patients with chronic non-cancer pain: an open, randomized controlled parallel study protocol.

Science.gov (United States)

Morales-Fernandez, Angeles; Morales-Asencio, Jose Miguel; Canca-Sanchez, Jose Carlos; Moreno-Martin, Gabriel; Vergara-Romero, Manuel

2016-05-01

To determine the effect of a nurse-led intervention programme for patients with chronic non-cancer pain. Chronic non-cancer pain is a widespread health problem and one that is insufficiently controlled. Nurses can play a vital role in pain management, using best practices in the assessment and management of pain under a holistic approach where the patient plays a proactive role in addressing the disease process. Improving the quality of life, reducing disability, achieving acceptance of health status, coping and breaking the vicious circle of pain should be the prime objectives of our care management programme. Open randomized parallel controlled study. The experimental group will undertake one single initial session, followed by six group sessions led by nurses, aimed at empowering patients for the self-management of pain. Healthy behaviours will be encouraged, such as sleep and postural hygiene, promotion of physical activity and healthy eating. Educational interventions on self-esteem, pain-awareness, communication and relaxing techniques will be carried out. As primary end points, quality of life, perceived level of pain, anxiety and depression will be evaluated. Secondary end points will be coping and satisfaction. Follow-up will be performed at 12 and 24 weeks. The study was approved by the Ethics and Research Committee Costa del Sol. If significant effects were detected, impact on quality of life through a nurse-led programme would offer a complementary service to existing pain clinics for a group of patients with frequent unmet needs. © 2016 John Wiley & Sons Ltd.

Termo technology programme. Final report 1993-1997

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-12-31

The TERMO-technology programme was realised in 1993-1997. The aim of the programme was to promote the profitability and sustainable development of district heating by means of research and development actions. The programme included 36 research projects that were distributed to four research areas. These included heat distribution, metering, information and control systems, the economy of district heating as well as system development. The costs totaled to FIM 12 million. The programme was financed by the participating companies and the Technology Development Centre TEKES. Around eighty Finnish companies and institutions participated in the programme. In addition, the programme participated in international research cooperation in the framework of the Nordic Council of Ministers and the International Energy Agency programmes. The research area Heat Distribution included projects on rehabilitation and status control of district heating networks, pumping, thermal stresses in district heating pipes, material questions, water treatment, steam pipe systems as well as drag reducing additives in district heating water. The research area Metering, Information and Control Systems included projects on forecasts of district heating load, calibration of flow meters, heat cost allocation in buildings, control systems and their qualifications in buildings and improved cooling of district heating water in the consumer equipment. The research area Economy included projects on determination of subscribed heat demand, pricing methods of district heating, success factors of energy companies as well as long term prospects of district heating in Finland. The research area System Development included projects on changing heat loads, district cooling as well as combined heat and power production. After the TERMO programme joint efforts will be continued for the development of district heating technology. The emphasis will be to improve the feasibility of combined heat and power

Importance of intersectoral co-ordination in the control of communicable diseases, with special reference to plague in Tanzania.

Science.gov (United States)

Kilonzo, B S

1994-07-01

Human health, agriculture, including livestock, energy, education, wildlife, construction, forestry and trade sectors are inter-related and their co-ordination is an important pre-requisite for successful control of most communicable diseases including plague. Similar linkage between research, policy, training and extension activities in each sector are essential for any successful control strategy. Inadequate agricultural produce, inaccessibility of people to the available food and ignorance on proper preparation and usage of available food materials are responsible for malnutrition, and malnourished people are very vulnerable to disease. Irrigation schemes facilitate breeding of various disease vectors and transmission of some communicable diseases. Forests are ecologically favourable for some disease vectors and reservoirs for tsetse flies and rodents, while deforestation leads to soil erosion, lack of rainfall and consequently reduced productivity in agriculture which may result in poor nutrition of the population. Wildlife and livestock serve as reservoirs and/or carriers of various zoonoses including plague, trypanosomiasis and rabies. Lack of proper co-ordination of these sectors in communicable disease control programmes can result in serious and undesirable consequences. Indiscriminate killing of rodents in order to minimize food damage by these vermin forces their flea ectoparasites to seek alternative hosts, including man, a development which may result in transmission of plague from rodents to man. Similarly, avoidance of proper quarantine during plague epidemics, an undertaking which is usually aimed at maintaining economic and social links with places outside the affected focus, can result in the disease becoming widespread and consequently make any control strategies more difficult and expensive.(ABSTRACT TRUNCATED AT 250 WORDS)

Restoring State Control Over Forest Resources Through Administrative Procedures: Evidence From a Community Forestry Programme in Central Java, Indonesia

Directory of Open Access Journals (Sweden)

Ahmad Maryudi

2012-01-01

Full Text Available In recent years, community forestry has emerged as a means to reform power constellations with regard to forest governance. Through community forestry, the central state promised to devolve several forest rights to local communities and encouraged them to get involved in decision making processes and the implementation of forest activities. However, experience in some countries indicates that the implementation of community forestry programmes is rarely followed by genuine power devolution to local forest users. Instead, these programmes may even serve as a means to retain or restore the central state’s control over forests. Using a case study of a community forestry programme implemented in Java, Indonesia, by a state forest company, this paper argues that the implementation of community forestry is also driven by the state’s interests to regain control over the forests. Research in eight villages in Central Java province reveals that the community forestry programmes are carefully structured according to numerous administrative procedures and estab- lish a mode of control through a bureaucratic design. ----- In den letzten Jahren hat sich community forestry als Mittel zur Reform von Machtkonstellationen in Bezug auf die Verwaltung von Wäldern herausgebildet. Der Zentralstaat versprach durch community forestry bestimmte Waldrechte an lokale Communities abzugeben und ermutigte sie, sich an Entscheidungsprozessen und der Implementierung von Forstaktivitäten zu beteiligen. Erfahrungen in einigen Ländern zeigen jedoch, dass die Implementierung von community forestry-Programmen selten mit einem tatsächlichen Machttransfer an lokale ForstnutzerInnen einhergeht, sondern diese Programme sogar als Mittel zur Rückgewinnung von zentralstaatlicher Kontrolle über Wälder dienen können. Anhand eines Fallbeispiels eines community forestry-Programms, das in Java, Indonesien, von einem staatlichen Forstunternehmen implementiert wird, argumentiere ich

[Institutional insertion of Chagas' disease control].

Science.gov (United States)

Silveira, Antônio Carlos; Pimenta, Fabiano

2011-01-01

After the starting of the Center for studies and prophylaxis of Chagas disease in 1943, with the help of Oswaldo Cruz Foundation, in the city of Bambuí, state of Minas Gerais, technological and methodological basis for the extensive control of the disease were conceived. A main step to achieve success was the introduction of a new insecticide (gammexane, P 530) and the demonstration of its efficacy in the vector control. A consequence of these improvements was the official inauguration of the first prophylactic campaign for Chagas disease in Brazil, held in Uberaba in May, 1950. Even with the knowledge of how to control the vectorial transmission, financial resources were not available by this time, at a necessary degree to make it both regularly and in all the affected area. The institutional allocation of these activities is useful to understand the low priority given to them at that time. Several national services were created in 1941, for diseases as malaria, pest, smallpox, among others, but Chagas was included in a group of diseases with lower importance, inside a Division of Sanitary Organization. In 1956, the National Department of Rural endemies (DNERu) allocate all the major endemic diseases in a single institution, however this was not translated in an implementation program for the control of Chagas disease. After profound changes at the Ministry of Health, in 1970, the Superintendência de Campanhas de Saúde Pública (SUCAM) was in charge of all rural endemies including Chagas disease, which now could compete with other diseases transmitted by vectors, formerly priorities, included in the National Division. With this new status, more funds were available, as well as redistribution of personnel and expenses from the malaria program to the vectorial control of Chagas disease. In 1991 the Health National foundation was created to substitute SUCAM in the control of endemic diseases and it included all the units of the Ministry of Health related to

Embracing the complexity of educational programmes

Directory of Open Access Journals (Sweden)

Elly Govers

2016-12-01

Full Text Available Systems of monitoring and control have left many educators and organisations in the field of post-compulsory education struggling to find ways to meet the needs of an increasingly diverse society. Education is complex. Many educators would agree that it is influenced by many, often contradictory, voices and power structures. Based on the findings of a case study involving multiple programmes in a post-compulsory education institution in Aotearoa/New Zealand, this paper aims to unravel this complexity for the case of educational programmes. It describes how programmes can be seen as complex systems, created by people and directed by discourses in society, some of which are more influential than others. If programmes are seen as complex systems, the experience of struggle as referred to above can be understood as a consequence of the attempt to control the complexity rather than work with it. This control limits the possibilities for development and innovation. Alternatively, as this paper will explain, acknowledging and embracing the complexity of programmes helps open up spaces for innovation that would otherwise remain hidden. It is argued that the ultimate space for change is educators’ personal and collective responsibility for the discourses in society they choose to follow.

The preventive effect of the bounding exercise programme on hamstring injuries in amateur soccer players: the design of a randomized controlled trial.

Science.gov (United States)

Van de Hoef, S; Huisstede, B M A; Brink, M S; de Vries, N; Goedhart, E A; Backx, F J G

2017-08-22

Hamstring injuries are the most common muscle injury in amateur and professional soccer. Most hamstring injuries occur in the late swing phase, when the hamstring undergoes a stretch-shortening cycle and the hamstring does a significant amount of eccentric work. The incidence of these injuries has not decreased despite there being effective injury prevention programmes focusing on improving eccentric hamstring strength. As this might be because of poor compliance, a more functional injury prevention exercise programme that focuses on the stretch-shortening cycle might facilitate compliance. In this study, a bounding exercise programme consisting of functional plyometric exercises is being evaluated. A cluster-randomized controlled trial (RCT). Male amateur soccer teams (players aged 18-45 years) have been randomly allocated to intervention and control groups. Both groups are continuing regular soccer training and the intervention group is additionally performing a 12-week bounding exercise programme (BEP), consisting of a gradual build up and maintenance programme for the entire soccer season. The primary outcome is hamstring injury incidence. Secondary outcome is compliance with the BEP during the soccer season and 3 months thereafter. Despite effective hamstring injury prevention programmes, the incidence of these injuries remains high in soccer. As poor compliance with these programmes may be an issue, a new plyometric exercise programme may encourage long-term compliance and is expected to enhance sprinting and jumping performance besides preventing hamstring injuries. NTR6129 . Retrospectively registered on 1 November 2016.

Programmable Nucleic Acid Based Polygons with Controlled Neuroimmunomodulatory Properties for Predictive QSAR Modeling.

Science.gov (United States)

Johnson, Morgan Brittany; Halman, Justin R; Satterwhite, Emily; Zakharov, Alexey V; Bui, My N; Benkato, Kheiria; Goldsworthy, Victoria; Kim, Taejin; Hong, Enping; Dobrovolskaia, Marina A; Khisamutdinov, Emil F; Marriott, Ian; Afonin, Kirill A

2017-11-01

In the past few years, the study of therapeutic RNA nanotechnology has expanded tremendously to encompass a large group of interdisciplinary sciences. It is now evident that rationally designed programmable RNA nanostructures offer unique advantages in addressing contemporary therapeutic challenges such as distinguishing target cell types and ameliorating disease. However, to maximize the therapeutic benefit of these nanostructures, it is essential to understand the immunostimulatory aptitude of such tools and identify potential complications. This paper presents a set of 16 nanoparticle platforms that are highly configurable. These novel nucleic acid based polygonal platforms are programmed for controllable self-assembly from RNA and/or DNA strands via canonical Watson-Crick interactions. It is demonstrated that the immunostimulatory properties of these particular designs can be tuned to elicit the desired immune response or lack thereof. To advance the current understanding of the nanoparticle properties that contribute to the observed immunomodulatory activity and establish corresponding designing principles, quantitative structure-activity relationship modeling is conducted. The results demonstrate that molecular weight, together with melting temperature and half-life, strongly predicts the observed immunomodulatory activity. This framework provides the fundamental guidelines necessary for the development of a new library of nanoparticles with predictable immunomodulatory activity. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The effectiveness of a structured education pulmonary rehabilitation programme for improving the health status of people with moderate and severe chronic obstructive pulmonary disease in primary care: the PRINCE cluster randomised trial.

Science.gov (United States)

Casey, Dympna; Murphy, Kathy; Devane, Declan; Cooney, Adeline; McCarthy, Bernard; Mee, Lorraine; Newell, John; O'Shea, Eamon; Scarrott, Carl; Gillespie, Paddy; Kirwan, Collette; Murphy, Andrew W

2013-10-01

To evaluate the effectiveness of a structured education pulmonary rehabilitation programme on the health status of people with chronic obstructive pulmonary disease (COPD). Two-arm, cluster randomised controlled trial. 32 general practices in the Republic of Ireland. 350 participants with a diagnosis of moderate or severe COPD. Experimental group received a structured education pulmonary rehabilitation programme, delivered by the practice nurse and physiotherapist. Control group received usual care. Health status as measured by the Chronic Respiratory Questionnaire (CRQ) at baseline and at 12-14 weeks postcompletion of the programme. Participants allocated to the intervention group had statistically significant higher mean change total CRQ scores (adjusted mean difference (MD) 1.11, 95% CI 0.35 to 1.87). However, the CI does not exclude a smaller difference than the one that was prespecified as clinically important. Participants allocated to the intervention group also had statistically significant higher mean CRQ Dyspnoea scores after intervention (adjusted MD 0.49, 95% CI 0.20 to 0.78) and CRQ Physical scores (adjusted MD 0.37, 95% CI 0.14 to 0.60). However, CIs for both the CRQ Dyspnoea and CRQ Physical subscales do not exclude smaller differences as prespecified as clinically important. No other statistically significant differences between groups were seen. A primary care based structured education pulmonary rehabilitation programme is feasible and may increase local accessibility to people with moderate and severe COPD. ISRCTN52403063.

Programmer's manual for CAMCON: Compliance Assessment Methodology CONtroller

International Nuclear Information System (INIS)

Rechard, R.P.; Gilkey, A.P.; Rudeen, D.K.; Byle, K.A.; Iuzzolino, H.J.

1993-05-01

CAMCON, the Compliance Assessment Methodology CONtroller, is an analysis system that assists in assessing the compliance of the Waste Isolation Pilot Plant (WIPP) with applicable long-term regulations of the US Environmental Protection Agency, including Subpart B of the Environmental Standards for the Management and Disposal of spent Nuclear Fuel, High-Level and Transuranic Radioactive Wastes, 40 CFR 191 and 40CFR268.6, which is the portion of the Land Disposal Restrictions implementing the Resource, Conservative, and Recovery Act of 1976, as amended that states the conditions for disposal of hazardous chemical wastes. This manual provides an architectural overview of the CAMCON system. Furthermore this manual presents guidelines and presents suggestions for programmers developing the many different types of software necessary to investigate various events and physical processes of the WIPP. These guidelines include user interface requirements, minimum quality assurance requirements, coding style suggestions, and the use of numerous software libraries developed specifically for or adapted for the CAMCON system

System design and installation for RS600 programmable control system for solar heating and cooling

Science.gov (United States)

1978-01-01

Procedures for installing, operating, and maintaining a programmable control system which utilizes a F8 microprocessor to perform all timing, control, and calculation functions in order to customize system performance to meet individual requirements for solar heating, combined heating and cooling, and/or hot water systems are described. The manual discusses user configuration and options, displays, theory of operation, trouble-shooting procedures, and warranty and assistance. Wiring lists, parts lists, drawings, and diagrams are included.

There are calls for a national screening programme for prostate cancer: what is the evidence to justify such a national screening programme?

Science.gov (United States)

Green, A; Tait, C; Aboumarzouk, O; Somani, B K; Cohen, N P

2013-05-01

Prostate cancer is the commonest cancer in men and a major health issue worldwide. Screening for early disease has been available for many years, but there is still no national screening programme established in the United Kingdom. To assess the latest evidence regarding prostate cancer screening and whether it meets the necessary requirements to be established as a national programme for all men. Electronic databases and library catalogues were searched electronically and manual retrieval was performed. Only primary research results were used for the analysis. In recent years, several important randomised controlled trials have produced varied outcomes. In Europe the largest study thus far concluded that screening reduced prostate cancer mortality by 20%. On the contrary, a large American trial found no reduction in mortality after 7-10 years follow-up. Most studies comment on the adverse effects of screening - principally those of overdiagnosis and subsequent overtreatment. Further information about the natural history of prostate cancer and accuracy of screening is needed before a screening programme can be truly justified. In the interim, doctors and patients should discuss the risks, benefits and sequelae of taking part in voluntary screening for prostate cancer.

Quality Control in Screening for Infectious Diseases at Blood Banks. Rationale and Methodology.

Science.gov (United States)

Sáez-Alquezar, Amadeo; Albajar-Viñas, Pedro; Guimarães, André Valpassos; Corrêa, José Abol

2015-11-01

Quality control procedures are indispensable to ensure the reliability of the results provided by laboratories responsible for serological screening in blood banks. International recommendations on systems of quality management classify as a top component the inclusion of two types of control: (a) internal quality control (IQC) and (b) external quality control (EQC). In EQC it is essential to have, at least, a monthly frequency of laboratory assessment. On the other hand, IQC involves the daily use of low-reactivity control sera, which should be systematically added in all run, carried out in the laboratory for each parameter. Through the IQC analysis some variations in the criteria of run acceptance and rejection may be revealed, but it is of paramount importance to ensure the previous definition of these criteria and even more importantly, the adherence to them; and that corresponds to the validation of analytical runs of each test. Since 2010 this has been, for instance, the experience of the PNCQ*, developing external quality control programmes on serology for blood banks. These programmes use samples of lyophilized sera well-characterized for the reactivity related to the parameters used for the serological screening of blood donors. The programmes have used blind panels of six samples for monthly assessments. In the last 50 assessments, which involved 68 blood banks in Brazil, a significant number of instances of non-compliance were observed in all monthly assessments. These results provide strong support to the recommendation of systematic monthly assessments. (*) National Quality Control Programme (PNCQ).

Use of advanced programmable logic controllers to monitor and control the Elmo Bumpy Torus-proof-of-principle device

International Nuclear Information System (INIS)

Boyd, B.A.

1983-01-01

The Elmo Bumpy Torus - Proof-of-Principle (EBT-P) device is designed with an instrumentation and control system based upon the use of an advanced Programmable Logic Controller (PLC). The modern PLC incorporates many advanced programming features not available in earlier PLC's intended for application to conventional relay logic replacement. The additional power and flexibility of these modern PLC's is especially applicable to an experimental device such as EBT-P which is made up of several complex interrelated subsystems whose operational characteristics will be evolving throughout the lifetime of the device. The rationale for the selection of advanced PLC's for EBT-P and the approach taken to design of the software developed to control EBT-P are the topics addressed in this paper

Programmable release of multiple protein drugs from aptamer-functionalized hydrogels via nucleic acid hybridization.

Science.gov (United States)

Battig, Mark R; Soontornworajit, Boonchoy; Wang, Yong

2012-08-01

Polymeric delivery systems have been extensively studied to achieve localized and controlled release of protein drugs. However, it is still challenging to control the release of multiple protein drugs in distinct stages according to the progress of disease or treatment. This study successfully demonstrates that multiple protein drugs can be released from aptamer-functionalized hydrogels with adjustable release rates at predetermined time points using complementary sequences (CSs) as biomolecular triggers. Because both aptamer-protein interactions and aptamer-CS hybridization are sequence-specific, aptamer-functionalized hydrogels constitute a promising polymeric delivery system for the programmable release of multiple protein drugs to treat complex human diseases.

Integrated vector management for malaria control

Directory of Open Access Journals (Sweden)

Impoinvil Daniel E

2008-12-01

Full Text Available Abstract Integrated vector management (IVM is defined as "a rational decision-making process for the optimal use of resources for vector control" and includes five key elements: 1 evidence-based decision-making, 2 integrated approaches 3, collaboration within the health sector and with other sectors, 4 advocacy, social mobilization, and legislation, and 5 capacity-building. In 2004, the WHO adopted IVM globally for the control of all vector-borne diseases. Important recent progress has been made in developing and promoting IVM for national malaria control programmes in Africa at a time when successful malaria control programmes are scaling-up with insecticide-treated nets (ITN and/or indoor residual spraying (IRS coverage. While interventions using only ITNs and/or IRS successfully reduce transmission intensity and the burden of malaria in many situations, it is not clear if these interventions alone will achieve those critical low levels that result in malaria elimination. Despite the successful employment of comprehensive integrated malaria control programmes, further strengthening of vector control components through IVM is relevant, especially during the "end-game" where control is successful and further efforts are required to go from low transmission situations to sustained local and country-wide malaria elimination. To meet this need and to ensure sustainability of control efforts, malaria control programmes should strengthen their capacity to use data for decision-making with respect to evaluation of current vector control programmes, employment of additional vector control tools in conjunction with ITN/IRS tactics, case-detection and treatment strategies, and determine how much and what types of vector control and interdisciplinary input are required to achieve malaria elimination. Similarly, on a global scale, there is a need for continued research to identify and evaluate new tools for vector control that can be integrated with

The impact of a disease management program (COACH) on the attainment of better cardiovascular risk control in dyslipidaemic patients at primary care centres (The DISSEMINATE Study): a randomised controlled trial.

Science.gov (United States)

Selvaraj, Francis Jude; Mohamed, Mafauzy; Omar, Khairani; Nanthan, Sudha; Kusiar, Zainab; Subramaniam, Selvaraj Y; Ali, Norsiah; Karanakaran, Kamalakaran; Ahmad, Fauziah; Low, Wilson H H

2012-10-10

To evaluate the efficacy of Counselling and Advisory Care for Health (COACH) programme in managing dyslipidaemia among primary care practices in Malaysia. This open-label, parallel, randomised controlled trial compared the COACH programme delivered by primary care physicians alone (PCP arm) and primary care physicians assisted by nurse educators (PCP-NE arm). This was a multi-centre, open label, randomised trial of a disease management programme (COACH) among dyslipidaemic patients in 21 Malaysia primary care practices. The participating centres enrolled 297 treatment naïve subjects who had the primary diagnosis of dyslipidaemia; 149 were randomised to the COACH programme delivered by primary care physicians assisted by nurse educators (PCP-NE) and 148 to care provided by primary care physicians (PCP) alone. The primary efficacy endpoint was the mean percentage change from baseline LDL-C at week 24 between the 2 study arms. Secondary endpoints included mean percentage change from baseline of lipid profile (TC, LDL-C, HDL-C, TG, TC: HDL ratio), Framingham Cardiovascular Health Risk Score and absolute risk change from baseline in blood pressure parameters at week 24. The study also assessed the sustainability of programme efficacy at week 36. Both study arms demonstrated improvement in LDL-C from baseline. The least squares (LS) mean change from baseline LDL-C were -30.09% and -27.54% for PCP-NE and PCP respectively. The difference in mean change between groups was 2.55% (p=0.288), with a greater change seen in the PCP-NE arm. Similar observations were made between the study groups in relation to total cholesterol change at week 24. Significant difference in percentage change from baseline of HDL-C were observed between the PCP-NE and PCP groups, 3.01%, 95% CI 0.12-5.90, p=0.041, at week 24. There was no significant difference in lipid outcomes between 2 study groups at week 36 (12 weeks after the programme had ended). Patients who received coaching and advice from

Testing a Dutch web-based tailored lifestyle programme among adults: a study protocol

Directory of Open Access Journals (Sweden)

van Osch Liesbeth ADM

2011-02-01

Full Text Available Abstract Background Smoking, high alcohol consumption, unhealthy eating habits and physical inactivity often lead to (chronic diseases, such as cardiovascular diseases and cancer. Tailored online interventions have been proven to be effective in changing health behaviours. The aim of this study is to test and compare the effectiveness of two different tailoring strategies for changing lifestyle compared to a control group using a multiple health behaviour web-based approach. Methods In our Internet-based tailored programme, the five lifestyle behaviours of smoking, alcohol intake, fruit consumption, vegetable consumption, and physical activity are addressed. This randomized controlled trial, conducted among Dutch adults, includes two experimental groups (i.e., a sequential behaviour tailoring condition and a simultaneous behaviour tailoring condition and a control group. People in the sequential behaviour tailoring condition obtain feedback on whether their lifestyle behaviours meet the Dutch recommendations. Using a step-by-step approach, they are stimulated to continue with a computer tailored module to change only one unhealthy behaviour first. In the course of the study, they can proceed to change a second behaviour. People in the simultaneous behaviour tailoring condition receive computer tailored feedback about all their unhealthy behaviours during their first visit as a stimulation to change all unhealthy behaviours. The experimental groups can re-visit the website and can then receive ipsative feedback (i.e., current scores are compared to previous scores in order to give feedback about potential changes. The (difference in effectiveness of the different versions of the programme will be tested and compared to a control group, in which respondents only receive a short health risk appraisal. Programme evaluations will assess satisfaction with and appreciation and personal relevance of the intervention among the respondents. Finally

Establishment of an X radiation equipment quality control programme using non invasive meters

International Nuclear Information System (INIS)

Lucena, Rodrigo Ferreira de

2010-01-01

The objective of this work was to study the behavior of the mainly X ray equipment calibration laboratory of IPEN, operated in the range from 25 kV to 150 kV using a PTW non invasive meter, model Diavolt TM , and an ORTEC spectrometry system, model NOMAD-PLUS 92X, for the establishment of a quality control programme. The Diavolt meter was used for measurements of air kerma, peak voltage and practical peak voltage. The measurements were made varying parameters such as electrical current, X radiation quality for radiation diagnostic, angulations of the meter and its distance in relation to the focal spot of the X ray tube. The results were compared with data found in the literature. Several spectra were generated with the spectrometer system with the purpose of determine the peak voltage in function of the nominal voltage and to characterize the radiation qualities for radiation diagnostic previously determined. The established quality control programme enables the management of the appropriate functioning of the measurement instruments (ionization chambers, voltage and current meter and spectrometer) as well as of the X radiation system. This work also has proposed a time interval to run each one of the tests. (author)

Evaluation of the COPING parent online universal programme: study protocol for a pilot randomised controlled trial.

Science.gov (United States)

Owen, Dawn Adele; Griffith, Nia; Hutchings, Judy

2017-04-26

Bangor University, Brigantia Building, College Road, Bangor, LL57 2AS, UK INTRODUCTION: The COPING parent online universal programme is a web-based parenting intervention for parents of children aged 3-8 years with an interest in positive parenting. The programme focuses on strengthening parent-child relationships and encouraging positive child behaviour. This trial will evaluate whether the intervention is effective in increasing the use of positive parenting strategies outlined in the programme using parent report and blind observation measures. This is a pilot randomised controlled trial with intervention and wait-list control conditions. The intervention is a 10-week online parenting programme to promote positive parent-child relations by teaching core social learning theory principles that encourage positive child behaviour, primarily through the use of praise and rewards. Health visitors and school nurses will circulate a recruitment poster to parents of children aged 3-8 years on their current caseloads. Recruitment posters will also be distributed via local primary schools and nurseries. Parents recruited to the trial will be randomised on a 2:1 ratio to intervention or wait-list control conditions (stratified according to child gender and age). The primary outcome measure is positive parenting as measured by a behavioural observation of parent-child interactions using the Dyadic Parent-Child Interaction Coding System. Secondary outcomes include parent report of child behaviour, and self-reported parental sense of competence, parenting behaviour and parental mental health. Data will be collected at baseline and 3 months later (postintervention) for all participants and 6 months postbaseline for the intervention group only. Analysis of covariance will be the main statistical method used. The trial has received ethical approval from the NHS Betsi Cadwaladr University Health Board Ethics Committee (REC) and the School of Psychology, Bangor University REC (15

Joint sampling programme-Verification of data obtained in environmental monitoring

Energy Technology Data Exchange (ETDEWEB)

Lauria, D.C. [Instituto de Radioprotecao e Dosimetria, Comissao Nacional de Energia Nuclear, Av. Salvador Allende s/no., CEP 22780-160, Rio de Janeiro, RJ (Brazil)], E-mail: dejanira@ird.gov.br; Martins, N.S.F.; Vasconcellos, M.L.H.; Zenaro, R.; Peres, S.S.; Pires do Rio, M.A. [Instituto de Radioprotecao e Dosimetria, Comissao Nacional de Energia Nuclear, Av. Salvador Allende s/no., CEP 22780-160, Rio de Janeiro, RJ (Brazil)

2008-11-15

The objective of the Environmental Radiological Monitoring Control programme carried out by the Institute of Radiation Protection and Dosimetry (IRD) in Brazil is to verify the licensee's compliance with the requirements for environmental monitoring of Brazilian facilities. The Joint Sampling Programme (JSP) is just one part of the control programme. In order to verify that the data reported by the licensees is representative and legitimate, this programme verifies sampling procedures, accuracy and precision of the data and the changes in the environmental conditions. This paper discusses the main findings of this programme that allowed IRD to optimize its available resources to control the monitoring of the eight facilities in Brazil.

An evaluation of a nurse-led rehabilitation programme (the ProBalance Programme) to improve balance and reduce fall risk of community-dwelling older people: A randomised controlled trial.

Science.gov (United States)

Gouveia, Bruna Raquel; Gonçalves Jardim, Helena; Martins, Maria Manuela; Gouveia, Élvio Rúbio; de Freitas, Duarte Luís; Maia, José António; Rose, Debra J

2016-04-01

This study aims to assess the effect of a nurse-led rehabilitation programme (the ProBalance Programme) on balance and fall risk of community-dwelling older people from Madeira Island, Portugal. Single-blind, randomised controlled trial. University laboratory. Community-dwelling older people, aged 65-85, with balance impairments. Participants were randomly allocated to an intervention group (IG; n=27) or a wait-list control group (CG; n=25). A rehabilitation nursing programme included gait, balance, functional training, strengthening, flexibility, and 3D training. One trained rehabilitation nurse administered the group-based intervention over a period of 12 weeks (90min sessions, 2 days per week). A wait-list control group was instructed to maintain their usual activities during the same time period. Balance was assessed using the Fullerton Advanced Balance (FAB) scale. The time points for assessment were at zero (pre-test), 12 (post-test), and 24 weeks (follow up). Changes in the mean (SD) FAB scale scores immediately following the 12-week intervention were 5.15 (2.81) for the IG and -1.45 (2.80) for the CG. At follow-up, the mean (SD) change scores were -1.88 (1.84) and 0.75 (2.99) for the IG and CG, respectively. The results of a mixed between-within subjects analysis of variance, controlling for physical activity levels at baseline, revealed a significant interaction between group and time (F (2, 42)=27.89, pbalance and reducing fall risk in a group of older people with balance impairment, immediately after the intervention. A decline in balance was observed for the IG after a period of no intervention. ACTRN12612000301864. Copyright © 2015 Elsevier Ltd. All rights reserved.

Private Practitioners’ Perspectives on Their Involvement With the Tuberculosis Control Programme in a Southern Indian State

Directory of Open Access Journals (Sweden)

Solomon Salve

2016-11-01

Full Text Available Background Public and private health sectors both play a crucial role in the health systems of low- and middleincome countries (LMICs. The tuberculosis (TB control strategy in India encourages the public sector to actively partner with private practitioners (PPs to improve the quality of front line service delivery. However, ensuring effective and sustainable involvement of PPs constitutes a major challenge. This paper reports the findings from an empirical study focusing on the perspectives and experiences of PPs towards their involvement in TB control programme in India. Methods The study was carried out between November 2010 and December 2011 in a district of a Southern Indian State and utilised qualitative methodologies, combining observations and in-depth interviews with 21 PPs from different medical systems. The collected data was coded and analysed using thematic analysis. Results PPs perceived themselves to be crucial healthcare providers, with different roles within the public-private mix (PPM TB policy. Despite this, PPs felt neglected and undervalued in the actual process of implementation of the PPM-TB policy. The entire process was considered to be government driven and their professional skills and knowledge of different medical systems remained unrecognised at the policy level, and weakened their relationship and bond with the policy and with the programme. PPs had contrasting perceptions about the different components of the TB programme that demonstrated the public sector’s dominance in the overall implementation of the DOTS strategy. Although PPs felt responsible for their TB patients, they found it difficult to perceive themselves as ‘partners with the TB programme.’ Conclusion Public-private partnerships (PPPs are increasingly utilized as a public health strategy to strengthen health systems. These policies will fail if the concerns of the PPs are neglected. To ensure their long-term involvement in the programme the

Independent programmable CAMAC crate controller based on KR580IK80A microprocessor

International Nuclear Information System (INIS)

Kulik, O.V.; Andronov, M.A.

1986-01-01

The RTKAM-2 independent programmable CAMAC crate controller is designed for use as a remote terminal in systems for automation of physics research. The built-in 12K-byte RAM is automatically changed to 24-bit organization in exchanges with the crate dataway. A nonstandard 24-level priority-interrupt system allows an LAM-request routing to be accessed in 5.5 μsec. Communication with the base computer is through a two conductor line

Advances in disease control of tick and tick-borne diseases

African Journals Online (AJOL)

J.nfection and treatment method ofimmunisation has been devised ... providing research and training and in extension work on. TBDs. ... systems, cattle types, level of disease risk, disease control policies ... This paper highlights tick .control,.

A tool box for operational mosquito larval control: preliminary results and early lessons from the Urban Malaria Control Programme in Dar es Salaam, Tanzania

Directory of Open Access Journals (Sweden)

Govella Nico J

2008-01-01

Full Text Available Abstract Background As the population of Africa rapidly urbanizes, large populations could be protected from malaria by controlling aquatic stages of mosquitoes if cost-effective and scalable implementation systems can be designed. Methods A recently initiated Urban Malaria Control Programme in Dar es Salaam delegates responsibility for routine mosquito control and surveillance to modestly-paid community members, known as Community-Owned Resource Persons (CORPs. New vector surveillance, larviciding and management systems were designed and evaluated in 15 city wards to allow timely collection, interpretation and reaction to entomologic monitoring data using practical procedures that rely on minimal technology. After one year of baseline data collection, operational larviciding with Bacillus thuringiensis var. israelensis commenced in March 2006 in three selected wards. Results The procedures and staff management systems described greatly improved standards of larval surveillance relative to that reported at the outset of this programme. In the first year of the programme, over 65,000 potential Anopheles habitats were surveyed by 90 CORPs on a weekly basis. Reaction times to vector surveillance at observations were one day, week and month at ward, municipal and city levels, respectively. One year of community-based larviciding reduced transmission by the primary malaria vector, Anopheles gambiae s.l., by 31% (95% C.I. = 21.6–37.6%; p = 0.04. Conclusion This novel management, monitoring and evaluation system for implementing routine larviciding of malaria vectors in African cities has shown considerable potential for sustained, rapidly responsive, data-driven and affordable application. Nevertheless, the true programmatic value of larviciding in urban Africa can only be established through longer-term programmes which are stably financed and allow the operational teams and management infrastructures to mature by learning from experience.

Feasibility and effects of a physical exercise programme in adults with myotonic dystrophy type 1: a randomized controlled pilot study.

Science.gov (United States)

Kierkegaard, Marie; Harms-Ringdahl, Karin; Edström, Lars; Widén Holmqvist, Lotta; Tollbäck, Anna

2011-07-01

To investigate the feasibility and effects of a physical exercise programme on functioning and health-related quality of life in adults with myotonic dystrophy type 1. A randomized controlled trial. Thirty-five adults with myotonic dystrophy type 1. After stratification for level of functioning, study participants were assigned by lot to either a training group or a control group. Training-group participants attended a 60-minute comprehensive group-training programme, Friskis&Svettis® Open Doors, twice a week for 14 weeks. The six-minute walk test was the primary outcome measure and the timed-stands test, the timed up-and-go test, the Epworth sleepiness scale and the Short Form-36 health survey were secondary outcome measures. Intention-to-treat analyses revealed no significant differences in any outcome measures, except for an increased between-group difference after intervention in the Short Form-36 mental health subscale and a decrease in the vitality subscale for the control group. The programme was well tolerated and many training-group participants perceived subjective changes for the better. No negative effects were reported. The Friskis&Svettis® Open Doors programme was feasible for adults with myotonic dystrophy type 1 who had been screened for cardiac involvement, had distal or mild-to-moderate proximal muscle impairment, and no severe cognitive impairments. No beneficial or detrimental effects were evident.

The Norwegian healthy body image programme: study protocol for a randomized controlled school-based intervention to promote positive body image and prevent disordered eating among Norwegian high school students.

Science.gov (United States)

Sundgot-Borgen, Christine; Bratland-Sanda, Solfrid; Engen, Kethe M E; Pettersen, Gunn; Friborg, Oddgeir; Torstveit, Monica Klungland; Kolle, Elin; Piran, Niva; Sundgot-Borgen, Jorunn; Rosenvinge, Jan H

2018-03-06

Body dissatisfaction and disordered eating raise the risk for eating disorders. In the prevention of eating disorders, many programmes have proved partly successful in using cognitive techniques to combat such risk factors. However, specific strategies to actively promote a positive body image are rarely used. The present paper outlines a protocol for a programme integrating the promotion of a positive body image and the prevention of disordered eating. Using a cluster randomized controlled mixed methods design, 30 high schools and 2481 12th grade students were allocated to the Healthy Body Image programme or to a control condition. The intervention comprised three workshops, each of 90 min with the main themes body image, media literacy, and lifestyle. The intervention was interactive in nature, and were led by trained scientists. The outcome measures include standardized instruments administered pre-post intervention, and at 3 and 12 months follow-ups, respectively. Survey data cover feasibility and implementation issues. Qualitative interviews covers experiential data about students' benefits and satisfaction with the programme. The present study is one of the first in the body image and disordered eating literature that integrates a health promotion and a disease prevention approach, as well as integrating standardized outcome measures and experiential findings. Along with mediator and moderator analyses it is expected that the Healthy Body Image programme may prove its efficacy. If so, plans are made with respect to further dissemination as well as communicating the findings to regional and national decision makers in the education and health care services. The study was registered and released at ClinicalTrials.gov 21th August 2016 with the Clinical Trial.gov ID: PRSNCT02901457 . In addition, the study is approved by the Regional Committee for Medical and Health Research Ethics.

The association between individual counselling and health behaviour change: the See Kidney Disease (SeeKD) targeted screening programme for chronic kidney disease.

Science.gov (United States)

Galbraith, Lauren; Hemmelgarn, Brenda; Manns, Braden; Samuel, Susan; Kappel, Joanne; Valk, Nadine; Ronksley, Paul

2016-01-01

Health behaviour change is an important component of management for patients with chronic kidney disease (CKD); however, the optimal method to promote health behaviour change for self-management of CKD is unknown. The See Kidney Disease (SeeKD) targeted screening programme screened Canadians at risk for CKD and promoted health behaviour change through individual counselling and goal setting. The objectives of this study are to determine the effectiveness of individual counselling sessions for eliciting behaviour change and to describe participant characteristics associated with behaviour change. This is a cross-sectional, descriptive study. The study setting is the National SeeKD targeted screening programme. The participants are all 'at risk' patients who were screened for CKD and returned a follow-up health behaviour survey (n = 1129). Health behaviour change was defined as a self-reported change in lifestyle, including dietary changes or medication adherence. An individual counselling session was provided to participants by allied healthcare professionals to promote health behaviour change. A survey was mailed to all participants at risk of CKD within 2-4 weeks following the screening event to determine if behaviour changes had been initiated. Descriptive statistics were used to describe respondent characteristics and self-reported behaviour change following screening events. Results were stratified by estimated glomerular filtration rate (eGFR) (change. Of the 1129 respondents, the majority (89.8 %) reported making a health behaviour change after the screening event. Respondents who were overweight (body mass index [BMI] 25-29.9 kg/m(2)) or obese (BMI ≥ 30.0 kg/m(2)) were more likely to report a behaviour change (prevalence rate ratio (PRR) 0.66, 95 % confidence interval (CI) 0.44-0.99 and PRR 0.49, 95 % CI 0.30-0.80, respectively). Further, participants with a prior intent to change their behaviour were more likely to make a behaviour change

The cost-effectiveness of an eradication programme in the end game: Evidence from guinea worm disease.

Science.gov (United States)

Fitzpatrick, Christopher; Sankara, Dieudonné P; Agua, Junerlyn Farah; Jonnalagedda, Lakshmi; Rumi, Filippo; Weiss, Adam; Braden, Matthew; Ruiz-Tiben, Ernesto; Kruse, Nicole; Braband, Kate; Biswas, Gautam

2017-10-01

Of the three diseases targeted for eradication by WHO, two are so-called Neglected Tropical Diseases (NTDs)-guinea worm disease (GWD) and yaws. The Guinea Worm Eradication Programme (GWEP) is in its final stages, with only 25 reported in 2016. However, global eradication still requires certification by WHO of the absence of transmission in all countries. We analyze the cost-effectiveness of the GWEP in the end game, when the number of cases is lower and the cost per case is higher than at any other time. Ours is the first economic evaluation of the GWEP since a World Bank study in 1997. Using data from the GWEP, we estimate the cost of the implementation, pre-certification and certification stages. We model cost-effectiveness in the period 1986-2030. We compare the GWEP to two alternative scenarios: doing nothing (no intervention since 1986) and control (only surveillance and outbreak response during 2016-2030). We report the cost per case averted, cost per disability adjusted life year (DALY) averted and cost per at-risk life year averted. We assess cost-effectiveness against a threshold of about one half GDP per capita (less than US$ 500 in low income countries). All costs are expressed in US$ of 2015. The GWEP cost an estimated US$ 11 (95% uncertainty interval, 4.70-12.49) per case averted in the period 1986-2030. The pre-certification and certification phases can cost as much as US$ 0.0041 and US$ 0.0015 per capita per year. The cost per DALY averted by the GWEP relative to doing nothing is estimated at US$ 222 (118-372) in 1986-2030. The GWEP is probably more cost-effective than control by the year 2030. The GWEP is certainly more cost-effective than control if willingness to pay for one year of life lived without the risk of GWD exceeds US$ 0.10. Even if economic costs are two times as high as the financial costs estimated for the period to 2020, the GWEP will still be cost-effective relative to doing nothing. Whether the GWEP turns out to be the most cost

The cost-effectiveness of an eradication programme in the end game: Evidence from guinea worm disease.

Directory of Open Access Journals (Sweden)

Christopher Fitzpatrick

2017-10-01

Full Text Available Of the three diseases targeted for eradication by WHO, two are so-called Neglected Tropical Diseases (NTDs-guinea worm disease (GWD and yaws. The Guinea Worm Eradication Programme (GWEP is in its final stages, with only 25 reported in 2016. However, global eradication still requires certification by WHO of the absence of transmission in all countries. We analyze the cost-effectiveness of the GWEP in the end game, when the number of cases is lower and the cost per case is higher than at any other time. Ours is the first economic evaluation of the GWEP since a World Bank study in 1997.Using data from the GWEP, we estimate the cost of the implementation, pre-certification and certification stages. We model cost-effectiveness in the period 1986-2030. We compare the GWEP to two alternative scenarios: doing nothing (no intervention since 1986 and control (only surveillance and outbreak response during 2016-2030. We report the cost per case averted, cost per disability adjusted life year (DALY averted and cost per at-risk life year averted. We assess cost-effectiveness against a threshold of about one half GDP per capita (less than US$ 500 in low income countries. All costs are expressed in US$ of 2015.The GWEP cost an estimated US$ 11 (95% uncertainty interval, 4.70-12.49 per case averted in the period 1986-2030. The pre-certification and certification phases can cost as much as US$ 0.0041 and US$ 0.0015 per capita per year. The cost per DALY averted by the GWEP relative to doing nothing is estimated at US$ 222 (118-372 in 1986-2030. The GWEP is probably more cost-effective than control by the year 2030. The GWEP is certainly more cost-effective than control if willingness to pay for one year of life lived without the risk of GWD exceeds US$ 0.10.Even if economic costs are two times as high as the financial costs estimated for the period to 2020, the GWEP will still be cost-effective relative to doing nothing. Whether the GWEP turns out to be the most

COMPUTER-ASSISTED CONTROL OF ACADEMIC PERFORMANCE IN ENGINEERING GRAPHICS WITHIN THE FRAMEWORK OF DISTANCE LEARNING PROGRAMMES

Directory of Open Access Journals (Sweden)

Tel'noy Viktor Ivanovich

2012-10-01

Full Text Available Development of computer-assisted computer technologies and their integration into the academic activity with a view to the control of the academic performance within the framework of distance learning programmes represent the subject matter of the article. The article is a brief overview of the software programme designated for the monitoring of the academic performance of students enrolled in distance learning programmes. The software is developed on Delphi 7.0 for Windows operating system. The strength of the proposed software consists in the availability of the two modes of its operation that differ in the principle of the problem selection and timing parameters. Interim academic performance assessment is to be performed through the employment of computerized testing procedures that contemplate the use of a data base of testing assignments implemented in the eLearning Server media. Identification of students is to be performed through the installation of video cameras at workplaces of students.

The RESCueH Programme

DEFF Research Database (Denmark)

Søgaard Nielsen, Anette; Nielsen, Bent; Andersen, Kjeld

2016-01-01

Excessive alcohol consumption is one of the most important lifestyle factors affecting the disease burden in the Western world. The results of treatment in daily practice are modest at best. The aim of the RESCueH programme is to develop and evaluate methods, which are as practice-near as possible...

The European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP)--a sentinel approach in the European Union (EU)/European Economic Area (EEA).

Science.gov (United States)

Spiteri, Gianfranco; Cole, Michelle; Unemo, Magnus; Hoffmann, Steen; Ison, Catherine; van de Laar, Marita

2013-12-01

Antimicrobial resistance in Neisseria gonorrhoeae is monitored in the European Union/European Economic Area through the European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) coordinated by the European Centre for Disease Prevention and Control. Euro-GASP includes a sentinel surveillance programme which aims to detect in a timely manner changes in resistance patterns and inform treatment guidelines. The programme aims to test a representative number of isolates from each European Union/European Economic Area member state per year for a range of therapeutically relevant antimicrobials through a biannual hybrid centralised/decentralised system. Testing is supported by an External Quality Assurance programme and a laboratory training programme. Participation in the programme has increased to 21 countries in 2012. Euro-GASP has been able to detect the rapid spread of isolates with decreased susceptibility to cefixime across Europe in 2010 and 2011. Results from the programme have informed changes in European treatment guidelines for gonorrhoea and led to the development of the 'Response plan to control and manage the threat of multidrug resistant gonorrhoea in Europe'. Future challenges for Euro-GASP include supporting countries to participate in Euro-GASP through decentralised testing, improving timeliness and epidemiological data quality, and increasing participation from Eastern Europe.

COMET: a multicomponent home-based disease-management programme versus routine care in severe COPD.

Science.gov (United States)

Kessler, Romain; Casan-Clara, Pere; Koehler, Dieter; Tognella, Silvia; Viejo, Jose Luis; Dal Negro, Roberto W; Díaz-Lobato, Salvador; Reissig, Karina; Rodríguez González-Moro, José Miguel; Devouassoux, Gilles; Chavaillon, Jean-Michel; Botrus, Pierre; Arnal, Jean-Michel; Ancochea, Julio; Bergeron-Lafaurie, Anne; De Abajo, Carlos; Randerath, Winfried J; Bastian, Andreas; Cornelissen, Christian G; Nilius, Georg; Texereau, Joëlle B; Bourbeau, Jean

2018-01-01

The COPD Patient Management European Trial (COMET) investigated the efficacy and safety of a home-based COPD disease management intervention for severe COPD patients.The study was an international open-design clinical trial in COPD patients (forced expiratory volume in 1 s management intervention or to the usual management practices at the study centre. The disease management intervention included a self-management programme, home telemonitoring, care coordination and medical management. The primary end-point was the number of unplanned all-cause hospitalisation days in the intention-to-treat (ITT) population. Secondary end-points included acute care hospitalisation days, BODE (body mass index, airflow obstruction, dyspnoea and exercise) index and exacerbations. Safety end-points included adverse events and deaths.For the 157 (disease management) and 162 (usual management) patients eligible for ITT analyses, all-cause hospitalisation days per year (mean±sd) were 17.4±35.4 and 22.6±41.8, respectively (mean difference -5.3, 95% CI -13.7 to -3.1; p=0.16). The disease management group had fewer per-protocol acute care hospitalisation days per year (p=0.047), a lower BODE index (p=0.01) and a lower mortality rate (1.9% versus 14.2%; pmanagement intervention did not significantly reduce unplanned all-cause hospitalisation days, but reduced acute care hospitalisation days and mortality in severe COPD patients. Copyright ©ERS 2018.

National disease management plans for key chronic non-communicable diseases in Singapore.

Science.gov (United States)

Tan, C C

2002-07-01

In Singapore, chronic, non-communicable diseases, namely coronary heart disease, stroke and cancer, account for more than 60% of all deaths and a high burden of disability and healthcare expenditure. The burden of these diseases is likely to rise with our rapidly ageing population and changing lifestyles, and will present profound challenges to our healthcare delivery and financing systems over the next 20 to 30 years. The containment and optimal management of these conditions require a strong emphasis on patient education and the development of integrated models of healthcare delivery in place of the present uncoordinated, compartmentalised way of delivering healthcare. To meet these challenges, the Ministry of Health's major thrusts are disease control measures which focus mainly on primary prevention; and disease management, which coordinates the national effort to reduce the incidence of these key diseases and their predisposing factors and to ameliorate their long-term impact by optimising control to reduce mortality, morbidity and complications, and improving functional status through rehabilitation. The key initiatives include restructuring of the public sector healthcare institutions into two clusters, each comprising a network of primary health care polyclinics, regional hospitals and tertiary institutions. The functional integration of these healthcare elements within each cluster under a common senior administrative and professional management, and the development of common clinical IT systems will greatly facilitate the implementation of disease management programmes. Secondly, the Ministry is establishing National Disease Registries in coronary heart disease, cancer, stroke, myopia and kidney failure, which will be valuable sources of clinical and outcomes data. Thirdly, in partnership with expert groups, national committees and professional agencies, the Ministry will produce clinical practice guidelines which will assist doctors and healthcare

The IAEA’s Role in Nutrition Programmes (French Edition)

International Nuclear Information System (INIS)

2016-01-01

The International Atomic Energy Agency (IAEA) programme on nutrition enhances countries’ capabilities to combat malnutrition for better health throughout life. It complements the work of other United Nations (UN) agencies, non-governmental organizations (NGOs) and interested stakeholders in the field of nutrition and health, by encouraging the use of accurate nuclear techniques (including stable isotopes) to design and evaluate interventions aimed at addressing malnutrition in all its forms with specific focus on: infant and young child feeding; maternal and adolescent nutrition; diet quality; prevention and control of non-communicable diseases (NCDs); and healthy ageing.

The IAEA’s Role in Nutrition Programmes (Spanish Edition)

International Nuclear Information System (INIS)

2016-01-01

The International Atomic Energy Agency (IAEA) programme on nutrition enhances countries’ capabilities to combat malnutrition for better health throughout life. It complements the work of other United Nations (UN) agencies, non-governmental organizations (NGOs) and interested stakeholders in the field of nutrition and health, by encouraging the use of accurate nuclear techniques (including stable isotopes) to design and evaluate interventions aimed at addressing malnutrition in all its forms with specific focus on: infant and young child feeding; maternal and adolescent nutrition; diet quality; prevention and control of non-communicable diseases (NCDs); and healthy ageing.

Key indicators for the monitoring and evaluation of control programmes of human African trypanosomiasis due to Trypanosoma brucei gambiense.

Science.gov (United States)

Bouchet, B; Legros, D; Lee, E

1998-06-01

Very little research has been devoted to the design of epidemiological tools for the monitoring and evaluation of National Human African Trypanosomiasis (HAT) Control Programmes and daily management decisions are made in the absence of accurate knowledge of the situation. This paper identifies key indicators necessary to make decisions in the field and constantly adjust control activities to changing situations. Examples are derived from the Médecins Sans Frontières (MSF) HAT Control Programme in Adjumani, Uganda. Based on the principles of quality assurance, the focus is placed on process indicators. A conceptual framework derived from a system view/planning cycle perspective is also described for the construction of indicators. Finally, some specific challenging aspects of the epidemiology of HAT are presented and the limitations of the interpretation of the indicators discussed.

Evolution of Chagas' disease in Brazil. Epidemiological perspective and challenges for the future: a critical review.

Science.gov (United States)

Bello Corassa, Rafael; Aceijas, Carmen; Alves, Paula Aryane Brito; Garelick, Hemda

2017-09-01

This article aimed to provide a critical review of the evolution of Chagas' disease (ChD) in Brazil, its magnitude, historical development and management, and challenges for the future. A literature search was performed using PubMed, SciELO and Google Scholar and throughout collected articles' references. Narrative analysis was structured around five main themes identified: vector transmission, control programme, transfusion, oral and congenital transmission. In Brazil, the Chagas' Disease Control Programme was fully implemented in the 1980s, when it reached practically all the endemic areas, and in 1991, the Southern Cone Initiative was created, aiming to control the disease transmission through eliminating the Triatoma infestans and controlling blood banks. As a result, the prevalence of chagasic donors in blood banks reduced from 4.4% in the 1980s to 0.2% in 2005. In 2006, Pan American Health Organization (PAHO) certified the interruption of transmission of ChD through this vector in Brazil. However, there are still challenges, such as the domiciliation of new vector species, the need for medical care of the infected individuals, the prevention of alternative mechanisms of transmission, the loss of political concern regarding the disease and the weakening of the control programme. Despite the progress towards control, there are still many challenges ahead to maintain and expand such control and minimise the risk of re-emergence.

Horizontal schools-based health programme in rural Kenya.

Science.gov (United States)

Bogie, James; Eder, Ben; Magnus, Dan; Amonje, Onguko David; Gant, Martina

2017-09-01

Primary school children in low-income countries are at risk of many diseases and poor health affects attendance, cognition and ability to learn. Developing school health and nutrition strategies has been extensively highlighted as a global priority, with a particular focus on complex programme design. However, such programmes are relatively untested in low-income settings. We implemented a complex school health and nutrition programme in two schools in Western Kenya over 3 years. There were numerous elements covering health policy, skills-based health education, infrastructure and disease prevention. A local non-governmental organisation, with involvement from local government and the community, performed programme implementation. Height-for-age, weight-for-age,height-for-weight, anaemia prevalence, academic performance and school attendance were the primary outcome measures. The programme improved nutrition, academic performance and anaemia prevalence. The number of underweight children fell from 20% to 11% (OR 0.51 95% CI 0.39 to 0.68 p=effect on school attendance, the reasons for which are unclear. These results are encouraging and demonstrate that complex schools health programmes can lead to positive gains in health, nutrition and importantly academic performance. There is a need for further evaluation of comprehensive school health interventions in poor communities. © 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.

Redox phenomena controlling systems - a 7. framework programme collaborative project (2008-2012)

International Nuclear Information System (INIS)

2013-01-01

The objective of this EURATOM collaborative project is to understand Redox phenomena controlling the long-term release/retention of radionuclides (ReCosy programme) in nuclear waste disposal and to provide tools to apply the results to safety assessment. The project has been organized into 6 task forces: 1) implications of Redox for safety, 2) development of Redox determination methods, 3) Redox response of defined and near-natural systems, 4) Redox reactions of radionuclides, 5) Redox processes in radionuclide transport, and 6) Redox reactions affecting the spent fuel source-term

The clinical effectiveness of different parenting programmes for children with conduct problems: a systematic review of randomised controlled trials

Directory of Open Access Journals (Sweden)

Taylor Rod S

2009-03-01

Full Text Available Abstract Background Conduct problems are common, disabling and costly. The prognosis for children with conduct problems is poor, with outcomes in adulthood including criminal behaviour, alcoholism, drug abuse, domestic violence, child abuse and a range of psychiatric disorders. There has been a rapid expansion of group based parent-training programmes for the treatment of children with conduct problems in a number of countries over the past 10 years. Existing reviews of parent training have methodological limitations such as inclusion of non-randomised studies, the absence of investigation for heterogeneity prior to meta-analysis or failure to report confidence intervals. The objective of the current study was to systematically review randomised controlled trials of parenting programmes for the treatment of children with conduct problems. Methods Standard systematic review methods were followed including duplicate inclusion decisions, data extraction and quality assessment. Twenty electronic databases from the fields of medicine, psychology, social science and education were comprehensively searched for RCTs and systematic reviews to February 2006. Inclusion criteria were: randomised controlled trial; of structured, repeatable parenting programmes; for parents/carers of children up to the age of 18 with a conduct problem; and at least one measure of child behaviour. Meta-analysis and qualitative synthesis were used to summarise included studies. Results 57 RCTs were included. Studies were small with an average group size of 21. Meta-analyses using both parent (SMD -0.67; 95% CI: -0.91, -0.42 and independent (SMD -0.44; 95% CI: -0.66, -0.23 reports of outcome showed significant differences favouring the intervention group. There was insufficient evidence to determine the relative effectiveness of different approaches to delivering parenting programmes. Conclusion Parenting programmes are an effective treatment for children with conduct problems

Control strategies for peste des petits ruminants in small ruminants of India.

Science.gov (United States)

Singh, R P

2011-12-01

Peste des petits ruminants (PPR) is a contagious viral disease of small ruminants. It is endemic in several African, Middle Eastern and Asian countries, including India. India has recently taken comprehensive steps to deal with PPR through the development and production of potent vaccines and monoclonal-antibody-based diagnostic kits, while also gathering baseline information on the disease situation and human resources. As a result, PPR can now be controlled by focused vaccinations in high-risk populations of sheep and goats, followed by mass vaccination campaigns. Mass vaccination campaigns must achieve high levels of herd immunity (70% to 80%) to block the epidemic cycle of the virus. With the tools currently available, disease control and subsequent eradication programmes for PPR may be a feasible option, following the example of the National Rinderpest Eradication Programme, which has successfully eradicated rinderpest from India. An understanding of the cultural and socio-economic circumstances of goat and sheep owners and a keen watch on the endemic nature of PPR in neighbouring countries will enhance the success of this approach. Coordinated efforts from all stakeholders, combined with proper funding and execution of control programmes, will be needed to achieve the goal of a PPR-free India. In addition, the availability of effective combined vaccines of PPR with goat pox or sheep pox offers a cost-effective way of simultaneously launching control programmes against all three of these diseases.

Effectiveness of cognitive behavioural therapy in a community-based pulmonary rehabilitation programme: A controlled clinical trial.

Science.gov (United States)

Luk, Edwin K; Gorelik, Alexandra; Irving, Louis; Khan, Fary

2017-03-06

To investigate whether the use of cognitive behavioural therapy in pulmonary rehabilitation addresses the depression and anxiety burden and thereby improves rehabilitation outcomes. Prospective controlled clinical trial. A total of 70 patients with chronic obstructive pulmonary disease who were referred to a community centre for pulmonary rehabilitation. Patients were allocated to either the control group, consisting of pulmonary rehabilitation alone, or to the treatment group, receiving pulmonary rehabilitation and an additional 6 sessions of group-based cognitive behavioural therapy. Assessments consisting of questionnaires and walk tests were conducted pre- and post-pulmonary rehabilitation. A total of 28 patients were enrolled. The cognitive behavioural therapy group had significant improvements in exercise capacity following pulmonary rehabilitation (mean change 32.9 m, p = 0.043), which was maintained at 3 months post-pulmonary rehabilitation (mean change 23.4 m, p = 0.045). Patients in the cognitive behavioural therapy group showed significant short-term improvements in fatigue, stress and depression (mean change 2.4, p = 0.016, 3.9, p = 0.024 and 4.3, p = 0.047, respectively) and a 3-month post-pulmonary rehabilitation improvement in anxiety score (mean change 3.1, p = 0.01). No significant changes were seen in the control group. The addition of cognitive behavioural therapy improved patients' physical, psychological and quality of life results. Cognitive behavioural therapy should be considered for inclusion in a pulmonary rehabilitation programme to enhance outcomes.

Review of the first 50 cases completed by the RACR mammography QA programme; Phantom image quality, processor control and dose considerations

International Nuclear Information System (INIS)

McLean, D.; Chan, W.; Eckert, M.; Heard, R.

1997-01-01

The Mammography Quality Assurance Programme, recently established by the Royal Australasian College of Radiologists, has processed the first 50 applications. This programme, which closely follows the programme of the American College of Radiology (ACR), utilizes phantom film images, thermoluminescent dosimetry measurement of mean glandular dose, processor control charts, clinical images, equipment reports and required survey information to establish that a centre conforms to a minimum standard in mammography. The present paper describes the initial results of the first phantom images, dose measurements, processor control and survey information. Fifty films have been evaluated up to the present time with a failure rate of 26%. The major causes of failure were unacceptable film artefacts and poor contrast (as indicated by reduced fibre and mass visibility). A surprising result was the high failure in processing, where 23% of units reviewed had significant problems, including failure to keep the processor within required control limits. Only one centre recorded a mean glandular dose above 2 mGy with no centre over the 3 mGy limit. A review of the frequency of the quality control testing shows that the acceptance of quality assurance in mammography, while greater than in the initial stages of the ACR programme, is less than current US practice. These initial results for the accreditation process probably reflect an initial period of adjustment, as seen by the high pass rate achieved by centres that have re submitted material to gain accreditation. (authors)

Effect of a self-efficacy promotion training programme on the body weight changes in patients undergoing haemodialysis.

Science.gov (United States)

Aliasgharpour, Mansooreh; Shomali, Maryam; Moghaddam, Masoumeh Zakeri; Faghihzadeh, Sograt

2012-09-01

Haemodialysis is the most common form of medical management of patients affected by end-stage renal disease (ESRD). For haemodialysis to be successful, strict fluid and weight control is recommended. Education, in terms of self-care activities, is an important intervention for improving patients' outcomes. A self-efficacy promotion training programme can be an effective strategy to bring about behavioural change. The aim of this study was to investigate the effect of a self-efficacy promotion training programme on the body weight changes in patients undergoing haemodialysis. In this single-blind quasi-experimental study, we recruited a convenience sample of 63 patients undergoing haemodialy-sis from two teaching hospitals and allocated them randomly to the experimental or control group. Patients in the experimental group received a six-session self-efficacy promotion training programme while the control group received the routine care of the institute. Mean body weight gain and self-efficacy were measured before, immediately and two months after the study. The groups did not differ significantly regarding the study variable before the study. However, immediately and two months after the study, the mean body weight gain and self-efficacy in the experimental group were significantly lower and higher, respectively, than the control group (p training programme is effective in decreasing weight gain and increasing self-efficacy in patients undergoing haemodialysis. Nurses in haemodialysis units can use self-efficacy promotion training programmes as an effective intervention for improving patients' outcomes. © 2012 European Dialysis and Transplant Nurses Association/European Renal Care Association.

The analytical quality control programme of the IAEA

Energy Technology Data Exchange (ETDEWEB)

Suschny, O; Richman, D M [International Atomic Energy Agency, Division of Research and Laboratories, Seibersdorf (Austria)

1973-10-01

The International Atomic Energy Agency has distributed calibrated radioisotope solutions, standard reference materials and intercomparison materials in the nuclear and radioisotope materials and intercomparison materials in the nuclear and radioisotope fields since the early 1960's. The purpose of this activity was to help laboratories in the Member States to assess and, if necessary, to improve the reliability of their analytical work and to enable them, in this way, to render better service in a large number of areas ranging from nuclear technology to isotope applications in medicine and environmental sciences. The usefulness and the need for this service was demonstrated by the results of many intercomparisons which proved that without continued analytical quality control adequate reliability of analytical data could not be taken for granted. The scope and the size of the future programme of the Agency in this field has been delineated by recommendations made by several Panels of Experts. They have all agreed on the importance of it and made detailed recommendations in their areas of expertise.

The analytical quality control programme of the IAEA

International Nuclear Information System (INIS)

Suschny, O.; Richman, D.M.

1973-10-01

The International Atomic Energy Agency has distributed calibrated radioisotope solutions, standard reference materials and intercomparison materials in the nuclear and radioisotope materials and intercomparison materials in the nuclear and radioisotope fields since the early 1960's. The purpose of this activity was to help laboratories in the Member States to assess and, if necessary, to improve the reliability of their analytical work and to enable them, in this way, to render better service in a large number of areas ranging from nuclear technology to isotope applications in medicine and environmental sciences. The usefulness and the need for this service was demonstrated by the results of many intercomparisons which proved that without continued analytical quality control adequate reliability of analytical data could not be taken for granted. The scope and the size of the future programme of the Agency in this field has been delineated by recommendations made by several Panels of Experts. They have all agreed on the importance of it and made detailed recommendations in their areas of expertise

Madeira-Med, a sterile insect technique programme for control of the Mediterranean fruit fly in Madeira, Portugal

International Nuclear Information System (INIS)

Pereira, R.; Barbosa, A.; Silva, N.; Caldeira, J.; Dantas, L.; Pacheco, J.

2000-01-01

The islands of Madeira are located 980 km west-southwest from mainland Portugal and have a population of approximately 255,000. The islands are volcanic with very little level land suitable for large agricultural production. Approximately 47% of the land area is above 700 m. Thus the area likely to require Medfly control is about half of the islands. Agricultural production is on small scale, frequently part-time and mostly terraced because of the volcanic nature of the land. Grapes for wine and bananas are the predominant fruit crops. Neither are primary Medfly hosts. Citrus and tropical fruits are not produced in large quantities and are generally not of high quality. This is, to a large extent, because intensive Mediterranean fruit fly (Medfly), Ceratitis capitata (Wied.), attack has prevented the establishment of citrus and tropical fruit production. Medflies are present the year round on land below 300 m, resulting in the necessity of continuous control measures, usually insecticide bait sprays. Current annual losses from the Medflies in Madeira are estimated at US$3 million. In 1992, the agricultural officials of Madeira applied for an European Union (EU) grant to eliminate the Medfly from Madeira using the sterile insect technique (SIT). After extensive discussions, the project was changed from eradication to control and approved in late 1993 with EU support of about 8 million ECU over a 7-year period. Subsequently, the Madeira officials applied for, and received, a technical assistance project from the International Atomic Energy Agency (IAEA). The IAEA support is primarily for training and consultant services. Sterile female Medflies puncture fruits when they try to lay eggs. These punctures, called 'sterile stings', result in a reduced crop value. For this reason, the Madeira-Med programme will use only sterile male Medflies in its SIT programme. This not only eliminates the sterile sting problem but also increases the efficacy of the sterile males from

Rotavirus vaccination within the South African Expanded Programme on Immunisation.

Science.gov (United States)

Seheri, L Mapaseka; Page, Nicola A; Mawela, Mothahadini P B; Mphahlele, M Jeffrey; Steele, A Duncan

2012-09-07

Diarrhoeal diseases are ranked the third major cause of childhood mortality in South African children less than 5 years, where the majority of deaths are among black children. Acute severe dehydrating rotavirus diarrhoea remains an important contributor towards childhood mortality and morbidity and has been well documented in South Africa. As the preventive strategy to control rotavirus diarrhoea, South Africa became the first country in the WHO African Region to adopt the rotavirus vaccine in the national childhood immunisation programme in August 2009. The rotavirus vaccine in use, Rotarix, GSK Biologicals, is given at 6 and 14 weeks of age, along with other vaccines as part of Expanded Programme on Immunisation (EPI). Studies which facilitated the introduction of rotavirus vaccine in South Africa included the burden of rotavirus disease and strain surveillance, economic burden of rotavirus infection and clinical trials to assess the safety and efficacy of vaccine candidates. This paper reviews the epidemiology of rotavirus in South Africa, outlines some of the steps followed to introduce rotavirus vaccine in the EPI, and highlights the early positive impact of vaccination in reducing the rotavirus burden of disease based on the post-marketing surveillance studies at Dr George Mukhari hospital, a sentinel site at University of Limpopo teaching hospital in Pretoria, South Africa, which has conducted rotavirus surveillance for >20 years. Copyright © 2012 Elsevier Ltd. All rights reserved.

Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations

Directory of Open Access Journals (Sweden)

Julie Storr

2017-01-01

Full Text Available Abstract Health care-associated infections (HAI are a major public health problem with a significant impact on morbidity, mortality and quality of life. They represent also an important economic burden to health systems worldwide. However, a large proportion of HAI are preventable through effective infection prevention and control (IPC measures. Improvements in IPC at the national and facility level are critical for the successful containment of antimicrobial resistance and the prevention of HAI, including outbreaks of highly transmissible diseases through high quality care within the context of universal health coverage. Given the limited availability of IPC evidence-based guidance and standards, the World Health Organization (WHO decided to prioritize the development of global recommendations on the core components of effective IPC programmes both at the national and acute health care facility level, based on systematic literature reviews and expert consensus. The aim of the guideline development process was to identify the evidence and evaluate its quality, consider patient values and preferences, resource implications, and the feasibility and acceptability of the recommendations. As a result, 11 recommendations and three good practice statements are presented here, including a summary of the supporting evidence, and form the substance of a new WHO IPC guideline.

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

Effect of sex education programme on at-risk sexual behaviour of ...

African Journals Online (AJOL)

Effect of sex education programme on at-risk sexual behaviour of ... that place them at risk for Sexually Transmitted Diseases (STDs). ... The treatment group evaluated the intervention programme positively and their knowledge of sexual health ...

The IAEA's programme in analytical quality control

International Nuclear Information System (INIS)

Suschny, O.

1980-10-01

The purpose of the Analytical Quality Control Programme of the International Atomic Energy Agency is to help laboratories in the Agency's Member States to assess and, if necessary, to improve the reliability of their analytical work in areas related to nuclear technology and radioisotope utilisation. This is done by the organisation of analytical intercomparisons and by the provision of certified or uncertified reference materials. Recently intercomparisons have been organised of trace element analysis in a soil and a lake sediment sample which have led to the certification of two new reference materials, SOIL-5 and SL-1 (lake sediment). A technique has been developed to recognise and to remove outlying results. Criteria have been established to classify element-concentration values into the categories ''established with a high degree of confidence'', ''established with a reasonable degree of confidence'' and ''information value only''. Four radionuclide intercomparisons have recently been carried out: W-1/1 and W-2/1 of the determination of selected radionuclides in water and Air-1/1 and Air-2/1 of that of selected radionuclides on simulated air filters. Details of the preparation of materials for these intercomparisons, and of data treatment and some results are discussed in the paper

Cost distribution of bluetongue surveillance and vaccination programmes in Austria and Switzerland (2007–2016)

Science.gov (United States)

Pinior, Beate; Loitsch, Angelika; Stockreiter, Simon; Hutter, Sabine; Richter, Veronika; Lebl, Karin; Schwermer, Heinzpeter; Käsbohrer, Annemarie

2018-01-01

Bluetongue virus (BTV) is an emerging transboundary disease in Europe, which can cause significant production losses among ruminants. The analysis presented here assessed the costs of BTV surveillance and vaccination programmes in Austria and Switzerland between 2007 and 2016. Costs were compared with respect to time, type of programme, geographical area and who was responsible for payment. The total costs of the BTV vaccination and surveillance programmes in Austria amounted to €23.6 million, whereas total costs in Switzerland were €18.3 million. Our analysis demonstrates that the costs differed between years and geographical areas, both within and between the two countries. Average surveillance costs per animal amounted to approximately €3.20 in Austria compared with €1.30 in Switzerland, whereas the average vaccination costs per animal were €6.20 in Austria and €7.40 in Switzerland. The comparability of the surveillance costs is somewhat limited, however, due to differences in each nation’s surveillance (and sampling) strategy. Given the importance of the export market for cattle production, investments in such programmes are more justified for Austria than for Switzerland. The aim of the retrospective assessment presented here is to assist veterinary authorities in planning and implementing cost-effective and efficient control strategies for emerging livestock diseases. PMID:29363572

Saltwell Leak Detector Station Programmable Logic Controller (PLC) Software Configuration Management Plan (SCMP)

International Nuclear Information System (INIS)

WHITE, K.A.

2000-01-01

This document provides the procedures and guidelines necessary for computer software configuration management activities during the operation and maintenance phases of the Saltwell Leak Detector Stations as required by HNF-PRO-309/Rev.1, Computer Software Quality Assurance, Section 2.4, Software Configuration Management. The software configuration management plan (SCMP) integrates technical and administrative controls to establish and maintain technical consistency among requirements, physical configuration, and documentation for the Saltwell Leak Detector Station Programmable Logic Controller (PLC) software during the Hanford application, operations and maintenance. This SCMP establishes the Saltwell Leak Detector Station PLC Software Baseline, status changes to that baseline, and ensures that software meets design and operational requirements and is tested in accordance with their design basis

Private Practitioners' Perspectives on Their Involvement With the Tuberculosis Control Programme in a Southern Indian State.

Science.gov (United States)

Salve, Solomon; Sheikh, Kabir; Porter, John Dh

2016-05-08

Public and private health sectors both play a crucial role in the health systems of low- and middle-income countries (LMICs). The tuberculosis (TB) control strategy in India encourages the public sector to actively partner with private practitioners (PPs) to improve the quality of front line service delivery. However, ensuring effective and sustainable involvement of PPs constitutes a major challenge. This paper reports the findings from an empirical study focusing on the perspectives and experiences of PPs towards their involvement in TB control programme in India. The study was carried out between November 2010 and December 2011 in a district of a Southern Indian State and utilised qualitative methodologies, combining observations and in-depth interviews with 21 PPs from different medical systems. The collected data was coded and analysed using thematic analysis. PPs perceived themselves to be crucial healthcare providers, with different roles within the public-private mix (PPM) TB policy. Despite this, PPs felt neglected and undervalued in the actual process of implementation of the PPM-TB policy. The entire process was considered to be government driven and their professional skills and knowledge of different medical systems remained unrecognised at the policy level, and weakened their relationship and bond with the policy and with the programme. PPs had contrasting perceptions about the different components of the TB programme that demonstrated the public sector's dominance in the overall implementation of the DOTS strategy. Although PPs felt responsible for their TB patients, they found it difficult to perceive themselves as 'partners with the TB programme.' Public-private partnerships (PPPs) are increasingly utilized as a public health strategy to strengthen health systems. These policies will fail if the concerns of the PPs are neglected. To ensure their long-term involvement in the programme the abilities of PPs and the important perspectives from other

The national immunisation programme in the Netherlands: current status and potential future developments

NARCIS (Netherlands)

Abbink F; Al MJ; Berbers GAM; Binnendijk RS van; Boot HJ; Duynhoven YTHP van; Gageldonk-Lafeber AB van; Greeff SC de; Kimman TG; Meijer LA; Mooi FR; Oosten M van; Plas SM van der; Schouls LM; Soolingen D van; Vermeer-de Bondt PE; Vliet JA van; Melker HE de; Hahne SJM; Boer IM de; CIE

2005-01-01

The national immunisation programme in the Netherlands is very effective and safe. To improve the success and effectiveness of the immunisation programme, vaccination of other (age)groups is indicated. Extension of the programme with new target diseases can result in considerable health gain for

International programme on the health effects of the Chernobyl accidents (IPHECA). Protocol for the pilot project ''Thyroid''

International Nuclear Information System (INIS)

1994-01-01

The protocol document for the Thyroid Project of International Programme on the Health Effects of the Chernobyl Accidents (IPHECA) describes the main aims of the project, namely 1) to detect and describe selected diseases of the thyroid among children and adolescents in population centres assigned earlier as ''strictly controlled zones'' and, 2) to determine, if possible, the link between the prevalence of the diseases and radiation doses received by the thyroid. Population to be investigated, medical and laboratory examinations and advanced diagnostics for thyroid diseases to be undertaken are enlisted in the protocol

Farmer and Veterinarian Attitudes towards the Bovine Tuberculosis Eradication Programme in Spain: What Is Going on in the Field?

Science.gov (United States)

Ciaravino, Giovanna; Ibarra, Patricia; Casal, Ester; Lopez, Sergi; Espluga, Josep; Casal, Jordi; Napp, Sebastian; Allepuz, Alberto

2017-01-01

The effectiveness of health interventions against bovine tuberculosis (bTB) is influenced by several " non-biological " factors that may hamper bTB detection and control. Although the engagement of stakeholders is a key factor for the eradication programme's success, social factors have been often ignored in the control programmes of animal diseases, especially in developed countries. In this study, we used a qualitative approach to investigate perceptions, opinions, attitudes, and beliefs of farmers, and veterinarians who may influence the effectiveness of the Spanish bTB eradication programme. The study was carried out in two phases. First, 13 key representatives of different groups involved in the programme were interviewed through exploratory interviews to identify most relevant themes circulating in the population. Interviews focused on strong and weak points of the programme; reasons for failure to achieve eradication; benefits of being disease free; future perspectives, and proposed changes to the programme. Based on these results, a thematic guide was developed and detailed information was gained through face-to-face in-depth interviews conducted on a purposive sample of 39 farmers and veterinarians. Data were analysed following an ethnographic methodology. Main results suggested that the bTB programme is perceived as a law enforcement duty without an adequate motivation of some stakeholders and a general feeling of distrust arose. The complexity of bTB epidemiology combined with gaps in knowledge and weak communication throughout stakeholders contributed to causing disbeliefs, which in turn generated different kinds of guesses and interpretations. Low reliability in the routine skin test for bTB screening was expressed and the level of confidence on test results interpretation was linked with skills and experience of public and private veterinarians in the field. Lack of training for farmers and pressure faced by veterinarians during field activities also

Effectiveness of telerehabilitation programme following surgery in shoulder impingement syndrome (SIS): study protocol for a randomized controlled non-inferiority trial.

Science.gov (United States)

Pastora-Bernal, Jose-Manuel; Martín-Valero, Rocío; Barón-López, Francisco Javier; García-Gómez, Oscar

2017-02-23

Shoulder pain is common in society, with high prevalence in the general population. Shoulder impingement syndrome (SIS) is the most frequent cause. Patients suffer pain, muscle weakness and loss of movement in the affected joint. Initial treatment is predominantly conservative. The surgical option has high success rates and is often used when conservative strategy fails. Traditional physiotherapy and post-operative exercises are needed for the recovery of joint range, muscle strength, stability and functionality. Telerehabilitation programmes have shown positive results in some orthopaedic conditions after surgery. Customized telerehabilitation intervention programmes should be developed to recover shoulder function after SIS surgery. The objective of this study is to evaluate the feasibility and effectiveness of a telerehabilitation intervention compared with usual care in patients after subacromial decompression surgery. We will compare an intervention group receiving videoconferences and a telerehabilitation programme to a control group receiving traditional physiotherapy intervention in a single-blind, randomized controlled non-inferiority trial study design. Through this study, we will further develop our preliminary data set and practical experience with the telerehabilitation programmes to evaluate their effectiveness and compare this with traditional intervention. We will also explore patient satisfaction and cost-effectiveness. Patient enrolment is ongoing. ClinicalTrials.gov, NCT02909920 . 14 September 2016.

Commentary: restarting NTD programme activities after the Ebola outbreak in Liberia.

Science.gov (United States)

Thomas, Brent C; Kollie, Karsor; Koudou, Benjamin; Mackenzie, Charles

2017-05-01

It is widely known that the recent Ebola Virus Disease (EVD) in West Africa caused a serious disruption to the national health system, with many of ongoing disease focused programmes, such as mass drug administration (MDA) for onchocerciasis (ONC), lymphatic filariasis (LF) and schistosomiasis (SCH), being suspended or scaled-down. As these MDA programmes attempt to restart post-EVD it is important to understand the challenges that may be encountered. This commentary addresses the opinions of the major health sectors involved, as well as those of community members, regarding logistic needs and challenges faced as these important public health programmes consider restarting. There appears to be a strong desire by the communities to resume NTD programme activities, although it is clear that some important challenges remain, the most prominent being those resulting from the severe loss of trained staff.

A pilot effectiveness study of the Enhancing Parenting Skills (EPaS) 2014 programme for parents of children with behaviour problems: study protocol for a randomised controlled trial

OpenAIRE

Williams, Margiad Elen; Hutchings, Judy

2015-01-01

Background The Enhancing Parenting Skills (EPaS) 2014 programme is a home-based, health visitor-delivered parenting support programme for parents of children with identified behaviour problems. This trial aims to evaluate the effectiveness of the EPaS 2014 programme compared to a waiting-list treatment as usual control group. Methods/Design This is a pragmatic, multicentre randomised controlled trial. Sixty health visitors will each be asked to identify two families that have a child scoring ...

The association of retail promotions for cigarettes with the Master Settlement Agreement, tobacco control programmes and cigarette excise taxes.

Science.gov (United States)

Loomis, Brett R; Farrelly, Matthew C; Mann, Nathan H

2006-12-01

Retail stores are the primary medium for marketing cigarettes to smokers in the US. The prevalence and characteristics of cigarette retail advertising and promotions have been described by several investigators. Less is known about the proportion of cigarette sales occurring as part of a retail promotion and about the effects of tobacco control policies on cigarette promotions. To estimate the effect of the Master Settlement Agreement (MSA), state tobacco control programme funding and cigarette taxes on retail promotions for cigarettes in supermarkets in the US. Proportion of cigarette sales occurring under a retail promotion and the value of multipack promotions (eg, buy one pack, get one pack free) and cents-off promotions, measured using scanner data in supermarkets from 50 retail market areas from 1994 to 2004. Promoted cigarette sales have increased significantly since the MSA (pmarket areas with high tobacco control programme funding (pmarket areas with high cigarette tax (pmarket areas with strong tobacco control policies, compared with market areas with weaker tobacco control policies, may partially offset the decline in smoking achieved in those areas.

A research agenda for helminth diseases of humans: social ecology, environmental determinants, and health systems.

Directory of Open Access Journals (Sweden)

Andrea Gazzinelli

Full Text Available In this paper, the Disease Reference Group on Helminth Infections (DRG4, established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR, with the mandate to review helminthiases research and identify research priorities and gaps, focuses on the environmental, social, behavioural, and political determinants of human helminth infections and outlines a research and development agenda for the socioeconomic and health systems research required for the development of sustainable control programmes. Using Stockols' social-ecological approach, we describe the role of various social (poverty, policy, stigma, culture, and migration and environmental determinants (the home environment, water resources development, and climate change in the perpetuation of helminthic diseases, as well as their impact as contextual factors on health promotion interventions through both the regular and community-based health systems. We examine these interactions in regard to community participation, intersectoral collaboration, gender, and possibilities for upscaling helminthic disease control and elimination programmes within the context of integrated and interdisciplinary approaches. The research agenda summarises major gaps that need to be addressed.

National and regional asthma programmes in Europe.

Science.gov (United States)

Selroos, Olof; Kupczyk, Maciej; Kuna, Piotr; Łacwik, Piotr; Bousquet, Jean; Brennan, David; Palkonen, Susanna; Contreras, Javier; FitzGerald, Mark; Hedlin, Gunilla; Johnston, Sebastian L; Louis, Renaud; Metcalf, Leanne; Walker, Samantha; Moreno-Galdó, Antonio; Papadopoulos, Nikolaos G; Rosado-Pinto, José; Powell, Pippa; Haahtela, Tari

2015-09-01

This review presents seven national asthma programmes to support the European Asthma Research and Innovation Partnership in developing strategies to reduce asthma mortality and morbidity across Europe. From published data it appears that in order to influence asthma care, national/regional asthma programmes are more effective than conventional treatment guidelines. An asthma programme should start with the universal commitments of stakeholders at all levels and the programme has to be endorsed by political and governmental bodies. When the national problems have been identified, the goals of the programme have to be clearly defined with measures to evaluate progress. An action plan has to be developed, including defined re-allocation of patients and existing resources, if necessary, between primary care and specialised healthcare units or hospital centres. Patients should be involved in guided self-management education and structured follow-up in relation to disease severity. The three evaluated programmes show that, thanks to rigorous efforts, it is possible to improve patients' quality of life and reduce hospitalisation, asthma mortality, sick leave and disability pensions. The direct and indirect costs, both for the individual patient and for society, can be significantly reduced. The results can form the basis for development of further programme activities in Europe. Copyright ©ERS 2015.

National and regional asthma programmes in Europe

Directory of Open Access Journals (Sweden)

Olof Selroos

2015-09-01

Full Text Available This review presents seven national asthma programmes to support the European Asthma Research and Innovation Partnership in developing strategies to reduce asthma mortality and morbidity across Europe. From published data it appears that in order to influence asthma care, national/regional asthma programmes are more effective than conventional treatment guidelines. An asthma programme should start with the universal commitments of stakeholders at all levels and the programme has to be endorsed by political and governmental bodies. When the national problems have been identified, the goals of the programme have to be clearly defined with measures to evaluate progress. An action plan has to be developed, including defined re-allocation of patients and existing resources, if necessary, between primary care and specialised healthcare units or hospital centres. Patients should be involved in guided self-management education and structured follow-up in relation to disease severity. The three evaluated programmes show that, thanks to rigorous efforts, it is possible to improve patients' quality of life and reduce hospitalisation, asthma mortality, sick leave and disability pensions. The direct and indirect costs, both for the individual patient and for society, can be significantly reduced. The results can form the basis for development of further programme activities in Europe.

Cost distribution of bluetongue surveillance and vaccination programmes in Austria and Switzerland (2007-2016).

Science.gov (United States)

Pinior, Beate; Firth, Clair L; Loitsch, Angelika; Stockreiter, Simon; Hutter, Sabine; Richter, Veronika; Lebl, Karin; Schwermer, Heinzpeter; Käsbohrer, Annemarie

2018-03-03

Bluetongue virus (BTV) is an emerging transboundary disease in Europe, which can cause significant production losses among ruminants. The analysis presented here assessed the costs of BTV surveillance and vaccination programmes in Austria and Switzerland between 2007 and 2016. Costs were compared with respect to time, type of programme, geographical area and who was responsible for payment. The total costs of the BTV vaccination and surveillance programmes in Austria amounted to €23.6 million, whereas total costs in Switzerland were €18.3 million. Our analysis demonstrates that the costs differed between years and geographical areas, both within and between the two countries. Average surveillance costs per animal amounted to approximately €3.20 in Austria compared with €1.30 in Switzerland, whereas the average vaccination costs per animal were €6.20 in Austria and €7.40 in Switzerland. The comparability of the surveillance costs is somewhat limited, however, due to differences in each nation's surveillance (and sampling) strategy. Given the importance of the export market for cattle production, investments in such programmes are more justified for Austria than for Switzerland. The aim of the retrospective assessment presented here is to assist veterinary authorities in planning and implementing cost-effective and efficient control strategies for emerging livestock diseases. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The impact of a disease management program (COACH on the attainment of better cardiovascular risk control in dyslipidaemic patients at primary care centres (The DISSEMINATE Study: a randomised controlled trial

Directory of Open Access Journals (Sweden)

Selvaraj Francis Jude

2012-10-01

Full Text Available Abstract Background To evaluate the efficacy of Counselling and Advisory Care for Health (COACH programme in managing dyslipidaemia among primary care practices in Malaysia. This open-label, parallel, randomised controlled trial compared the COACH programme delivered by primary care physicians alone (PCP arm and primary care physicians assisted by nurse educators (PCP-NE arm. Methods This was a multi-centre, open label, randomised trial of a disease management programme (COACH among dyslipidaemic patients in 21 Malaysia primary care practices. The participating centres enrolled 297 treatment naïve subjects who had the primary diagnosis of dyslipidaemia; 149 were randomised to the COACH programme delivered by primary care physicians assisted by nurse educators (PCP-NE and 148 to care provided by primary care physicians (PCP alone. The primary efficacy endpoint was the mean percentage change from baseline LDL-C at week 24 between the 2 study arms. Secondary endpoints included mean percentage change from baseline of lipid profile (TC, LDL-C, HDL-C, TG, TC: HDL ratio, Framingham Cardiovascular Health Risk Score and absolute risk change from baseline in blood pressure parameters at week 24. The study also assessed the sustainability of programme efficacy at week 36. Results Both study arms demonstrated improvement in LDL-C from baseline. The least squares (LS mean change from baseline LDL-C were −30.09% and −27.54% for PCP-NE and PCP respectively. The difference in mean change between groups was 2.55% (p=0.288, with a greater change seen in the PCP-NE arm. Similar observations were made between the study groups in relation to total cholesterol change at week 24. Significant difference in percentage change from baseline of HDL-C were observed between the PCP-NE and PCP groups, 3.01%, 95% CI 0.12-5.90, p=0.041, at week 24. There was no significant difference in lipid outcomes between 2 study groups at week 36 (12 weeks after the programme had

Programmable Digital Controller

Science.gov (United States)

Wassick, Gregory J.

2012-01-01

An existing three-channel analog servo loop controller has been redesigned for piezoelectric-transducer-based (PZT-based) etalon control applications to a digital servo loop controller. This change offers several improvements over the previous analog controller, including software control over proportional-integral-derivative (PID) parameters, inclusion of other data of interest such as temperature and pressure in the control laws, improved ability to compensate for PZT hysteresis and mechanical mount fluctuations, ability to provide pre-programmed scanning and stepping routines, improved user interface, expanded data acquisition, and reduced size, weight, and power.

Efficacy of the FIFA 11+ Warm-Up Programme in Male Youth Football: A Cluster Randomised Controlled Trial

Science.gov (United States)

Owoeye, Oluwatoyosi B. A.; Akinbo, Sunday R. A.; Tella, Bosede A.; Olawale, Olajide A.

2014-01-01

The FIFA 11+ is a structured warm-up programme specially designed to prevent injuries among football players from age 14 years and above. However, studies to prove its efficacy are generally few and it is yet to be tested in male youth footballers and among African players. The purpose of the study was to examine the efficacy of the FIFA 11+ programme in reducing the risk of injuries among male youth football players of the Lagos Junior League. A cluster randomised controlled trial was conducted. All the 20 teams (414 players aged 14 -19 years) in the Premier League division were block-randomised into either an intervention (INT) or a control (CON) group. The INT group performed the FIFA 11+ exercises as warm-up during training sessions and the CON group performed usual warm-up. Participating teams were prospectively followed through an entire league season of 6 months in which they were visited every week to assess injured players for time-loss injuries in both groups. The primary outcomes were any injury to the players, injuries by type of exposure and injuries specific to the lower extremities. The secondary outcomes were injuries reported by body location, aetiology, mechanism and severity. In total, 130 injuries were recorded affecting 104 (25%) of the 416 players. Team and player compliance with the INT was 60% and 74% respectively. Based on the primary outcome measures of the study, the FIFA 11+ programme significantly reduced the overall rate of injury in the INT group by 41% [RR = 0.59 (95% CI: 0.40 – 0.86; p = 0.006)] and all lower extremity injuries by 48% [RR = 0.52 (95% CI: 0.34 – 0.82; p = 0.004)]. However, the rate of injury reduction based on secondary outcomes mostly did not reach the level of statistical significance. The FIFA 11+ programme is effective in reducing the rates of injuries in male youth football players. Key points The FIFA 11+ has only been tested in randomised controlled trials conducted on female youth football players; this

Monitoring of tsetse and trypanosomosis control programmes in south easter Uganda

International Nuclear Information System (INIS)

Okuna, N.M.; Magona, J.

1997-01-01

A total of 3035 cattle, 2733 from a tsetse infested area and 302 from a tsetse free area, were screened for trypanosomosis by the buffy coat technique (BCT). In addition, sample from the tsetse free area were analysed for the presence of trypasonome antigens by antigen ELISA (Ag-ELISA). Using the BCT, trypanosome were detected in 64 cattle from the tsetse infested are and none were detected in the animals from the tsetse free area. However, using the Ag-ELISA, 17(5.6%) of the cattle from the tsetse free area were found positive for T. brucei, one (0.3%) for T. vivax and none for T. congolense. The results indicate that the tsetse and animal trypanosomosis situation has improved markedly since the control programme started in 1990. However both tsetse and animal trypanosomosis still occur particularly in the souther zones of the control area. (author). 5 refs, 1 fig., 4 tabs

Monitoring of tsetse and trypanosomosis control programmes in south easter Uganda

Energy Technology Data Exchange (ETDEWEB)

Okuna, N M; Magona, J [Livestock Health Research Inst. (LIRI), Tororo (Uganda)

1997-02-01

A total of 3035 cattle, 2733 from a tsetse infested area and 302 from a tsetse free area, were screened for trypanosomosis by the buffy coat technique (BCT). In addition, sample from the tsetse free area were analysed for the presence of trypasonome antigens by antigen ELISA (Ag-ELISA). Using the BCT, trypanosome were detected in 64 cattle from the tsetse infested are and none were detected in the animals from the tsetse free area. However, using the Ag-ELISA, 17(5.6%) of the cattle from the tsetse free area were found positive for T. brucei, one (0.3%) for T. vivax and none for T. congolense. The results indicate that the tsetse and animal trypanosomosis situation has improved markedly since the control programme started in 1990. However both tsetse and animal trypanosomosis still occur particularly in the souther zones of the control area. (author). 5 refs, 1 fig., 4 tabs.

Factors influencing the quality of patient data captured by nurses for the tuberculosis control programme in Oshakati District, Namibia

Directory of Open Access Journals (Sweden)

Linda V. Kagasi

2013-07-01

Full Text Available Effective tuberculosis control relies heavily upon the general health system of the country, particularly on well-functioning primary healthcare services. This study investigated factors influencing the quality of data for the tuberculosis control programme in Oshakati district in Namibia. A quantitative, contextual, cross-sectional descriptive survey was conducted using 50 nursing personnel of different cadres who were sampled from five departments in Oshakati State Hospital. Data was collected by means of a self-administered questionnaire. Most participants reported that tuberculosis-related training improved correct recording and reporting amongst nursing personnel, which is a requirement for a quality tuberculosis control programme. The number of documents to be completed for each patient influences the quality of data recording and completeness. Factors such as the lack of resources and of adequate training as well as knowledge of tuberculosis control guidelines, in particular the use of records to capture the core tuberculosis indicators, influence the quality of data in the tuberculosis control programme. Knowledge, attitudes and practice are the main factors influencing the quality of data in the tuberculosis control programme in Oshakati district. Die effektiewe beheer van tuberkulose steun grootliks op die algemene gesondheidstelsel van ’n land, veral op die goeie werkende primêre gesondheidsorgdienste. Die studie het faktore wat die gehalte van data vir die teringbeheerprogram in die Oshakati Distrik in Namibië ondersoek.’n Kwantitatiewe, kontekstuele, kruisseksionele, beskrywende opname was onderneem met ’n steekproef van 50 verpleegpersoneel van verskillende kadres uit vyf departemente in Oshakati Staatshospitaal. Data was deur middel van ’n selftoegediende vraelys ingewin. Die meeste deelnemers het genoem dat teringverwante opleiding die korrekte afneem en rapportering onder verpleegpersoneel verbeter het, wat �

A randomized-controlled trial focusing on socio-economic status for promoting vegetable intake among adults using a web-based nutrition intervention programme: study protocol

Directory of Open Access Journals (Sweden)

Saki Nakamura

2017-01-01

Full Text Available Abstract Background Web-based nutritional education programmes appear to be comparable to those delivered face-to-face. However, no existing web-based nutrition education or similar programme has yet been evaluated with consideration of socio-economic status. The objective of a nutritional education programme of promoting vegetable intake designed a randomized controlled trial (RCT is to evaluate the results of intervention and to determine how socio-economic status influences the programme effects. Methods/Design Participants will be randomly sampled individuals (aged 30–59 stratified according national population statistics for sex, age, and household income. Participants were consented to survey participation (n = 1500, and will be randomly divided into intervention and control groups. The intervention period is 5 weeks with one step of diet-related education per week. The main outcome of the programme is dietary behaviour as eating vegetable (350 g per day, five small bowl. To encourage behavioural changes, the programme contents are prepared using behavioural theories and techniques tailored to the assumed group stages of behavioural change. In the first step, we employ the health belief model to encourage a shift from the pre-contemplative to the contemplative phase; in the second and third steps, social cognitive theory is used to encourage transition to the preparatory phase; in the fourth step, social cognitive theory and strengthening social support are used to promote progression to the execution phase; finally, in the fifth step, strengthening social capital and social support are used to promote the shift to the maintenance phase. The baseline, post intervention and follow-up survey was assessed using a self-administered questionnaire. For process evaluation, we use five items relating to programme participation and satisfaction. A follow-up survey of participants will be carried out 3 months after intervention completion

Development and evaluation of two root caries controlling programmes for home-based frail people older than 75 years

DEFF Research Database (Denmark)

Ekstrand, Kim; Martignon, Stefania; Holm-Pedersen, Poul

2008-01-01

(i) Initially, to devise and examine the validity of a system for determining lesion activity on root surfaces, and (ii) compare the effectiveness of two preventive programmes in controlling root caries in elderly people using the devised system....

The women's heart health programme: a pilot trial of sex-specific cardiovascular management.

Science.gov (United States)

Low, Ting Ting; Chan, Siew Pang; Wai, Shin Hnin; Ang, Zhou; Kyu, Kyu; Lee, Kim Yee; Ching, Anne; Comer, Sarah; Tan, Naomi Qiu Pin; Thong, Elizabeth Grace Hui En; Nang, Tracy; Dutta, Mohan; Lam, Carolyn S P

2018-04-16

There is increasing knowledge of sex-specific differences in cardiovascular disease and recognition of sex disparities in management. In our study, we investigated whether a cardiovascular programme tailored to the specific needs of women could lead to improved outcomes. We randomised 100 female patients to receive cardiology follow-up with the conventional sex-neutral cardiac programme (control), or the sex-tailored Women's Heart Health Programme (intervention). The intervention group was managed by an all-women multidisciplinary team and received culture-centred health intervention workshops, designed through in-depth interviews with the participants. The primary outcome was cardiovascular risk factor improvement at 1 year. Secondary outcomes include cardiovascular event rates, quality of life scores, and self-reported improvement in knowledge, attitudes, intentions and practices. Generalised structural equation model analysis was used to determine if the intervention group had better outcomes at alpha level 0.1. The mean age was 67.3 ± 12.7 years, with an ethnic distribution of 70% Chinese, 18% Malays, and 12% Indians. The majority of these patients had no formal or primary level of education (63%), and were mostly unemployed (78%). Patients in intervention group had better control of diabetes mellitus (lower HbA1c of 0.63% [CI 0.21-1.04], p = 0.015) and lower body-mass-index (0.74 kg/m 2 [CI 0.02-1.46], p = 0.092) at 1 year, but there was no significant difference in blood pressure or lipid control. Overall, there was a trend towards better risk factor control, 31.6% of intervention group versus 26.5% of control group achieved improvement in at least 1 CV risk factor control to target range. There was no significant difference in incidence of cardiovascular events, quality of life, or domains in knowledge, attitudes, intention and practices. This pilot study is the first of its kind evaluating a new model of care for women with heart disease

Socio-Economic-Political-Cultural Aspects in Malaria Control Programme Implementation in Southern India

Directory of Open Access Journals (Sweden)

S. K. Ghosh

2012-01-01

Full Text Available Objective. A Socio-economic-political-cultural (SEPC study was undertaken under the Roll Back Malaria (RBM initiative to understand the process of programme implementation and how far in the changing malaria context, the broader environment has been understood and programme components have undergone changes. Material and Methods. Two studies were carried out; first in four villages under the primary health unit (PHU Banavaralu in Tiptur Taluka in September 2002 and the second one in April 2003 in four villages in Chitradurga district, namely, Kappagere, Kellodu in Hosadurga Taluka, and Vani Vilas Puram and Kathrikenhally in Hiriyur Taluka. Focus group discussion and key interviews were adopted to collect the qualitative data. Results. Gender discrimination and lack of empowerment of women came out strongly in social analysis. In the rural elected bodies called Panchayats, the concept of health committees was not known. Health committees as one of the important statutory committees under every Panchayat were nonexistent in reality in these villages. Financial difficulties at Grama Panchayat level and also meager budget allocation for health have led to indifferent attitude of Panchayat members towards health. It was observed that there were generally no specific cultural practices in relation to malaria cure. Cultural and traditional practices in malaria-related issues were not predominant in the community except for some sporadic instances. Conclusion and Recommendation. SEPC study is an important indicator in malaria control programme. It is ultimately the community that takes the major decision directly or indirectly and the health authority must guide them in right direction.

Socio-economic-political-cultural aspects in malaria control programme implementation in southern India.

Science.gov (United States)

Ghosh, S K; Patil, Rajan R; Tiwari, S N

2012-01-01

Objective. A Socio-economic-political-cultural (SEPC) study was undertaken under the Roll Back Malaria (RBM) initiative to understand the process of programme implementation and how far in the changing malaria context, the broader environment has been understood and programme components have undergone changes. Material and Methods. Two studies were carried out; first in four villages under the primary health unit (PHU) Banavaralu in Tiptur Taluka in September 2002 and the second one in April 2003 in four villages in Chitradurga district, namely, Kappagere, Kellodu in Hosadurga Taluka, and Vani Vilas Puram and Kathrikenhally in Hiriyur Taluka. Focus group discussion and key interviews were adopted to collect the qualitative data. Results. Gender discrimination and lack of empowerment of women came out strongly in social analysis. In the rural elected bodies called Panchayats, the concept of health committees was not known. Health committees as one of the important statutory committees under every Panchayat were nonexistent in reality in these villages. Financial difficulties at Grama Panchayat level and also meager budget allocation for health have led to indifferent attitude of Panchayat members towards health. It was observed that there were generally no specific cultural practices in relation to malaria cure. Cultural and traditional practices in malaria-related issues were not predominant in the community except for some sporadic instances. Conclusion and Recommendation. SEPC study is an important indicator in malaria control programme. It is ultimately the community that takes the major decision directly or indirectly and the health authority must guide them in right direction.

Evaluation of a group based cognitive behavioural therapy programme for menstrual pain management in young women with intellectual disabilities: protocol for a mixed methods controlled clinical trial

Science.gov (United States)

2014-01-01

Background Menstrual pain which is severe enough to impact on daily activities is very common amongst menstruating females. Research suggests that menstrual pain which impacts on daily functioning may be even more prevalent amongst those with intellectual disabilities. Despite this, little research attention has focused on pain management programmes for those with intellectual disabilities. The aims of this pilot study were to develop and evaluate a theory-based cognitive behavioural therapy (CBT) programme for menstrual pain management in young women with intellectual disabilities. Methods/Design The study utilised a mixed methods controlled clinical trial to evaluate elements from a CBT programme called Feeling Better (McGuire & McManus, 2010). The Feeling Better programme is a modular, manualised intervention designed for people with an intellectual disability and their carers. The programme was delivered to 36 young women aged 12 – 30 years who have a Mild - Moderate Intellectual Disability, split between two conditions. The treatment group received the Feeling Better intervention and the control group received treatment as usual. To evaluate the effectiveness of the programme, measures were taken of key pain variables including impact, knowledge, self-efficacy and coping. Process evaluation was conducted to examine which elements of the programme were most successful in promoting change. Discussion Participants in the intervention group were expected to report the use of a greater number of coping strategies and have greater knowledge of pain management strategies following participation in the intervention and at three month follow-up, when compared to control group participants. A significant advantage of the study was the use of mixed methods and inclusion of process evaluation to determine which elements of a cognitive behavioural therapy programme work best for individuals with intellectual disabilities. Trial registration Current Controlled Trials

Randomised controlled trial: Effects of aerobic exercise training programme on indices of adiposity and metabolic markers in hypertension

International Nuclear Information System (INIS)

Lamina, S.; Okoye, C.G.

2013-01-01

Objective: To investigate the effects of interval training programme on blood pressure, maximal oxygen consumption, indices of adiposity and metabolic markers in black African men with essential hypertension. Methods: The study was conducted at Murtala Muhammed Specialist Hospital, Kano, Nigeria, from October 24, 2007 to February 24, 2009. It comprised 245 male patients with mild to moderate (systolic blood pressure 140-179 and diastolic blood pressure 90-109 mmHg) essential hypertension who were age-matched and grouped into experimental and control groups. The experimental group was involved in an 8-week training programme of between 45 and 60 minutes, while the controls remained sedentary during the period. Cardiovascular parameters, maximal oxygen consumption, per cent body fat, waist-to-hip ratio, body mass index, fasting blood sugar, total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein and artherogenic index were assessed. Analysis of co-variance and Pearson correlation tests were used in data analysis which was done using SPSS 16. Results: The study had 140 (57.1%) cases with a mean age of 58.90+-7.35 years, and 105 (42.9%) controls with a mean age of 58.27+-6.24 years. It revealed significant increased effect of interval training programme on maximal oxygen consumption and high-density lipoprotein. There was significant reduction in on all the other controls. Changes in maximal oxygen consumption as a result of interval training significantly and negatively correlated with the other variables except high-density lipoprotein. Conclusions: The therapeutic role of interval exercise training on blood pressure reduction may be mediated through elevation of high-density lipoprotein, reduction of other markers of metabolism, and reduction in bodyweight and fatness. (author)

PATHway: Decision Support in Exercise Programmes for Cardiac Rehabilitation.

Science.gov (United States)

Filos, Dimitris; Triantafyllidis, Andreas; Chouvarda, Ioanna; Buys, Roselien; Cornelissen, Véronique; Budts, Werner; Walsh, Deirdre; Woods, Catherine; Moran, Kieran; Maglaveras, Nicos

2016-01-01

Rehabilitation is important for patients with cardiovascular diseases (CVD) to improve health outcomes and quality of life. However, adherence to current exercise programmes in cardiac rehabilitation is limited. We present the design and development of a Decision Support System (DSS) for telerehabilitation, aiming to enhance exercise programmes for CVD patients through ensuring their safety, personalising the programme according to their needs and performance, and motivating them toward meeting their physical activity goals. The DSS processes data originated from a Microsoft Kinect camera, a blood pressure monitor, a heart rate sensor and questionnaires, in order to generate a highly individualised exercise programme and improve patient adherence. Initial results within the EU-funded PATHway project show the potential of our approach.

Evaluation of an occupational health intervention programme on whole-body vibration in forklift truck drivers: a controlled trial

NARCIS (Netherlands)

Hulshof, C. T. J.; Verbeek, J. H. A. M.; Braam, I. T. J.; Bovenzi, M.; van Dijk, F. J. H.

2006-01-01

OBJECTIVES: To evaluate process and outcome of a multifaceted occupational health intervention programme on whole-body vibration (WBV) in forklift truck drivers. METHODS: An experimental pretest/post-test control group study design. The authors trained occupational health services (OHS) in the

Behavioural intervention to increase physical activity among patients with coronary heart disease: protocol for a randomised controlled trial.

Science.gov (United States)

Alsaleh, Eman; Blake, Holly; Windle, Richard

2012-12-01

Although physical activity has significant health benefits in the treatment of patients with coronary heart disease, patients often do not follow prescribed physical activity recommendations. Behavioural strategies have been shown to be efficacious in increasing physical activity among those patients with coronary heart disease who are attending structured cardiac rehabilitation programmes. Research has also shown that tailoring consultation according to patients' needs and sending motivational reminders are successful ways of motivating patients to be physically active. However, there is a lack of evidence for the efficacy of behavioural interventions based on individualised consultation in promoting physical activity among those patients with coronary heart disease who are not attending structured physical activity programmes. This paper outlines the study protocol for a trial which is currently underway, to examine the effect of a behavioural change intervention delivered through individualised consultation calls and motivational reminder text messages on the level of physical activity among patients with coronary heart disease. Two large hospitals in Jordan. Eligible patients aged between 18 and 70 years, who are clinically stable, are able to perform physical activity and who have access to a mobile telephone have been randomly allocated to control or intervention group. Two-group randomised controlled trial. Behavioural intervention will be compared with usual care in increasing physical activity levels among patients with coronary heart disease. The control group (n=85) will receive advice from their doctors about physical activity as they would in usual practice. The intervention group (n=71) will receive the same advice, but will also receive behavioural change intervention (goal-setting, feed-back, self-monitoring) that will be delivered over a period of six months. Intervention will be delivered through individually tailored face-to-face and telephone