WorldWideScience

Sample records for integrated structural health

  1. Integrating structural health and condition monitoring

    DEFF Research Database (Denmark)

    May, Allan; Thöns, Sebastian; McMillan, David

    2015-01-01

    window’ allowing for the possible detection of faults up to 6 months in advance. The SHM system model uses a reduction in the probability of failure factor to account for lower modelling uncertainties. A case study is produced that shows a reduction in operating costs and also a reduction in risk......There is a large financial incentive to minimise operations and maintenance (O&M) costs for offshore wind power by optimising the maintenance plan. The integration of condition monitoring (CM) and structural health monitoring (SHM) may help realise this. There is limited work on the integration...

  2. Integrated Structural Health Management, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Cornerstone Research Group Inc. (CRG) proposes to advance the state of the art in composite health management through refinement of an existing technology developed...

  3. Integrating Structural Health Management with Contingency Control for Wind Turbines

    Directory of Open Access Journals (Sweden)

    Kai Goebel

    2013-01-01

    Full Text Available Maximizing turbine up-time and reducing maintenance costs are key technology drivers for wind turbine operators. Components within wind turbines are subject to considerable stresses due to unpredictable environmental conditions resulting from rapidly changing local dynamics. In that context, systems health management has the aim to assess the state-of-health of components within a wind turbine, to estimate remaining life, and to aid in autonomous decision-making to minimize damage to the turbine. Advanced contingency control is one way to enable autonomous decision-making by providing the mechanism to enable safe and efficient turbine operation. The work reported herein explores the integration of condition monitoring of wind turbine blades with contingency control to balance the trade-offs between maintaining system health and energy capture. Results are demonstrated using a high fidelity simulator of a utility-scale wind turbine.

  4. The Structure and Effectiveness of Health Systems: Exploring the Impact of System Integration in Rural China

    OpenAIRE

    Wang, Xin; Birch, Stephen; Ma, Huifen; Zhu, Weiming; Meng, Qingyue

    2016-01-01

    Introduction: Facing the challenges of aging populations, increasing chronic diseases prevalence and health system fragmentation, there have been several pilots of integrated health systems in China. But little is known about their structure, mechanism and effectiveness. The aim of this paper is to analyze health system integration and develop recommendations for achieving integration. Method: Huangzhong and Hualong counties in Qinghai province were studied as study sites, with only Huangzhon...

  5. The Structure and Effectiveness of Health Systems: Exploring the Impact of System Integration in Rural China

    Directory of Open Access Journals (Sweden)

    Xin Wang

    2016-08-01

    Full Text Available Introduction: Facing the challenges of aging populations, increasing chronic diseases prevalence and health system fragmentation, there have been several pilots of integrated health systems in China. But little is known about their structure, mechanism and effectiveness. The aim of this paper is to analyze health system integration and develop recommendations for achieving integration. Method: Huangzhong and Hualong counties in Qinghai province were studied as study sites, with only Huangzhong having implemented health system integration. Questionnaires, interviews, and health ­insurance records were sources of data. Social network analysis was employed to analyze integration, through structure measurement and effectiveness evaluation. Results: Health system integration in Huangzhong is higher than in Hualong, so is system ­effectiveness. The patient referral network in Hualong has more “leapfrog” referrals. The information sharing ­networks in both counties are larger than the other types of networks. The average distance in the joint ­training network of Huangzhong is less than in Hualong. Meanwhile, there are deficiencies common to both systems. Conclusion: Both county health systems have strengths and limitations regarding system integration. The use of medical consortia in Huangzhong has contributed to system effectiveness. Future research might consider alternative more context specific models of health system integration.

  6. The Structure and Effectiveness of Health Systems: Exploring the Impact of System Integration in Rural China.

    Science.gov (United States)

    Wang, Xin; Birch, Stephen; Ma, Huifen; Zhu, Weiming; Meng, Qingyue

    2016-08-12

    Facing the challenges of aging populations, increasing chronic diseases prevalence and health system fragmentation, there have been several pilots of integrated health systems in China. But little is known about their structure, mechanism and effectiveness. The aim of this paper is to analyze health system integration and develop recommendations for achieving integration. Huangzhong and Hualong counties in Qinghai province were studied as study sites, with only Huangzhong having implemented health system integration. Questionnaires, interviews, and health insurance records were sources of data. Social network analysis was employed to analyze integration, through structure measurement and effectiveness evaluation. Health system integration in Huangzhong is higher than in Hualong, so is system effectiveness. The patient referral network in Hualong has more "leapfrog" referrals. The information sharing networks in both counties are larger than the other types of networks. The average distance in the joint training network of Huangzhong is less than in Hualong. Meanwhile, there are deficiencies common to both systems. Both county health systems have strengths and limitations regarding system integration. The use of medical consortia in Huangzhong has contributed to system effectiveness. Future research might consider alternative more context specific models of health system integration.

  7. Integrated Structural Health Sensors for Inflatable Space Habitats, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Luna proposes to continue development of integrated high-definition fiber optic sensors (HD-FOS) and carbon nanotube (CNT)-graphene piezoresistive sensors for...

  8. Integration of structural health monitoring and asset management.

    Science.gov (United States)

    2012-08-01

    This project investigated the feasibility and potential benefits of the integration of infrastructure monitoring systems into enterprise-scale transportation management systems. An infrastructure monitoring system designed for bridges was implemented...

  9. Role of innovative institutional structures in integrated governance. A case study of integrating health and nutrition programs in Chhattisgarh, India.

    Science.gov (United States)

    Kalita, Anuska; Mondal, Shinjini

    2012-01-01

    The aim of this paper is to highlight the significance of integrated governance in bringing about community participation, improved service delivery, accountability of public systems and human resource rationalisation. It discusses the strategies of innovative institutional structures in translating such integration in the areas of public health and nutrition for poor communities. The paper draws on experience of initiating integrated governance through innovations in health and nutrition programming in the resource-poor state of Chhattisgarh, India, at different levels of governance structures--hamlets, villages, clusters, blocks, districts and at the state. The study uses mixed methods--i.e. document analysis, interviews, discussions and quantitative data from facilities surveys--to present a case study analyzing the process and outcome of integration. The data indicate that integrated governance initiatives improved convergence between health and nutrition departments of the state at all levels. Also, innovative structures are important to implement the idea of integration, especially in contexts that do not have historical experience of such partnerships. Integration also contributed towards improved participation of communities in self-governance, community monitoring of government programs, and therefore, better services. As governments across the world, especially in developing countries, struggle towards achieving better governance, integration can serve as a desirable process to address this. Integration can affect the decentralisation of power, inclusion, efficiency, accountability and improved service quality in government programs. The institutional structures detailed in this paper can provide models for replication in other similar contexts for translating and sustaining the idea of integrated governance. This paper is one of the few to investigate innovative public institutions of a and community mobilisation to explore this important, and under

  10. Integration of computer imaging and sensor data for structural health monitoring of bridges

    International Nuclear Information System (INIS)

    Zaurin, R; Catbas, F N

    2010-01-01

    The condition of civil infrastructure systems (CIS) changes over their life cycle for different reasons such as damage, overloading, severe environmental inputs, and ageing due normal continued use. The structural performance often decreases as a result of the change in condition. Objective condition assessment and performance evaluation are challenging activities since they require some type of monitoring to track the response over a period of time. In this paper, integrated use of video images and sensor data in the context of structural health monitoring is demonstrated as promising technologies for the safety of civil structures in general and bridges in particular. First, the challenges and possible solutions to using video images and computer vision techniques for structural health monitoring are presented. Then, the synchronized image and sensing data are analyzed to obtain unit influence line (UIL) as an index for monitoring bridge behavior under identified loading conditions. Subsequently, the UCF 4-span bridge model is used to demonstrate the integration and implementation of imaging devices and traditional sensing technology with UIL for evaluating and tracking the bridge behavior. It is shown that video images and computer vision techniques can be used to detect, classify and track different vehicles with synchronized sensor measurements to establish an input–output relationship to determine the normalized response of the bridge

  11. Integrated system of structural health monitoring and intelligent management for a cable-stayed bridge.

    Science.gov (United States)

    Chen, Bin; Wang, Xu; Sun, Dezhang; Xie, Xu

    2014-01-01

    It is essential to construct structural health monitoring systems for large important bridges. Zhijiang Bridge is a cable-stayed bridge that was built recently over the Hangzhou Qiantang River (the largest river in Zhejiang Province). The length of Zhijiang Bridge is 478 m, which comprises an arched twin-tower space and a twin-cable plane structure. As an example, the present study describes the integrated system of structural health monitoring and intelligent management for Zhijiang Bridge, which comprises an information acquisition system, data management system, evaluation and decision-making system, and application service system. The monitoring components include the working environment of the bridge and various factors that affect bridge safety, such as the stress and strain of the main bridge structure, vibration, cable force, temperature, and wind speed. In addition, the integrated system includes a forecasting and decision-making module for real-time online evaluation, which provides warnings and makes decisions based on the monitoring information. From this, the monitoring information, evaluation results, maintenance decisions, and warning information can be input simultaneously into the bridge monitoring center and traffic emergency center to share the monitoring data, thereby facilitating evaluations and decision making using the system.

  12. Integrated System of Structural Health Monitoring and Intelligent Management for a Cable-Stayed Bridge

    Directory of Open Access Journals (Sweden)

    Bin Chen

    2014-01-01

    Full Text Available It is essential to construct structural health monitoring systems for large important bridges. Zhijiang Bridge is a cable-stayed bridge that was built recently over the Hangzhou Qiantang River (the largest river in Zhejiang Province. The length of Zhijiang Bridge is 478 m, which comprises an arched twin-tower space and a twin-cable plane structure. As an example, the present study describes the integrated system of structural health monitoring and intelligent management for Zhijiang Bridge, which comprises an information acquisition system, data management system, evaluation and decision-making system, and application service system. The monitoring components include the working environment of the bridge and various factors that affect bridge safety, such as the stress and strain of the main bridge structure, vibration, cable force, temperature, and wind speed. In addition, the integrated system includes a forecasting and decision-making module for real-time online evaluation, which provides warnings and makes decisions based on the monitoring information. From this, the monitoring information, evaluation results, maintenance decisions, and warning information can be input simultaneously into the bridge monitoring center and traffic emergency center to share the monitoring data, thereby facilitating evaluations and decision making using the system.

  13. Integration of High-Resolution Laser Displacement Sensors and 3D Printing for Structural Health Monitoring

    Directory of Open Access Journals (Sweden)

    Shu-Wei Chang

    2017-12-01

    Full Text Available This paper presents a novel experimental design for complex structural health monitoring (SHM studies achieved by integrating 3D printing technologies, high-resolution laser displacement sensors, and multiscale entropy SHM theory. A seven-story structure with a variety of composite bracing systems was constructed using a dual-material 3D printer. A wireless Bluetooth vibration speaker was used to excite the ground floor of the structure, and high-resolution laser displacement sensors (1-μm resolution were used to monitor the displacement history on different floors. Our results showed that the multiscale entropy SHM method could detect damage on the 3D-printed structures. The results of this study demonstrate that integrating 3D printing technologies and high-resolution laser displacement sensors enables the design of cheap, fast processing, complex, small-scale civil structures for future SHM studies. The novel experimental design proposed in this study provides a suitable platform for investigating the validity and sensitivity of SHM in different composite structures and damage conditions for real life applications in the future.

  14. Integration of High-Resolution Laser Displacement Sensors and 3D Printing for Structural Health Monitoring.

    Science.gov (United States)

    Chang, Shu-Wei; Lin, Tzu-Kang; Kuo, Shih-Yu; Huang, Ting-Hsuan

    2017-12-22

    This paper presents a novel experimental design for complex structural health monitoring (SHM) studies achieved by integrating 3D printing technologies, high-resolution laser displacement sensors, and multiscale entropy SHM theory. A seven-story structure with a variety of composite bracing systems was constructed using a dual-material 3D printer. A wireless Bluetooth vibration speaker was used to excite the ground floor of the structure, and high-resolution laser displacement sensors (1-μm resolution) were used to monitor the displacement history on different floors. Our results showed that the multiscale entropy SHM method could detect damage on the 3D-printed structures. The results of this study demonstrate that integrating 3D printing technologies and high-resolution laser displacement sensors enables the design of cheap, fast processing, complex, small-scale civil structures for future SHM studies. The novel experimental design proposed in this study provides a suitable platform for investigating the validity and sensitivity of SHM in different composite structures and damage conditions for real life applications in the future.

  15. Smart patch integration development of compression connector structural health monitoring in overhead transmission lines

    Science.gov (United States)

    Wang, Hong; Wang, Jy-An J.; Ren, Fei; Chan, John

    2016-04-01

    Integration of smart patches into full-tension splice connectors in overhead power transmission lines was investigated. Lead zirconate titanate (PZT) -5A was used as a smart material and an aluminum beam was used as a host structure. Negative electrode termination was examined by using copper adhesive tape and direct bonding methods. Various commercial adhesives were studied for PZT integration onto the host structure. Aluminum beam specimens with integrated PZT smart patches were tested under thermal cycling at a temperature of 125°C, which is the higher-end temperature experienced by in-service aluminum conductor steel-reinforced cables. Electromechanical impedance (EMI) measurements were conducted at room temperature, and the root mean square deviation (RMSD) of the conductance signals was used to analyze the EMI data. It has been shown that the negative electrode method has an important effect on the performance of the integrated PZT. The PZT displayed more susceptibility to cracking when copper tape was used than when direct bonding was used. The reliability of PZT in direct bonding depended on the adhesives used in bonding layers. Although a hard alumina-based adhesive can lead to cracking of the PZT, a high-temperature epoxy with adequate flexibility, such as Duralco 4538D, can provide the desired performance under target thermal cycling conditions. The RMSD parameter can characterize conductance signatures effectively. It also was demonstrated that RMSD can be used to quantify the fatigue of the PZT integration system, although RMSD is used primarily as a damage index in monitoring structural health.

  16. Structural integration and performance of inter-sectoral public health-related policy networks: An analysis across policy phases

    NARCIS (Netherlands)

    Peters, D. T. J. M.; Raab, J.; Grêaux, K. M.; Stronks, K.; Harting, J.

    2017-01-01

    Background: Inter-sectoral policy networks may be effective in addressing environmental determinants of health with interventions. However, contradictory results are reported on relations between structural network characteristics (i.e., composition and integration) and network performance, such as

  17. Structural integration and performance of inter-sectoral public health-related policy networks : An analysis across policy phases

    NARCIS (Netherlands)

    Peters, Dorothee; Raab, J.; Grêaux, Kimberley M.; Stronks, Karien; Harting, Janneke

    2017-01-01

    Background: Inter-sectoral policy networks may be effective in addressing environmental determinants of health with interventions. However, contradictory results are reported on relations between structure and network characteristics (i.e., composition and integration) and network performance, such

  18. Integrated smart structures wingbox

    Science.gov (United States)

    Simon, Solomon H.

    1993-09-01

    One objective of smart structures development is to demonstrate the ability of a mechanical component to monitor its own structural integrity and health. Achievement of this objective requires the integration of different technologies, i.e.: (1) structures, (2) sensors, and (3) artificial intelligence. We coordinated a team of experts from these three fields. These experts used reliable knowledge towards the forefront of their technologies and combined the appropriate features into an integrated hardware/software smart structures wingbox (SSW) test article. A 1/4 in. hole was drilled into the SSW test article. Although the smart structure had never seen damage of this type, it correctly recognized and located the damage. Based on a knowledge-based simulation, quantification and assessment were also carried out. We have demonstrated that the SSW integrated hardware & software test article can perform six related functions: (1) identification of a defect; (2) location of the defect; (3) quantification of the amount of damage; (4) assessment of performance degradation; (5) continued monitoring in spite of damage; and (6) continuous recording of integrity data. We present the successful results of the integrated test article in this paper, along with plans for future development and deployment of the technology.

  19. Integration of structural health monitoring solutions onto commercial aircraft via the Federal Aviation Administration structural health monitoring research program

    Science.gov (United States)

    Swindell, Paul; Doyle, Jon; Roach, Dennis

    2017-02-01

    The Federal Aviation Administration (FAA) started a research program in structural health monitoring (SHM) in 2011. The program's goal was to understand the technical gaps of implementing SHM on commercial aircraft and the potential effects on FAA regulations and guidance. The program evolved into a demonstration program consisting of a team from Sandia National Labs Airworthiness Assurance NDI Center (AANC), the Boeing Corporation, Delta Air Lines, Structural Monitoring Systems (SMS), Anodyne Electronics Manufacturing Corp (AEM) and the FAA. This paper will discuss the program from the selection of the inspection problem, the SHM system (Comparative Vacuum Monitoring-CVM) that was selected as the inspection solution and the testing completed to provide sufficient data to gain the first approved use of an SHM system for routine maintenance on commercial US aircraft.

  20. Ultrasonic Structural Health Monitoring to Assess the Integrity of Spinal Growing Rods In Vitro.

    Science.gov (United States)

    Oetgen, Matthew E; Goodley, Addison; Yoo, Byungseok; Pines, Darryll J; Hsieh, Adam H

    2016-01-01

    Rod fracture is a common complication of growing rods and can result in loss of correction, patient discomfort, and unplanned revision surgery. The ability to quantitate rod integrity at each lengthening would be advantageous to avoid this complication. We investigate the feasibility of applying structural health monitoring to evaluate the integrity of growing rods in vitro. Single-rod titanium 4.5-mm growing rod constructs (n = 9), one screw proximally and one distally connected by in-line connectors, were assembled with pedicle screws fixed in polyethylene blocks. Proximal and distal ends were loaded and constructs subjected to cyclic axial compression (0-100 N at 1 Hz), with incrementally increasing maximum compressive loads of 10 N every 9k cycles until failure. Four piezoceramic transducers (PZTs) were mounted along the length the constructs to interrogate the integrity of the rods with an ultrasonic, guided lamb wave approach. Every 9k cycles, an 80 V excitatory voltage was applied to a PZT to generate high-frequency vibrations, which, after propagating through the construct, was detected by the remaining PZTs. Amplitude differences between pre- and postload waveform signals were calculated until rod failure. Average construct lifetime was 88,991 ± 13,398 cycles. All constructs failed due to rod fracture within 21 mm (mean = 15 ± 4.5 mm) of a screw or connector. Amplitude differences between pre- and postload increased in a stepwise fashion as constructs were cycled. Compared to baseline, we found a 1.8 ± 0.6-fold increase in amplitude 18k cycles before failure, a 2.2 ± 1.0-fold increase in amplitude 9k cycles before failure, and a 2.75 ± 1.5-fold increase in amplitude immediately before rod fracture. We describe a potential method for assessing the structural integrity of growing rods using ultrasonic structural health monitoring. These preliminary data demonstrate the ability of periodic rod assessment to detect structural changes in cycled growing

  1. Fully integrated carbon nanotube composite thin film strain sensors on flexible substrates for structural health monitoring

    Science.gov (United States)

    Burton, A. R.; Lynch, J. P.; Kurata, M.; Law, K. H.

    2017-09-01

    Multifunctional thin film materials have opened many opportunities for novel sensing strategies for structural health monitoring. While past work has established methods of optimizing multifunctional materials to exhibit sensing properties, comparatively less work has focused on their integration into fully functional sensing systems capable of being deployed in the field. This study focuses on the advancement of a scalable fabrication process for the integration of multifunctional thin films into a fully integrated sensing system. This is achieved through the development of an optimized fabrication process that can create a broad range of sensing systems using multifunctional materials. A layer-by-layer deposited multifunctional composite consisting of single walled carbon nanotubes (SWNT) in a polyvinyl alcohol and polysodium-4-styrene sulfonate matrix are incorporated with a lithography process to produce a fully integrated sensing system deposited on a flexible substrate. To illustrate the process, a strain sensing platform consisting of a patterned SWNT-composite thin film as a strain-sensitive element within an amplified Wheatstone bridge sensing circuit is presented. Strain sensing is selected because it presents many of the design and processing challenges that are core to patterning multifunctional thin film materials into sensing systems. Strain sensors fabricated on a flexible polyimide substrate are experimentally tested under cyclic loading using standard four-point bending coupons and a partial-scale steel frame assembly under lateral loading. The study reveals the material process is highly repeatable to produce fully integrated strain sensors with linearity and sensitivity exceeding 0.99 and 5 {{V}}/{ε }, respectively. The thin film strain sensors are robust and are capable of high strain measurements beyond 3000 μ {ε }.

  2. Groundwater Arsenic Adsorption on Granular TiO2: Integrating Atomic Structure, Filtration, and Health Impact.

    Science.gov (United States)

    Hu, Shan; Shi, Qiantao; Jing, Chuanyong

    2015-08-18

    A pressing challenge in arsenic (As) adsorptive filtration is to decipher how the As atomic surface structure obtained in the laboratory can be used to accurately predict the field filtration cycle. The motivation of this study was therefore to integrate molecular level As adsorption mechanisms and capacities to predict effluent As from granular TiO2 columns in the field as well as its health impacts. Approximately 2,955 bed volumes of groundwater with an average of 542 μg/L As were filtered before the effluent As concentration exceeded 10 μg/L, corresponding to an adsorption capacity of 1.53 mg As/g TiO2. After regeneration, the TiO2 column could treat 2,563 bed volumes of groundwater, resulting in an As load of 1.36 mg/g TiO2. Column filtration and EXAFS results showed that among coexisting ions present in groundwater, only Ca(2+), Si(OH)4, and HCO3(-) would interfere with As adsorption. The compound effects of coexisting ions and molecular level structural information were incorporated in the PHREEQC program to satisfactorily predict the As breakthrough curves. The total urinary As concentration from four volunteers of local residences, ranging from 972 to 2,080 μg/L before groundwater treatment, decreased to the range 31.7-73.3 μg/L at the end of the experimental cycle (15-33 days).

  3. The Structural Integrity Centre

    International Nuclear Information System (INIS)

    Tomkins, B.

    1987-01-01

    The paper concerns the development and work of the Structural Integrity Centre (SIC) at Risley Nuclear Laboratories, United Kingdom. The centre was set up to provide authoritative advice to plant designers and operators on the integrity and life assessment of structures and components across the reactor projects in the United Kingdom. A description is given of the structure and role of the SIC, as well as the Structural Integrity Assessment work. The assessment methods are described for thermally loaded structures and welded structures. Finally, defect significance assessment and environmental effects are outlined. (U.K.)

  4. Structural Health Monitoring of Tall Buildings with Numerical Integrator and Convex-Concave Hull Classification

    Directory of Open Access Journals (Sweden)

    Suresh Thenozhi

    2012-01-01

    Full Text Available An important objective of health monitoring systems for tall buildings is to diagnose the state of the building and to evaluate its possible damage. In this paper, we use our prototype to evaluate our data-mining approach for the fault monitoring. The offset cancellation and high-pass filtering techniques are combined effectively to solve common problems in numerical integration of acceleration signals in real-time applications. The integration accuracy is improved compared with other numerical integrators. Then we introduce a novel method for support vector machine (SVM classification, called convex-concave hull. We use the Jarvis march method to decide the concave (nonconvex hull for the inseparable points. Finally the vertices of the convex-concave hull are applied for SVM training.

  5. An Integrated Health Monitoring Method for Structural Fatigue Life Evaluation Using Limited Sensor Data

    Directory of Open Access Journals (Sweden)

    Jingjing He

    2016-11-01

    Full Text Available A general framework for structural fatigue life evaluation under fatigue cyclic loading using limited sensor data is proposed in this paper. First, limited sensor data are measured from various sensors which are preset on the complex structure. Then the strain data at remote spots are used to obtain the strain responses at critical spots by the strain/stress reconstruction method based on empirical mode decomposition (REMD method. All the computations in this paper are directly performed in the time domain. After the local stress responses at critical spots are determined, fatigue life evaluation can be performed for structural health management and risk assessment. Fatigue life evaluation using the reconstructed stresses from remote strain gauge measurement data is also demonstrated with detailed error analysis. Following this, the proposed methodology is demonstrated using a three-dimensional frame structure and a simplified airfoil structure. Finally, several conclusions and future work are drawn based on the proposed study.

  6. Structural integration and performance of inter-sectoral public health-related policy networks: An analysis across policy phases.

    Science.gov (United States)

    Peters, D T J M; Raab, J; Grêaux, K M; Stronks, K; Harting, J

    2017-12-01

    Inter-sectoral policy networks may be effective in addressing environmental determinants of health with interventions. However, contradictory results are reported on relations between structural network characteristics (i.e., composition and integration) and network performance, such as addressing environmental determinants of health. This study examines these relations in different phases of the policy process. A multiple-case study was performed on four public health-related policy networks. Using a snowball method among network actors, overall and sub-networks per policy phase were identified and the policy sector of each actor was assigned. To operationalise the outcome variable, interventions were classified by the proportion of environmental determinants they addressed. In the overall networks, no relation was found between structural network characteristics and network performance. In most effective cases, the policy development sub-networks were characterised by integration with less interrelations between actors (low cohesion), more equally distributed distances between the actors (low closeness centralisation), and horizontal integration in inter-sectoral cliques. The most effective case had non-public health central actors with less connections in all sub-networks. The results suggest that, to address environmental determinants of health, sub-networks should be inter-sectorally composed in the policy development rather than in the intervention development and implementation phases, and that policy development actors should have the opportunity to connect with other actors, without strong direction from a central actor. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Integrated Structural Design Education

    DEFF Research Database (Denmark)

    Bjerregaard Jensen, Lotte; Almegaard, Henrik

    2011-01-01

    to EU legislation. And a successful engineering student must be prepared to work in the open-ended, multidisciplinary environment necessary to produce structures which comply with EIA demands. This paper describes an innovative course developed at the Technical University of Denmark which integrates...... landscaping and structural design. The integrated courses create a setting for learning about the design of large-scale structures and involve geometry, statics, computer simulation, graphical design and landscape architecture. Together, they educate engineers who can take part in the early design phases...... of a project, function well in design teams, and comply with EU EIA demands....

  8. Integrated Health Management Definitions

    Data.gov (United States)

    National Aeronautics and Space Administration — The Joint Army Navy NASA Air Force Modeling and Simulation Subcommittee's Integrated Health Management panel was started about 6 years ago to help foster...

  9. An integrated health and social care organisation in Sweden: creation and structure of a unique local public health and social care system.

    Science.gov (United States)

    Øvretveit, John; Hansson, Johan; Brommels, Mats

    2010-10-01

    Research and citizens have noted failures in coordinating health and social services and professionals, and the need to address this issue to realize benefits from increasing specialisation. Different methods have been proposed and one has been structural integration of separate services within one organisation. This paper reports an empirical longitudinal study of the development of an integrated health and social care organisation in Sweden combining service provision, purchasing and political governance for a defined population. The study found a combination of influences contributed to the development of this new organisation. The initial structural macro-integration facilitated, but did not of itself result in better clinical care coordination. Other actions were needed to modify the specialised systems and cultures which the organisation inherited. The study design was not able to establish with any degree of certainty whether better patient and cost outcomes resulted, but it did find structural and process changes which make improved outcomes likely. The study concludes that coordinated actions at different levels and of different types were needed to achieve care coordination for patients and that a phased approach was necessary where management capacity and outside expertise are limited. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  10. Integrated circuit structure

    International Nuclear Information System (INIS)

    1981-01-01

    The invention describes the fabrication of integrated circuit structures, such as read-only memory components of field-effect transistors, which may be fabricated and then maintained in inventory, and later selectively modified in accordance with a desired pattern. It is claimed that MOS depletion-mode devices in accordance with the invention can be fabricated at lower cost and at higher yields. (U.K.)

  11. The influence of health system organizational structure and culture on integration of health services: the example of HIV service monitoring in South Africa.

    Science.gov (United States)

    Kawonga, Mary; Blaauw, Duane; Fonn, Sharon

    2016-11-01

    Administrative integration of disease control programmes (DCPs) within the district health system has been a health sector reform priority in South Africa for two decades. The reforms entail district managers assuming authority for the planning and monitoring of DCPs in districts, with DCP managers providing specialist support. There has been little progress in achieving this, and a dearth of research exploring why. Using a case study of HIV programme monitoring and evaluation (M&E), this article explores whether South Africa's health system is configured to support administrative integration. The article draws on data from document reviews and interviews with 54 programme and district managers in two of nine provinces, exploring their respective roles in decision-making regarding HIV M&E system design and in using HIV data for monitoring uptake of HIV interventions in districts. Using Mintzberg's configurations framework, we describe three organizational parameters: (a) extent of centralization (whether district managers play a role in decisions regarding the design of the HIV M&E system); (b) key part of the organization (extent to which sub-national programme managers vs district managers play the central role in HIV monitoring in districts); and (c) coordination mechanisms used (whether highly formalized and rules-based or more output-based to promote agency). We find that the health system can be characterized as Mintzberg's machine bureaucracy. It is centralized and highly formalized with structures, management styles and practices that promote programme managers as lead role players in the monitoring of HIV interventions within districts. This undermines policy objectives of district managers assuming this leadership role. Our study enhances the understanding of organizational factors that may limit the success of administrative integration reforms and suggests interventions that may mitigate this. © The Author 2016. Published by Oxford University Press in

  12. System-on-Chip Integration of a New Electromechanical Impedance Calculation Method for Aircraft Structure Health Monitoring

    Directory of Open Access Journals (Sweden)

    Daniel Medale

    2012-10-01

    Full Text Available The work reported on this paper describes a new methodology implementation for active structural health monitoring of recent aircraft parts made from carbon-fiber-reinforced polymer. This diagnosis is based on a new embedded method that is capable of measuring the local high frequency impedance spectrum of the structure through the calculation of the electro-mechanical impedance of a piezoelectric patch pasted non-permanently onto its surface. This paper involves both the laboratory based E/M impedance method development, its implementation into a CPU with limited resources as well as a comparison with experimental testing data needed to demonstrate the feasibility of flaw detection on composite materials and answer the question of the method reliability. The different development steps are presented and the integration issues are discussed. Furthermore, we present the unique advantages that the reconfigurable electronics through System-on-Chip (SoC technology brings to the system scaling and flexibility. At the end of this article, we demonstrate the capability of a basic network of sensors mounted onto a real composite aircraft part specimen to capture its local impedance spectrum signature and to diagnosis different delamination sizes using a comparison with a baseline.

  13. System-on-chip integration of a new electromechanical impedance calculation method for aircraft structure health monitoring.

    Science.gov (United States)

    Boukabache, Hamza; Escriba, Christophe; Zedek, Sabeha; Medale, Daniel; Rolet, Sebastien; Fourniols, Jean Yves

    2012-10-11

    The work reported on this paper describes a new methodology implementation for active structural health monitoring of recent aircraft parts made from carbon-fiber-reinforced polymer. This diagnosis is based on a new embedded method that is capable of measuring the local high frequency impedance spectrum of the structure through the calculation of the electro-mechanical impedance of a piezoelectric patch pasted non-permanently onto its surface. This paper involves both the laboratory based E/M impedance method development, its implementation into a CPU with limited resources as well as a comparison with experimental testing data needed to demonstrate the feasibility of flaw detection on composite materials and answer the question of the method reliability. The different development steps are presented and the integration issues are discussed. Furthermore, we present the unique advantages that the reconfigurable electronics through System-on-Chip (SoC) technology brings to the system scaling and flexibility. At the end of this article, we demonstrate the capability of a basic network of sensors mounted onto a real composite aircraft part specimen to capture its local impedance spectrum signature and to diagnosis different delamination sizes using a comparison with a baseline.

  14. Study on structural integrity in box structures

    International Nuclear Information System (INIS)

    Asano, Masayuki; Ueta, Masahiro; Kanaoka, Tadashi; Ikeuchi, Toshiaki; Kodama, Tetsuhiro.

    1991-01-01

    This study was carried out to give an experimental foundation to the structural integrity of a box structure. Crack growth tests were performed on the reduced scale models, simulating typical portions of the box structure, in air at room temperature. The results show that the amount of crack growth is too small to injure the structural integrity of the models for the postulated loading cycle, and make clear the effective structure against crack growth. (author)

  15. SRS Tank Structural Integrity Program

    International Nuclear Information System (INIS)

    Maryak, Matthew

    2010-01-01

    The mission of the Structural Integrity Program is to ensure continued safe management and operation of the waste tanks for whatever period of time these tanks are required. Matthew Maryak provides an overview of the Structural Integrity Program to open Session 5 (Waste Storage and Tank Inspection) of the 2010 EM Waste Processing Technical Exchange.

  16. System-on-Chip Integration of a New Electromechanical Impedance Calculation Method for Aircraft Structure Health Monitoring

    OpenAIRE

    Boukabache, Hamza; Escriba, Christophe; Zedek, Sabeha; Medale, Daniel; Rolet, Sebastien; Fourniols, Jean Yves

    2012-01-01

    The work reported on this paper describes a new methodology implementation for active structural health monitoring of recent aircraft parts made from carbon-fiber-reinforced polymer. This diagnosis is based on a new embedded method that is capable of measuring the local high frequency impedance spectrum of the structure through the calculation of the electro-mechanical impedance of a piezoelectric patch pasted non-permanently onto its surface. This paper involves both the laboratory based E/M...

  17. A Randomized Trial of Pocket-Echocardiography Integrated Mobile Health Device Assessments in Modern Structural Heart Disease Clinics.

    Science.gov (United States)

    Bhavnani, Sanjeev P; Sola, Srikanth; Adams, David; Venkateshvaran, Ashwin; Dash, P K; Sengupta, Partho P

    2018-04-01

    This study sought to determine whether mobile health (mHealth) device assessments used as clinical decision support tools at the point-of-care can reduce the time to treatment and improve long-term outcomes among patients with rheumatic and structural heart diseases (SHD). Newly developed smartphone-connected mHealth devices represent promising methods to diagnose common diseases in resource-limited areas; however, the impact of technology-based care on long-term outcomes has not been rigorously evaluated. A total of 253 patients with SHD were randomized to an initial diagnostic assessment with wireless devices in mHealth clinics (n = 139) or to standard-care (n = 114) in India. mHealth clinics were equipped with point-of-care devices including pocket-echocardiography, smartphone-connected-electrocardiogram blood pressure and oxygen measurements, activity monitoring, and portable brain natriuretic peptide laboratory testing. All individuals underwent comprehensive transthoracic echocardiography to assess the severity of SHD. The primary endpoint was the time to referral for therapy with percutaneous valvuloplasty or surgical valve replacement. Secondary endpoints included the probability of a cardiovascular hospitalization and/or death over 1 year. An initial mHealth assessment was associated with a shorter time to referral for valvuloplasty and/or valve replacement (83 ± 79 days vs. 180 ± 101 days; p Mobile Health Device Assessments in Modern Structural Heart Disease Clinics; NCT02881398). Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  18. Fatigue Performance of Ti-6Al-4V Additively Manufactured Specimens with Integrated Capillaries of an Embedded Structural Health Monitoring System.

    Science.gov (United States)

    Hinderdael, Michaël; Strantza, Maria; De Baere, Dieter; Devesse, Wim; De Graeve, Iris; Terryn, Herman; Guillaume, Patrick

    2017-08-25

    Additive manufacturing (AM) of metals offers new possibilities for the production of complex structures. Up to now, investigations on the mechanical response of AM metallic parts show a significant spread and unexpected failures cannot be excluded. In this work, we focus on the detection of fatigue cracks through the integration of a Structural Health Monitoring (SHM) system in Ti-6Al-4V specimens. The working principle of the presented system is based on the integration of small capillaries that are capable of detecting fatigue cracks. Four-point bending fatigue tests have been performed on Ti-6Al-4V specimens with integrated capillaries and compared to the reference specimenswithout capillaries. Specimens were produced by conventional subtractive manufacturing of wrought material and AM, using the laser based Directed Energy Deposition (DED) process. In this study, we investigated the effect of the presence of the capillary on the fatigue strength and fatigue initiation location. Finite element (FEM) simulations were performed to validate the experimental test results. The presence of a drilled capillary in the specimens did not alter the fatigue initiation location. However, the laser based DED production process introduced roughness on the capillary surface that altered the fatigue initiation location to the capillary surface. The fatigue performance was greatly reduced when considering a printed capillary. It is concluded that the surface quality of the integrated capillary is of primary importance in order not to influence the structural integrity of the component to be monitored.

  19. Integrated materials–structural models

    DEFF Research Database (Denmark)

    Stang, Henrik; Geiker, Mette Rica

    2008-01-01

    , repair works and strengthening methods for structures. A very significant part of the infrastructure consists of reinforced concrete structures. Even though reinforced concrete structures typically are very competitive, certain concrete structures suffer from various types of degradation. A framework...... should define a framework in which materials research results eventually should fit in and on the other side the materials research should define needs and capabilities in structural modelling. Integrated materials-structural models of a general nature are almost non-existent in the field of cement based...

  20. Integrated Management of Structural Pests in Schools.

    Science.gov (United States)

    Illinois State Dept. of Public Health, Springfield.

    The state of Illinois is encouraging schools to better inspect and evaluate the causes of their pest infestation problems through use of the Integrated Pest Management (IPM) guidelines developed by the Illinois Department of Public Health. This guide reviews the philosophy and organization of an IPM program for structural pests in schools,…

  1. Integrated Building Health Management

    Data.gov (United States)

    National Aeronautics and Space Administration — Abstract: Building health management is an important part in running an efficient and cost-effective building. Many problems in a building’s system can go undetected...

  2. Integrative Cardiac Health Project

    Science.gov (United States)

    2014-10-01

    primary cardiac arrest. Circulation. 1998;97(2):155Y160. 8. Sesso HD, Lee IM, Gaziano JM, Rexrode KM, Glynn RJ, Buring JE. Maternal and paternal ...to signal transduction, inflammation, and host–pathogen interactions .27 Whole blood RNA isolation systems such as PAXgene accurately capture in vivo...the effect of healthy behaviors on leukocyte function and leukocyte–endothelium interactions that are important for cardiovascular health

  3. European networks in structural integrity

    International Nuclear Information System (INIS)

    Crutzen, S.; Davies, M.; Hemsworth, B.; Hurst, R.; Kussmaul, K.

    1994-01-01

    Several institutions and electrical utilities in Europe, including the Joint Research Centre (JRC) have the capability to deal problems posed by the operation and ageing of structural components and with their structural integrity assessment. These institutions and the JRC have developed cooperative programmes now organised in networks. They include utilities, engineering companies, R and D laboratories and Regulatory Bodies. Networks are organised and managed like the successful PISC programme: The Institute for Advanced Materials of JRC plays the role of Operating Agent and Manager of these networks: ENIQ, AMES, NESC, each of them dealing with a specific aspect of fitness for purpose of materials in structural components. There exist strong links between the networks and EC Working Groups on Structural Integrity Codes and Standards. (orig.)

  4. Intelligent Integrated System Health Management

    Science.gov (United States)

    Figueroa, Fernando

    2012-01-01

    Intelligent Integrated System Health Management (ISHM) is the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system (Management: storage, distribution, sharing, maintenance, processing, reasoning, and presentation). Presentation discusses: (1) ISHM Capability Development. (1a) ISHM Knowledge Model. (1b) Standards for ISHM Implementation. (1c) ISHM Domain Models (ISHM-DM's). (1d) Intelligent Sensors and Components. (2) ISHM in Systems Design, Engineering, and Integration. (3) Intelligent Control for ISHM-Enabled Systems

  5. Integration of acoustic emission systems within Integri-TechTM analysis system for structural health monitoring of pressurised engineering plant

    International Nuclear Information System (INIS)

    Ghouri, A A; Galbraith, Walter; Pierce, S Gareth; Gachagan, Anthony; Rafferty, Steven; Pickwell, Andy

    2015-01-01

    The aim of this Acoustic Emission (AE) based Structural Health Monitoring project is to enable accurate location of AE sources in pressurised engineering plant and to use AE source location data to establish defect locations for use within Integri-Tech TM ; a finite element based analysis, monitoring and fitness for service assessment system. Integri-Tech TM is a windows based system which carries out combined analysis and assessment providing fatigue life and remnant life calculations and inspection priorities presenting the results in an accessible web portal format. The software uses finite element stress models created in the companion software Model Wizard. The AE monitoring system that has been developed can be used with an array of up to four AE broad band sensor channels with associated signal processing. Using a flexible approach in MATLAB, the authors have developed algorithms which were used for analysing the received AE signals to extract information about the nature and location of the source. The ability to carry out source location and possibly perform real time monitoring (detecting cracking as it occurs) is attractive feature of the AE system developed for this project. The time of arrival (TOA) data was used by Integri-Tech TM software to calculate source location using its own built-in algorithm, and this was verified independently using a MATLAB approach. (paper)

  6. Licensing aspects of structural integrity

    International Nuclear Information System (INIS)

    Turner, M.J.; Hemsworth, B.; Boydon, F.M.D.; Harrop, L.P.; Waters, R.

    1992-01-01

    Examples are given of the wide variety of structural integrity assessments of nuclear plant carried out by the United Kingdom Nuclear Installations Inspectorate (NII) and the consequent need for a flexible approach within the framework provided by the Safety Assessment Principles. The paper describes the use of the Special Case Procedure and draws the distinction between the assessment of incredibility of failure of components and components whose failures are considered within the design basis. Assessment examples provided are the Sizewell B reactor pressure vessel, Magnox reactor pressure vessels, the Prototype Fast Reactor core support structure, Advanced Gas-cooled Reactor steam plant, Thermal Oxide Reprocessing Plant (THORP) vessels, and Steam Generating Heavy Water Reactor pressure tubes. (author)

  7. Integrated piping structural analysis system

    International Nuclear Information System (INIS)

    Motoi, Toshio; Yamadera, Masao; Horino, Satoshi; Idehata, Takamasa

    1979-01-01

    Structural analysis of the piping system for nuclear power plants has become larger in scale and in quantity. In addition, higher quality analysis is regarded as of major importance nowadays from the point of view of nuclear plant safety. In order to fulfill to the above requirements, an integrated piping structural analysis system (ISAP-II) has been developed. Basic philosophy of this system is as follows: 1. To apply the date base system. All information is concentrated. 2. To minimize the manual process in analysis, evaluation and documentation. Especially to apply the graphic system as much as possible. On the basis of the above philosophy four subsystems were made. 1. Data control subsystem. 2. Analysis subsystem. 3. Plotting subsystem. 4. Report subsystem. Function of the data control subsystem is to control all information of the data base. Piping structural analysis can be performed by using the analysis subsystem. Isometric piping drawing and mode shape, etc. can be plotted by using the plotting subsystem. Total analysis report can be made without the manual process through the reporting subsystem. (author)

  8. Integrating physical and mental health promotion strategies

    OpenAIRE

    Palma, Jessica Anne

    2010-01-01

    While health is defined as ‘a state of complete physical, mental and social well-being’, physical and mental health have traditionally been separated. This paper explores the question: How can physical and mental health promotion strategies be integrated and addressed simultaneously? A literature review on why physical and mental health are separated and why these two areas need to be integrated was conducted. A conceptual framework for how to integrate physical and mental health promotion st...

  9. Integrative structure modeling with the Integrative Modeling Platform.

    Science.gov (United States)

    Webb, Benjamin; Viswanath, Shruthi; Bonomi, Massimiliano; Pellarin, Riccardo; Greenberg, Charles H; Saltzberg, Daniel; Sali, Andrej

    2018-01-01

    Building models of a biological system that are consistent with the myriad data available is one of the key challenges in biology. Modeling the structure and dynamics of macromolecular assemblies, for example, can give insights into how biological systems work, evolved, might be controlled, and even designed. Integrative structure modeling casts the building of structural models as a computational optimization problem, for which information about the assembly is encoded into a scoring function that evaluates candidate models. Here, we describe our open source software suite for integrative structure modeling, Integrative Modeling Platform (https://integrativemodeling.org), and demonstrate its use. © 2017 The Protein Society.

  10. Development, implementation, and evaluation of an integrated multidisciplinary Objective Structured Clinical Examination (OSCE) in primary health care settings within limited resources.

    Science.gov (United States)

    Abdelaziz, Adel; Hany, Mohamed; Atwa, Hani; Talaat, Wagdy; Hosny, Somaya

    2016-01-01

    In ordinary circumstances, objective structured clinical examination (OSCE) is a resource-intensive assessment method. In case of developing and implementing multidisciplinary OSCE, there is no doubt that the cost will be greater. Through this study a research project was conducted to develop, implement and evaluate a multidisciplinary OSCE model within limited resources. This research project went through the steps of blueprinting, station writing, resources reallocation, implementation and finally evaluation. The developed model was implemented in the Primary Health Care (PHC) program which is one of the pillars of the Community-Based undergraduate curriculum of the Faculty of Medicine, Suez Canal University (FOM-SCU). Data for evaluation of the implemented OSCE model were derived from two resources. First, feedback of the students and assessors through self-administered questionnaires was obtained. Second, evaluation of the OSCE psychometrics was done. The deliverables of this research project included a set of validated integrated multi-disciplinary and low cost OSCE stations with an estimated reliability index of 0.6. After having this experience, we have a critical mass of faculty members trained on blueprinting and station writing and a group of trained assessors, facilitators and role players. Also there is a state of awareness among students on how to proceed in this type of OSCE which renders future implementation more feasible.

  11. Structural Integrity in Measures of Self Concept.

    Science.gov (United States)

    Stenner, A. Jackson; Katzenmeyer, W.G.

    Structural integrity of a measure is defined in terms of its replicability, constancy, invariance, and stability. Work completed in the development and validation of the Self Observation Scales (SOS) Primary Level (Stenner and Katzenmeyer, 1973) serves to illustrate one method of establishing structural integrity. The name of each scale of the SOS…

  12. Quantum integrals from coalgebra structure

    International Nuclear Information System (INIS)

    Post, S; Riglioni, D

    2015-01-01

    Quantum versions of the hydrogen atom and the harmonic oscillator are studied on non Euclidean spaces of dimension N. 2N−1 integrals, of arbitrary order, are constructed via a multi-dimensional version of the factorization method, thus confirming the conjecture of Riglioni (2013 J. Phys. A: Math. Theor. 46 265207). The systems are extended via coalgebra extension of sl(2) representations, although not all integrals are expressible in these generators. As an example, dimensional reduction is applied to four-dimensional systems to obtain extension and new proofs of the superintegrability of known families of Hamiltonians. (paper)

  13. The European structural integrity research programme

    International Nuclear Information System (INIS)

    Townley, C.H.A.; Acker, D.; Laue, H.

    1990-01-01

    A thermal hydraulics evaluation of the European Fast Reactor (EFR) design followed by structural analysis is presented in this article to assess the structural integrity research programme to date. Improved design methods are being achieved as a result of the structural integrity programme for the EFR. Excellent collaboration between the nationally based research organizations and the design and construction companies has been important in achieving these improvements. (UK)

  14. Integrating SEA in institutional structures

    DEFF Research Database (Denmark)

    Kørnøv, Lone

    The paper decribes and disusses how institutional structures influenced the decision making proces during the development of the regional planning in the Danish county of North Jutland for the period 1993-1997.......The paper decribes and disusses how institutional structures influenced the decision making proces during the development of the regional planning in the Danish county of North Jutland for the period 1993-1997....

  15. [European health systems and the integration problem of modern societies].

    Science.gov (United States)

    Lüschen, G

    2000-04-01

    With reference to the national health systems in Germany and the UK we must acknowledge that it was in particular Bismarck's Reform, originally directed toward a solidarity among the socially weak, which entailed in its development a marked redistribution via progressive health fees and standardized health services. In view of Alfred Marshall's original expectations this has resulted in a specific integration of the socially weak and with some difference for nationally tax-financed and social security financed health systems to a genuine contribution towards integration of modern society. An open research question is whether as a consequence of solidarity and integration through health systems there is a decline of social inequality for health. Equally open is the question as to the socio-structural and economic consequences the expansion of modern health systems has.

  16. Plated lamination structures for integrated magnetic devices

    Science.gov (United States)

    Webb, Bucknell C.

    2014-06-17

    Semiconductor integrated magnetic devices such as inductors, transformers, etc., having laminated magnetic-insulator stack structures are provided, wherein the laminated magnetic-insulator stack structures are formed using electroplating techniques. For example, an integrated laminated magnetic device includes a multilayer stack structure having alternating magnetic and insulating layers formed on a substrate, wherein each magnetic layer in the multilayer stack structure is separated from another magnetic layer in the multilayer stack structure by an insulating layer, and a local shorting structure to electrically connect each magnetic layer in the multilayer stack structure to an underlying magnetic layer in the multilayer stack structure to facilitate electroplating of the magnetic layers using an underlying conductive layer (magnetic or seed layer) in the stack as an electrical cathode/anode for each electroplated magnetic layer in the stack structure.

  17. Contracted and expanded integrable structures

    International Nuclear Information System (INIS)

    Doikou, Anastasia; Sfetsos, Konstadinos

    2009-01-01

    We propose a generic framework to obtain certain types of contracted and centrally extended algebras. This is based on the existence of quadratic algebras (reflection algebras and twisted Yangians), naturally arising in the context of boundary integrable models. A quite old misconception regarding the 'expansion' of the E 2 algebra into sl 2 is resolved using the representation theory of the aforementioned quadratic algebras. We also obtain centrally extended algebras associated with rational and trigonometric (q-deformed) R-matrices that are solutions of the Yang-Baxter equation.

  18. Subdomain Precise Integration Method for Periodic Structures

    Directory of Open Access Journals (Sweden)

    F. Wu

    2014-01-01

    Full Text Available A subdomain precise integration method is developed for the dynamical responses of periodic structures comprising many identical structural cells. The proposed method is based on the precise integration method, the subdomain scheme, and the repeatability of the periodic structures. In the proposed method, each structural cell is seen as a super element that is solved using the precise integration method, considering the repeatability of the structural cells. The computational efforts and the memory size of the proposed method are reduced, while high computational accuracy is achieved. Therefore, the proposed method is particularly suitable to solve the dynamical responses of periodic structures. Two numerical examples are presented to demonstrate the accuracy and efficiency of the proposed method through comparison with the Newmark and Runge-Kutta methods.

  19. Integrated occupational health care at sea

    DEFF Research Database (Denmark)

    Jensen, Olaf Chresten

    2011-01-01

    exposures during life at sea and work place health promotion. SEAHEALTH and some of the shipping companies have already added workplace health promotion to occupational health care programs. The purpose of this article is to reinforce this trend by adding some international perspectives and by providing......Workplace Health Promotion is the combined efforts of employers, employees and society to improve the health and well-being of people at work. Integrated maritime health care can be defined as the total maritime health care function that includes the prevention of health risks from harmful...

  20. Test Structures For Bumpy Integrated Circuits

    Science.gov (United States)

    Buehler, Martin G.; Sayah, Hoshyar R.

    1989-01-01

    Cross-bridge resistors added to comb and serpentine patterns. Improved combination of test structures built into integrated circuit used to evaluate design rules, fabrication processes, and quality of interconnections. Consist of meshing serpentines and combs, and cross bridge. Structures used to make electrical measurements revealing defects in design or fabrication. Combination of test structures includes three comb arrays, two serpentine arrays, and cross bridge. Made of aluminum or polycrystalline silicon, depending on material in integrated-circuit layers evaluated. Aluminum combs and serpentine arrays deposited over steps made by polycrystalline silicon and diffusion layers, while polycrystalline silicon versions of these structures used to cross over steps made by thick oxide layer.

  1. Intacting Integrity in coping with health issues

    DEFF Research Database (Denmark)

    Jepsen, Stine Leegaard; Bastrup Jørgensen, Lene; Fridlund, Bengt

    2017-01-01

    The aim of this study was to develop a formal substantive theory (FST) on the multidimensional behavioral process of coping with health issues. Intacting integrity while coping with health issues emerged as the core category of this FST. People facing health issues strive to safeguard and keep...

  2. Workshop: health workforce governance and integration.

    NARCIS (Netherlands)

    Batenburg, R.

    2014-01-01

    Background: Health workforce governance is increasingly recognized as a burning policy issue and focused on workforce shortages. Yet the most pressing problem is to solve maldistributions through governance and integration. Poor management of health 242 European Journal of Public Health, Vol. 24,

  3. Managing the physics of the economics of integrated health care.

    Science.gov (United States)

    Zismer, Daniel K; Werner, Mark J

    2012-01-01

    The physics metaphor, as applied to the economics (and financial performance) of the integrated health system, seems appropriate when considered together with the nine principles of management framework provided. The nature of the integrated design enhances leaders' management potential as they consider organizational operations and strategy in the markets ahead. One question begged by this argument for the integrated design is the durability, efficiency and ultimate long-term survivability of the more "traditional" community health care delivery models, which, by design, are fragmented, internally competitive and less capital efficient. They also cannot exploit the leverage of teams, optimal access management or the pursuit of revenues made available in many forms. For those who wish to move from the traditional to the more integrated community health system designs (especially those who have not yet started the journey), the path requires: * Sufficient balance sheet capacity to fund the integration process-especially as the model requires physician practice acquisitions and electronic health record implementations * A well-prepared board13, 14 * A functional, durable and sustainable physician services enterprise design * A redesigned organizational and governance structure * Favorable internal financial incentives alignment design * Effective accountable physician leadership * Awareness that the system is not solely a funding strategy for acquired physicians, rather a fully -.. committed clinical and business model, one in which patient-centered integrated care is the core service (and not acute care hospital-based services) A willingness to create and exploit the implied and inherent potential of an integrated design and unified brand Last, it's important to remember that an integrated health system is a tool that creates a "new potential" (a physics metaphor reference, one last time). The design doesn't operate itself. Application of the management principles

  4. Integrable structures in quantum field theory

    International Nuclear Information System (INIS)

    Negro, Stefano

    2016-01-01

    This review was born as notes for a lecture given at the Young Researchers Integrability School (YRIS) school on integrability in Durham, in the summer of 2015. It deals with a beautiful method, developed in the mid-nineties by Bazhanov, Lukyanov and Zamolodchikov and, as such, called BLZ. This method can be interpreted as a field theory version of the quantum inverse scattering, also known as the algebraic Bethe ansatz. Starting with the case of conformal field theories (CFTs) we show how to build the field theory analogues of commuting transfer T matrices and Baxter Q -operators of integrable lattice models. These objects contain the complete information of the integrable structure of the theory, viz. the integrals of motion, and can be used, as we will show, to derive the thermodynamic Bethe ansatz and nonlinear integral equations. This same method can be easily extended to the description of integrable structures of certain particular massive deformations of CFTs; these, in turn, can be described as quantum group reductions of the quantum sine-Gordon model and it is an easy step to include this last theory in the framework of BLZ approach. Finally we show an interesting and surprising connection of the BLZ structures with classical objects emerging from the study of classical integrable models via the inverse scattering transform method. This connection goes under the name of ODE/IM correspondence and we will present it for the specific case of quantum sine-Gordon model only. (topical review)

  5. A revisionist view of the integrated academic health center.

    Science.gov (United States)

    Rodin, Judith

    2004-02-01

    Like many academic health centers that had expanded aggressively during the 1990s, the nation's first vertically integrated academic health center, the University of Pennsylvania Health System, was profoundly challenged by the dramatic and unanticipated financial impacts of the Balanced Budget Act of 1997. The author explains why-although Penn's Health System had lost $300 million over two years and its debts threatened to cause serious financial and educational damage to the rest of the University-Penn chose to manage its way out of the financial crisis (instead of selling or spinning off its four hospitals, clinical practices, and possibly even its medical school). A strategy of comprehensive integration has not only stabilized Penn's Health System financially, but strengthened its position of leadership in medical education, research, and health care delivery. The author argues that a strategy of greater horizontal integration offers important strategic advantages to academic health centers. In an era when major social and scientific problems demand broadly multidisciplinary and highly-integrated approaches, such horizontally integrated institutions will be better able to educate citizens and train physicians, develop new approaches to health care policy, and answer pressing biomedical research questions. Institutional cultural integration is also crucial to create new, innovative organizational structures that bridge traditional disciplinary, school, and clinical boundaries.

  6. GENERIC Integrators: Structure Preserving Time Integration for Thermodynamic Systems

    Science.gov (United States)

    Öttinger, Hans Christian

    2018-04-01

    Thermodynamically admissible evolution equations for non-equilibrium systems are known to possess a distinct mathematical structure. Within the GENERIC (general equation for the non-equilibrium reversible-irreversible coupling) framework of non-equilibrium thermodynamics, which is based on continuous time evolution, we investigate the possibility of preserving all the structural elements in time-discretized equations. Our approach, which follows Moser's [1] construction of symplectic integrators for Hamiltonian systems, is illustrated for the damped harmonic oscillator. Alternative approaches are sketched.

  7. Structural integrity aspects of reactor safety

    Indian Academy of Sciences (India)

    A large experimental programme supported the structural integrity demonstration. ... Categories in which the structures, systems and components (SSC) are .... One of the ways in which the decision to live with the defect can be aided is the .... The Advanced Heavy Water Reactor (AHWR) (figure 18) being designed by BARC ...

  8. Assessment of integrity of structures containing cracks

    International Nuclear Information System (INIS)

    Townley, C.H.A.

    1976-01-01

    The object of the investigations is to provide a method of assessing the safety and integrity of structures containing cracklike defects. Estimated load at which the cracked structure will fail is compared with the highest load likely to be applied in service

  9. Nonlinear structural analysis using integrated force method

    Indian Academy of Sciences (India)

    A new formulation termed the Integrated Force Method (IFM) was proposed by Patnaik ... nated ``Structure (nY m)'' where (nY m) are the force and displacement degrees of ..... Patnaik S N, Yadagiri S 1976 Frequency analysis of structures.

  10. Risk Informed Structural Systems Integrity Management

    DEFF Research Database (Denmark)

    Nielsen, Michael Havbro Faber

    2017-01-01

    The present paper is predominantly a conceptual contribution with an appraisal of major developments in risk informed structural integrity management for offshore installations together with a discussion of their merits and the challenges which still lie ahead. Starting point is taken in a selected...... overview of research and development contributions which have formed the basis for Risk Based Inspection Planning (RBI) as we know it today. Thereafter an outline of the methodical basis for risk informed structural systems integrity management, i.e. the Bayesian decision analysis is provided in summary....... The main focus is here directed on RBI for offshore facilities subject to fatigue damages. New ideas and methodical frameworks in the area of robustness and resilience modeling of structural systems are then introduced, and it is outlined how these may adequately be utilized to enhance Structural Integrity...

  11. Migrant integration policies and health inequalities in Europe.

    Science.gov (United States)

    Giannoni, Margherita; Franzini, Luisa; Masiero, Giuliano

    2016-06-01

    Research on socio-economic determinants of migrant health inequalities has produced a large body of evidence. There is lack of evidence on the influence of structural factors on lives of fragile groups, frequently exposed to health inequalities. The role of poor socio-economic status and country level structural factors, such as migrant integration policies, in explaining migrant health inequalities is unclear. The objective of this paper is to examine the role of migrant socio-economic status and the impact of migrant integration policies on health inequalities during the recent economic crisis in Europe. Using the 2012 wave of Eurostat EU-SILC data for a set of 23 European countries, we estimate multilevel mixed-effects ordered logit models for self-assessed poor health (SAH) and self-reported limiting long-standing illnesses (LLS), and multilevel mixed-effects logit models for self-reported chronic illness (SC). We estimate two-level models with individuals nested within countries, allowing for both individual socio-economic determinants of health and country-level characteristics (healthy life years expectancy, proportion of health care expenditure over the GDP, and problems in migrant integration policies, derived from the Migrant Integration Policy Index (MIPEX). Being a non-European citizen or born outside Europe does not increase the odds of reporting poor health conditions, in accordance with the "healthy migrant effect". However, the country context in terms of problems in migrant integration policies influences negatively all of the three measures of health (self-reported health status, limiting long-standing illnesses, and self-reported chronic illness) in foreign people living in European countries, and partially offsets the "healthy migrant effect". Policies for migrant integration can reduce migrant health disparities.

  12. Structural health monitoring 2012. Proceedings. Vol. 1

    International Nuclear Information System (INIS)

    Boller, Christian

    2012-01-01

    Structural Health Monitoring (SHM) is an emerging technology, dealing with the development and implementation of techniques and systems where monitoring, inspection and damage detection become an integral part of structures and thus a matter of automation. It further merges with a variety of techniques related to diagnostics and prognostics. SHM emerged from the field of smart structures and laterally encompasses disciplines such as structural dynamics, materials and structures, fatigue and fracture, non-destructive testing and evaluation, sensors and actuators, microelectronics, signal processing and much more. To be effective in the development of SHM systems, a multidisciplinary approach is therefore required. Without this global view it will be difficult for engineers to holistically manage the operation of an engineering structure through its life cycle in the future and to generate new breakthroughs in structural engineering. The first volume of the proceedings contains topics dealing with physics, materials and sensors. Five of the contributions are separately analyzed for the ENERGY database.

  13. Integrating health and environmental impact analysis

    DEFF Research Database (Denmark)

    Reis, S; Morris, G.; Fleming, L. E.

    2015-01-01

    which addresses human activity in all its social, economic and cultural complexity. The new approach must be integral to, and interactive, with the natural environment. We see the continuing failure to truly integrate human health and environmental impact analysis as deeply damaging, and we propose...... while equally emphasizing the health of the environment, and the growing calls for 'ecological public health' as a response to global environmental concerns now suffusing the discourse in public health. More revolution than evolution, ecological public health will demand new perspectives regarding...... the interconnections among society, the economy, the environment and our health and well-being. Success must be built on collaborations between the disparate scientific communities of the environmental sciences and public health as well as interactions with social scientists, economists and the legal profession...

  14. Integrating mental health into primary health care – Uganda's ...

    African Journals Online (AJOL)

    Adele

    demographic and health indicators.1 The data showed a high growth rate in excess of 3% ... an integrated form with all other health care needs including promotive and ... In 1999 the government of Uganda (Ministry of Health) developed a ten .... The usual drug procurement system was strengthened with a special project.

  15. Integrated primary health care in Australia

    Directory of Open Access Journals (Sweden)

    Gawaine Powell Davies

    2009-10-01

    Full Text Available Introduction: To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy: Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion: Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

  16. Integrated primary health care in Australia.

    Science.gov (United States)

    Davies, Gawaine Powell; Perkins, David; McDonald, Julie; Williams, Anna

    2009-10-14

    To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

  17. From parallel practice to integrative health care: a conceptual framework

    Directory of Open Access Journals (Sweden)

    O'Hara Dennis

    2004-07-01

    Full Text Available Abstract Background "Integrative health care" has become a common term to describe teams of health care providers working together to provide patient care. However this term has not been well-defined and likely means many different things to different people. The purpose of this paper is to develop a conceptual framework for describing, comparing and evaluating different forms of team-oriented health care practices that have evolved in Western health care systems. Discussion Seven different models of team-oriented health care practice are illustrated in this paper: parallel, consultative, collaborative, coordinated, multidisciplinary, interdisciplinary and integrative. Each of these models occupies a position along the proposed continuum from the non-integrative to fully integrative approach they take to patient care. The framework is developed around four key components of integrative health care practice: philosophy/values; structure, process and outcomes. Summary This framework can be used by patients and health care practitioners to determine what styles of practice meet their needs and by policy makers, healthcare managers and researchers to document the evolution of team practices over time. This framework may also facilitate exploration of the relationship between different practice models and health outcomes.

  18. Integrated System Health Management Development Toolkit

    Science.gov (United States)

    Figueroa, Jorge; Smith, Harvey; Morris, Jon

    2009-01-01

    This software toolkit is designed to model complex systems for the implementation of embedded Integrated System Health Management (ISHM) capability, which focuses on determining the condition (health) of every element in a complex system (detect anomalies, diagnose causes, and predict future anomalies), and to provide data, information, and knowledge (DIaK) to control systems for safe and effective operation.

  19. Structural integrity assessment of HANARO pool cover

    International Nuclear Information System (INIS)

    Ryu, Jeong Soo

    2001-11-01

    This report is for the seismic analysis and the structural integrity evaluation of HANARO Pool Cover in accordances with the requirement of the Technical Specification for Seismic Analysis of HANARO Pool Cover. For performing the seismic analysis and evaluating the structural integrity for HANARO Pool Cover, the finite element analysis model using ANSYS 5.7 was developed and the dynamic characteristics were analyzed. The seismic response spectrum analyses of HANARO Pool Cover under the design floor response spectrum loads of OBE and SSE were performed. The analysis results show that the stress values in HANARO Pool Cover for the seismic loads are within the ASME Code limits. It is also confirmed that the fatigue usage factor is less than 1.0. Therefore any damage on structural integrity is not expected when an HANARO Pool Cover is installed in the upper part of the reactor pool

  20. Does cultural integration explain a mental health advantage for adolescents?

    Science.gov (United States)

    Bhui, Kamaldeep S; Lenguerrand, Erik; Maynard, Maria J; Stansfeld, Stephen A; Harding, Seeromanie

    2012-06-01

    A mental health advantage has been observed among adolescents in urban areas. This prospective study tests whether cultural integration measured by cross-cultural friendships explains a mental health advantage for adolescents. A prospective cohort of adolescents was recruited from 51 secondary schools in 10 London boroughs. Cultural identity was assessed by friendship choices within and across ethnic groups. Cultural integration is one of four categories of cultural identity. Using gender-specific linear-mixed models we tested whether cultural integration explained a mental health advantage, and whether gender and age were influential. Demographic and other relevant factors, such as ethnic group, socio-economic status, family structure, parenting styles and perceived racism were also measured and entered into the models. Mental health was measured by the Strengths and Difficulties Questionnaire as a 'total difficulties score' and by classification as a 'probable clinical case'. A total of 6643 pupils in first and second years of secondary school (ages 11-13 years) took part in the baseline survey (2003/04) and 4785 took part in the follow-up survey in 2005-06. Overall mental health improved with age, more so in male rather than female students. Cultural integration (friendships with own and other ethnic groups) was associated with the lowest levels of mental health problems especially among male students. This effect was sustained irrespective of age, ethnicity and other potential explanatory variables. There was a mental health advantage among specific ethnic groups: Black Caribbean and Black African male students (Nigerian/Ghanaian origin) and female Indian students. This was not fully explained by cultural integration, although cultural integration was independently associated with better mental health. Cultural integration was associated with better mental health, independent of the mental health advantage found among specific ethnic groups: Black Caribbean and

  1. Does cultural integration explain a mental health advantage for adolescents?

    Science.gov (United States)

    Bhui, Kamaldeep S; Lenguerrand, Erik; Maynard, Maria J; Stansfeld, Stephen A; Harding, Seeromanie

    2012-01-01

    Background A mental health advantage has been observed among adolescents in urban areas. This prospective study tests whether cultural integration measured by cross-cultural friendships explains a mental health advantage for adolescents. Methods A prospective cohort of adolescents was recruited from 51 secondary schools in 10 London boroughs. Cultural identity was assessed by friendship choices within and across ethnic groups. Cultural integration is one of four categories of cultural identity. Using gender-specific linear-mixed models we tested whether cultural integration explained a mental health advantage, and whether gender and age were influential. Demographic and other relevant factors, such as ethnic group, socio-economic status, family structure, parenting styles and perceived racism were also measured and entered into the models. Mental health was measured by the Strengths and Difficulties Questionnaire as a ‘total difficulties score’ and by classification as a ‘probable clinical case’. Results A total of 6643 pupils in first and second years of secondary school (ages 11–13 years) took part in the baseline survey (2003/04) and 4785 took part in the follow-up survey in 2005–06. Overall mental health improved with age, more so in male rather than female students. Cultural integration (friendships with own and other ethnic groups) was associated with the lowest levels of mental health problems especially among male students. This effect was sustained irrespective of age, ethnicity and other potential explanatory variables. There was a mental health advantage among specific ethnic groups: Black Caribbean and Black African male students (Nigerian/Ghanaian origin) and female Indian students. This was not fully explained by cultural integration, although cultural integration was independently associated with better mental health. Conclusions Cultural integration was associated with better mental health, independent of the mental health advantage

  2. Structural health monitoring for ship structures

    Energy Technology Data Exchange (ETDEWEB)

    Farrar, Charles [Los Alamos National Laboratory; Park, Gyuhae [Los Alamos National Laboratory; Angel, Marian [Los Alamos National Laboratory; Bement, Matthew [Los Alamos National Laboratory; Salvino, Liming [NSWC, CADEROCK

    2009-01-01

    Currently the Office of Naval Research is supporting the development of structural health monitoring (SHM) technology for U.S. Navy ship structures. This application is particularly challenging because of the physical size of these structures, the widely varying and often extreme operational and environmental conditions associated with these ships missions, lack of data from known damage conditions, limited sensing that was not designed specifically for SHM, and the management of the vast amounts of data that can be collected during a mission. This paper will first define a statistical pattern recognition paradigm for SHM by describing the four steps of (1) Operational Evaluation, (2) Data Acquisition, (3) Feature Extraction, and (4) Statistical Classification of Features as they apply to ship structures. Note that inherent in the last three steps of this process are additional tasks of data cleansing, compression, normalization and fusion. The presentation will discuss ship structure SHM challenges in the context of applying various SHM approaches to sea trials data measured on an aluminum multi-hull high-speed ship, the HSV-2 Swift. To conclude, the paper will discuss several outstanding issues that need to be addressed before SHM can make the transition from a research topic to actual field applications on ship structures and suggest approaches for addressing these issues.

  3. Integrative health coaching: an organizational case study.

    Science.gov (United States)

    Wolever, Ruth Q; Caldwell, Karen L; Wakefield, Jessica P; Little, Kerry J; Gresko, Jeanne; Shaw, Andrea; Duda, Linda V; Kosey, Julie M; Gaudet, Tracy

    2011-01-01

    The aim of this study was to describe integrative health (IH) coaching as developed in three different interventions offered through a major medical center, as a step toward further defining the field of health coaching. An organizational case study was conducted with document analysis and interviews. Interviewees were the first six IH coaches at Duke Integrative Medicine who provided 360 clients with individual and/or group coaching (two to 28 sessions) in a randomized clinical study and two work-site wellness programs. Qualitative analysis using the constant comparative method was conducted. Integrative health coaching is characterized by a process of self-discovery that informs goal setting and builds internal motivation by linking clients' goals to their values and sense of purpose. Time, commitment, and motivation are necessary in the IH coaching process. The underpinnings of IH coaching are distinct from the medical model, and the process is distinct from health education, executive coaching, and psychotherapy. Integrative health coaching fits well with the assumptions of integrative medicine and has a role in supporting behavior change. Copyright © 2011. Published by Elsevier Inc.

  4. [Integrated health care organizations: guideline for analysis].

    Science.gov (United States)

    Vázquez Navarrete, M Luisa; Vargas Lorenzo, Ingrid; Farré Calpe, Joan; Terraza Núñez, Rebeca

    2005-01-01

    There has been a tendency recently to abandon competition and to introduce policies that promote collaboration between health providers as a means of improving the efficiency of the system and the continuity of care. A number of countries, most notably the United States, have experienced the integration of health care providers to cover the continuum of care of a defined population. Catalonia has witnessed the steady emergence of increasing numbers of integrated health organisations (IHO) but, unlike the United States, studies on health providers' integration are scarce. As part of a research project currently underway, a guide was developed to study Catalan IHOs, based on a classical literature review and the development of a theoretical framework. The guide proposes analysing the IHO's performance in relation to their final objectives of improving the efficiency and continuity of health care by an analysis of the integration type (based on key characteristics); external elements (existence of other suppliers, type of services' payment mechanisms); and internal elements (model of government, organization and management) that influence integration. Evaluation of the IHO's performance focuses on global strategies and results on coordination of care and efficiency. Two types of coordination are evaluated: information coordination and coordination of care management. Evaluation of the efficiency of the IHO refers to technical and allocative efficiency. This guide may have to be modified for use in the Catalan context.

  5. The Benchmarking of Integrated Business Structures

    Directory of Open Access Journals (Sweden)

    Nifatova Olena M.

    2017-12-01

    Full Text Available The aim of the article is to study the role of the benchmarking in the process of integration of business structures in the aspect of knowledge sharing. The results of studying the essential content of the concept “integrated business structure” and its semantic analysis made it possible to form our own understanding of this category with an emphasis on the need to consider it in the plane of three projections — legal, economic and organizational one. The economic projection of the essential content of integration associations of business units is supported by the organizational projection, which is expressed through such essential aspects as existence of a single center that makes key decisions; understanding integration as knowledge sharing; using the benchmarking as exchange of experience on key business processes. Understanding the process of integration of business units in the aspect of knowledge sharing involves obtaining certain information benefits. Using the benchmarking as exchange of experience on key business processes in integrated business structures will help improve the basic production processes, increase the efficiency of activity of both the individual business unit and the IBS as a whole.

  6. Risk assessment of integrated electronic health records.

    Science.gov (United States)

    Bjornsson, Bjarni Thor; Sigurdardottir, Gudlaug; Stefansson, Stefan Orri

    2010-01-01

    The paper describes the security concerns related to Electronic Health Records (EHR) both in registration of data and integration of systems. A description of the current state of EHR systems in Iceland is provided, along with the Ministry of Health's future vision and plans. New legislation provides the opportunity for increased integration of EHRs and further collaboration between institutions. Integration of systems, along with greater availability and access to EHR data, requires increased security awareness since additional risks are introduced. The paper describes the core principles of information security as it applies to EHR systems and data. The concepts of confidentiality, integrity, availability, accountability and traceability are introduced and described. The paper discusses the legal requirements and importance of performing risk assessment for EHR data. Risk assessment methodology according to the ISO/IEC 27001 information security standard is described with examples on how it is applied to EHR systems.

  7. Local Health Integration Networks: Build on their purpose.

    Science.gov (United States)

    MacLeod, Hugh

    2015-11-01

    This article provides a high-level overview on the creation of Local Health Integration Networks (LHINs) and illustrates the complexities involved in their implementation. To understand regional structures such as LHINs, one must understand the context in which design and execution takes place. The article ends with a commentary on how Ontario is performing post-LHINs and discusses next steps. © 2015 The Canadian College of Health Leaders.

  8. Outcome mapping for health system integration

    Directory of Open Access Journals (Sweden)

    Tsasis P

    2013-03-01

    Full Text Available Peter Tsasis,1 Jenna M Evans,2 David Forrest,3 Richard Keith Jones4 1School of Health Policy and Management, Faculty of Health, York University, Toronto, Canada; 2Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Canada; 3Global Vision Consulting Ltd, Victoria, Canada; 4R Keith Jones and Associates, Victoria, Canada Abstract: Health systems around the world are implementing integrated care strategies to improve quality, reduce or maintain costs, and improve the patient experience. Yet few practical tools exist to aid leaders and managers in building the prerequisites to integrated care, namely a shared vision, clear roles and responsibilities, and a common understanding of how the vision will be realized. Outcome mapping may facilitate stakeholder alignment on the vision, roles, and processes of integrated care delivery via participative and focused dialogue among diverse stakeholders on desired outcomes and enabling actions. In this paper, we describe an outcome-mapping exercise we conducted at a Local Health Integration Network in Ontario, Canada, using consensus development conferences. Our preliminary findings suggest that outcome mapping may help stakeholders make sense of a complex system and foster collaborative capital, a resource that can support information sharing, trust, and coordinated change toward integration across organizational and professional boundaries. Drawing from the theoretical perspectives of complex adaptive systems and collaborative capital, we also outline recommendations for future outcome-mapping exercises. In particular, we emphasize the potential for outcome mapping to be used as a tool not only for identifying and linking strategic outcomes and actions, but also for studying the boundaries, gaps, and ties that characterize social networks across the continuum of care. Keywords: integrated care, integrated delivery systems, complex adaptive systems, social capital

  9. MMM: A toolbox for integrative structure modeling.

    Science.gov (United States)

    Jeschke, Gunnar

    2018-01-01

    Structural characterization of proteins and their complexes may require integration of restraints from various experimental techniques. MMM (Multiscale Modeling of Macromolecules) is a Matlab-based open-source modeling toolbox for this purpose with a particular emphasis on distance distribution restraints obtained from electron paramagnetic resonance experiments on spin-labelled proteins and nucleic acids and their combination with atomistic structures of domains or whole protomers, small-angle scattering data, secondary structure information, homology information, and elastic network models. MMM does not only integrate various types of restraints, but also various existing modeling tools by providing a common graphical user interface to them. The types of restraints that can support such modeling and the available model types are illustrated by recent application examples. © 2017 The Protein Society.

  10. Structural integrity of graphite core support structures of HTTR

    International Nuclear Information System (INIS)

    Inagaki, Yoshiyuki; Iyoku, Tatsuo; Toyota, Junji; Sato, Sadao; Shiozawa, Shusaku

    1990-02-01

    The graphite core support structures (GCSSs) of the HTTR (High Temperature Engineering Test Reactor) are an arrangement of graphite blocks and posts that support the core and provide a lower plenum and a hot-leg path for the primary coolant. The GCSSs are designed not to be replaced by new items during plant life time (about twenty years). To maintain structural integrity of the GCSSs, conservative design has been made sufficiently on the basis of structural tests. The present study confirmed that reactor safety was still maintained even if failure and destruction of the GCSSs is supposed to occur. The GCSSs are fabricated under strict quality control and the observation and surveillance programs are planed to examine the structual integrity of the GCSSs during an operation. This paper describes the concept of design and quality control and summarizes structural tests, observation and surveillance programs. (author)

  11. Integrating Community Health Workers (CHWs) into Health Care Organizations.

    Science.gov (United States)

    Payne, Julianne; Razi, Sima; Emery, Kyle; Quattrone, Westleigh; Tardif-Douglin, Miriam

    2017-10-01

    Health care organizations increasingly employ community health workers (CHWs) to help address growing provider shortages, improve patient outcomes, and increase access to culturally sensitive care among traditionally inaccessible or disenfranchised patient populations. Scholarly interest in CHWs has grown in recent decades, but researchers tend to focus on how CHWs affect patient outcomes rather than whether and how CHWs fit into the existing health care workforce. This paper focuses on the factors that facilitate and impede the integration of the CHWs into health care organizations, and strategies that organizations and their staff develop to overcome barriers to CHW integration. We use qualitative evaluation data from 13 awardees that received Health Care Innovation Awards from the Centers of Medicare and Medicaid Innovation to enhance the quality of health care, improve health outcomes, and reduce the cost of care using programs involving CHWs. We find that organizational capacity, support for CHWs, clarity about health care roles, and clinical workflow drive CHW integration. We conclude with practical recommendations for health care organizations interested in employing CHWs.

  12. Structural health monitoring 2012. Proceedings. Vol. 2

    International Nuclear Information System (INIS)

    Boller, Christian

    2012-01-01

    Structural Health Monitoring (SHM) is an emerging technology, dealing with the development and implementation of techniques and systems where monitoring, inspection and damage detection become an integral part of structures and thus a matter of automation. It further merges with a variety of techniques related to diagnostics and prognostics. SHM emerged from the field of smart structures and laterally encompasses disciplines such as structural dynamics, materials and structures, fatigue and fracture, non-destructive testing and evaluation, sensors and actuators, microelectronics, signal processing and much more. To be effective in the development of SHM systems, a multidisciplinary approach is therefore required. Without this global view it will be difficult for engineers to holistically manage the operation of an engineering structure through its life cycle in the future and to generate new breakthroughs in structural engineering. The second volume of the proceedings contains topics dealing with applications in the field of aeronautics, astronautic, civil engineering (bridges), energy (wind power), structural health monitoring (transportation), and poster presentations. Ten of the contributions are separately analyzed for the ENERGY database.

  13. Vertical Integration Spurs American Health Care Revolution.

    Science.gov (United States)

    Phillips, Richard C.

    1986-01-01

    Under new "managed health care systems," the classical functional separation of risk taker, claims payor, and provider are vertically integrated into a common entity. This evolution should produce a competitive environment with medical care rendered to all Americans on a more cost-effective basis. (CJH)

  14. Investigation of Integrated Vehicle Health Management Approaches

    Science.gov (United States)

    Paris, Deidre

    2005-01-01

    This report is to present the work that was performed during the summer in the Advance Computing Application office. The NFFP (NASA Faculty Fellow Program) had ten summer faculty members working on IVHM (Integrated Vehicle Health Management) technologies. The objective of this project was two-fold: 1) to become familiar with IVHM concepts and key demonstrated IVHM technologies; and 2) to integrate the research that has been performed by IVHM faculty members into the MASTLAB (Marshall Avionic Software Test Lab). IVHM is a NASA-wide effort to coordinate, integrate and apply advanced software, sensors and design technologies to increase the level of intelligence, autonomy, and health state of future vehicles. IVHM is an important concept because it is consistent with the current plan for NASA to go to the moon, mars, and beyond. In order for NASA to become more involved in deep exploration, avionic systems will need to be highly adaptable and autonomous.

  15. Integrating mental health services: the Finnish experience

    Directory of Open Access Journals (Sweden)

    Ville Lehtinen

    2001-06-01

    Full Text Available The aim of this paper is to give a short description of the most important developments of mental health services in Finland during the 1990s, examine their influences on the organisation and provision of services, and describe shortly some national efforts to handle the new situation. The Finnish mental health service system experienced profound changes in the beginning of the 1990s. These included the integration of mental health services, being earlier under own separate administration, with other specialised health services, decentralisation of the financing of health services, and de-institutionalisation of the services. The same time Finland underwent the deepest economic recession in Western Europe, which resulted in cut-offs especially in the mental health budgets. Conducting extensive national research and development programmes in the field of mental health has been one typically Finnish way of supporting the mental health service development. The first of these national programmes was the Schizophrenia Project 1981–97, whose main aims were to decrease the incidence of new long-term patients and the prevalence of old long-stay patients by developing an integrated treatment model. The Suicide Prevention Project 1986–96 aimed at raising awareness of this special problem and decreasing by 20% the proportionally high suicide rate in Finland. The National Depression Programme 1994–98 focused at this clearly increasing public health concern by several research and development project targeted both to the general population and specifically to children, primary care and specialised services. The latest, still on-going Meaningful Life Programme 1998–2003 which main aim is, by multi-sectoral co-operation, to improve the quality of life for people suffering from or living with the threat of mental disorders. Furthermore, the government launched in 1999 a new Goal and Action Programme for Social Welfare and Health Care 2000–2003, in

  16. Integrated Systems Health Management for Intelligent Systems

    Science.gov (United States)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

    The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this paper, concepts, procedures, and approaches are presented as a foundation for implementing an intelligent systems ]relevant ISHM capability. The capability stresses integration of DIaK from all elements of a system. Both ground-based (remote) and on-board ISHM capabilities are compared and contrasted. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

  17. Oswer integrated health and safety standard operating practices. Directive

    International Nuclear Information System (INIS)

    1993-02-01

    The directive implements the OSWER (Office of Solid Waste and Emergency Response) Integrated Health and Safety Standards Operating Practices in conjunction with the OSHA (Occupational Safety and Health Act) Worker Protection Standards, replacing the OSWER Integrated Health and Safety Policy

  18. Development of Technology for Structural Integrity Evaluation

    International Nuclear Information System (INIS)

    Choun, Young Sun; Choi, I. K.; Kim, M. K. and others

    2005-03-01

    The purpose of this study is a development of seismic safety and structural integrity evaluation method of the structure in the Nuclear Power plant (NPP). The purpose of 1st sub-Topic is the development and improvement of the seismic safety evaluation methodology for the Nuclear Power Plant structures and safety related equipment. The purpose of 2nd sub-topic is the increasing of structure and equipment seismic capacity through the reducing of seismic force. The purpose of 3rd sub-topic is the development of 3-D nonlinear finite element analysis program for prestressed concrete containment building. The last purpose if the evaluation of the failure mechanism of containment structure and structure capacity and the assessment of integrity of containment through the of leakage test. As a result of this research, there are many research results were produced. The scenario earthquake developing method was developed and the effect of the structures and equipment was analyzed. The effectiveness of isolation system was determined and optimum isolation systems for each equipment were selected. The NUCAS-3D program for the 3 dimensional numerical analysis of containment building using the embedded tendon element and rebar element was developed. The tension behavior of containment building was examined and the leakage rate of the concrete crack was determined. The results of this research can be successfully used for many fields of integrity of NPP site. It can be used for development of design earthquake for the seismic design and safety evaluation and establishment of seismic safety evaluation program and seismic capacity improvement program for existing NPP. In case of seismic isolation part, it can be used for the application to the selection of optimum isolation devices for equipment isolation and to the effective evaluation of each seismic isolation devices. In containment analysis part, it can be used for ultimate pressure capacity evaluation of prestressed concrete

  19. Bringing Wellness to Schools: Opportunities and Challenges to Mental Health Integration in School Health Centers

    Science.gov (United States)

    Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H.

    2016-01-01

    Objective School-based health centers (SBHCs) reduce mental health access-to-care barriers and improve educational outcomes for youth. This qualitative study evaluates the innovations and challenges of a unique network of SBHCs in a large, urban school district, as they attempt to integrate health, mental health, and educational services. Methods The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semi-structured interviews with each participant were audio-recorded and transcribed. Themes were identified and coded using Atlas.ti 5.1, and collapsed into three domains: Operations, Partnership, and Engagement. Results Interviews revealed provider models ranging from single agencies offering both health and mental health services to co-located services. Sites with the Health Agency providing at least some mental health services reported more mental health screenings. Many sites utilized SBHC coordinators and coordination team meetings to facilitate relationships between schools and Health Agency and Community Mental Health Clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement, through culturally sensitive services, peer health advocates, and “drop-in” lunches. Conclusions Staffing and operational models are critical in the success of health-mental health-education integration. Among the provider models observed, the combined health and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions for operational problems and family engagement in mental health services. Implications for future SBHCs as an integrated model are described. PMID:27417895

  20. Studying integrated health care systems with a structurationist approach

    Science.gov (United States)

    Demers, Louis; Arseneault, Stéphane; Couturier, Yves

    2010-01-01

    Introduction To implement an integrated health care system is not an easy task and to ensure its sustainability is yet more difficult. Aim Discuss how a structurationist approach can shed light on the stakes of these processes and guide the managers of such endeavours. Theory and method Structuration theory [1] has been used by numerous authors to cast new light on complex organizational phenomena. One of the central tenets of this theory is that social systems, such as integrated health care systems, are recurrent social practices across time-space and are characterized by structural properties which simultaneously constrain and enable the constitutive social actors who reproduce and transform the system through their practices. We will illustrate our theoretical standpoint with empirical material gathered during the study of an integrated health care system for the frail elderly in Quebec, Canada. This system has been implemented in 1997 and is still working well in 2010. Results and conclusion To implement an integrated health care system that is both effective and sustainable, its managers must shrewdly allow for the existing system and progressively introduce changes in the way managers and practitioners at work in the system view their role and act on a daily basis.

  1. Integrating health and environmental impact analysis.

    Science.gov (United States)

    Reis, S; Morris, G; Fleming, L E; Beck, S; Taylor, T; White, M; Depledge, M H; Steinle, S; Sabel, C E; Cowie, H; Hurley, F; Dick, J McP; Smith, R I; Austen, M

    2015-10-01

    Scientific investigations have progressively refined our understanding of the influence of the environment on human health, and the many adverse impacts that human activities exert on the environment, from the local to the planetary level. Nonetheless, throughout the modern public health era, health has been pursued as though our lives and lifestyles are disconnected from ecosystems and their component organisms. The inadequacy of the societal and public health response to obesity, health inequities, and especially global environmental and climate change now calls for an ecological approach which addresses human activity in all its social, economic and cultural complexity. The new approach must be integral to, and interactive, with the natural environment. We see the continuing failure to truly integrate human health and environmental impact analysis as deeply damaging, and we propose a new conceptual model, the ecosystems-enriched Drivers, Pressures, State, Exposure, Effects, Actions or 'eDPSEEA' model, to address this shortcoming. The model recognizes convergence between the concept of ecosystems services which provides a human health and well-being slant to the value of ecosystems while equally emphasizing the health of the environment, and the growing calls for 'ecological public health' as a response to global environmental concerns now suffusing the discourse in public health. More revolution than evolution, ecological public health will demand new perspectives regarding the interconnections among society, the economy, the environment and our health and well-being. Success must be built on collaborations between the disparate scientific communities of the environmental sciences and public health as well as interactions with social scientists, economists and the legal profession. It will require outreach to political and other stakeholders including a currently largely disengaged general public. The need for an effective and robust science-policy interface has

  2. Occupational Health Services Integrated in Primary Health Care in Iran.

    Science.gov (United States)

    Rafiei, Masoud; Ezzatian, Reza; Farshad, Asghar; Sokooti, Maryam; Tabibi, Ramin; Colosio, Claudio

    2015-01-01

    A healthy workforce is vital for maintaining social and economic development on a global, national and local level. Around half of the world's people are economically active and spend at least one third of their time in their place of work while only 15% of workers have access to basic occupational health services. According to WHO report, since the early 1980s, health indicators in Iran have consistently improved, to the extent that it is comparable with those in developed countries. In this paper it was tried to briefly describe about Health care system and occupational Health Services as part of Primary Health care in Iran. To describe the health care system in the country and the status of occupational health services to the workers and employers, its integration into Primary Health Care (PHC) and outlining the challenges in provision of occupational health services to the all working population. Iran has fairly good health indicators. More than 85 percent of the population in rural and deprived regions, for instance, have access to primary healthcare services. The PHC centers provide essential healthcare and public-health services for the community. Providing, maintaining and improving of the workers' health are the main goals of occupational health services in Iran that are presented by different approaches and mostly through Workers' Houses in the PHC system. Iran has developed an extensive network of PHC facilities with good coverage in most rural areas, but there are still few remote areas that might suffer from inadequate services. It seems that there is still no transparent policy to collaborate with the private sector, train managers or provide a sustainable mechanism for improving the quality of services. Finally, strengthening national policies for health at work, promotion of healthy work and work environment, sharing healthy work practices, developing updated training curricula to improve human resource knowledge including occupational health

  3. Making Technology Ready: Integrated Systems Health Management

    Science.gov (United States)

    Malin, Jane T.; Oliver, Patrick J.

    2007-01-01

    This paper identifies work needed by developers to make integrated system health management (ISHM) technology ready and by programs to make mission infrastructure ready for this technology. This paper examines perceptions of ISHM technologies and experience in legacy programs. Study methods included literature review and interviews with representatives of stakeholder groups. Recommendations address 1) development of ISHM technology, 2) development of ISHM engineering processes and methods, and 3) program organization and infrastructure for ISHM technology evolution, infusion and migration.

  4. DOH to integrate reproductive health in health care delivery.

    Science.gov (United States)

    According to a Department of Health (DOH) official speaking at the recent Reproductive Health Advocacy Forum in Zamboanga City, the concept of reproductive health (RH) is now on the way to being fully integrated into the Philippines' primary health care system. The DOH is also developing integrated information, education, and communication material for an intensified advocacy campaign on RH among target groups in communities. The forum was held to enhance the knowledge and practice of RH among health, population and development program managers, field workers, and local government units. In this new RH framework, family planning becomes just one of many concerns of the RH package of services which includes maternal and child health, sexuality education, the prevention and treatment of abortion complications, prevention of violence against women, and the treatment of reproductive tract infections. Of concern, however, the Asian economic crisis has led the Philippine government to reduce funding, jeopardizing the public sector delivery of basic services, including reproductive health care. The crisis has also forced other governments in the region to reassess their priorities and redirect their available resources into projects which are practical and sustainable.

  5. Advanced structural integrity assessment procedures. Working material

    International Nuclear Information System (INIS)

    1994-01-01

    The purpose of the meeting was to provide an international forum for discussion on recent results in research and utility practice in the field of methodology for the structural integrity assessment of components including relevant non-codified procedures. The scope of the meeting included deterministic and probabilistic approaches. The papers covered the following topics: Leak-before-break concepts; non-destructive examination (NDE) and surveillance results; statistical evaluation of non-destructive examination data; pressurized thermal shock evaluation; fatigue effects (including vibration); and verification qualification. The meeting was attended by 32 specialists from 8 countries. Refs, figs and tabs

  6. Plant life management. Progress for structural integrity

    International Nuclear Information System (INIS)

    Solin, J.

    2003-03-01

    A joint project cluster of industry, VTT and other R and D suppliers is dealing with managing of lifetime of critical structures and components in energy and process industry. The research topics include systematic component lifetime management, data management, integrity and lifetime of pressure bearing components, non-destructive inspection, interactions of coolant and materials, environmentally assisted cracking and ageing of reactor internals. This Symposium is a compilation of selected papers describing an intermediate status of the projects after three years of research and development. (orig.)

  7. Vertical integration models to prepare health systems for capitation.

    Science.gov (United States)

    Cave, D G

    1995-01-01

    Health systems will profit most under capitation if their vertical integration strategy provides operational stability, a strong primary care physician base, efficient delivery of medical services, and geographic access to physicians. Staff- and equity-based systems best meet these characteristics for success because they have one governance structure and a defined mission statement. Moreover, physician bonds are strong because these systems maximize physicians' income potential and control the revenue stream.

  8. Dynamic kirigami structures for integrated solar tracking

    Science.gov (United States)

    Lamoureux, Aaron; Lee, Kyusang; Shlian, Matthew; Forrest, Stephen R.; Shtein, Max

    2015-01-01

    Optical tracking is often combined with conventional flat panel solar cells to maximize electrical power generation over the course of a day. However, conventional trackers are complex and often require costly and cumbersome structural components to support system weight. Here we use kirigami (the art of paper cutting) to realize novel solar cells where tracking is integral to the structure at the substrate level. Specifically, an elegant cut pattern is made in thin-film gallium arsenide solar cells, which are then stretched to produce an array of tilted surface elements which can be controlled to within ±1°. We analyze the combined optical and mechanical properties of the tracking system, and demonstrate a mechanically robust system with optical tracking efficiencies matching conventional trackers. This design suggests a pathway towards enabling new applications for solar tracking, as well as inspiring a broader range of optoelectronic and mechanical devices. PMID:26348820

  9. Innovation in Evaluating the Impact of Integrated Service-Delivery: The Integra Indexes of HIV and Reproductive Health Integration.

    Science.gov (United States)

    Mayhew, Susannah H; Ploubidis, George B; Sloggett, Andy; Church, Kathryn; Obure, Carol D; Birdthistle, Isolde; Sweeney, Sedona; Warren, Charlotte E; Watts, Charlotte; Vassall, Anna

    2016-01-01

    The body of knowledge on evaluating complex interventions for integrated healthcare lacks both common definitions of 'integrated service delivery' and standard measures of impact. Using multiple data sources in combination with statistical modelling the aim of this study is to develop a measure of HIV-reproductive health (HIV-RH) service integration that can be used to assess the degree of service integration, and the degree to which integration may have health benefits to clients, or reduce service costs. Data were drawn from the Integra Initiative's client flow (8,263 clients in Swaziland and 25,539 in Kenya) and costing tools implemented between 2008-2012 in 40 clinics providing RH services in Kenya and Swaziland. We used latent variable measurement models to derive dimensions of HIV-RH integration using these data, which quantified the extent and type of integration between HIV and RH services in Kenya and Swaziland. The modelling produced two clear and uncorrelated dimensions of integration at facility level leading to the development of two sub-indexes: a Structural Integration Index (integrated physical and human resource infrastructure) and a Functional Integration Index (integrated delivery of services to clients). The findings highlight the importance of multi-dimensional assessments of integration, suggesting that structural integration is not sufficient to achieve the integrated delivery of care to clients--i.e. "functional integration". These Indexes are an important methodological contribution for evaluating complex multi-service interventions. They help address the need to broaden traditional evaluations of integrated HIV-RH care through the incorporation of a functional integration measure, to avoid misleading conclusions on its 'impact' on health outcomes. This is particularly important for decision-makers seeking to promote integration in resource constrained environments.

  10. Innovation in Evaluating the Impact of Integrated Service-Delivery: The Integra Indexes of HIV and Reproductive Health Integration.

    Directory of Open Access Journals (Sweden)

    Susannah H Mayhew

    Full Text Available The body of knowledge on evaluating complex interventions for integrated healthcare lacks both common definitions of 'integrated service delivery' and standard measures of impact. Using multiple data sources in combination with statistical modelling the aim of this study is to develop a measure of HIV-reproductive health (HIV-RH service integration that can be used to assess the degree of service integration, and the degree to which integration may have health benefits to clients, or reduce service costs.Data were drawn from the Integra Initiative's client flow (8,263 clients in Swaziland and 25,539 in Kenya and costing tools implemented between 2008-2012 in 40 clinics providing RH services in Kenya and Swaziland. We used latent variable measurement models to derive dimensions of HIV-RH integration using these data, which quantified the extent and type of integration between HIV and RH services in Kenya and Swaziland. The modelling produced two clear and uncorrelated dimensions of integration at facility level leading to the development of two sub-indexes: a Structural Integration Index (integrated physical and human resource infrastructure and a Functional Integration Index (integrated delivery of services to clients. The findings highlight the importance of multi-dimensional assessments of integration, suggesting that structural integration is not sufficient to achieve the integrated delivery of care to clients--i.e. "functional integration".These Indexes are an important methodological contribution for evaluating complex multi-service interventions. They help address the need to broaden traditional evaluations of integrated HIV-RH care through the incorporation of a functional integration measure, to avoid misleading conclusions on its 'impact' on health outcomes. This is particularly important for decision-makers seeking to promote integration in resource constrained environments.

  11. Telematics and smart cards in integrated health information system.

    Science.gov (United States)

    Sicurello, F; Nicolosi, A

    1997-01-01

    Telematics and information technology are the base on which it will be possible to build an integrated health information system to support population and improve their quality of life. This system should be based on record linkage of all data based on the interactions of the patients with the health structures, such as general practitioners, specialists, health institutes and hospitals, pharmacies, etc. The record linkage can provide the connection and integration of various records, thanks to the use of telematic technology (either urban or geographical local networks, such as the Internet) and electronic data cards. Particular emphasis should be placed on the introduction of smart cards, such as portable health cards, which will contain a standardized data set and will be sufficient to access different databases found in various health services. The inter-operability of the social-health records (including multimedia types) and the smart cards (which are one of the most important prerequisites for the homogenization and wide diffusion of these cards at an European level) should be strongly taken into consideration. In this framework a project is going to be developed aiming towards the integration of various data bases distributed territorially, from the reading of the software and the updating of the smart cards to the complete management of the patients' evaluation records, to the quality of the services offered and to the health planning. The applications developed will support epidemiological investigation software and data analysis. The inter-connection of all the databases of the various structures involved will take place through a coordination center, the most important system of which we will call "record linkage" or "integrated database". Smart cards will be distributed to a sample group of possible users and the necessary smart card management tools will be installed in all the structures involved. All the final users (the patients) in the whole

  12. Integrated corporate structure life cycle management modeling and organization

    OpenAIRE

    Naumenko, M.; Morozova, L.

    2011-01-01

    Integrated business structure presented as complementary pool of its participants skills. The methodical approach to integrated business structure life cycle modeling proposed. Recommendations of enterprises life cycles stages correlate are submitted.

  13. Review of behavioral health integration in primary care at Baylor Scott and White Healthcare, Central Region

    OpenAIRE

    Jolly, John B.; Fluet, Norman R.; Reis, Michael D.; Stern, Charles H.; Thompson, Alexander W.; Jolly, Gillian A.

    2016-01-01

    The integration of behavioral health services in primary care has been referred to in many ways, but ultimately refers to common structures and processes. Behavioral health is integrated into primary care because it increases the effectiveness and efficiency of providing care and reduces costs in the care of primary care patients. Reimbursement is one factor, if not the main factor, that determines the level of integration that can be achieved. The federal health reform agenda supports change...

  14. Damage Detection with Streamlined Structural Health Monitoring Data

    OpenAIRE

    Li, Jian; Deng, Jun; Xie, Weizhi

    2015-01-01

    The huge amounts of sensor data generated by large scale sensor networks in on-line structural health monitoring (SHM) systems often overwhelms the systems’ capacity for data transmission and analysis. This paper presents a new concept for an integrated SHM system in which a streamlined data flow is used as a unifying thread to integrate the individual components of on-line SHM systems. Such an integrated SHM system has a few desirable functionalities including embedded sensor data compressio...

  15. Structural integrity evaluations of CANDU pressure tubes

    International Nuclear Information System (INIS)

    Radu, Vasile

    2003-01-01

    The core of a CANDU-6 pressurized heavy water reactor consists of some hundred horizontal pressure tubes that are manufactured from a Zr-2.5%Nb alloy and which contain the fuel bundles. These tubes are susceptible to a damaging phenomenon known as Delayed Hydride Cracking (DHC). The Zr-2.5%Nb alloy is susceptible to DHC phenomenon when there is diffusion of hydrogen atoms to a service-induced flaws, followed by the hydride platelets formation on the certain crystallographic planes in the matrix material. Finally, the development of hydride regions at the flaw-tip will happened. These hydride regions are able to fracture under stress-temperature conditions (DHC initiation) and the cracks can extend and grow by DHC mechanism. Some studies have been focused on the potential to initiate DHC at the blunt flaws in a CANDU reactor pressure tube and a methodology for structural integrity evaluation was developed. The methodology based on the Failure Assessment Diagrams (FAD's) consists in an integrated graphical plot, where the fracture failure and plastic collapse are simultaneously evaluated by means of two non-dimensional variables (K r and L r ). These two variables represent the ratio of the applied value of either stress or stress intensity factor and the resistance parameter of corresponding magnitude (yield stress or fracture toughness, respectively). Once the plotting plane is determined by the variables K r and L r , the procedure defines a critical failure line that establishes the safe area. The paper will demonstrate the possibility to perform structural integrity evaluations by means of Failure Assessment Diagrams for flaws occurring in CANDU pressure tubes. (author)

  16. Defining and measuring integrated patient care: promoting the next frontier in health care delivery.

    Science.gov (United States)

    Singer, Sara J; Burgers, Jako; Friedberg, Mark; Rosenthal, Meredith B; Leape, Lucian; Schneider, Eric

    2011-02-01

    Integration of care is emerging as a central challenge of health care delivery, particularly for patients with multiple, complex chronic conditions. The authors argue that the concept of "integrated patient care" would benefit from further clarification regarding (a) the object of integration and (b) its essential components, particularly when constructing measures.To address these issues, the authors propose a definition of integrated patient care that distinguishes it from integrated delivery organizations, acknowledging that integrated organizational structures and processes may fail to produce integrated patient care. The definition emphasizes patients' central role as active participants in managing their own health by including patient centeredness as a key element of integrated patient care. Measures based on the proposed definition will enable empirical assessment of the potential relationships between the integration of organizations, the integration of patient care, and patient outcomes, providing valuable guidance to health systems reformers.

  17. Identification methods for structural health monitoring

    CERN Document Server

    Papadimitriou, Costas

    2016-01-01

    The papers in this volume provide an introduction to well known and established system identification methods for structural health monitoring and to more advanced, state-of-the-art tools, able to tackle the challenges associated with actual implementation. Starting with an overview on fundamental methods, introductory concepts are provided on the general framework of time and frequency domain, parametric and non-parametric methods, input-output or output only techniques. Cutting edge tools are introduced including, nonlinear system identification methods; Bayesian tools; and advanced modal identification techniques (such as the Kalman and particle filters, the fast Bayesian FFT method). Advanced computational tools for uncertainty quantification are discussed to provide a link between monitoring and structural integrity assessment. In addition, full scale applications and field deployments that illustrate the workings and effectiveness of the introduced monitoring schemes are demonstrated.

  18. Rocket Testing and Integrated System Health Management

    Science.gov (United States)

    Figueroa, Fernando; Schmalzel, John

    2005-01-01

    Integrated System Health Management (ISHM) describes a set of system capabilities that in aggregate perform: determination of condition for each system element, detection of anomalies, diagnosis of causes for anomalies, and prognostics for future anomalies and system behavior. The ISHM should also provide operators with situational awareness of the system by integrating contextual and timely data, information, and knowledge (DIaK) as needed. ISHM capabilities can be implemented using a variety of technologies and tools. This chapter provides an overview of ISHM contributing technologies and describes in further detail a novel implementation architecture along with associated taxonomy, ontology, and standards. The operational ISHM testbed is based on a subsystem of a rocket engine test stand. Such test stands contain many elements that are common to manufacturing systems, and thereby serve to illustrate the potential benefits and methodologies of the ISHM approach for intelligent manufacturing.

  19. Securing Health Sensing Using Integrated Circuit Metric

    Science.gov (United States)

    Tahir, Ruhma; Tahir, Hasan; McDonald-Maier, Klaus

    2015-01-01

    Convergence of technologies from several domains of computing and healthcare have aided in the creation of devices that can help health professionals in monitoring their patients remotely. An increase in networked healthcare devices has resulted in incidents related to data theft, medical identity theft and insurance fraud. In this paper, we discuss the design and implementation of a secure lightweight wearable health sensing system. The proposed system is based on an emerging security technology called Integrated Circuit Metric (ICMetric) that extracts the inherent features of a device to generate a unique device identification. In this paper, we provide details of how the physical characteristics of a health sensor can be used for the generation of hardware “fingerprints”. The obtained fingerprints are used to deliver security services like authentication, confidentiality, secure admission and symmetric key generation. The generated symmetric key is used to securely communicate the health records and data of the patient. Based on experimental results and the security analysis of the proposed scheme, it is apparent that the proposed system enables high levels of security for health monitoring in resource optimized manner. PMID:26492250

  20. Securing Health Sensing Using Integrated Circuit Metric

    Directory of Open Access Journals (Sweden)

    Ruhma Tahir

    2015-10-01

    Full Text Available Convergence of technologies from several domains of computing and healthcare have aided in the creation of devices that can help health professionals in monitoring their patients remotely. An increase in networked healthcare devices has resulted in incidents related to data theft, medical identity theft and insurance fraud. In this paper, we discuss the design and implementation of a secure lightweight wearable health sensing system. The proposed system is based on an emerging security technology called Integrated Circuit Metric (ICMetric that extracts the inherent features of a device to generate a unique device identification. In this paper, we provide details of how the physical characteristics of a health sensor can be used for the generation of hardware “fingerprints”. The obtained fingerprints are used to deliver security services like authentication, confidentiality, secure admission and symmetric key generation. The generated symmetric key is used to securely communicate the health records and data of the patient. Based on experimental results and the security analysis of the proposed scheme, it is apparent that the proposed system enables high levels of security for health monitoring in resource optimized manner.

  1. Securing health sensing using integrated circuit metric.

    Science.gov (United States)

    Tahir, Ruhma; Tahir, Hasan; McDonald-Maier, Klaus

    2015-10-20

    Convergence of technologies from several domains of computing and healthcare have aided in the creation of devices that can help health professionals in monitoring their patients remotely. An increase in networked healthcare devices has resulted in incidents related to data theft, medical identity theft and insurance fraud. In this paper, we discuss the design and implementation of a secure lightweight wearable health sensing system. The proposed system is based on an emerging security technology called Integrated Circuit Metric (ICMetric) that extracts the inherent features of a device to generate a unique device identification. In this paper, we provide details of how the physical characteristics of a health sensor can be used for the generation of hardware "fingerprints". The obtained fingerprints are used to deliver security services like authentication, confidentiality, secure admission and symmetric key generation. The generated symmetric key is used to securely communicate the health records and data of the patient. Based on experimental results and the security analysis of the proposed scheme, it is apparent that the proposed system enables high levels of security for health monitoring in resource optimized manner.

  2. Parallel processing of structural integrity analysis codes

    International Nuclear Information System (INIS)

    Swami Prasad, P.; Dutta, B.K.; Kushwaha, H.S.

    1996-01-01

    Structural integrity analysis forms an important role in assessing and demonstrating the safety of nuclear reactor components. This analysis is performed using analytical tools such as Finite Element Method (FEM) with the help of digital computers. The complexity of the problems involved in nuclear engineering demands high speed computation facilities to obtain solutions in reasonable amount of time. Parallel processing systems such as ANUPAM provide an efficient platform for realising the high speed computation. The development and implementation of software on parallel processing systems is an interesting and challenging task. The data and algorithm structure of the codes plays an important role in exploiting the parallel processing system capabilities. Structural analysis codes based on FEM can be divided into two categories with respect to their implementation on parallel processing systems. The first category codes such as those used for harmonic analysis, mechanistic fuel performance codes need not require the parallelisation of individual modules of the codes. The second category of codes such as conventional FEM codes require parallelisation of individual modules. In this category, parallelisation of equation solution module poses major difficulties. Different solution schemes such as domain decomposition method (DDM), parallel active column solver and substructuring method are currently used on parallel processing systems. Two codes, FAIR and TABS belonging to each of these categories have been implemented on ANUPAM. The implementation details of these codes and the performance of different equation solvers are highlighted. (author). 5 refs., 12 figs., 1 tab

  3. From social integration to health: Durkheim in the new millennium.

    Science.gov (United States)

    Berkman, L F; Glass, T; Brissette, I; Seeman, T E

    2000-09-01

    It is widely recognized that social relationships and affiliation have powerful effects on physical and mental health. When investigators write about the impact of social relationships on health, many terms are used loosely and interchangeably including social networks, social ties and social integration. The aim of this paper is to clarify these terms using a single framework. We discuss: (1) theoretical orientations from diverse disciplines which we believe are fundamental to advancing research in this area; (2) a set of definitions accompanied by major assessment tools; and (3) an overarching model which integrates multilevel phenomena. Theoretical orientations that we draw upon were developed by Durkheim whose work on social integration and suicide are seminal and John Bowlby, a psychiatrist who developed attachment theory in relation to child development and contemporary social network theorists. We present a conceptual model of how social networks impact health. We envision a cascading causal process beginning with the macro-social to psychobiological processes that are dynamically linked together to form the processes by which social integration effects health. We start by embedding social networks in a larger social and cultural context in which upstream forces are seen to condition network structure. Serious consideration of the larger macro-social context in which networks form and are sustained has been lacking in all but a small number of studies and is almost completely absent in studies of social network influences on health. We then move downstream to understand the influences network structure and function have on social and interpersonal behavior. We argue that networks operate at the behavioral level through four primary pathways: (1) provision of social support; (2) social influence; (3) on social engagement and attachment; and (4) access to resources and material goods.

  4. Structural integrity analysis of a steam turbine

    International Nuclear Information System (INIS)

    Villagarcia, Maria P.

    1997-01-01

    One of the most critical components of a power utility is the rotor of the steam turbine. Catastrophic failures of the last decades have promoted the development of life assessment procedures for rotors. The present study requires the knowledge of operating conditions, component geometry, the properties of materials, history of the component, size, location and nature of the existing flaws. The aim of the present work is the obtention of a structural integrity analysis procedure for a steam turbine rotor, taking into account the above-mentioned parameters. In this procedure, a stress thermal analysis by finite elements is performed initially, in order to obtain the temperature and stress distribution for a subsequent analysis by fracture mechanics. The risk of a fast fracture due to flaws in the central zone of the rotor is analyzed. The procedure is applied to an operating turbine: the main steam turbine of the Atucha I nuclear power utility. (author)

  5. Superconducting power distribution structure for integrated circuits

    International Nuclear Information System (INIS)

    Ruby, R.C.

    1991-01-01

    This patent describes a superconducting power distribution structure for an integrated circuit. It comprises a first superconducting capacitor plate; a second superconducting capacitor plate provided with electrical isolation means within the second capacitor plate; dielectric means separating the first capacitor plate from the second capacitor plate; first via means coupled at a first end to the first capacitor plate and extending through the dielectric and the electrical isolation means of the second capacitor plate; first contact means coupled to a second end of the first via means; and second contact means coupled to the second capacitor plate such that the first contact means and the second contact means are accessible from the same side of the second capacitor plate

  6. Rethinking global health research: towards integrative expertise

    Directory of Open Access Journals (Sweden)

    MacLachlan Malcolm

    2009-07-01

    Full Text Available Abstract The Bamako Call for Action on Research for Health stresses the importance of inter-disciplinary, inter-ministerial and inter-sectoral working. This challenges much of our current research and postgraduate research training in health, which mostly seeks to produce narrowly focused content specialists. We now need to compliment this type of research and research training, by offering alternative pathways that seek to create expertise, not only in specific narrow content areas, but also in the process and context of research, as well as in the interaction of these different facets of knowledge. Such an approach, developing 'integrative expertise', could greatly facilitate better research utilisation, helping policy makers and practitioners work through more evidence-based practice and across traditional research boundaries.

  7. Poling of PVDF matrix composites for integrated structural load sensing

    Science.gov (United States)

    Haghiashtiani, Ghazaleh; Greminger, Michael A.; Zhao, Ping

    2014-03-01

    The purpose of this study is to create and evaluate a smart composite structure that can be used for integrated load sensing and structural health monitoring. In this structure, PVDF films are used as the matrix material instead of epoxy resin or other thermoplastics. The reinforcements are two layers of carbon fiber with one layer of Kevlar separating them. Due to the electrical conductivity properties of carbon fiber and the dielectric effect of Kevlar, the structure acts as a capacitor. Furthermore, the piezoelectric properties of the PVDF matrix can be used to monitor the response of the structure under applied loads. In order to exploit the piezoelectric properties of PVDF, the PVDF material must be polarized to align the dipole moments of its crystalline structure. The optimal condition for poling the structure was found by performing a 23 factorial design of experiment (DoE). The factors that were studied in DoE were temperature, voltage, and duration of poling. Finally, the response of the poled structure was monitored by exposing the samples to an applied load.

  8. Highly Reliable Structural Health Monitoring of Smart Composite Vanes for Jet Engine, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Intelligent Fiber Optic Systems and Auburn University propose a Fiber Bragg Grating (FBG) integrated Structural Health Monitoring (SHM) sensor system capable of...

  9. Information processing for aerospace structural health monitoring

    Science.gov (United States)

    Lichtenwalner, Peter F.; White, Edward V.; Baumann, Erwin W.

    1998-06-01

    Structural health monitoring (SHM) technology provides a means to significantly reduce life cycle of aerospace vehicles by eliminating unnecessary inspections, minimizing inspection complexity, and providing accurate diagnostics and prognostics to support vehicle life extension. In order to accomplish this, a comprehensive SHM system will need to acquire data from a wide variety of diverse sensors including strain gages, accelerometers, acoustic emission sensors, crack growth gages, corrosion sensors, and piezoelectric transducers. Significant amounts of computer processing will then be required to convert this raw sensor data into meaningful information which indicates both the diagnostics of the current structural integrity as well as the prognostics necessary for planning and managing the future health of the structure in a cost effective manner. This paper provides a description of the key types of information processing technologies required in an effective SHM system. These include artificial intelligence techniques such as neural networks, expert systems, and fuzzy logic for nonlinear modeling, pattern recognition, and complex decision making; signal processing techniques such as Fourier and wavelet transforms for spectral analysis and feature extraction; statistical algorithms for optimal detection, estimation, prediction, and fusion; and a wide variety of other algorithms for data analysis and visualization. The intent of this paper is to provide an overview of the role of information processing for SHM, discuss various technologies which can contribute to accomplishing this role, and present some example applications of information processing for SHM implemented at the Boeing Company.

  10. Data driven innovations in structural health monitoring

    Science.gov (United States)

    Rosales, M. J.; Liyanapathirana, R.

    2017-05-01

    At present, substantial investments are being allocated to civil infrastructures also considered as valuable assets at a national or global scale. Structural Health Monitoring (SHM) is an indispensable tool required to ensure the performance and safety of these structures based on measured response parameters. The research to date on damage assessment has tended to focus on the utilization of wireless sensor networks (WSN) as it proves to be the best alternative over the traditional visual inspections and tethered or wired counterparts. Over the last decade, the structural health and behaviour of innumerable infrastructure has been measured and evaluated owing to several successful ventures of implementing these sensor networks. Various monitoring systems have the capability to rapidly transmit, measure, and store large capacities of data. The amount of data collected from these networks have eventually been unmanageable which paved the way to other relevant issues such as data quality, relevance, re-use, and decision support. There is an increasing need to integrate new technologies in order to automate the evaluation processes as well as to enhance the objectivity of data assessment routines. This paper aims to identify feasible methodologies towards the application of time-series analysis techniques to judiciously exploit the vast amount of readily available as well as the upcoming data resources. It continues the momentum of a greater effort to collect and archive SHM approaches that will serve as data-driven innovations for the assessment of damage through efficient algorithms and data analytics.

  11. Integrating environment health and safety management at Petro-Canada

    International Nuclear Information System (INIS)

    Raymond, G.

    1993-01-01

    Petro-Canada has developed a tool to integrate, measure, and improve its management systems of environment, health, and safety (EH ampersand S). This tool, called the Total Loss Management System, is described in the areas of general management issues, policies and procedures, evaluations, organization, stewardship, issue management, and performance measures. Petro-Canada's policies on occupational health and safety are consistent with its environmental policy, being structured in the same way. An integrated audit system is used to cover health, safety, industrial hygiene, reliability, environment, and risk management. EH ampersand S matters are integrated at the corporate level in a separate department. Regional divisions review EH ampersand S performance every month, incidents are discussed, and preventive measures are taken as necessary. Regional performances are combined every quarter for ultimate presentation to the Petro-Canada board. New or emerging issues that may affect divisions are assigned an issue sponsor, a member of divisional management who makes sure the issue receives the resources necessary to study and define its impact. Examples of issues include soil contamination, process hazard management, and benzene exposure limits. Performance measures flow from the corporate environment and occupational health and safety policies, and come in two types: those that measure activities to improve performance and those that measure the outcome of the activities

  12. Opportunities for and constraints to integration of health services in Poland

    Directory of Open Access Journals (Sweden)

    Alicja Sobczak

    2002-06-01

    Full Text Available At the beginning of the article the typologies, expected outcomes and forces aiming at health care integration are discussed. Integration is recognised as a multidimensional concept. The suggested typologies of integration are based on structural configurations, co-ordination mechanisms (including clinical co-ordination, and driving forces. A review of the Polish experience in integration/disintegration of health care systems is the main part of the article. Creation of integrated health care management units (ZOZs in the beginning of the 1970s serves as an example of structural vertical integration missing co-ordination mechanisms. ZOZs as huge, costly and inflexible organisations became subjects of public criticism and discredited the idea of health care integration. At the end of the 1980s and in the decade of the 1990s, management of public health care was decentralised, the majority of ZOZs dismantled, and many health care public providers got the status of independent entities. The private sector developed rapidly. Sickness funds, which in 1999 replaced the previous state system, introduced “quasi-market” conditions where health providers have to compete for contracts. Some providers developed strategies of vertical and horizontal integration to get a competitive advantage. Consolidation of private ambulatory clinics, the idea of “integrated care” as a “contracting package”, development of primary health care and ambulatory specialist clinics in hospitals are the examples of such strategies. The new health policy declared in 2002 has recognised integration as a priority. It stresses the development of payment mechanisms and information base (Register of Health Services – RUM that promote integration. The Ministry of Health is involved directly in integrated emergency system designing. It seems that after years of disintegration and deregulation the need for effective integration has become obvious.

  13. Building integrated care systems: a case study of Bidasoa Integrated Health Organisation

    Directory of Open Access Journals (Sweden)

    Nuria Toro Polanco

    2015-06-01

    Full Text Available Introduction: This paper analyses the implementation of integrated care policies in the Basque Country through the deployment of an Integrated Health Organisation in Bidasoa area during the period 2011–2014. Structural, functional and clinical integration policies have been employed with the aim to deliver integrated and person-centred care for patients, especially for those living with chronic conditions.Methods: This organisational case study used multiple data sources and methods in a pragmatic and reflexive manner to build a picture of the organisational development over a 4-year period. In order to measure the progress of integration three concepts have been measured: (i readiness for chronicity measured with Assessment of Readiness for Chronicity in Healthcare Organisations tool; (ii collaboration between clinicians from different care levels measured with the D'Amour Questionnaire, and (iii overall impact of integration through several indicators based on the Triple Aim Framework.Results: The measurement of organisational readiness for chronicity showed improvements in five of the six areas under evaluation. Similarly the collaboration between professionals of different care levels showed a steady improvement in each of the 10 items. Furthermore, the Triple Aim-based indicators showed a better experience of care in terms of patients’ perceptions of care coordination; a reduction in hospital utilisation, particularly for patients with complex chronic conditions; and cost-containment in terms of per capita expenditure.Conclusion: There is a significant amount of data that shows that Bidasoa Integrated Health Organisation has progressed in terms of delivering integrated care for chronic conditions with a positive impact on several Triple Aim outcomes.

  14. Building integrated care systems: a case study of Bidasoa Integrated Health Organisation

    Directory of Open Access Journals (Sweden)

    Nuria Toro Polanco

    2015-06-01

    Full Text Available Introduction: This paper analyses the implementation of integrated care policies in the Basque Country through the deployment of an Integrated Health Organisation in Bidasoa area during the period 2011–2014. Structural, functional and clinical integration policies have been employed with the aim to deliver integrated and person-centred care for patients, especially for those living with chronic conditions. Methods: This organisational case study used multiple data sources and methods in a pragmatic and reflexive manner to build a picture of the organisational development over a 4-year period. In order to measure the progress of integration three concepts have been measured: (i readiness for chronicity measured with Assessment of Readiness for Chronicity in Healthcare Organisations tool; (ii collaboration between clinicians from different care levels measured with the D'Amour Questionnaire, and (iii overall impact of integration through several indicators based on the Triple Aim Framework. Results: The measurement of organisational readiness for chronicity showed improvements in five of the six areas under evaluation. Similarly the collaboration between professionals of different care levels showed a steady improvement in each of the 10 items. Furthermore, the Triple Aim-based indicators showed a better experience of care in terms of patients’ perceptions of care coordination; a reduction in hospital utilisation, particularly for patients with complex chronic conditions; and cost-containment in terms of per capita expenditure. Conclusion: There is a significant amount of data that shows that Bidasoa Integrated Health Organisation has progressed in terms of delivering integrated care for chronic conditions with a positive impact on several Triple Aim outcomes.

  15. CREATING EFFECTIVE MODELS OF VERTICAL INTEGRATED STRUCTURES IN UKRAINE

    Directory of Open Access Journals (Sweden)

    D. V. Koliesnikov

    2011-01-01

    Full Text Available The results of scientific research aimed at development of methodology-theoretical mechanisms of building the effective models of vertically-integrated structures are presented. A presence of vertically-integrated structures on natural-monopolistic markets at private and governmental sectors of economy and priority directions of integration are given.

  16. Vibration-based structural health monitoring of harbor caisson structure

    Science.gov (United States)

    Lee, So-Young; Lee, So-Ra; Kim, Jeong-Tae

    2011-04-01

    This study presents vibration-based structural health monitoring method in foundation-structure interface of harbor caisson structure. In order to achieve the objective, the following approaches are implemented. Firstly, vibration-based response analysis method is selected and structural health monitoring (SHM) technique is designed for harbor caisson structure. Secondly, the performance of designed SHM technique for harbor structure is examined by FE analysis. Finally, the applicability of designed SHM technique for harbor structure is evaluated by dynamic tests on a lab-scaled caisson structure.

  17. Integration: the firm and the health care sector.

    Science.gov (United States)

    Laugesen, Miriam J; France, George

    2014-07-01

    Integration in health care is a key goal of health reform in United States and England. Yet past efforts in the 1990s to better integrate the delivery system were of limited success. Building on work by Bevan and Janus on delivery integration, this article explores integration through the lens of economic theories of integration. Firms generally integrate to increase efficiency through economies of scale, to improve their market power, and resolve the transaction costs involved with multiple external suppliers. Using the United States and England as laboratories, we apply concepts of economic integration to understand why integration does or does not occur in health care, and whether expectations of integrating different kinds of providers (hospital, primary care) and health and social services are realistic. Current enthusiasm for a more integrated health care system expands the scope of integration to include social services in England, but retains the focus on health care in the United States. We find mixed applicability of economic theories of integration. Economies of scale have not played a significant role in stimulating integration in both countries. Managerial incentives for monopoly or oligopoly may be more compelling in the United States, since hospitals seek higher prices and more leverage over payers. In both countries the concept of transaction costs could explain the success of new payment and budgeting methods, since health care integration ultimately requires resolving transaction costs across different delivery organizations.

  18. Integrating health belief model and technology acceptance model: an investigation of health-related internet use.

    Science.gov (United States)

    Ahadzadeh, Ashraf Sadat; Pahlevan Sharif, Saeed; Ong, Fon Sim; Khong, Kok Wei

    2015-02-19

    Today, people use the Internet to satisfy health-related information and communication needs. In Malaysia, Internet use for health management has become increasingly significant due to the increase in the incidence of chronic diseases, in particular among urban women and their desire to stay healthy. Past studies adopted the Technology Acceptance Model (TAM) and Health Belief Model (HBM) independently to explain Internet use for health-related purposes. Although both the TAM and HBM have their own merits, independently they lack the ability to explain the cognition and the related mechanism in which individuals use the Internet for health purposes. This study aimed to examine the influence of perceived health risk and health consciousness on health-related Internet use based on the HBM. Drawing on the TAM, it also tested the mediating effects of perceived usefulness of the Internet for health information and attitude toward Internet use for health purposes for the relationship between health-related factors, namely perceived health risk and health consciousness on health-related Internet use. Data obtained for the current study were collected using purposive sampling; the sample consisted of women in Malaysia who had Internet access. The partial least squares structural equation modeling method was used to test the research hypotheses developed. Perceived health risk (β=.135, t1999=2.676) and health consciousness (β=.447, t1999=9.168) had a positive influence on health-related Internet use. Moreover, perceived usefulness of the Internet and attitude toward Internet use for health-related purposes partially mediated the influence of health consciousness on health-related Internet use (β=.025, t1999=3.234), whereas the effect of perceived health risk on health-related Internet use was fully mediated by perceived usefulness of the Internet and attitude (β=.029, t1999=3.609). These results suggest the central role of perceived usefulness of the Internet and

  19. Social determinants and lifestyles: integrating environmental and public health perspectives.

    Science.gov (United States)

    Graham, H; White, P C L

    2016-12-01

    Industrialization and urbanization have been associated with an epidemiological transition, from communicable to non-communicable disease, and a geological transition that is moving the planet beyond the stable Holocene epoch in which human societies have prospered. The lifestyles of high-income countries are major drivers of these twin processes. Our objective is to highlight the common causes of chronic disease and environmental change and, thereby, contribute to shared perspectives across public health and the environment. Integrative reviews focused on social determinants and lifestyles as two 'bridging' concepts between the fields of public health and environmental sustainability. We drew on established frameworks to consider the position of the natural environment within social determinants of health (SDH) frameworks and the position of social determinants within environmental frameworks. We drew on evidence on lifestyle factors central to both public health and environmental change (mobility- and diet-related factors). We investigated how public health's focus on individual behaviour can be enriched by environmental perspectives that give attention to household consumption practices. While SDH frameworks can incorporate the biophysical environment, their causal structure positions it as a determinant and one largely separate from the social factors that shape it. Environmental frameworks are more likely to represent the environment and its ecosystems as socially determined. A few frameworks also include human health as an outcome, providing the basis for a combined public health/environmental sustainability framework. Environmental analyses of household impacts broaden public health's concern with individual risk behaviours, pointing to the more damaging lifestyles of high-income households. The conditions for health are being undermined by rapid environmental change. There is scope for frameworks reaching across public health and environmental

  20. Spaceflight Effect on White Matter Structural Integrity

    Science.gov (United States)

    Lee, Jessica K.; Kopplemans, Vincent; Paternack, Ofer; Bloomberg, Jacob J.; Mulavara, Ajitkumar P.; Seidler, Rachael D.

    2017-01-01

    Recent reports of elevated brain white matter hyperintensity (WMH) counts and volume in postflight astronaut MRIs suggest that further examination of spaceflight's impact on the microstructure of brain white matter is warranted. To this end, retrospective longitudinal diffusion-weighted MRI scans obtained from 15 astronauts were evaluated. In light of the recent reports of microgravity-induced cephalad fluid shift and gray matter atrophy seen in astronauts, we applied a technique to estimate diffusion tensor imaging (DTI) metrics corrected for free water contamination. This approach enabled the analysis of white matter tissue-specific alterations that are unrelated to fluid shifts, occurring from before spaceflight to after landing. After spaceflight, decreased fractional anisotropy (FA) values were detected in an area encompassing the superior and inferior longitudinal fasciculi and the inferior fronto-occipital fasciculus. Increased radial diffusivity (RD) and decreased axial diffusivity (AD) were also detected within overlapping regions. In addition, FA values in the corticospinal tract decreased and RD measures in the precentral gyrus white matter increased from before to after flight. The results show disrupted structural connectivity of white matter in tracts involved in visuospatial processing, vestibular function, and movement control as a result of spaceflight. The findings may help us understand the structural underpinnings of the extensive spaceflight-induced sensorimotor remodeling. Prospective longitudinal assessment of the white matter integrity in astronauts is needed to characterize the evolution of white matter microstructural changes associated with spaceflight, their behavioral consequences, and the time course of recovery. Supported by a grant from the National Space Biomedical Research Institute, NASA NCC 9-58.

  1. Integrated System Health Management (ISHM) and Autonomy

    Science.gov (United States)

    Figueroa, Fernando; Walker, Mark G.

    2018-01-01

    Systems capabilities on ISHM (Integrated System Health Management) and autonomy have traditionally been addressed separately. This means that ISHM functions, such as anomaly detection, diagnostics, prognostics, and comprehensive system awareness have not been considered traditionally in the context of autonomy functions such as planning, scheduling, and mission execution. One key reason is that although they address systems capabilities, both ISHM and autonomy have traditionally individually been approached as independent strategies and models for analysis. Additionally, to some degree, a unified paradigm for ISHM and autonomy has been difficult to implement due to limitations of hardware and software. This paper explores a unified treatment of ISHM and autonomy in the context of distributed hierarchical autonomous operations.

  2. Integration of Mental Health into Primary Health Care in a rural ...

    African Journals Online (AJOL)

    Objective: Mental health has been identified as a major priority in the Ugandan Health Sector Strategic Plan. Efforts are currently underway to integrate mental health services into the Primary Health Care system. In this study, we report aspects of the integration of mental health into primary health care in one rural district in ...

  3. Ionizing radiations in Italian health care structures

    International Nuclear Information System (INIS)

    Fizzano, M.R.; Frusteri, L.

    2006-01-01

    The Council of the European Union has completely renewed the framework regarding radiation protection by adopting some directives: Directive 97/43 EURATOM lays down the general principles of the radiation protection of individuals undergoing exposure to ionising radiations related to medical exposures, as a supplement of Directive 96/29 EURATOM laying down the basic safety standards for the protection of the health of workers and the general public against the dangers arising from ionising radiations.The incorporation into Italian legislation of the European Community directives on the improvement of health and safety at work has promoted a vast effort in order to revise the surveillance approach in many facilities, including hospitals. In Italy, safety law is referred to every workplace; anyway the use of ionising radiations is ruled by specific laws. So in the health care structures it is necessary integrating both the laws and this process is often difficult to carry on. The Italian Legislative Decree 230/95, one the main laws that aim to protect workers against ionising radiations, introduced Directive 96/29/EURATOM. This Decree asks that a doctor and a technical expert analyse the workplace and classify area and workers in according to dose of ionising radiation established by law. The Italian Legislative Decree 626/94 asks that risk analysis in general is made by doctor and specialist in risk. So, in case of risk from ionising radiation, all these figures have to cooperate in order to make an evaluation risk document. (N.C.)

  4. Ionizing radiations in Italian health care structures

    Energy Technology Data Exchange (ETDEWEB)

    Fizzano, M.R.; Frusteri, L. [Technical Advisory Dept. for Risk Assessment and Prevention, Italian Workers Compensation Authority, Rome (Italy)

    2006-07-01

    The Council of the European Union has completely renewed the framework regarding radiation protection by adopting some directives: Directive 97/43 EURATOM lays down the general principles of the radiation protection of individuals undergoing exposure to ionising radiations related to medical exposures, as a supplement of Directive 96/29 EURATOM laying down the basic safety standards for the protection of the health of workers and the general public against the dangers arising from ionising radiations.The incorporation into Italian legislation of the European Community directives on the improvement of health and safety at work has promoted a vast effort in order to revise the surveillance approach in many facilities, including hospitals. In Italy, safety law is referred to every workplace; anyway the use of ionising radiations is ruled by specific laws. So in the health care structures it is necessary integrating both the laws and this process is often difficult to carry on. The Italian Legislative Decree 230/95, one the main laws that aim to protect workers against ionising radiations, introduced Directive 96/29/EURATOM. This Decree asks that a doctor and a technical expert analyse the workplace and classify area and workers in according to dose of ionising radiation established by law. The Italian Legislative Decree 626/94 asks that risk analysis in general is made by doctor and specialist in risk. So, in case of risk from ionising radiation, all these figures have to cooperate in order to make an evaluation risk document. (N.C.)

  5. Integrated Thermal Protection Systems and Heat Resistant Structures

    Science.gov (United States)

    Pichon, Thierry; Lacoste, Marc; Glass, David E.

    2006-01-01

    In the early stages of NASA's Exploration Initiative, Snecma Propulsion Solide was funded under the Exploration Systems Research & Technology program to develop integrated thermal protection systems and heat resistant structures for reentry vehicles. Due to changes within NASA's Exploration Initiative, this task was cancelled early. This presentation provides an overview of the work that was accomplished prior to cancellation. The Snecma team chose an Apollo-type capsule as the reference vehicle for the work. They began with the design of a ceramic aft heatshield (CAS) utilizing C/SiC panels as the capsule heatshield, a C/SiC deployable decelerator and several ablators. They additionally developed a health monitoring system, high temperature structures testing, and the insulation characterization. Though the task was pre-maturely cancelled, a significant quantity of work was accomplished.

  6. ‘Trust and teamwork matter’: Community health workers' experiences in integrated service delivery in India

    Science.gov (United States)

    Mishra, Arima

    2014-01-01

    A comprehensive and integrated approach to strengthen primary health care has been the major thrust of the National Rural Health Mission (NRHM) that was launched in 2005 to revamp India's rural public health system. Though the logic of horizontal and integrated health care to strengthen health systems has long been acknowledged at policy level, empirical evidence on how such integration operates is rare. Based on recent (2011–2012) ethnographic fieldwork in Odisha, India, this article discusses community health workers' experiences in integrated service delivery through village-level outreach sessions within the NRHM. It shows that for health workers, the notion of integration goes well beyond a technical lens of mixing different health services. Crucially, they perceive ‘teamwork’ and ‘building trust with the community’ (beyond trust in health services) to be critical components of their practice. However, the comprehensive NRHM primary health care ideology – which the health workers espouse – is in constant tension with the exigencies of narrow indicators of health system performance. Our ethnography shows how monitoring mechanisms, the institutionalised privileging of statistical evidence over field-based knowledge and the highly hierarchical health bureaucratic structure that rests on top-down communications mitigate efforts towards sustainable health system integration. PMID:25025872

  7. 'Trust and teamwork matter': community health workers' experiences in integrated service delivery in India.

    Science.gov (United States)

    Mishra, Arima

    2014-01-01

    A comprehensive and integrated approach to strengthen primary health care has been the major thrust of the National Rural Health Mission (NRHM) that was launched in 2005 to revamp India's rural public health system. Though the logic of horizontal and integrated health care to strengthen health systems has long been acknowledged at policy level, empirical evidence on how such integration operates is rare. Based on recent (2011-2012) ethnographic fieldwork in Odisha, India, this article discusses community health workers' experiences in integrated service delivery through village-level outreach sessions within the NRHM. It shows that for health workers, the notion of integration goes well beyond a technical lens of mixing different health services. Crucially, they perceive 'teamwork' and 'building trust with the community' (beyond trust in health services) to be critical components of their practice. However, the comprehensive NRHM primary health care ideology - which the health workers espouse - is in constant tension with the exigencies of narrow indicators of health system performance. Our ethnography shows how monitoring mechanisms, the institutionalised privileging of statistical evidence over field-based knowledge and the highly hierarchical health bureaucratic structure that rests on top-down communications mitigate efforts towards sustainable health system integration.

  8. A Simple Demonstration of Concrete Structural Health Monitoring Framework

    Energy Technology Data Exchange (ETDEWEB)

    Mahadevan, Sankaran [Idaho National Lab. (INL), Idaho Falls, ID (United States); Agarwal, Vivek [Idaho National Lab. (INL), Idaho Falls, ID (United States); Cai, Guowei [Idaho National Lab. (INL), Idaho Falls, ID (United States); Nath, Paromita [Idaho National Lab. (INL), Idaho Falls, ID (United States); Bao, Yanqing [Idaho National Lab. (INL), Idaho Falls, ID (United States); Bru Brea, Jose Maria [Idaho National Lab. (INL), Idaho Falls, ID (United States); Koester, David [Idaho National Lab. (INL), Idaho Falls, ID (United States); Adams, Douglas [Idaho National Lab. (INL), Idaho Falls, ID (United States); Kosson, David [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-03-01

    Assessment and management of aging concrete structures in nuclear power plants require a more systematic approach than simple reliance on existing code margins of safety. Structural health monitoring of concrete structures aims to understand the current health condition of a structure based on heterogeneous measurements to produce high confidence actionable information regarding structural integrity that supports operational and maintenance decisions. This ongoing research project is seeking to develop a probabilistic framework for health diagnosis and prognosis of aging concrete structures in a nuclear power plant subjected to physical, chemical, environment, and mechanical degradation. The proposed framework consists of four elements—damage modeling, monitoring, data analytics, and uncertainty quantification. This report describes a proof-of-concept example on a small concrete slab subjected to a freeze-thaw experiment that explores techniques in each of the four elements of the framework and their integration. An experimental set-up at Vanderbilt University’s Laboratory for Systems Integrity and Reliability is used to research effective combination of full-field techniques that include infrared thermography, digital image correlation, and ultrasonic measurement. The measured data are linked to the probabilistic framework: the thermography, digital image correlation data, and ultrasonic measurement data are used for Bayesian calibration of model parameters, for diagnosis of damage, and for prognosis of future damage. The proof-of-concept demonstration presented in this report highlights the significance of each element of the framework and their integration.

  9. Structural hierarchy of autism spectrum disorder symptoms: an integrative framework.

    Science.gov (United States)

    Kim, Hyunsik; Keifer, Cara M; Rodriguez-Seijas, Craig; Eaton, Nicholas R; Lerner, Matthew D; Gadow, Kenneth D

    2018-01-01

    In an attempt to resolve questions regarding the symptom classification of autism spectrum disorder (ASD), previous research generally aimed to demonstrate superiority of one model over another. Rather than adjudicating which model may be optimal, we propose an alternative approach that integrates competing models using Goldberg's bass-ackwards method, providing a comprehensive understanding of the underlying symptom structure of ASD. The study sample comprised 3,825 individuals, consecutive referrals to a university hospital developmental disabilities specialty clinic or a child psychiatry outpatient clinic. This study analyzed DSM-IV-referenced ASD symptom statements from parent and teacher versions of the Child and Adolescent Symptom Inventory-4R. A series of exploratory structural equation models was conducted in order to produce interpretable latent factors that account for multivariate covariance. Results indicated that ASD symptoms were structured into an interpretable hierarchy across multiple informants. This hierarchy includes five levels; key features of ASD bifurcate into different constructs with increasing specificity. This is the first study to examine an underlying structural hierarchy of ASD symptomatology using the bass-ackwards method. This hierarchy demonstrates how core features of ASD relate at differing levels of resolution, providing a model for conceptualizing ASD heterogeneity and a structure for integrating divergent theories of cognitive processes and behavioral features that define the disorder. These findings suggest that a more coherent and complete understanding of the structure of ASD symptoms may be reflected in a metastructure rather than at one level of resolution. © 2017 Association for Child and Adolescent Mental Health.

  10. Crack turning in integrally stiffened aircraft structures

    Science.gov (United States)

    Pettit, Richard Glen

    Current emphasis in the aircraft industry toward reducing manufacturing cost has created a renewed interest in integrally stiffened structures. Crack turning has been identified as an approach to improve the damage tolerance and fail-safety of this class of structures. A desired behavior is for skin cracks to turn before reaching a stiffener, instead of growing straight through. A crack in a pressurized fuselage encounters high T-stress as it nears the stiffener---a condition favorable to crack turning. Also, the tear resistance of aluminum alloys typically varies with crack orientation, a form of anisotropy that can influence the crack path. The present work addresses these issues with a study of crack turning in two-dimensions, including the effects of both T-stress and fracture anisotropy. Both effects are shown to have relation to the process zone size, an interaction that is central to this study. Following an introduction to the problem, the T-stress effect is studied for a slightly curved semi-infinite crack with a cohesive process zone, yielding a closed form expression for the future crack path in an infinite medium. For a given initial crack tip curvature and tensile T-stress, the crack path instability is found to increase with process zone size. Fracture orthotropy is treated using a simple function to interpolate between the two principal fracture resistance values in two-dimensions. An extension to three-dimensions interpolates between the six principal values of fracture resistance. Also discussed is the transition between mode I and mode II fracture in metals. For isotropic materials, there is evidence that the crack seeks out a direction of either local symmetry (pure mode I) or local asymmetry (pure mode II) growth. For orthotropic materials the favored states are not pure modal, and have mode mixity that is a function of crack orientation. Drawing upon these principles, two crack turning prediction approaches are extended to include fracture

  11. Integrated environment, safety, and health management system description

    International Nuclear Information System (INIS)

    Zoghbi, J. G.

    2000-01-01

    The Integrated Environment, Safety, and Health Management System Description that is presented in this document describes the approach and management systems used to address integrated safety management within the Richland Environmental Restoration Project

  12. QUANTITATIVE СHARACTERISTICS OF COMPLEMENTARY INTEGRATED HEALTH CARE SYSTEM AND INTEGRATED MEDICATION MANAGEMENT INFORMATION SYSTEM

    Directory of Open Access Journals (Sweden)

    L. Yu. Babintseva

    2015-05-01

    i mportant elements of state regulation of the pharmaceutical sector health. For the first time creation of two information systems: integrated medication management infor mation system and integrated health care system in an integrated medical infor mation area, operating based on th e principle of complementarity was justified. Global and technological coefficients of these systems’ functioning were introduced.

  13. THE ESSENCE OF STRATEGY DEVELOPMENT COMPANY IN THE INTEGRATED STRUCTURE

    Directory of Open Access Journals (Sweden)

    A. I. Khorev

    2014-01-01

    Full Text Available Summary. In the beginning of the article is defined a rational sequence of the consideration of the nature of the strategy of a company development, included into an integrated structure. Further the article describes the following items separately: "a strategy", "a development of a company", and "an integrational structure", applying them to companies included to the integrated structure; separating them from a strategy of development of an autonomous company. The article defines functions which such strategy must define, taking into consideration the nature of the strategy of the company development, included into an integrated structure. Next, the article defines six steps which describe a sequence of development of the strategy of the company development, included into an integrated structure. The analysis which is defined in the article allows determining a complete definition of essence of the strategy of the company development, included into an integrated structure. The article also defines a place of the strategy of development into the hierarchical structure of the strategies. The strategy of the company development, included into an integrated structure (as well as the strategy of development of an autonomous company -- is a competition strategy, and it separates "strategy of leadership for costs", “differentiation strategy”, and “strategy of focusing for costs”. Also authors are analyzed the strategy of the cost optimization. According to the complex definition of the strategy, and the strategy's place inside the hierarchical structure, the article defines functions which corporate, competitive, and functional strategies execute during the management of companies inside an integrational structure. The article presents characteristics of applied strategic decisions at different levels of all three types of strategies. The article's researches allow companies included to the integrated structure define their place inside the

  14. Integrated Systems Health Management for Space Exploration

    Science.gov (United States)

    Uckun, Serdar

    2005-01-01

    Integrated Systems Health Management (ISHM) is a system engineering discipline that addresses the design, development, operation, and lifecycle management of components, subsystems, vehicles, and other operational systems with the purpose of maintaining nominal system behavior and function and assuring mission safety and effectiveness under off-nominal conditions. NASA missions are often conducted in extreme, unfamiliar environments of space, using unique experimental spacecraft. In these environments, off-nominal conditions can develop with the potential to rapidly escalate into mission- or life-threatening situations. Further, the high visibility of NASA missions means they are always characterized by extraordinary attention to safety. ISHM is a critical element of risk mitigation, mission safety, and mission assurance for exploration. ISHM enables: In-space maintenance and repair; a) Autonomous (and automated) launch abort and crew escape capability; b) Efficient testing and checkout of ground and flight systems; c) Monitoring and trending of ground and flight system operations and performance; d) Enhanced situational awareness and control for ground personnel and crew; e) Vehicle autonomy (self-sufficiency) in responding to off-nominal conditions during long-duration and distant exploration missions; f) In-space maintenance and repair; and g) Efficient ground processing of reusable systems. ISHM concepts and technologies may be applied to any complex engineered system such as transportation systems, orbital or planetary habitats, observatories, command and control systems, life support systems, safety-critical software, and even the health of flight crews. As an overarching design and operational principle implemented at the system-of-systems level, ISHM holds substantial promise in terms of affordability, safety, reliability, and effectiveness of space exploration missions.

  15. Structural integration of separation and reaction systems: I. Integration of stage-wise processes

    Directory of Open Access Journals (Sweden)

    Mitrović Milan

    2002-01-01

    Full Text Available The structural integration of separation processes, using multifunctional equipment, has been studied on four stage-wise liquid-liquid separations extraction, absorption, distillation, adsorption and on some combinations of these processes. It was shown for stage - wise processes that the ultimate aim of equipment integration is 3-way integration (by components by steps and by stages and that membrane multiphase contactors present concerning the equipment optimal solutions in many cases. First, by using partially integrated equipment and, later by developing fully integrated systems it was experimentally confirmed that structural 3-way integration produces much higher degrees of component separations and component enrichments in compact and safe equipment.

  16. Quantum algebra structure of certain Jackson integrals

    International Nuclear Information System (INIS)

    Matsuo, Atsushi

    1993-01-01

    The q-difference system satisfied by Jackson integrals with a configuration of A-type root system is studied. We explicitly construct some linear combination of Jackson integrals, which satisfies the quantum Knizhnik-Zamolodchikov equation for the 2-point correlation function of q-vertex operators, introduced by Frenkel and Reshetik hin, for the quantum affine algebra U q (sl 2 ). The expression of integrands for the n-point case is conjectured, and a set of linear relations for the corresponding Jackson integrals is proved. (orig.)

  17. Intelligent Structural Health Management of Civil Infrastructure

    Science.gov (United States)

    2012-10-19

    The collapse of the I-35W Mississippi River Bridge in Minneapolis has spawned a growing interest in the : development of reliable techniques for evaluating the structural integrity of civil infrastructure. Current inspection : techniques tailored to ...

  18. Sensor Area Network for Integrated Systems Health Management, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — The term Integrated Systems Health Management (ISHM) is used to describe a capability that focuses on determining the condition (health) of every element in a...

  19. Integrable structure in discrete shell membrane theory.

    Science.gov (United States)

    Schief, W K

    2014-05-08

    We present natural discrete analogues of two integrable classes of shell membranes. By construction, these discrete shell membranes are in equilibrium with respect to suitably chosen internal stresses and external forces. The integrability of the underlying equilibrium equations is proved by relating the geometry of the discrete shell membranes to discrete O surface theory. We establish connections with generalized barycentric coordinates and nine-point centres and identify a discrete version of the classical Gauss equation of surface theory.

  20. Strategies for integrating mental health into schools via a multitiered system of support.

    Science.gov (United States)

    Stephan, Sharon Hoover; Sugai, George; Lever, Nancy; Connors, Elizabeth

    2015-04-01

    To fully realize the potential of mental health supports in academic settings, it is essential to consider how to effectively integrate the mental health and education systems and their respective resources, staffing, and structures. Historically, school mental health services have not effectively spanned a full continuum of care from mental health promotion to treatment, and several implementation and service challenges have evolved. After an overview of these challenges, best practices and strategies for school and community partners are reviewed to systematically integrate mental health interventions within a school's multitiered system of student support. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Fibre Optic Sensors for Structural Health Monitoring of Aircraft Composite Structures: Recent Advances and Applications

    Science.gov (United States)

    Di Sante, Raffaella

    2015-01-01

    In-service structural health monitoring of composite aircraft structures plays a key role in the assessment of their performance and integrity. In recent years, Fibre Optic Sensors (FOS) have proved to be a potentially excellent technique for real-time in-situ monitoring of these structures due to their numerous advantages, such as immunity to electromagnetic interference, small size, light weight, durability, and high bandwidth, which allows a great number of sensors to operate in the same system, and the possibility to be integrated within the material. However, more effort is still needed to bring the technology to a fully mature readiness level. In this paper, recent research and applications in structural health monitoring of composite aircraft structures using FOS have been critically reviewed, considering both the multi-point and distributed sensing techniques. PMID:26263987

  2. Fibre Optic Sensors for Structural Health Monitoring of Aircraft Composite Structures: Recent Advances and Applications

    Directory of Open Access Journals (Sweden)

    Raffaella Di Sante

    2015-07-01

    Full Text Available In-service structural health monitoring of composite aircraft structures plays a key role in the assessment of their performance and integrity. In recent years, Fibre Optic Sensors (FOS have proved to be a potentially excellent technique for real-time in-situ monitoring of these structures due to their numerous advantages, such as immunity to electromagnetic interference, small size, light weight, durability, and high bandwidth, which allows a great number of sensors to operate in the same system, and the possibility to be integrated within the material. However, more effort is still needed to bring the technology to a fully mature readiness level. In this paper, recent research and applications in structural health monitoring of composite aircraft structures using FOS have been critically reviewed, considering both the multi-point and distributed sensing techniques.

  3. Integrated Control Using the SOFFT Control Structure

    Science.gov (United States)

    Halyo, Nesim

    1996-01-01

    The need for integrated/constrained control systems has become clearer as advanced aircraft introduced new coupled subsystems such as new propulsion subsystems with thrust vectoring and new aerodynamic designs. In this study, we develop an integrated control design methodology which accomodates constraints among subsystem variables while using the Stochastic Optimal Feedforward/Feedback Control Technique (SOFFT) thus maintaining all the advantages of the SOFFT approach. The Integrated SOFFT Control methodology uses a centralized feedforward control and a constrained feedback control law. The control thus takes advantage of the known coupling among the subsystems while maintaining the identity of subsystems for validation purposes and the simplicity of the feedback law to understand the system response in complicated nonlinear scenarios. The Variable-Gain Output Feedback Control methodology (including constant gain output feedback) is extended to accommodate equality constraints. A gain computation algorithm is developed. The designer can set the cross-gains between two variables or subsystems to zero or another value and optimize the remaining gains subject to the constraint. An integrated control law is designed for a modified F-15 SMTD aircraft model with coupled airframe and propulsion subsystems using the Integrated SOFFT Control methodology to produce a set of desired flying qualities.

  4. Quantification of the Value of Structural Health Monitoring Information for Fatigue Deteriorating Structural Systems

    DEFF Research Database (Denmark)

    Thöns, Sebastian; Schneider, Ronald; Faber, Michael Havbro

    2015-01-01

    This paper addresses the quantification of the value of structural health monitoring (SHM) before its implementation for structural systems on the basis of its Value of Information (VoI). The value of SHM is calculated utilizing the Bayesian pre-posterior decision analysis modelling the structural...... life cycle performance, the integrity management and the structural risks. The relevance and precision of SHM information for the reduction of the structural system risks and the expected cost of the structural integrity management throughout the life cycle constitutes the value of SHM...... and is quantified with this framework. The approach is focused on fatigue deteriorating structural steel systems for which a continuous resistance deterioration formulation is introduced. In a case study, the value of SHM for load monitoring is calculated for a Daniels system subjected to fatigue deterioration...

  5. Ethical Issues in Integrated Health Care: Implications for Social Workers.

    Science.gov (United States)

    Reamer, Frederic G

    2018-05-01

    Integrated health care has come of age. What began modestly in the 1930s has evolved into a mature model of health care that is quickly becoming the standard of care. Social workers are now employed in a wide range of comprehensive integrated health care organizations. Some of these settings were designed as integrated health care delivery systems from their beginning. Others evolved over time, some incorporating behavioral health into existing primary care centers and others incorporating primary care into existing behavioral health agencies. In all of these contexts, social workers are encountering complex, sometimes unprecedented, ethical challenges. This article identifies and discusses ethical issues facing social workers in integrated health care settings, especially related to informed consent, privacy, confidentiality, boundaries, dual relationships, and conflicts of interest. The author includes practical resources that social workers can use to develop state-of-the-art ethics policies and protocols.

  6. Exploring RNA structure by integrative molecular modelling

    DEFF Research Database (Denmark)

    Masquida, Benoît; Beckert, Bertrand; Jossinet, Fabrice

    2010-01-01

    RNA molecular modelling is adequate to rapidly tackle the structure of RNA molecules. With new structured RNAs constituting a central class of cellular regulators discovered every year, the need for swift and reliable modelling methods is more crucial than ever. The pragmatic method based...... on interactive all-atom molecular modelling relies on the observation that specific structural motifs are recurrently found in RNA sequences. Once identified by a combination of comparative sequence analysis and biochemical data, the motifs composing the secondary structure of a given RNA can be extruded...

  7. More than culture: structural racism, intersectionality theory, and immigrant health.

    Science.gov (United States)

    Viruell-Fuentes, Edna A; Miranda, Patricia Y; Abdulrahim, Sawsan

    2012-12-01

    Explanations for immigrant health outcomes often invoke culture through the use of the concept of acculturation. The over reliance on cultural explanations for immigrant health outcomes has been the topic of growing debate, with the critics' main concern being that such explanations obscure the impact of structural factors on immigrant health disparities. In this paper, we highlight the shortcomings of cultural explanations as currently employed in the health literature, and argue for a shift from individual culture-based frameworks, to perspectives that address how multiple dimensions of inequality intersect to impact health outcomes. Based on our review of the literature, we suggest specific lines of inquiry regarding immigrants' experiences with day-to-day discrimination, as well as on the roles that place and immigration policies play in shaping immigrant health outcomes. The paper concludes with suggestions for integrating intersectionality theory in future research on immigrant health. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Integrated structure/control design - Present methodology and future opportunities

    Science.gov (United States)

    Weisshaar, T. A.; Newsom, J. R.; Zeiler, T. A.; Gilbert, M. G.

    1986-01-01

    Attention is given to current methodology applied to the integration of the optimal design process for structures and controls. Multilevel linear decomposition techniques proved to be most effective in organizing the computational efforts necessary for ISCD (integrated structures and control design) tasks. With the development of large orbiting space structures and actively controlled, high performance aircraft, there will be more situations in which this concept can be applied.

  9. Structure, deformation, and integrity of materials

    NARCIS (Netherlands)

    With, de G.

    2006-01-01

    This first integrated approach to thermomechanics deals equally with the atomic scale, the mesoscale of microstructures and morphology, as well as the macroscopic level of actual components and workpieces for applications. With some 85 examples and 150 problems, it covers the three important

  10. Regional Power Integration : Structural and Regulatory Challenges

    OpenAIRE

    World Bank

    2011-01-01

    The Central America Regional Electricity Market (MER) trades electricity and transmission capacity among six Central American countries: Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua and Panama. The market differs from other electricity markets worldwide because it has its own regulatory body and system operator. Economic integration of the Central American countries has followed...

  11. Structural integrity assessment of piping components

    International Nuclear Information System (INIS)

    Kushwaha, H.S.; Chattopadhyay, J.

    2008-01-01

    Integrity assessment of piping components is very essential for safe and reliable operation of power plants. Over the last several decades, considerable work has been done throughout the world to develop a methodology for integrity assessment of pipes and elbows, appropriate for the material involved. However, there is scope of further development/improvement of issues, particularly for pipe bends, that are important for accurate integrity assessment of piping. Considering this aspect, a comprehensive Component Integrity Test Program was initiated in 1998 at Bhabha Atomic Research Centre (BARC), India. In this program, both theoretical and experimental investigations were undertaken to address various issues related to the integrity assessment of pipes and elbows. Under the experimental investigations, fracture mechanics tests have been conducted on pipes and elbows of 200-400 mm nominal bore (NB) diameter with various crack configurations and sizes under different loading conditions. Tests on small tensile and three point bend specimens, machined from the tested pipes, have also been done to evaluate the actual stress-strain and fracture resistance properties of pipe/elbow material. The load-deflection curve and crack initiation loads predicted by non-linear finite element analysis matched well with the experimental results. The theoretical collapse moments of throughwall circumferentially cracked elbows, predicted by the recently developed equations, are found to be closer to the test data compared to the other existing equations. The role of stress triaxialities ahead of crack tip is also shown in the transferability of J-Resistance curve from specimen to component. The cyclic loading and system compliance effect on the load carrying capacity of piping components are investigated and new recommendations are made. (author)

  12. Integrated Care Programme—Department of Health, UK

    OpenAIRE

    Dewji, Mo; Passmore, Julie; Wardell, John

    2010-01-01

    Introduction Integration is seen as a key building block within the strategic plan for improving the health and well-being of the population of England. The Integrated Care Pilot programme is a three-year academically assessed research programme sponsored by the Department of Health, England, which aims to explore and gather evidence to support different approaches to integration. Aims With 16 pilot sites across England the objectives of the programme are based upon a Government commitment to...

  13. Workplace mental health: developing an integrated intervention approach

    Science.gov (United States)

    2014-01-01

    Background Mental health problems are prevalent and costly in working populations. Workplace interventions to address common mental health problems have evolved relatively independently along three main threads or disciplinary traditions: medicine, public health, and psychology. In this Debate piece, we argue that these three threads need to be integrated to optimise the prevention of mental health problems in working populations. Discussion To realise the greatest population mental health benefits, workplace mental health intervention needs to comprehensively 1) protect mental health by reducing work–related risk factors for mental health problems; 2) promote mental health by developing the positive aspects of work as well as worker strengths and positive capacities; and 3) address mental health problems among working people regardless of cause. We outline the evidence supporting such an integrated intervention approach and consider the research agenda and policy developments needed to move towards this goal, and propose the notion of integrated workplace mental health literacy. Summary An integrated approach to workplace mental health combines the strengths of medicine, public health, and psychology, and has the potential to optimise both the prevention and management of mental health problems in the workplace. PMID:24884425

  14. Integrated seismic design of structure and control systems

    CERN Document Server

    Castaldo, Paolo

    2014-01-01

    The structural optimization procedure presented in this book makes it possible to achieve seismic protection through integrated structural/control system design. In particular, it is explained how slender structural systems with a high seismic performance can be achieved through inclusion of viscous and viscoelastic dampers as an integral part of the system. Readers are provided with essential introductory information on passive structural control and passive energy dissipation systems. Dynamic analyses of both single and multiple degree of freedom systems are performed in order to verify the achievement of pre-assigned performance targets, and it is explained how the optimal integrated design methodology, also relevant to retrofitting of existing buildings, should be applied. The book illustrates how structural control research is opening up new possibilities in structural forms and configurations without compromising structural performance.

  15. Integrated Employee Occupational Health and Organizational-Level Registered Nurse Outcomes.

    Science.gov (United States)

    Mohr, David C; Schult, Tamara; Eaton, Jennifer Lipkowitz; Awosika, Ebi; McPhaul, Kathleen M

    2016-05-01

    The study examined organizational culture, structural supports, and employee health program integration influence on registered nurse (RN) outcomes. An organizational health survey, employee health clinical operations survey, employee attitudes survey, and administration data were collected. Multivariate regression models examined outcomes of sick leave, leave without pay, voluntary turnover, intention to leave, and organizational culture using 122 medical centers. Lower staffing ratios were associated with greater sick leave, higher turnover, and intention to leave. Safety climate was favorably associated with each of the five outcomes. Both onsite employee occupational health services and a robust health promotion program were associated with more positive organizational culture perceptions. Findings highlight the positive influence of integrating employee health and health promotion services on organizational health outcomes. Attention to promoting employee health may benefit organizations in multiple, synergistic ways.

  16. Integrating Ecosystem Services Into Health Impact Assessment

    Science.gov (United States)

    Health Impact Assessment (HIA) provides a methodology for incorporating considerations of public health into planning and decision-making processes. HIA promotes interdisciplinary action, stakeholder participation, and timeliness and takes into account equity, sustainability, and...

  17. Structural integrity evaluation of FTL in-pool piping

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J. Y

    1998-05-01

    HANARO fuel test loop will be equipped in HANARO to obtain the development betterment of advanced fuel and materials through the irradiation test. The object of this study is to evaluate the structural integrity of FTL in-pool piping by investigating a dynamic analysis of the loop containing a postulated rupture section. The method to perform the dynamic analysis and structural integrity evaluation caused by the pipe whip in water environment can be a reference for a similar structural integrity evaluation. (author). 7 refs., 39 tabs., 34 figs.

  18. Principles and core functions of integrated child health information systems.

    Science.gov (United States)

    Hinman, Alan R; Atkinson, Delton; Diehn, Tonya Norvell; Eichwald, John; Heberer, Jennifer; Hoyle, Therese; King, Pam; Kossack, Robert E; Williams, Donna C; Zimmerman, Amy

    2004-11-01

    Infants undergo a series of preventive and therapeutic health interventions and activities. Typically, each activity includes collection and submission of data to a dedicated information system. Subsequently, health care providers, families, and health programs must query each information system to determine the child's status in a given area. Efforts are underway to integrate information in these separate information systems. This requires specifying the core functions that integrated information systems must perform.

  19. Integrating ICTs within health systems | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-06-10

    Jun 10, 2016 ... But for too long, ICT and health system researchers have worked in isolation ... be used to enable the governance and functioning of health systems in ... most African countries adopted direct payment for health services as the ...

  20. Integrating ICTs within health systems | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-06-10

    Jun 10, 2016 ... ... to help improve service delivery, build local capacity for primary health care, and address the ... There is limited evidence on how electronic health (eHealth) technologies can be ... The world is now home to the greatest num.

  1. The social income inequality, social integration and health status of internal migrants in China.

    Science.gov (United States)

    Lin, Yanwei; Zhang, Qi; Chen, Wen; Ling, Li

    2017-08-04

    To examine the interaction between social income inequality, social integration, and health status among internal migrants (IMs) who migrate between regions in China. We used the data from the 2014 Internal Migrant Dynamic Monitoring Survey in China, which sampled 15,999 IMs in eight cities in China. The Gini coefficient at the city level was calculated to measure social income inequality and was categorized into low (0.2 0.5). Health status was measured based upon self-reported health, subjective well-being, and perceptions of stress and mental health. Social integration was measured from four perspectives (acculturation and integration willingness, social insurance, economy, social communication). Linear mixed models were used to examine the interaction effects between health statuses, social integration, and the Gini coefficient. Factors of social integration, such as economic integration and acculturation and integration willingness, were significantly related to health. Social income inequality had a negative relationship with the health status of IMs. For example, IMs in one city, Qingdao, with a medium income inequality level (Gini = 0.329), had the best health statuses and better social integration. On the other hand, IMs in another city, Shenzhen, who had a large income inequality (Gini = 0.447) were worst in health statues and had worse social integration. Policies or programs targeting IMs should support integration willingness, promote a sense of belonging, and improve economic equality. In the meantime, social activities to facilitate employment and create social trust should also be promoted. At the societal level, structural and policy changes are necessary to promote income equity to promote IMs' general health status.

  2. Simultaneous Structural Health Monitoring and Vibration Control of Adaptive Structures Using Smart Materials

    Directory of Open Access Journals (Sweden)

    Myung-Hyun Kim

    2002-01-01

    Full Text Available The integration of actuators and sensors using smart materials enabled various applications including health monitoring and structural vibration control. In this study, a robust control technique is designed and implemented in order to reduce vibration of an active structure. Special attention is given to eliminating the possibility of interaction between the health monitoring system and the control system. Exploiting the disturbance decoupling characteristic of the sliding mode observer, it is demonstrated that the proposed observer can eliminate the possible high frequency excitation from the health monitoring system. At the same time, a damage identification scheme, which tracks the changes of mechanical impedance due to the presence of damage, has been applied to assess the health condition of structures. The main objective of this paper is to examine the potential of combining the two emerging techniques together. Using the collocated piezoelectric sensors/actuators for vibration suppression as well as for health monitoring, this technique enabled to reduce the number of system components, while enhancing the performance of structures. As an initial study, both simulation and experimental investigations were performed for an active beam structure. The results show that this integrated technique can provide substantial vibration reductions, while detecting damage on the structure at the same time.

  3. Packaging of structural health monitoring components

    Science.gov (United States)

    Kessler, Seth S.; Spearing, S. Mark; Shi, Yong; Dunn, Christopher T.

    2004-07-01

    Structural Health Monitoring (SHM) technologies have the potential to realize economic benefits in a broad range of commercial and defense markets. Previous research conducted by Metis Design and MIT has demonstrated the ability of Lamb waves methods to provide reliable information regarding the presence, location and type of damage in composite specimens. The present NSF funded program was aimed to study manufacturing, packaging and interface concepts for critical SHM components. The intention is to be able to cheaply manufacture robust actuating/sensing devices, and isolate them from harsh operating environments including natural, mechanical, or electrical extremes. Currently the issues related to SHM system durability have remained undressed. During the course of this research several sets of test devices were fabricated and packaged to protect the piezoelectric component assemblies for robust operation. These assemblies were then tested in hot and wet conditions, as well as in electrically noisy environments. Future work will aim to package the other supporting components such as the battery and wireless chip, as well as integrating all of these components together for operation. SHM technology will enable the reduction or complete elimination of scheduled inspections, and will allow condition-based maintenance for increased reliability and reduced overall life-cycle costs.

  4. An autonomous structural health monitoring solution

    Science.gov (United States)

    Featherston, Carol A.; Holford, Karen M.; Pullin, Rhys; Lees, Jonathan; Eaton, Mark; Pearson, Matthew

    2013-05-01

    Combining advanced sensor technologies, with optimised data acquisition and diagnostic and prognostic capability, structural health monitoring (SHM) systems provide real-time assessment of the integrity of bridges, buildings, aircraft, wind turbines, oil pipelines and ships, leading to improved safety and reliability and reduced inspection and maintenance costs. The implementation of power harvesting, using energy scavenged from ambient sources such as thermal gradients and sources of vibration in conjunction with wireless transmission enables truly autonomous systems, reducing the need for batteries and associated maintenance in often inaccessible locations, alongside bulky and expensive wiring looms. The design and implementation of such a system however presents numerous challenges. A suitable energy source or multiple sources capable of meeting the power requirements of the system, over the entire monitoring period, in a location close to the sensor must be identified. Efficient power management techniques must be used to condition the power and deliver it, as required, to enable appropriate measurements to be taken. Energy storage may be necessary, to match a continuously changing supply and demand for a range of different monitoring states including sleep, record and transmit. An appropriate monitoring technique, capable of detecting, locating and characterising damage and delivering reliable information, whilst minimising power consumption, must be selected. Finally a wireless protocol capable of transmitting the levels of information generated at the rate needed in the required operating environment must be chosen. This paper considers solutions to some of these challenges, and in particular examines SHM in the context of the aircraft environment.

  5. Integrating intersectionality and biomedicine in health disparities research.

    Science.gov (United States)

    Kelly, Ursula A

    2009-01-01

    Persisting health disparities have lead to calls for an increase in health research to address them. Biomedical scientists call for research that stratifies individual indicators associated with health disparities, for example, ethnicity. Feminist social scientists recommend feminist intersectionality research. Intersectionality is the multiplicative effect of inequalities experienced by nondominant marginalized groups, for example, ethnic minorities, women, and the poor. The elimination of health disparities necessitates integration of both paradigms in health research. This study provides a practical application of the integration of biomedical and feminist intersectionality paradigms in nursing research, using a psychiatric intervention study with battered Latino women as an example.

  6. Knowledge integration, teamwork and performance in health care.

    Science.gov (United States)

    Körner, Mirjam; Lippenberger, Corinna; Becker, Sonja; Reichler, Lars; Müller, Christian; Zimmermann, Linda; Rundel, Manfred; Baumeister, Harald

    2016-01-01

    Knowledge integration is the process of building shared mental models. The integration of the diverse knowledge of the health professions in shared mental models is a precondition for effective teamwork and team performance. As it is known that different groups of health care professionals often tend to work in isolation, the authors compared the perceptions of knowledge integration. It can be expected that based on this isolation, knowledge integration is assessed differently. The purpose of this paper is to test these differences in the perception of knowledge integration between the professional groups and to identify to what extent knowledge integration predicts perceptions of teamwork and team performance and to determine if teamwork has a mediating effect. The study is a multi-center cross-sectional study with a descriptive-explorative design. Data were collected by means of a staff questionnaire for all health care professionals working in the rehabilitation clinics. The results showed that there are significant differences in knowledge integration within interprofessional health care teams. Furthermore, it could be shown that knowledge integration is significantly related to patient-centered teamwork as well as to team performance. Mediation analysis revealed partial mediation of the effect of knowledge integration on team performance through teamwork. PRACTICAL/IMPLICATIONS: In practice, the results of the study provide a valuable starting point for team development interventions. This is the first study that explored knowledge integration in medical rehabilitation teams and its relation to patient-centered teamwork and team performance.

  7. Hamiltonian structure for rescaled integrable Lorenz systems

    International Nuclear Information System (INIS)

    Haas, F.; Goedert, J.

    1993-01-01

    It is shown that three among the known invariants for the Lorenz system recast the original equations into a Hamiltonian form. This is made possible by an appropriate time-dependent rescaling and the use of a generalized formalism with non-trivial structure functions. (author)

  8. Integrating spatial and numerical structure in mathematical patterning

    Science.gov (United States)

    Ni’mah, K.; Purwanto; Irawan, E. B.; Hidayanto, E.

    2018-03-01

    This paper reports a study monitoring the integrating spatial and numerical structure in mathematical patterning skills of 30 students grade 7th of junior high school. The purpose of this research is to clarify the processes by which learners construct new knowledge in mathematical patterning. Findings indicate that: (1) students are unable to organize the structure of spatial and numerical, (2) students were only able to organize the spatial structure, but the numerical structure is still incorrect, (3) students were only able to organize numerical structure, but its spatial structure is still incorrect, (4) students were able to organize both of the spatial and numerical structure.

  9. Structural Integrity Inspection and Visualization System, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Based on the successful feasibility demonstration in Phase I, Physical Optics Corporation (POC) proposes to continue the development of a novel Structural Integrity...

  10. Economic analysis of the structure, Integration and Performance of ...

    African Journals Online (AJOL)

    The data for the study were collected with the aid of a questionnaire. Statistical tools such as simple descriptive statistics, Gini coefficient, Shepherd-Futrel functional ... Key words: Rice; Market structure; Market integration and Performance.

  11. Integrating personality structure, personality process, and personality development

    NARCIS (Netherlands)

    Baumert, Anna; Schmitt, Manfred; Perugini, Marco; Johnson, Wendy; Blum, Gabriela; Borkenau, Peter; Costantini, Giulio; Denissen, J.J.A.; Fleeson, William; Grafton, Ben; Jayawickreme, Eranda; Kurzius, Elena; MacLeod, Colin; Miller, Lynn C.; Read, Stephen J.; Robinson, Michael D.; Wood, Dustin; Wrzus, Cornelia

    2017-01-01

    In this target article, we argue that personality processes, personality structure, and personality development have to be understood and investigated in integrated ways in order to provide comprehensive responses to the key questions of personality psychology. The psychological processes and

  12. Integrating Intelligent Structured Training with a Virtual Dismounted Environment

    National Research Council Canada - National Science Library

    Jensen, Randy; Tasoluk, Coskun; Marshall, Henry; Sims, Jason; Green, Gary

    2007-01-01

    .... This paper reviews results from the integration of an Intelligent Structured Trainer with the embedded Virtual Warrior Soldier prototype developed for the Army RDECOM Simulation and Training Technology Center...

  13. INTEGRATING HEALTH INTO BUILDINGS OF THE FUTURE.

    Science.gov (United States)

    Heidari, Leila; Younger, Margalit; Chandler, George; Gooch, James; Schramm, Paul

    2016-01-01

    The health and wellbeing of building occupants should be a key priority in the design, building, and operation of new and existing buildings. Buildings can be designed, renovated, and constructed to promote healthy environments and behaviors and mitigate adverse health outcomes. This paper highlights health in terms of the relationship between occupants and buildings, as well as the relationship of buildings to the community. In the context of larger systems, smart buildings and green infrastructure strategies serve to support public health goals. At the level of the individual building, interventions that promote health can also enhance indoor environmental quality and provide opportunities for physical activity. Navigating the various programs that use metrics to measure a building's health impacts reveals that there are multiple co-benefits of a "healthy building," including those related to the economy, environment, society, transportation, planning, and energy efficiency.

  14. A Support Database System for Integrated System Health Management (ISHM)

    Science.gov (United States)

    Schmalzel, John; Figueroa, Jorge F.; Turowski, Mark; Morris, John

    2007-01-01

    The development, deployment, operation and maintenance of Integrated Systems Health Management (ISHM) applications require the storage and processing of tremendous amounts of low-level data. This data must be shared in a secure and cost-effective manner between developers, and processed within several heterogeneous architectures. Modern database technology allows this data to be organized efficiently, while ensuring the integrity and security of the data. The extensibility and interoperability of the current database technologies also allows for the creation of an associated support database system. A support database system provides additional capabilities by building applications on top of the database structure. These applications can then be used to support the various technologies in an ISHM architecture. This presentation and paper propose a detailed structure and application description for a support database system, called the Health Assessment Database System (HADS). The HADS provides a shared context for organizing and distributing data as well as a definition of the applications that provide the required data-driven support to ISHM. This approach provides another powerful tool for ISHM developers, while also enabling novel functionality. This functionality includes: automated firmware updating and deployment, algorithm development assistance and electronic datasheet generation. The architecture for the HADS has been developed as part of the ISHM toolset at Stennis Space Center for rocket engine testing. A detailed implementation has begun for the Methane Thruster Testbed Project (MTTP) in order to assist in developing health assessment and anomaly detection algorithms for ISHM. The structure of this implementation is shown in Figure 1. The database structure consists of three primary components: the system hierarchy model, the historical data archive and the firmware codebase. The system hierarchy model replicates the physical relationships between

  15. Integrating health law and health policy: a European perspective

    NARCIS (Netherlands)

    Legemaate, Johan

    2002-01-01

    Health law is intended to create an environment in which the promotion of health goes hand in hand with the protection of individual rights and the general principles of equality and justice. Over the years, the importance of health law has grown, both at national and international level. As health

  16. Promoting Mental Health Equity: The Role of Integrated Care.

    Science.gov (United States)

    Satcher, David; Rachel, Sharon A

    2017-12-01

    People suffering from mental illness experience poor physical health outcomes, including an average life expectancy of 25 years less than the rest of the population. Stigma is a frequent barrier to accessing behavioral health services. Health equity refers to the opportunity for all people to experience optimal health; the social determinants of health can enable or impede health equity. Recommendations from the U.S. government and the World Health Organization support mental health promotion while recognizing barriers that preclude health equity. The United States Preventive Services Task Force recently recommended screening all adults for depression. The Satcher Health Leadership Institute at the Morehouse School of Medicine (SHLI/MSM) is committed to developing leaders who will help to reduce health disparities as the nation moves toward health equity. The SHLI/MSM Integrated Care Leadership Program (ICLP) provides clinical and administrative healthcare professionals with knowledge and training to develop culturally-sensitive integrated care practices. Integrating behavioral health and primary care improves quality of life and lowers health system costs.

  17. Integrated optical interrogation of micro-structures

    Science.gov (United States)

    Evans, III, Boyd M.; Datskos, Panagiotis G.; Rajic, Slobodan

    2003-01-01

    The invention is an integrated optical sensing element for detecting and measuring changes in position or deflection. A deflectable member, such as a microcantilever, is configured to receive a light beam. A waveguide, such as an optical waveguide or an optical fiber, is positioned to redirect light towards the deflectable member. The waveguide can be incorporated into the deflectable member or disposed adjacent to the deflectable member. Means for measuring the extent of position change or deflection of the deflectable member by receiving the light beam from the deflectable member, such as a photodetector or interferometer, receives the reflected light beam from the deflectable member. Changes in the light beam are correlated to the changes in position or deflection of the deflectable member. A plurality of deflectable members can be arranged in a matrix or an array to provide one or two-dimensional imaging or sensing capabilities.

  18. Addressable-Matrix Integrated-Circuit Test Structure

    Science.gov (United States)

    Sayah, Hoshyar R.; Buehler, Martin G.

    1991-01-01

    Method of quality control based on use of row- and column-addressable test structure speeds collection of data on widths of resistor lines and coverage of steps in integrated circuits. By use of straightforward mathematical model, line widths and step coverages deduced from measurements of electrical resistances in each of various combinations of lines, steps, and bridges addressable in test structure. Intended for use in evaluating processes and equipment used in manufacture of application-specific integrated circuits.

  19. Path Integration Applied to Structural Systems with Uncertain Properties

    DEFF Research Database (Denmark)

    Nielsen, Søren R.K.; Köylüoglu, H. Ugur

    Path integration (cell-to-cell mapping) method is applied to evaluate the joint probability density function (jpdf) of the response of the structural systems, with uncertain properties, subject to white noise excitation. A general methodology to deal with uncertainties is outlined and applied...... to the friction controlled slip of a structure on a foundation where the friction coefficient is modelled as a random variable. Exact results derived using the total probability theorem are compared to the ones obtained via path integration....

  20. FOREWORD: Structural Health Monitoring and Intelligent Infrastructure

    Science.gov (United States)

    Wu, Zhishen; Fujino, Yozo

    2005-06-01

    This special issue collects together 19 papers that were originally presented at the First International Conference on Structural Health Monitoring and Intelligent Infrastructure (SHMII-1'2003), held in Tokyo, Japan, on 13-15 November 2003. This conference was organized by the Japan Society of Civil Engineers (JSCE) with partial financial support from the Japan Society for the Promotion of Science (JSPS) and the Ministry of Education, Culture, Sport, Science and Technology, Japan. Many related organizations supported the conference. A total of 16 keynote papers including six state-of-the-art reports from different counties, six invited papers and 154 contributed papers were presented at the conference. The conference was attended by a diverse group of about 300 people from a variety of disciplines in academia, industry and government from all over the world. Structural health monitoring (SHM) and intelligent materials, structures and systems have been the subject of intense research and development in the last two decades and, in recent years, an increasing range of applications in infrastructure have been discovered both for existing structures and for new constructions. SHMII-1'2003 addressed progress in the development of building, transportation, marine, underground and energy-generating structures, and other civilian infrastructures that are periodically, continuously and/or actively monitored where there is a need to optimize their performance. In order to focus the current needs on SHM and intelligent technologies, the conference theme was set as 'Structures/Infrastructures Sustainability'. We are pleased to have the privilege to edit this special issue on SHM and intelligent infrastructure based on SHMII-1'2003. We invited some of the presenters to submit a revised/extended version of their paper that was included in the SHMII-1'2003 proceedings for possible publication in the special issue. Each paper included in this special issue was edited with the same

  1. A Few Expanding Integrable Models, Hamiltonian Structures and Constrained Flows

    International Nuclear Information System (INIS)

    Zhang Yufeng

    2011-01-01

    Two kinds of higher-dimensional Lie algebras and their loop algebras are introduced, for which a few expanding integrable models including the coupling integrable couplings of the Broer-Kaup (BK) hierarchy and the dispersive long wave (DLW) hierarchy as well as the TB hierarchy are obtained. From the reductions of the coupling integrable couplings, the corresponding coupled integrable couplings of the BK equation, the DLW equation, and the TB equation are obtained, respectively. Especially, the coupling integrable coupling of the TB equation reduces to a few integrable couplings of the well-known mKdV equation. The Hamiltonian structures of the coupling integrable couplings of the three kinds of soliton hierarchies are worked out, respectively, by employing the variational identity. Finally, we decompose the BK hierarchy of evolution equations into x-constrained flows and t n -constrained flows whose adjoint representations and the Lax pairs are given. (general)

  2. Integral Design workshops: organization, structure and testing

    OpenAIRE

    Zeiler, W Wim; Savanovic, P Perica

    2010-01-01

    The purpose of this paper is to achieve an understanding of design activities in the context of building design. The starting point is an overview of design research and design methodology. From the insights gained by this analysis of design in this specific context, we present an 'organization structure and design' workshop approach for collaborative multi-discipline design management. The workshops set-up, used to implement and to test the approach, are presented as well as the experiences ...

  3. Investigation of Wireless Sensor Networks for Structural Health Monitoring

    Directory of Open Access Journals (Sweden)

    Ping Wang

    2012-01-01

    Full Text Available Wireless sensor networks (WSNs are one of the most able technologies in the structural health monitoring (SHM field. Through intelligent, self-organising means, the contents of this paper will test a variety of different objects and different working principles of sensor nodes connected into a network and integrated with data processing functions. In this paper the key issues of WSN applied in SHM are discussed, including the integration of different types of sensors with different operational modalities, sampling frequencies, issues of transmission bandwidth, real-time ability, and wireless transmitter frequency. Furthermore, the topology, data fusion, integration, energy saving, and self-powering nature of different systems will be investigated. In the FP7 project “Health Monitoring of Offshore Wind Farms,” the above issues are explored.

  4. Integrative Structural Biomechanical Concepts of Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Alfonse T. Masi

    2011-01-01

    Full Text Available Ankylosing spondylitis (AS is not fully explained by inflammatory processes. Clinical, epidemiological, genetic, and course of disease features indicate additional host-related risk processes and predispositions. Collectively, the pattern of predisposition to onset in adolescent and young adult ages, male preponderance, and widely varied severity of AS is unique among rheumatic diseases. However, this pattern could reflect biomechanical and structural differences between the sexes, naturally occurring musculoskeletal changes over life cycles, and a population polymorphism. During juvenile development, the body is more flexible and weaker than during adolescent maturation and young adulthood, when strengthening and stiffening considerably increase. During middle and later ages, the musculoskeletal system again weakens. The novel concept of an innate axial myofascial hypertonicity reflects basic mechanobiological principles in human function, tissue reactivity, and pathology. However, these processes have been little studied and require critical testing. The proposed physical mechanisms likely interact with recognized immunobiological pathways. The structural biomechanical processes and tissue reactions might possibly precede initiation of other AS-related pathways. Research in the combined structural mechanobiology and immunobiology processes promises to improve understanding of the initiation and perpetuation of AS than prevailing concepts. The combined processes might better explain characteristic enthesopathic and inflammatory processes in AS.

  5. Engagement of Sectors Other than Health in Integrated Health Governance, Policy, and Action.

    Science.gov (United States)

    de Leeuw, Evelyne

    2017-03-20

    Health is created largely outside the health sector. Engagement in health governance, policy, and intervention development and implementation by sectors other than health is therefore important. Recent calls for building and implementing Health in All Policies, and continued arguments for intersectoral action, may strengthen the potential that other sectors have for health. This review clarifies the conceptual foundations for integral health governance, policy, and action, delineates the different sectors and their possible engagement, and provides an overview of a continuum of methods of engagement with other sectors to secure integration. This continuum ranges from institutional (re)design to value-based narratives. Depending on the lens applied, different elements can be identified within the continuum. This review is built on insights from political science, leadership studies, public health, empirical Health in All Policy research, knowledge and evidence nexus approaches, and community perspectives. Successful integration of health governance, policy, and action depends on integration of the elements on the continuum.

  6. Health monitoring of civil structures using fiber optic sensors

    International Nuclear Information System (INIS)

    Varma, Veto; Kumar, Praveen; Charan, J.J.; Reddy, G.R.; Vaze, K.K.; Kushwaha, H.S.

    2003-08-01

    During the lifetime of the reactor, the civil structure is subjected to many operational and environmental loads. Hence it is increasingly important to monitor the conditions of the structure and insure its safety and integrity. The conventional gauges have proved to be not sufficiently catering the problem of long term health monitoring of the structure because of its many limitations. Hence it is mandatory to develop a technique for the above purpose. Present study deals with the application of Fiber optic sensors (EFPI strain Gauges) in the civil structure for its health monitoring. Various experiments were undertaken and suitability of sensors was checked. A technique to embed the optical sensor inside the concrete is successfully developed and tested. (author)

  7. Reactor pressure vessel structural integrity research

    International Nuclear Information System (INIS)

    Pennell, W.E.; Corwin, W.R.

    1994-01-01

    Development continues on the technology used to assess the safety of irradiation-embrittled nuclear reactor pressure vessels (RPVs) containing flaws. Fracture mechanics tests on RPV steel, coupled with detailed elastic-plastic finite-element analyses of the crack-tip stress fields, have shown that (1) constraint relaxation at the crack tip of shallow surface flaws results in increased data scatter but no increase in the lower-bound fracture toughness, (2) the nil ductility temperature (NDT) performs better than the reference temperature for nil ductility transition (RT NDT ) as a normalizing parameter for shallow-flaw fracture toughness data, (3) biaxial loading can reduce the shallow-flaw fracture toughness, (4) stress-based dual-parameter fracture toughness correlations cannot predict the effect of biaxial loading on shallow-flaw fracture toughness because in-plane stresses at the crack tip are not influenced by biaxial loading, and (5) an implicit strain-based dual-parameter fracture toughness correlation can predict the effect of biaxial loading on shallow-flaw fracture toughness. Experimental irradiation investigations have shown that (1) the irradiation-induced shift in Charpy V-notch vs temperature behavior may not be adequate to conservatively assess fracture toughness shifts due to embrittlement, and (2) the wide global variations of initial chemistry and fracture properties of a nominally uniform material within a pressure vessel may confound accurate integrity assessments that require baseline properties

  8. Tutorial: Integrated-photonic switching structures

    Science.gov (United States)

    Soref, Richard

    2018-02-01

    Recent developments in waveguided 2 × 2 and N × M photonic switches are reviewed, including both broadband and narrowband resonant devices for the Si, InP, and AlN platforms. Practical actuation of switches by electro-optical and thermo-optical techniques is discussed. Present datacom-and-computing applications are reviewed, and potential applications are proposed for chip-scale photonic and optoelectronic integrated switching networks. Potential is found in the reconfigurable, programmable "mesh" switches that enable a promising group of applications in new areas beyond those in data centers and cloud servers. Many important matrix switches use gated semiconductor optical amplifiers. The family of broadband, directional-coupler 2 × 2 switches featuring two or three side-coupled waveguides deserves future experimentation, including devices that employ phase-change materials. The newer 2 × 2 resonant switches include standing-wave resonators, different from the micro-ring traveling-wave resonators. The resonant devices comprise nanobeam interferometers, complex-Bragg interferometers, and asymmetric contra-directional couplers. Although the fast, resonant devices offer ultralow switching energy, ˜1 fJ/bit, they have limitations. They require several trade-offs when deployed, but they do have practical application.

  9. Improving Acceptance, Integration and Health among LGBT Service Members

    Science.gov (United States)

    2017-10-01

    these stressors on LGBT service members is poorly understood, with very little data available on the unique physical and mental health needs of these...Bullying • Overall health • Healthcare utilization • Lost duty days • Sick call visits • Physical health symptoms • Sexual/gender identity disclosure...Award Numbers: W81XWH-15-1-0699 Title: Improving Acceptance, Integration and Health among LGBT Service Members Principal Investigators: Jeremy

  10. Is vertical integration adding value to health systems?

    Science.gov (United States)

    Weil, T P

    2000-04-01

    Vertical integration is a concept used by health systems when attempting to achieve economies of scale, greater coordination of services, and improved market penetration. This article focuses on the actual outcomes of utilizing vertical integration in the health field and then compares these findings with those reported in other industries. This analysis concludes that this organizational model does not work particularly well in the health industry, as illustrated by health alliances' poor fiscal performance when they acquire physician practices or when they start their own HMO plans.

  11. Sensor Area Network for Integrated Systems Health Management, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — The term Integrated Systems Health Management (ISHM) is used to describe a capability that focuses on determining the condition of every element in a complex System...

  12. Expanding horizons. Integrating environmental health in occupational health nursing.

    Science.gov (United States)

    Rogers, B; Cox, A R

    1998-01-01

    1. Environmental hazards are ubiquitous. Many exist in the workplace or occur as a result of work process exposures. 2. Environmental health is a natural component of the expanding practice of occupational health nursing. 3. AAOHN's vision for occupational and environmental health will continue to set the standard and provide leadership in the specialty.

  13. Integrating mental health into primary health care – Uganda's ...

    African Journals Online (AJOL)

    Most developing countries and indeed many African countries have been undertaking reforms of the mental health policies and strategies to improve access and equity for the community to mental health and psychiatric services. This has been in conformity with a health policy philosophy which emphasize decentralization ...

  14. Integrating mental health and social development in theory and practice.

    Science.gov (United States)

    Plagerson, Sophie

    2015-03-01

    In many low and middle income countries, attention to mental illness remains compartmentalized and consigned as a matter for specialist policy. Despite great advances in global mental health, mental health policy and practice dovetail only to a limited degree with social development efforts. They often lag behind broader approaches to health and development. This gap ignores the small but growing evidence that social development unavoidably impacts the mental health of those affected, and that this influence can be both positive and negative. This article examines the theoretical and practical challenges that need to be overcome for a more effective integration of social development and mental health policy. From a theoretical perspective, this article demonstrates compatibility between social development and mental health paradigms. In particular, the capability approach is shown to provide a strong framework for integrating mental health and development. Yet, capability-oriented critiques on 'happiness' have recently been applied to mental health with potentially detrimental outcomes. With regard to policy and practice, horizontal and vertical integration strategies are suggested. Horizontal strategies require stronger devolution of mental health care to the primary care level, more unified messages regarding mental health care provision and the gradual expansion of mental health packages of care. Vertical integration refers to the alignment of mental health with related policy domains (particularly the social, economic and political domains). Evidence from mental health research reinforces aspects of social development theory in a way that can have tangible implications on practice. First, it encourages a focus on avoiding exclusion of those affected by or at risk of mental illness. Secondly, it underscores the importance of the process of implementation as an integral component of successful policies. Finally, by retaining a focus on the individual, it seeks to

  15. Model reduction in integrated controls-structures design

    Science.gov (United States)

    Maghami, Peiman G.

    1993-01-01

    It is the objective of this paper to present a model reduction technique developed for the integrated controls-structures design of flexible structures. Integrated controls-structures design problems are typically posed as nonlinear mathematical programming problems, where the design variables consist of both structural and control parameters. In the solution process, both structural and control design variables are constantly changing; therefore, the dynamic characteristics of the structure are also changing. This presents a problem in obtaining a reduced-order model for active control design and analysis which will be valid for all design points within the design space. In other words, the frequency and number of the significant modes of the structure (modes that should be included) may vary considerably throughout the design process. This is also true as the locations and/or masses of the sensors and actuators change. Moreover, since the number of design evaluations in the integrated design process could easily run into thousands, any feasible order-reduction method should not require model reduction analysis at every design iteration. In this paper a novel and efficient technique for model reduction in the integrated controls-structures design process, which addresses these issues, is presented.

  16. Influence of an integral life practice workshop on health and ...

    African Journals Online (AJOL)

    The aim of the present investigation was to evaluate the effect of an Integral Life Practice workshop on perceptions of health and spirituality. An integral psychological approach using mixed quantitative and qualitative methods in a pre- and post-test, quasi experimental and control group design was used to assess changes ...

  17. Integrating Occupational Safety and Health into TAFE Courses: Policy Guidelines.

    Science.gov (United States)

    Hill, Graham L.; Mageean, Pauline

    Intended to help administrators, curriculum developers, and teachers integrate occupational health and safety into Australian vocational courses on bricklaying, metal fabrication, and horticulture, this document suggests specific policies and provides further amplification concerning three general policies for that integration. The three general…

  18. Integrative Medicine and Mood, Emotions and Mental Health.

    Science.gov (United States)

    Shah, Anuj K; Becicka, Roman; Talen, Mary R; Edberg, Deborah; Namboodiri, Sreela

    2017-06-01

    An integrative approach to individuals with mood, emotional or mental health concerns involves a comprehensive model of care that is person-centered. Integrative medicine builds on a patient's personal meaning and goals (spiritual aspects) and includes herbal therapies, nutritional support, movement and physical manipulative therapies, mindfulness, relaxation strategies, and psychotherapies. Published by Elsevier Inc.

  19. Integrated Ecological River Health Assessments, Based on Water Chemistry, Physical Habitat Quality and Biological Integrity

    Directory of Open Access Journals (Sweden)

    Ji Yoon Kim

    2015-11-01

    Full Text Available This study evaluated integrative river ecosystem health using stressor-based models of physical habitat health, chemical water health, and biological health of fish and identified multiple-stressor indicators influencing the ecosystem health. Integrated health responses (IHRs, based on star-plot approach, were calculated from qualitative habitat evaluation index (QHEI, nutrient pollution index (NPI, and index of biological integrity (IBI in four different longitudinal regions (Groups I–IV. For the calculations of IHRs values, multi-metric QHEI, NPI, and IBI models were developed and their criteria for the diagnosis of the health were determined. The longitudinal patterns of the river were analyzed by a self-organizing map (SOM model and the key major stressors in the river were identified by principal component analysis (PCA. Our model scores of integrated health responses (IHRs suggested that mid-stream and downstream regions were impaired, and the key stressors were closely associated with nutrient enrichment (N and P and organic matter pollutions from domestic wastewater disposal plants and urban sewage. This modeling approach of IHRs may be used as an effective tool for evaluations of integrative ecological river health..

  20. Structural health monitoring using wireless sensor networks

    Science.gov (United States)

    Sreevallabhan, K.; Nikhil Chand, B.; Ramasamy, Sudha

    2017-11-01

    Monitoring and analysing health of large structures like bridges, dams, buildings and heavy machinery is important for safety, economical, operational, making prior protective measures, and repair and maintenance point of view. In recent years there is growing demand for such larger structures which in turn make people focus more on safety. By using Microelectromechanical Systems (MEMS) Accelerometer we can perform Structural Health Monitoring by studying the dynamic response through measure of ambient vibrations and strong motion of such structures. By using Wireless Sensor Networks (WSN) we can embed these sensors in wireless networks which helps us to transmit data wirelessly thus we can measure the data wirelessly at any remote location. This in turn reduces heavy wiring which is a cost effective as well as time consuming process to lay those wires. In this paper we developed WSN based MEMS-accelerometer for Structural to test the results in the railway bridge near VIT University, Vellore campus.

  1. Integrating an Academic Electronic Health Record: Challenges and Success Strategies.

    Science.gov (United States)

    Herbert, Valerie M; Connors, Helen

    2016-08-01

    Technology is increasing the complexity in the role of today's nurse. Healthcare organizations are integrating more health information technologies and relying on the electronic health record for data collection, communication, and decision making. Nursing faculty need to prepare graduates for this environment and incorporate an academic electronic health record into a nursing curriculum to meet student-program outcomes. Although the need exists for student preparation, some nursing programs are struggling with implementation, whereas others have been successful. To better understand these complexities, this project was intended to identify current challenges and success strategies of effective academic electronic health record integration into nursing curricula. Using Rogers' 1962 Diffusion of Innovation theory as a framework for technology adoption, a descriptive survey design was used to gain insights from deans and program directors of nursing schools involved with the national Health Informatics & Technology Scholars faculty development program or Cerner's Academic Education Solution Consortium, working to integrate an academic electronic health record in their respective nursing schools. The participants' experiences highlighted approaches used by these schools to integrate these technologies. Data from this project provide nursing education with effective strategies and potential challenges that should be addressed for successful academic electronic health record integration.

  2. Integrative Mental Health (IMH): paradigm, research, and clinical practice.

    Science.gov (United States)

    Lake, James; Helgason, Chanel; Sarris, Jerome

    2012-01-01

    This paper provides an overview of the rapidly evolving paradigm of "Integrative Mental Health (IMH)." The paradigm of contemporary biomedical psychiatry and its contrast to non-allopathic systems of medicine is initially reviewed, followed by an exploration of the emerging paradigm of IMH, which aims to reconcile the bio-psycho-socio-spiritual model with evidence-based methods from traditional healing practices. IMH is rapidly transforming conventional understandings of mental illness and has significant positive implications for the day-to-day practice of mental health care. IMH incorporates mainstream interventions such as pharmacologic treatments, psychotherapy, and psychosocial interventions, as well as alternative therapies such as acupuncture, herbal and nutritional medicine, dietary modification, meditation, etc. Two recent international conferences in Europe and the United States show that interest in integrative mental health care is growing rapidly. In response, the International Network of Integrative Mental Health (INIMH: www.INIMH.org) was established in 2010 with the objective of creating an international network of clinicians, researchers, and public health advocates to advance a global agenda for research, education, and clinical practice of evidence-based integrative mental health care. The paper concludes with a discussion of emerging opportunities for research in IMH, and an exploration of potential clinical applications of integrative mental health care. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. A Structural Model Proposal for Turkish Faculties of Education Regarding ICT Integration Indicators

    Science.gov (United States)

    Akbulut, Yavuz

    2010-01-01

    A recent survey study with 2515 pre-service teachers suggested an underlying structure to shelter ICT integration indicators. Eleven indicators were extracted, which were Teaching-Learning Methods, E-learning, E-interaction, Learning Communities, Infrastructure, Access, Ease of Use, Technical Assistance, Policy, Special Education and Health. In…

  4. Romanian network for structural integrity assessment of nuclear components

    International Nuclear Information System (INIS)

    Roth, Maria; Constantinescu, Dan Mihai; Brad, Sebastian; Ducu, Catalin

    2008-01-01

    Full text: Based of the Romanian option to develop and operate nuclear facilities, using as model the networks created at European level and taking into account the international importance of the structural integrity assessments for lifetime extension of the nuclear components, a national Project started since 2005 in the framework of the National Program 'Research of Excellence', Modulus I 2006-2008, managed by the Ministry of Education and Research. Entitled 'Integrated Network for Structural Integrity Monitoring of Critical Components in Nuclear Facilities', with the acronym RIMIS, the Project had two main objectives: - to elaborate a procedure applicable to the structural integrity assessment of the critical components used in Romanian nuclear facilities; - to integrate the national networking in a similar one, at European level, to enhance the scientific significance of Romanian R and D organizations as well as to increase the contribution to solving one of the major issue of the nuclear field. The paper aimed to present the activities performed in the Romanian institutes, involved in the Project, the final results obtained as part of the R and D activities, including experimental, theoretical and modeling ones regarding structural integrity assessment of nuclear components employed in CANDU type reactors. Also the activity carried out in the framework of the NULIFE network, created at European level of the FP6 Program and sustained by the RIMIS network will be described. (authors)

  5. Overview Of Hanford Single Shell Tank (SST) Structural Integrity - 12123

    International Nuclear Information System (INIS)

    Rast, R.S.; Rinker, M.W.; Washenfelder, D.J.; Johnson, J.B.

    2012-01-01

    To improve the understanding of the single-shell tanks (SSTs) integrity, Washington River Protection Solutions, LLC (WRPS), the USDOE Hanford Site tank contractor, developed an enhanced Single-Shell Tank Integrity Project in 2009. An expert panel on SST integrity, consisting of various subject matters experts in industry and academia, was created to provide recommendations supporting the development of the project. This panel developed 33 recommendations in four main areas of interest: structural integrity, liner degradation, leak integrity and prevention, and mitigation of contamination migration. Seventeen of these recommendations were used to develop the basis for the M-45-10-1 Change Package for the Hanford Federal Agreement and Compliance Order, which is also known as the Tri-Party Agreement. The structural integrity of the tanks is a key element in completing the cleanup mission at the Hanford Site. There are eight primary recommendations related to the structural integrity of Hanford SSTs. Six recommendations are being implemented through current and planned activities. The structural integrity of the Hanford SSTs is being evaluated through analysis, monitoring, inspection, materials testing, and construction document review. Structural evaluation in the form of analysis is performed using modern finite element models generated in ANSYS(reg s ign) The analyses consider in-situ, thermal, operating loads and natural phenomena such as earthquakes. Structural analysis of 108 of 149 Hanford SSTs has concluded that the tanks are structurally sound and meet current industry standards. Analyses of the remaining Hanford SSTs are scheduled for FY2013. Hanford SSTs are monitored through a dome deflection program. The program looks for deflections of the tank dome greater than 1/4 inch. No such deflections have been recorded. The tanks are also subjected to visual inspection. Digital cameras record the interior surface of the concrete tank domes, looking for cracks and

  6. Overview of Hanford Single Shell Tank (SST) Structural Integrity

    Energy Technology Data Exchange (ETDEWEB)

    Rast, Richard S.; Washenfelder, Dennis J.; Johnson, Jeremy M.

    2013-11-14

    To improve the understanding of the single-shell tanks (SSTs) integrity, Washington River Protection Solutions, LLC (WRPS), the USDOE Hanford Site tank contractor, developed an enhanced Single-Shell Tank Integrity Project (SSTIP) in 2009. An expert panel on SST integrity, consisting of various subject matters experts in industry and academia, was created to provide recommendations supporting the development of the project. This panel developed 33 recommendations in four main areas of interest: structural integrity, liner degradation, leak integrity and prevention, and mitigation of contamination migration, Seventeen of these recommendations were used to develop the basis for the M-45-10-1 Change Package for the Hanford Federal Agreement and Compliance Order, which is also known as the Tri-Party Agreement. The structural integrity of the tanks is a key element in completing the cleanup mission at the Hanford Site. There are eight primary recommendations related to the structural integrity of Hanford Single-Shell Tanks. Six recommendations are being implemented through current and planned activities. The structural integrity of the Hanford is being evaluated through analysis, monitoring, inspection, materials testing, and construction document review. Structural evaluation in the form of analysis is performed using modern finite element models generated in ANSYS. The analyses consider in-situ, thermal, operating loads and natural phenomena such as earthquakes. Structural analysis of 108 of 149 Hanford Single-Shell Tanks has concluded that the tanks are structurally sound and meet current industry standards. Analysis of the remaining Hanford Single-Shell Tanks is scheduled for FY2014. Hanford Single-Shell Tanks are monitored through a dome deflection program. The program looks for deflections of the tank dome greater than 1/4 inch. No such deflections have been recorded. The tanks are also subjected to visual inspection. Digital cameras record the interior surface of

  7. OVERVIEW OF HANFORD SINGLE SHELL TANK (SST) STRUCTURAL INTEGRITY - 12123

    Energy Technology Data Exchange (ETDEWEB)

    RAST RS; RINKER MW; WASHENFELDER DJ; JOHNSON JB

    2012-01-25

    To improve the understanding of the single-shell tanks (SSTs) integrity, Washington River Protection Solutions, LLC (WRPS), the USDOE Hanford Site tank contractor, developed an enhanced Single-Shell Tank Integrity Project in 2009. An expert panel on SST integrity, consisting of various subject matters experts in industry and academia, was created to provide recommendations supporting the development of the project. This panel developed 33 recommendations in four main areas of interest: structural integrity, liner degradation, leak integrity and prevention, and mitigation of contamination migration. Seventeen of these recommendations were used to develop the basis for the M-45-10-1 Change Package for the Hanford Federal Agreement and Compliance Order, which is also known as the Tri-Party Agreement. The structural integrity of the tanks is a key element in completing the cleanup mission at the Hanford Site. There are eight primary recommendations related to the structural integrity of Hanford SSTs. Six recommendations are being implemented through current and planned activities. The structural integrity of the Hanford SSTs is being evaluated through analysis, monitoring, inspection, materials testing, and construction document review. Structural evaluation in the form of analysis is performed using modern finite element models generated in ANSYS{reg_sign} The analyses consider in-situ, thermal, operating loads and natural phenomena such as earthquakes. Structural analysis of 108 of 149 Hanford SSTs has concluded that the tanks are structurally sound and meet current industry standards. Analyses of the remaining Hanford SSTs are scheduled for FY2013. Hanford SSTs are monitored through a dome deflection program. The program looks for deflections of the tank dome greater than 1/4 inch. No such deflections have been recorded. The tanks are also subjected to visual inspection. Digital cameras record the interior surface of the concrete tank domes, looking for cracks and

  8. Overview of Hanford Single Shell Tank (SST) Structural Integrity

    International Nuclear Information System (INIS)

    Rast, Richard S.; Washenfelder, Dennis J.; Johnson, Jeremy M.

    2013-01-01

    To improve the understanding of the single-shell tanks (SSTs) integrity, Washington River Protection Solutions, LLC (WRPS), the USDOE Hanford Site tank contractor, developed an enhanced Single-Shell Tank Integrity Project (SSTIP) in 2009. An expert panel on SST integrity, consisting of various subject matters experts in industry and academia, was created to provide recommendations supporting the development of the project. This panel developed 33 recommendations in four main areas of interest: structural integrity, liner degradation, leak integrity and prevention, and mitigation of contamination migration, Seventeen of these recommendations were used to develop the basis for the M-45-10-1 Change Package for the Hanford Federal Agreement and Compliance Order, which is also known as the Tri-Party Agreement. The structural integrity of the tanks is a key element in completing the cleanup mission at the Hanford Site. There are eight primary recommendations related to the structural integrity of Hanford Single-Shell Tanks. Six recommendations are being implemented through current and planned activities. The structural integrity of the Hanford is being evaluated through analysis, monitoring, inspection, materials testing, and construction document review. Structural evaluation in the form of analysis is performed using modern finite element models generated in ANSYS. The analyses consider in-situ, thermal, operating loads and natural phenomena such as earthquakes. Structural analysis of 108 of 149 Hanford Single-Shell Tanks has concluded that the tanks are structurally sound and meet current industry standards. Analysis of the remaining Hanford Single-Shell Tanks is scheduled for FY2014. Hanford Single-Shell Tanks are monitored through a dome deflection program. The program looks for deflections of the tank dome greater than 1/4 inch. No such deflections have been recorded. The tanks are also subjected to visual inspection. Digital cameras record the interior surface of

  9. Structurally Integrated Coatings for Wear and Corrosion

    Energy Technology Data Exchange (ETDEWEB)

    Beardsley, M. Brad; Sebright, Jason L.

    2008-11-18

    Wear and corrosion of structures cuts across industries and continues to challenge materials scientists and engineers to develop cost effective solutions. Industries typically seek mature technologies that can be implemented for production with rapid or minimal development and have little appetite for the longer-term materials research and development required to solve complex problems. The collaborative work performed in this project addressed the complexity of this problem in a multi-year program that industries would be reluctant to undertake without government partnership. This effort built upon the prior development of Advanced Abrasion Resistant Materials conduct by Caterpillar Inc. under DOE Cooperative Agreement No. DE-FC26-01NT41054. In this referenced work, coatings were developed that exhibited significant wear life improvements over standard carburized heat treated steel in abrasive wear applications. The technology used in this referenced work, arc lamp fusing of thermal spray coatings, was one of the primary technical paths in this work effort. In addition to extending the capability of the coating technology to address corrosion issues, additional competitive coating technologies were evaluated to insure that the best technology was developed to meet the goals of the program. From this, plasma transferred arc (PTA) welding was selected as the second primary technology that was investigated. Specifically, this project developed improved, cost effective surfacing materials and processes for wear and corrosion resistance in both sliding and abrasive wear applications. Materials with wear and corrosion performance improvements that are 4 to 5 times greater than heat treated steels were developed. The materials developed were based on low cost material systems utilizing ferrous substrates and stainless steel type matrix with hard particulates formed from borides and carbides. Affordability was assessed against other competing hard surfacing or coating

  10. Damage Detection with Streamlined Structural Health Monitoring Data

    Directory of Open Access Journals (Sweden)

    Jian Li

    2015-04-01

    Full Text Available The huge amounts of sensor data generated by large scale sensor networks in on-line structural health monitoring (SHM systems often overwhelms the systems’ capacity for data transmission and analysis. This paper presents a new concept for an integrated SHM system in which a streamlined data flow is used as a unifying thread to integrate the individual components of on-line SHM systems. Such an integrated SHM system has a few desirable functionalities including embedded sensor data compression, interactive sensor data retrieval, and structural knowledge discovery, which aim to enhance the reliability, efficiency, and robustness of on-line SHM systems. Adoption of this new concept will enable the design of an on-line SHM system with more uniform data generation and data handling capacity for its subsystems. To examine this concept in the context of vibration-based SHM systems, real sensor data from an on-line SHM system comprising a scaled steel bridge structure and an on-line data acquisition system with remote data access was used in this study. Vibration test results clearly demonstrated the prominent performance characteristics of the proposed integrated SHM system including rapid data access, interactive data retrieval and knowledge discovery of structural conditions on a global level.

  11. Damage detection with streamlined structural health monitoring data.

    Science.gov (United States)

    Li, Jian; Deng, Jun; Xie, Weizhi

    2015-04-15

    The huge amounts of sensor data generated by large scale sensor networks in on-line structural health monitoring (SHM) systems often overwhelms the systems' capacity for data transmission and analysis. This paper presents a new concept for an integrated SHM system in which a streamlined data flow is used as a unifying thread to integrate the individual components of on-line SHM systems. Such an integrated SHM system has a few desirable functionalities including embedded sensor data compression, interactive sensor data retrieval, and structural knowledge discovery, which aim to enhance the reliability, efficiency, and robustness of on-line SHM systems. Adoption of this new concept will enable the design of an on-line SHM system with more uniform data generation and data handling capacity for its subsystems. To examine this concept in the context of vibration-based SHM systems, real sensor data from an on-line SHM system comprising a scaled steel bridge structure and an on-line data acquisition system with remote data access was used in this study. Vibration test results clearly demonstrated the prominent performance characteristics of the proposed integrated SHM system including rapid data access, interactive data retrieval and knowledge discovery of structural conditions on a global level.

  12. Structural integrity monitoring of critical components in nuclear facilities

    International Nuclear Information System (INIS)

    Roth, Maria; Constantinescu, Dan Mihai; Brad, Sebastian; Ducu, Catalin; Malinovschi, Viorel

    2007-01-01

    Full text: The paper presents the results obtained as part of the Project 'Integrated Network for Structural Integrity Monitoring of Critical Components in Nuclear Facilities', RIMIS, a research work underway within the framework of the Ministry of Education and Research Programme 'Research of Excellence'. The main objective of the Project is to constitute a network integrating the national R and D institutes with preoccupations in the structural integrity assessment of critical components in the nuclear facilities operating in Romania, in order to elaborate a specific procedure for this field. The degradation mechanisms of the structural materials used in the CANDU type reactors, operated by Unit 1 and Unit 2 at Cernavoda (pressure tubes, fuel elements sheaths, steam generator tubing) and in the nuclear facilities relating to reactors of this type as, for instance, the Hydrogen Isotopes Separation facility, will be investigated. The development of a flexible procedure will offer the opportunity to extend the applications to other structural materials used in the nuclear field and in the non-nuclear fields as well, in cooperation with other institutes involved in the developed network. The expected results of the project will allow the integration of the network developed at national level in the structures of similar networks operating within the EU, the enhancement of the scientific importance of Romanian R and D organizations as well as the increase of our country's contribution in solving the major issues of the nuclear field. (authors)

  13. Integration of health care organizations: using the power strategies of horizontal and vertical integration in public and private health systems.

    Science.gov (United States)

    Thaldorf, Carey; Liberman, Aaron

    2007-01-01

    Integration in health care attempts to provide all elements in a seamless continuum of care. Pressures influencing development of system-wide integration primarily come from unsustainable cost increases in the United States over the later part of the 20th century and the early 21st century. Promoters of health care integration assume that it will lead to increased effectiveness and quality of care while concurrently increasing cost-effectiveness and possibly facilitating cost savings. The primary focus of this literature review is on the Power Strategies of Horizontal and Vertical Integration. The material presented suggests that vertical integration is most effective in markets where the partners involved are larger and dominant in the regions they serve. The research has also found that integrating health care networks had little or no significant effect on improving overall organizational efficiencies or profits. Capital investment in information technologies still is cost prohibitive and outweighs its benefits to integration efficiencies in the private sector; however, there are some indications of improvements in publicly provided health care. Further research is needed to understand the reasons the public sector has had greater success in improving effectiveness and efficiency through integration than the private sector.

  14. Integrating Biopsychosocial Intervention Research in a Changing Health Care Landscape

    Science.gov (United States)

    Ell, Kathleen; Oh, Hyunsung; Wu, Shinyi

    2016-01-01

    Objective: Safety net care systems are experiencing unprecedented change from the "Affordable Care Act," Patient-Centered Medical Home (PCMH) uptake, health information technology application, and growing of mental health care integration within primary care. This article provides a review of previous and current efforts in which social…

  15. Integrating Occupational Health and Safety into TAFE Courses: Curriculum Topics.

    Science.gov (United States)

    Hall, Bob; Mageean, Pauline

    This guide is designed to help technical and further education (TAFE) curriculum writers in Australia integrate safety education into vocational education courses. It provides a general overview of occupational health and safety from the perspective of TAFE trade training and a brief summary of the major health and safety issues that might be…

  16. Integration of pediatric mental health in general pediatrics in eritrea ...

    African Journals Online (AJOL)

    Background: Recognition of mental health problems among children continues to be a diagnostic challenge especially in resource poor countries where integration of such services within the primary health care framework has not been fully successfully. Objective: To document the prevailing mental services among ...

  17. Integrating mental health into the basic nursing curriculum: Benefits ...

    African Journals Online (AJOL)

    Integration of mental health into the basic nursing curricula provides an environment for and affords students an opportunity to learn how a client should be treated holistically. Nurses constitute the largest proportion of health workers in most countries of the world. They work in the remotest areas where there are hardly any ...

  18. Software for the occupational health and safety integrated management system

    International Nuclear Information System (INIS)

    Vătăsescu, Mihaela

    2015-01-01

    This paper intends to present the design and the production of a software for the Occupational Health and Safety Integrated Management System with the view to a rapid drawing up of the system documents in the field of occupational health and safety

  19. Integrating reproductive and child health and HIV services in Tanzania

    African Journals Online (AJOL)

    Integrating reproductive and child health and HIV services in Tanzania: Implication to policy, systems and services. ... Experts around the world recognize the central role of Sexual and Reproductive Health (SRH) services in preventing HIV infection. Evidence suggests that improving access to contraception for women to ...

  20. Social Integration and the Mental Health of Black Adolescents

    Science.gov (United States)

    Rose, Theda; Joe, Sean; Shields, Joseph; Caldwell, Cleopatra H.

    2014-01-01

    The influence of family, school, and religious social contexts on the mental health of Black adolescents has been understudied. This study used Durkheim's social integration theory to examine these associations in a nationally representative sample of 1,170 Black adolescents, ages 13-17. Mental health was represented by positive and negative…

  1. Owned vertical integration and health care: promise and performance.

    Science.gov (United States)

    Walston, S L; Kimberly, J R; Burns, L R

    1996-01-01

    This article examines the alleged benefits and actual outcomes of vertical integration in the health sector and compares them to those observed in other sectors of the economy. This article concludes that the organizational models on which these arrangements are based may be poorly adapted to the current environment in health care.

  2. Software for the occupational health and safety integrated management system

    Energy Technology Data Exchange (ETDEWEB)

    Vătăsescu, Mihaela [University Politehnica Timisoara, Department of Engineering and Management, 5 Revolutiei street, 331128 Hunedoara (Romania)

    2015-03-10

    This paper intends to present the design and the production of a software for the Occupational Health and Safety Integrated Management System with the view to a rapid drawing up of the system documents in the field of occupational health and safety.

  3. Social Integration and Health Behavioral Change in San Luis, Honduras

    Science.gov (United States)

    McQuestion, Michael J.; Calle, Ana Quijano; Drasbek, Christopher; Harkins, Thomas; Sagastume, Lourdes J.

    2010-01-01

    This study explores the effects of social integration on behavioral change in the course of an intensive, community-based public health intervention. The intervention trained volunteers and mobilized local organizations to promote 16 key family health practices in rural San Luis, Honduras, during 2004 to 2006. A mixed methods approach is used.…

  4. Lights, Camera, Action: Integrating Popular Film in the Health Classroom

    Science.gov (United States)

    Diez, Keri S.; Pleban, Francis T.; Wood, Ralph J.

    2005-01-01

    This article discusses the benefits as well as the important considerations that should be taken into account in integrating popular films in health education classes. Use of popular films in the classroom, termed "cinema education," is becoming increasingly popular in teaching health education. As a matter of convenience, popular films are easy…

  5. A tool to guide the process of integrating health system responses to public health problems

    Directory of Open Access Journals (Sweden)

    Tilahun Nigatu Haregu

    2015-06-01

    Full Text Available An integrated model of health system responses to public health problems is considered to be the most preferable approach. Accordingly, there are several models that stipulate what an integrated architecture should look like. However, tools that can guide the overall process of integration are lacking. This tool is designed to guide the entire process of integration of health system responses to major public health problems. It is developed by taking into account the contexts of health systems of developing countries and the emergence of double-burden of chronic diseases in these settings. Chronic diseases – HIV/AIDS and NCDs – represented the evidence base for the development of the model. System level horizontal integration of health system responses were considered in the development of this tool.

  6. Health Technology Assessment of Integrated Home Care

    DEFF Research Database (Denmark)

    Larsen, Torben

    2012-01-01

    application for Tele-medicine (MAST). An introductory literature review identified stroke, heart failure (HF) and COPD as prototypes of IHC. Pre-existing evidence has been complemented by additional trials and surveys. Results: 1. Definition/organization of IHC: (1) Is carried out by a multidisciplinary team......-analysis of the effect on all-cause readmissions concludes OR=0.60 (CI95%: 0.40-0.92) COPD: 3 RCT (N=381) demonstrate each a significant reduction in readmissions. A meta-analysis of readmissions concludes (OR=0.5; CI: 0.25-0.80). 3. Health economic evaluation: For each selected condition the first year benefit...... satisfaction: Focus group interviews confirm literature findings of very good satisfaction by IHC both among patients/carers and health professionals. Discussion: The calculated net savings by IHC are not supposed to materialize in ‘cool’- cash but should enable local negotiation of adapted solutions...

  7. Integrated Systems Health Management (ISHM) Toolkit

    Science.gov (United States)

    Venkatesh, Meera; Kapadia, Ravi; Walker, Mark; Wilkins, Kim

    2013-01-01

    A framework of software components has been implemented to facilitate the development of ISHM systems according to a methodology based on Reliability Centered Maintenance (RCM). This framework is collectively referred to as the Toolkit and was developed using General Atomics' Health MAP (TM) technology. The toolkit is intended to provide assistance to software developers of mission-critical system health monitoring applications in the specification, implementation, configuration, and deployment of such applications. In addition to software tools designed to facilitate these objectives, the toolkit also provides direction to software developers in accordance with an ISHM specification and development methodology. The development tools are based on an RCM approach for the development of ISHM systems. This approach focuses on defining, detecting, and predicting the likelihood of system functional failures and their undesirable consequences.

  8. Review of behavioral health integration in primary care at Baylor Scott and White Healthcare, Central Region.

    Science.gov (United States)

    Jolly, John B; Fluet, Norman R; Reis, Michael D; Stern, Charles H; Thompson, Alexander W; Jolly, Gillian A

    2016-04-01

    The integration of behavioral health services in primary care has been referred to in many ways, but ultimately refers to common structures and processes. Behavioral health is integrated into primary care because it increases the effectiveness and efficiency of providing care and reduces costs in the care of primary care patients. Reimbursement is one factor, if not the main factor, that determines the level of integration that can be achieved. The federal health reform agenda supports changes that will eventually permit behavioral health to be fully integrated and will allow the health of the population to be the primary target of intervention. In an effort to develop more integrated services at Baylor Scott and White Healthcare, models of integration are reviewed and the advantages and disadvantages of each model are discussed. Recommendations to increase integration include adopting a disease management model with care management, planned guideline-based stepped care, follow-up, and treatment monitoring. Population-based interventions can be completed at the pace of the development of alternative reimbursement methods. The program should be based upon patient-centered medical home standards, and research is needed throughout the program development process.

  9. Employee health services integration: meeting the challenge. Successful program.

    Science.gov (United States)

    Lang, Y C

    1998-02-01

    1. The first step of a successful Employee Health Service integration is to have a plan supported by management. The plan must be presented to the employees prior to implementation in a "user friendly" manner. 2. Prior to computerization of employee health records, a record order system must be developed to prevent duplication and to enhance organization. 3. Consistency of services offered must be maintained. Each employee must have the opportunity to receive the same service. Complexity of services will determine the site of delivery. 4. Integration is a new and challenging development for the health care field. Flexibility and brainstorming are necessary in an attempt to meet both employee and employer needs.

  10. Integrated Approaches to Occupational Health and Safety: A Systematic Review.

    Science.gov (United States)

    Cooklin, A; Joss, N; Husser, E; Oldenburg, B

    2017-09-01

    The study objective was to conduct a systematic review of the effectiveness of integrated workplace interventions that combine health promotion with occupational health and safety. Electronic databases (n = 8), including PsychInfo and MEDLINE, were systematically searched. Studies included were those that reported on workplace interventions that met the consensus definition of an "integrated approach," published in English, in the scientific literature since 1990. Data extracted were occupation, worksite, country, sample size, intervention targets, follow-up period, and results reported. Quality was assessed according to American College of Occupational and Environmental Medicine Practice Guidelines. Heterogeneity precluded formal meta-analyses. Results were classified according to the outcome(s) assessed into five categories (health promotion, injury prevention, occupational health and safety management, psychosocial, and return-on-investment). Narrative synthesis of outcomes was performed. A total of 31 eligible studies were identified; 23 (74%) were (quasi-)experimental trials. Effective interventions were most of those aimed at improving employee physical or mental health. Less consistent results were reported from integrated interventions targeting occupational health and safety management, injury prevention, or organizational cost savings. Integrated approaches have been posed as comprehensive solutions to complex issues. Empirical evidence, while still emerging, provides some support for this. Continuing investment in, and evaluation of, integrated approaches are worthwhile.

  11. New trends in structural health monitoring

    CERN Document Server

    Güemes, J

    2013-01-01

    Experts actively working in structural health monitoring and control techniques present the current research, areas of application and tendencies for the future of this technology, including various design issues involved. Examples using some of the latest hardware and software tools, experimental data from small scale laboratory demonstrators and measurements made on real structures illustrate the book. It will be a reference for professionals and students in the areas of engineering, applied natural sciences and engineering management.

  12. Structural Integrity Management for Fixed Offshore Platforms in Malaysia

    OpenAIRE

    Narayanan Sambu Potty; Mohammad Kabir B. Mohd Akram

    2009-01-01

    Structural Integrity Management (SIM) is important for the protection of offshore crew, environment, business assets and company and industry reputation. API RP 2A contained guidelines for assessment of existing platforms mostly for the Gulf of Mexico (GOM). ISO 19902 SIM framework also does not specifically cater for Malaysia. There are about 200 platforms in Malaysia with 90 exceeding their design life. The Petronas Carigali Sdn Bhd (PCSB) uses the Asset Integrity Management ...

  13. Structural Integrity and Hydraulic Stability of Dolos Armour Layers

    DEFF Research Database (Denmark)

    Burcharth, H. F.

    A method for development of design diagrams to ensure structural integrity of slender unreinforced concrete breakwater armour units is presented. The method is based on experimental data from small scale flume tests as well as impact loading of prototype and small scale units. A prerequisite......-parameter characterization makes it possible to develop simple design diagrams for engineering purposes. Specific design diagrams for integrity of Dolos armour units with the waist ratio as a variable have been produced....

  14. Structural health monitoring of compression connectors for overhead transmission lines

    Science.gov (United States)

    Wang, Hong; Wang, Jy-An John; Swindeman, Joseph P.; Ren, Fei; Chan, John

    2017-04-01

    Two-stage aluminum conductor steel-reinforced (ACSR) compression connectors are extensively used in US overhead transmission lines. The connectors are made by crimping a steel sleeve onto a steel core and an aluminum sleeve over electrical conducting aluminum strands. The connectors are designed to operate at temperatures up to 125°C, but their performance is increasingly degrading because of overloading of lines. Currently, electric utilities conduct routine line inspections using thermal and electrical measurements, but these methods do not provide information about the structural integrity of connectors. In this work, structural health monitoring (SHM) of compression connectors was studied using electromechanical impedance (EMI) analysis. Lead zirconate titanate (PZT)-5A was identified as a smart material for SHM. A flexible high-temperature bonding layer was used to address challenges in PZT integration due to a significant difference in the coefficients of thermal expansion of PZT and the aluminum substrate. The steel joint on the steel core was investigated because it is responsible for the ultimate tensile strength of the connector. Tensile testing was used to induce structural damage to the joint, or steel core pullout, and thermal cycling introduced additional structural perturbations. EMI measurements were conducted between the tests. The root mean square deviation (RMSD) of EMI was identified as a damage index. The use of steel joints has been shown to enable SHM under simulated conditions. The EMI signature is sensitive to variations in structural conditions. RMSD can be correlated to the structural health of a connector and has potential for use in the SHM and structural integrity evaluation.

  15. An integrated framework for health and ecological risk assessment

    International Nuclear Information System (INIS)

    Suter, Glenn W.; Vermeire, Theo; Munns, Wayne R.; Sekizawa, Jun

    2005-01-01

    The worldHealth Organization's (WHO's) International Program for Chemical Safety has developed a framework for performing risk assessments that integrate the assessment of risks to human health and risks to nonhuman organisms and ecosystems. The WHO's framework recognizes that stakeholders and risk managers have their own processes that are parallel to the scientific process of risk assessment and may interact with the risk assessment at various points, depending on the context. Integration of health and ecology provides consistent expressions of assessment results, incorporates the interdependence of humans and the environment, uses sentinel organisms, and improves the efficiency and quality of assessments relative to independent human health and ecological risk assessments. The advantage of the framework to toxicologists lies in the opportunity to use understanding of toxicokinetics and toxicodynamics to inform the integrated assessment of all exposed species

  16. First Canadian workshop on engineering structural integrity : CWESI. Proceedings

    International Nuclear Information System (INIS)

    2002-01-01

    The First Canadian Workshop on Engineering Structural Integrity (CWESI) was held on October 16 and 17, 2002, in Toronto, Canada. The purpose of the Workshop was to review strategies for ESI in a number of key industries, and to attempt to plot a course for co-operation in ESI activities and implementation of ESI initiatives in Canadian industry, together with support for appropriate educational, research and development activities. The Workshop consisted of presentations by speakers from a number of industries. Presentations focused on in-service experience under service conditions related to the Canadian environment. This Workshop was attended by practising structural integrity engineers, managers with the responsibility for delivery of safe and reliable operation, and researchers in the structural integrity area

  17. Improving Acceptance, Integration, and Health Among LGBT Service Members

    Science.gov (United States)

    2016-10-01

    Military, LGBT, health disparities, minority stress , social networks 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a...physical and mental health needs of this community. This project includes LGBT service members from all four services, Army, Air Force, Navy and...acceptance and integration of sexual minorities into traditional heterosexual work environments. Further, the findings will address possible health

  18. From childhood adversity to problem behaviors: Role of psychological and structural social integration.

    Science.gov (United States)

    Chao, Lo-Hsin; Tsai, Meng-Che; Liang, Ya-Lun; Strong, Carol; Lin, Chung-Ying

    2018-01-01

    Childhood adversity (CA) is associated with problem behaviors in adolescence, but the mediators, that is, those factors that help build resilience and prevent some children who experience CA from engaging in problem behaviors, await more exploration, including social integration. The aim of this study was to identify the association between CA and adolescent problem behaviors, and to further examine the mediating role of social integration distinctly as psychological and structural integration. Data used were from the Taiwan Education Panel Survey, a core panel of 4,261 students (age 13) surveyed in 2001 and followed for three more waves until age 18. For psychological integration, an average score was calculated to represent adolescents' feelings about their school. Structural integration was constructed using several items about adolescents' school and extracurricular activities. We used structural equation modeling with the diagonally weighted least squares method to examine the effect of CA on the primary outcome: adolescent problem behaviors via social integration. The hypothesized structural equation model specifying the path from CA to adolescent problem behavior had good fit. Respondents with one CA were indirectly linked to problem behaviors via psychological but not structural integration (e.g. the level of participation in school and non-school activities). On mediation analysis, psychological integration significantly mediated the paths from one CA to all six problem behaviors (all P integration; two or more CA were not associated with significant paths to problem behaviors. The contribution of social integration is crucial to an adolescent's development from CA to problem behaviors. To form supportive social relationships to achieve better health, we suggest that those adolescents who have been exposed to CA should be helped to join more teams and take part in more activities, thereby increasing their opportunities for social interaction, and improving

  19. Integrated health of the girl child.

    Science.gov (United States)

    Ghosh, S

    1995-01-01

    This article discusses factors that affect the well-being and health of female children in India: sex ratio, literacy, food intake, morbidity, mortality, early marriage, maternal mortality, nutrition, prenatal care and delivery, family planning responsibilities, and access to health services. India has recognized within its Constitution and other government documents and programs equality for women, but practices lag behind principles. A National Action Plan was formulated for the period 1991-2000 for the girl child. Women themselves must change their attitudes about themselves and their female children. Several pilot programs have demonstrated the potential to empower girls to be outspoken, vocal, and enthusiastic. Girls in India are disadvantaged even before their birth. Patriarchal norms reinforce the view of girls as a bad investment. Women are blamed for not bearing a son, despite the evidence that males carry the deciding gender-specific chromosome. Tamil Nadu districts are known for their female infanticide. The declining sex ratio is attributed to the higher death rate among females younger than 35 years. Females until recently had a lower life expectancy than males. Sex ratios vary between states. The only state with a positive female sex ratio is Kerala. Males outnumber females by almost 10% in most of the northern and eastern states. Illiteracy among women is high in about 100 districts. Female school enrollment is 50% less than male enrollment. Females suffer from higher rates of malnutrition, morbidity, and death. Girls' adolescent growth spurt is delayed until 18 years. Maternal mortality accounts for the largest proportion of deaths among women of reproductive age. The most common reason for abortion is "too many children." Lower socioeconomic status is associated with lower nutrition. Women do not have control over their fertility. Women are limited in their access to reproductive health care.

  20. High throughput platforms for structural genomics of integral membrane proteins.

    Science.gov (United States)

    Mancia, Filippo; Love, James

    2011-08-01

    Structural genomics approaches on integral membrane proteins have been postulated for over a decade, yet specific efforts are lagging years behind their soluble counterparts. Indeed, high throughput methodologies for production and characterization of prokaryotic integral membrane proteins are only now emerging, while large-scale efforts for eukaryotic ones are still in their infancy. Presented here is a review of recent literature on actively ongoing structural genomics of membrane protein initiatives, with a focus on those aimed at implementing interesting techniques aimed at increasing our rate of success for this class of macromolecules. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Control structure selection for energy integrated distillation column

    DEFF Research Database (Denmark)

    Hansen, J.E.; Jørgensen, Sten Bay

    1998-01-01

    This paper treats a case study on control structure selection for an almost binary distillation column. The column is energy integrated with a heat pump in order to transfer heat from the condenser to the reboiler. This integrated plant configuration renders the possible control structures somewhat...... different from what is usual for binary distillation columns. Further the heat pump enables disturbances to propagate faster through the system. The plant has six possible actuators of which three must be used to stabilize the system. Hereby three actuators are left for product purity control. An MILP...

  2. The integrable structure of nonrational conformal field theory

    Energy Technology Data Exchange (ETDEWEB)

    Bytsko, A. [Steklov Mathematics Institute, St. Petersburg (Russian Federation); Teschner, J. [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)

    2009-02-15

    Using the example of Liouville theory, we show how the separation into left- and rightmoving degrees of freedom of a nonrational conformal field theory can be made explicit in terms of its integrable structure. The key observation is that there exist separate Baxter Q-operators for left- and right-moving degrees of freedom. Combining a study of the analytic properties of the Q-operators with Sklyanin's Separation of Variables Method leads to a complete characterization of the spectrum. Taking the continuum limit allows us in particular to rederive the Liouville reflection amplitude using only the integrable structure. (orig.)

  3. Integrative computational models of cardiac arrhythmias -- simulating the structurally realistic heart

    Science.gov (United States)

    Trayanova, Natalia A; Tice, Brock M

    2009-01-01

    Simulation of cardiac electrical function, and specifically, simulation aimed at understanding the mechanisms of cardiac rhythm disorders, represents an example of a successful integrative multiscale modeling approach, uncovering emergent behavior at the successive scales in the hierarchy of structural complexity. The goal of this article is to present a review of the integrative multiscale models of realistic ventricular structure used in the quest to understand and treat ventricular arrhythmias. It concludes with the new advances in image-based modeling of the heart and the promise it holds for the development of individualized models of ventricular function in health and disease. PMID:20628585

  4. Health literacy and public health: A systematic review and integration of definitions and models

    LENUS (Irish Health Repository)

    Sorensen, Kristine

    2012-01-25

    Abstract Background Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy. Methods A systematic literature review was performed to identify definitions and conceptual frameworks of health literacy. A content analysis of the definitions and conceptual frameworks was carried out to identify the central dimensions of health literacy and develop an integrated model. Results The review resulted in 17 definitions of health literacy and 12 conceptual models. Based on the content analysis, an integrative conceptual model was developed containing 12 dimensions referring to the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion setting, respectively. Conclusions Based upon this review, a model is proposed integrating medical and public health views of health literacy. The model can serve as a basis for developing health literacy enhancing interventions and provide a conceptual basis for the development and validation of measurement tools, capturing the different dimensions of health literacy within the healthcare, disease prevention and health promotion settings.

  5. Integrity of Safety-Related Fast Reactor Structures

    International Nuclear Information System (INIS)

    Rose, R.T.; Tomkins, B.

    1981-01-01

    The LMFBR contains several structural items whose integrity must be safeguarded during the life of the plant. These items include the main core support structures (strongback, diagrid) and the primary tank to which these structures are attached. In order to demonstrate an acceptable level of structural integrity, the chosen design philosophy must be supported by both analytical and experimental evidence. This paper describes the current approaches in the UK to these requirements. Section 2 describes the materials mechanical properties tests performed to date on both fracture toughness and fatigue crack growth in Type 316 austenitic stainless steel plate and weldments. This data illustrates the problems in identifying the relevant materials fracture parameters for use in assessments. Section 3 shows the test programmes in hand to extend the materials programmes to tests on structural features (mainly welded wide plate tests) which incorporate the complexity of weldments in a structural context. This includes experimental evidence on the effects of local weld residual stresses on structural failure. Various routes are open for the integrity assessment of FR structures. These are discussed in Section 4 but in effect they reduce to a fracture mechanics approach using some technique to cope with elastic-plastic fracture. The main problems at present relate to our ability in analysis to cope with residual stresses and the post-initiation region of the fracture resistance curve. Also, there is the problem of initial defect sizing by current NDE techniques. Current conservative analytical assessments give acceptable defect sizes of order a few millimetres in irradiated weldments. Finally, Section 5 discusses the options open in design to cope with safety related structures under normal and abnormal loading conditions. It is clear that several options exist in design to satisfy the demand for high integrity

  6. Integrated network for structural integrity monitoring of critical components in nuclear facilities, RIMIS

    International Nuclear Information System (INIS)

    Roth, Maria; Constantinescu, Dan Mihai; Brad, Sebastian; Ducu, Catalin; Malinovschi, Viorel

    2008-01-01

    The round table aims to join specialists working in the research area of the Romanian R and D Institutes and Universities involved in structural integrity assessment of materials, especially those working in the nuclear field, together with the representatives of the end user, the Cernavoda NPP. This scientific event will offer the opportunity to disseminate the theoretical, experimental and modelling activities, carried out to date, in the framework of the National Program 'Research of Excellence', Module I 2006-2008, managed by the National Authority for Scientific Research. Entitled 'Integrated Network for Structural Integrity Monitoring of Critical Components in Nuclear Facilities, RIMIS, the project has two main objectives: 1. - to elaborate a procedure applicable to the structural integrity assessment of critical components used in Romanian nuclear facilities (CANDU type Reactor, Hydrogen Isotopes Separation installations); 2. - to integrate the national networking into a similar one of European level, and to enhance the scientific significance of Romanian R and D organisations as well as to increase the contribution in solving major issues of the nuclear field. The topics of the round table will be focused on: 1. Development of a Structural Integrity Assessment Methodology applicable to the nuclear facilities components; 2. Experimental investigation methods and procedures; 3. Numeric simulation of nuclear components behaviour; 4. Further activities to finalize the assessment procedure. Also participations and contributions to sustain the activity in the European Network NULIFE, FP6 will be discussed. (authors)

  7. Civil war, social integration and mental health in Croatia.

    Science.gov (United States)

    Kunovich, R M; Hodson, R

    1999-12-01

    Research has shown that social relationships are generally beneficial for mental health (Thoits 1995). However, few scholars have examined this association after the occurrence of a significant shock to the social system as a whole. The purpose of this article is to examine the relationship between social integration and war-related distress in Croatia immediately following the recent civil war. Does social integration decrease war-related distress? Does social integration buffer the effect of traumatic events on war-related distress? We analyze these questions using nationally representative survey data collected in Croatia in 1996. Results suggest that social integration has both positive and negative direct effects on distress. Being a member of informal organizations, such as sports clubs, and participating in social activities are beneficial for mental health. On the other hand, being a member of some formal organizations, such as church organizations and unions, is detrimental to mental health. There is little support for the idea that social integration buffers the effect of traumatic events on distress. Only one of thirty-six possible interactions is significant and supports the buffer hypothesis. Frequent participation in social activities buffers the effect of experiencing violence on war-related distress. Also, some forms of social integration appear to aggravate the effect of traumatic events on war-related distress. In sum, social integration does affect war-related distress after a system shock, but in complex and sometimes unexpected ways.

  8. An Assessment of Integrated Health Management (IHM) Frameworks

    International Nuclear Information System (INIS)

    Lybeck, N.; Tawfik, M.; Coble, J.; Bond, L.J.

    2012-01-01

    In order to meet the ever increasing demand for energy, the United States (U.S.) nuclear industry is turning to life extension of existing nuclear power plants (NPPs). Economically ensuring the safe, secure, and reliable operation of aging nuclear power plants presents many challenges. The 2009 Light Water Reactor Sustainability Workshop identified online monitoring of active and structural components as essential to the better understanding and management of the challenges posed by aging nuclear power plants. Additionally, there is increasing adoption of condition-based maintenance (CBM) for active components in NPPs. These techniques provide a foundation upon which a variety of advanced online surveillance, diagnostic, and prognostic techniques can be deployed to continuously monitor and assess the health of NPP systems and components. The next step in the development of advanced online monitoring is to move beyond CBM to estimating the remaining useful life of active components using prognostic tools. Deployment of prognostic health management (PHM) on the scale of a NPP requires the use of an integrated health management (IHM) framework-a software product (or suite of products) used to manage the necessary elements needed for a complete implementation of online monitoring and prognostics. This paper provides a thoughtful look at the desirable functions and features of IHM architectures. A full PHM system involves several modules, including data acquisition, system modeling, fault detection, fault diagnostics, system prognostics, and advisory generation (operations and maintenance planning). The standards applicable to PHM applications are indentified and summarized. A list of evaluation criteria for PHM software products, developed to ensure scalability of the toolset to an environment with the complexity of a NPP, is presented. Fourteen commercially available PHM software products are identified and classified into four groups: research tools, PHM system

  9. An Assessment of Integrated Health Management (IHM) Frameworks

    International Nuclear Information System (INIS)

    Lybeck, N.; Tawfik, M.; Bond, L.; Coble, J.

    2012-01-01

    In order to meet the ever increasing demand for energy, the United States nuclear industry is turning to life extension of existing nuclear power plants (NPPs). Economically ensuring the safe, secure, and reliable operation of aging nuclear power plants presents many challenges. The 2009 Light Water Reactor Sustainability Workshop identified online monitoring of active and structural components as essential to the better understanding and management of the challenges posed by aging nuclear power plants. Additionally, there is increasing adoption of condition-based maintenance (CBM) for active components in NPPs. These techniques provide a foundation upon which a variety of advanced online surveillance, diagnostic, and prognostic techniques can be deployed to continuously monitor and assess the health of NPP systems and components. The next step in the development of advanced online monitoring is to move beyond CBM to estimating the remaining useful life of active components using prognostic tools. Deployment of prognostic health management (PHM) on the scale of a NPP requires the use of an integrated health management (IHM) framework - a software product (or suite of products) used to manage the necessary elements needed for a complete implementation of online monitoring and prognostics. This paper provides a thoughtful look at the desirable functions and features of IHM architectures. A full PHM system involves several modules, including data acquisition, system modeling, fault detection, fault diagnostics, system prognostics, and advisory generation (operations and maintenance planning). The standards applicable to PHM applications are indentified and summarized. A list of evaluation criteria for PHM software products, developed to ensure scalability of the toolset to an environment with the complexity of a NPP, is presented. Fourteen commercially available PHM software products are identified and classified into four groups: research tools, PHM system

  10. West-Life, Tools for Integrative Structural Biology

    CERN Multimedia

    CERN. Geneva

    2018-01-01

    Structural biology is part of molecular biology focusing on determining structure of macromolecules inside living cells and cell membranes. As macromolecules determines most of the functions of cells the structural knowledge is very useful for further research in metabolism, physiology to application in pharmacology etc. As macromolecules are too small to be observed directly by light microscope, there are other methods used to determine the structure including nuclear magnetic resonance (NMR), X-Ray crystalography, cryo electron microscopy and others. Each method has it's advantages and disadvantages in the terms of availability, sample preparation, resolution. West-Life project has ambition to facilitate integrative approach using multiple techniques mentioned above. As there are already lot of software tools to process data produced by the techniques above, the challenge is to integrate them together in a way they can be used by experts in one technique but not experts in other techniques. One product ...

  11. Visualization of RNA structure models within the Integrative Genomics Viewer.

    Science.gov (United States)

    Busan, Steven; Weeks, Kevin M

    2017-07-01

    Analyses of the interrelationships between RNA structure and function are increasingly important components of genomic studies. The SHAPE-MaP strategy enables accurate RNA structure probing and realistic structure modeling of kilobase-length noncoding RNAs and mRNAs. Existing tools for visualizing RNA structure models are not suitable for efficient analysis of long, structurally heterogeneous RNAs. In addition, structure models are often advantageously interpreted in the context of other experimental data and gene annotation information, for which few tools currently exist. We have developed a module within the widely used and well supported open-source Integrative Genomics Viewer (IGV) that allows visualization of SHAPE and other chemical probing data, including raw reactivities, data-driven structural entropies, and data-constrained base-pair secondary structure models, in context with linear genomic data tracks. We illustrate the usefulness of visualizing RNA structure in the IGV by exploring structure models for a large viral RNA genome, comparing bacterial mRNA structure in cells with its structure under cell- and protein-free conditions, and comparing a noncoding RNA structure modeled using SHAPE data with a base-pairing model inferred through sequence covariation analysis. © 2017 Busan and Weeks; Published by Cold Spring Harbor Laboratory Press for the RNA Society.

  12. Intelligent Integrated Health Management for a System of Systems

    Science.gov (United States)

    Smith, Harvey; Schmalzel, John; Figueroa, Fernando

    2008-01-01

    An intelligent integrated health management system (IIHMS) incorporates major improvements over prior such systems. The particular IIHMS is implemented for any system defined as a hierarchical distributed network of intelligent elements (HDNIE), comprising primarily: (1) an architecture (Figure 1), (2) intelligent elements, (3) a conceptual framework and taxonomy (Figure 2), and (4) and ontology that defines standards and protocols. Some definitions of terms are prerequisite to a further brief description of this innovation: A system-of-systems (SoS) is an engineering system that comprises multiple subsystems (e.g., a system of multiple possibly interacting flow subsystems that include pumps, valves, tanks, ducts, sensors, and the like); 'Intelligent' is used here in the sense of artificial intelligence. An intelligent element may be physical or virtual, it is network enabled, and it is able to manage data, information, and knowledge (DIaK) focused on determining its condition in the context of the entire SoS; As used here, 'health' signifies the functionality and/or structural integrity of an engineering system, subsystem, or process (leading to determination of the health of components); 'Process' can signify either a physical process in the usual sense of the word or an element into which functionally related sensors are grouped; 'Element' can signify a component (e.g., an actuator, a valve), a process, a controller, an actuator, a subsystem, or a system; The term Integrated System Health Management (ISHM) is used to describe a capability that focuses on determining the condition (health) of every element in a complex system (detect anomalies, diagnose causes, prognosis of future anomalies), and provide data, information, and knowledge (DIaK) not just data to control systems for safe and effective operation. A major novel aspect of the present development is the concept of intelligent integration. The purpose of intelligent integration, as defined and

  13. Structural Health Monitoring with Fiber Bragg Grating and Piezo Arrays

    Science.gov (United States)

    Black, Richard J.; Faridian, Ferey; Moslehi, Behzad; Sotoudeh, Vahid

    2012-01-01

    Structural health monitoring (SHM) is one of the most important tools available for the maintenance, safety, and integrity of aerospace structural systems. Lightweight, electromagnetic-interference- immune, fiber-optic sensor-based SHM will play an increasing role in more secure air transportation systems. Manufacturers and maintenance personnel have pressing needs for significantly improving safety and reliability while providing for lower inspection and maintenance costs. Undetected or untreated damage may grow and lead to catastrophic structural failure. Damage can originate from the strain/stress history of the material, imperfections of domain boundaries in metals, delamination in multi-layer materials, or the impact of machine tools in the manufacturing process. Damage can likewise develop during service life from wear and tear, or under extraordinary circumstances such as with unusual forces, temperature cycling, or impact of flying objects. Monitoring and early detection are key to preventing a catastrophic failure of structures, especially when these are expected to perform near their limit conditions.

  14. Structural Integrity and Aging-Related Issues of Helicopters

    Science.gov (United States)

    2000-10-01

    inherently damage lolerant , any damage- inspection in critical locations where tests have indicated tolerant features in airframe design only enhances...required, so European Rotorcraft Forum. Marseilles, France, 15- that helicopters are equipped with such features as fly- 17 September 1998 . by-wire and...fatigue Evaluation of structural integrity issues of aging helicopters. The Structure," 29 April, 1998 . extended safe-life approach encompasses the best

  15. 77 FR 42313 - Recharter of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2012-07-18

    ... Promotion, and Integrative and Public Health AGENCY: Office of the Assistant Secretary for Health, Office of... Promotion, and Integrative and Public Health. FOR FURTHER INFORMATION CONTACT: Corinne Graffunder... Integrative and Public Health (the ``Advisory Group'') within the Department of Health and Human Services. To...

  16. Governance structures impact on eHealth

    DEFF Research Database (Denmark)

    Kierkegaard, Patrick

    2015-01-01

    Background National eHealth implementation efforts need to move beyond the scope of making technology the primary focus and instead consider the broader spectrum of influences that can either hinder or facilitate eHealth adoption such as governance structures and policies. In this study, Denmark...... serves as an ideal candidate for further examination due to the country׳s rich history of intertwining events that have played an important role in the dynamic relationship between governance and eHealth success and failures. Methods A case study approach was used to gather a combination of primary...... and secondary data sources. All data collection was carried out through desk-research. Data collection relied on performing an extensive search of literature for relevant studies using combinations of keywords that reflected eHealth and governance-related topics. Inclusion and exclusion criteria׳s were applied...

  17. Value-based choice: An integrative, neuroscience-informed model of health goals.

    Science.gov (United States)

    Berkman, Elliot T

    2018-01-01

    Traditional models of health behaviour focus on the roles of cognitive, personality and social-cognitive constructs (e.g. executive function, grit, self-efficacy), and give less attention to the process by which these constructs interact in the moment that a health-relevant choice is made. Health psychology needs a process-focused account of how various factors are integrated to produce the decisions that determine health behaviour. I present an integrative value-based choice model of health behaviour, which characterises the mechanism by which a variety of factors come together to determine behaviour. This model imports knowledge from research on behavioural economics and neuroscience about how choices are made to the study of health behaviour, and uses that knowledge to generate novel predictions about how to change health behaviour. I describe anomalies in value-based choice that can be exploited for health promotion, and review neuroimaging evidence about the involvement of midline dopamine structures in tracking and integrating value-related information during choice. I highlight how this knowledge can bring insights to health psychology using illustrative case of healthy eating. Value-based choice is a viable model for health behaviour and opens new avenues for mechanism-focused intervention.

  18. Payment reform in the patient-centered medical home: Enabling and sustaining integrated behavioral health care.

    Science.gov (United States)

    Miller, Benjamin F; Ross, Kaile M; Davis, Melinda M; Melek, Stephen P; Kathol, Roger; Gordon, Patrick

    2017-01-01

    The patient-centered medical home (PCMH) is a promising framework for the redesign of primary care and more recently specialty care. As defined by the Agency for Healthcare Research and Quality, the PCMH framework has 5 attributes: comprehensive care, patient-centered care, coordinated care, accessible services, and quality and safety. Evidence increasingly demonstrates that for the PCMH to best achieve the Triple Aim (improved outcomes, decreased cost, and enhanced patient experience), treatment for behavioral health (including mental health, substance use, and life stressors) must be integrated as a central tenet. However, challenges to implementing the PCMH framework are compounded for real-world practitioners because payment reform rarely happens concurrently. Nowhere is this more evident than in attempts to integrate behavioral health clinicians into primary care. As behavioral health clinicians find opportunities to work in integrated settings, a comprehensive understanding of payment models is integral to the dialogue. This article describes alternatives to the traditional fee for service (FFS) model, including modified FFS, pay for performance, bundled payments, and global payments (i.e., capitation). We suggest that global payment structures provide the best fit to enable and sustain integrated behavioral health clinicians in ways that align with the Triple Aim. Finally, we present recommendations that offer specific, actionable steps to achieve payment reform, complement PCMH, and support integration efforts through policy. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. Integrating Poverty and Gender into Health Programs: A Sourcebook for Health Professionals.

    Science.gov (United States)

    Coll-Black, Sarah; Bhushan, Anjana; Fritsch, Kathleen

    2007-12-01

    Evidence increasingly shows that poverty and gender inequalities are important determinants of health and influence the opportunity for timely and appropriate health care. These findings suggest that health professionals need to have a sound understanding of health inequalities and their causes, as well as of how they can be addressed. However, through surveys to health ministries and educational institutions in 2001, the World Health Organization Regional Office for the Western Pacific found that awareness of, and capacity to respond to, poverty and gender concerns in health was weak. In response, the Regional Office initiated a project to develop materials to support the integration of poverty and gender concerns into health professional education curricula. The multimodule publication, Integrating Poverty and Gender into Health Programmes: A Sourcebook for Health Professionals, supports evidence-based and participatory learning. The experience to date suggests that the publication might be meeting a long-felt need for such a response.

  20. Development of Probabilistic Structural Analysis Integrated with Manufacturing Processes

    Science.gov (United States)

    Pai, Shantaram S.; Nagpal, Vinod K.

    2007-01-01

    An effort has been initiated to integrate manufacturing process simulations with probabilistic structural analyses in order to capture the important impacts of manufacturing uncertainties on component stress levels and life. Two physics-based manufacturing process models (one for powdered metal forging and the other for annular deformation resistance welding) have been linked to the NESSUS structural analysis code. This paper describes the methodology developed to perform this integration including several examples. Although this effort is still underway, particularly for full integration of a probabilistic analysis, the progress to date has been encouraging and a software interface that implements the methodology has been developed. The purpose of this paper is to report this preliminary development.

  1. Employer-driven consumerism: integrating health into the business model.

    Science.gov (United States)

    Thompson, Michael; Checkley, Joseph

    2006-01-01

    Consumer-driven health care is a misnomer. Notwithstanding the enormous role the individual consumer has to play in reshaping the U.S. health care delivery system, this article will focus on the employer as the key driver of change and innovation in the consumerism revolution. American Standard provides a case study of how one major employer has evaluated health care in the context of its business and aggressively integrated consumerism and health into the core of its business. Other companies will appropriately execute consumerism strategies in a fashion consistent with their own needs, culture, resources and populations. However, the principles supporting those strategies will be very much consistent.

  2. Safety Concepts in Structural Glass Engineering : Towards an Integrated Approach

    NARCIS (Netherlands)

    Bos, F.P.

    2009-01-01

    This dissertation proposes the Integrated Approach to Structural Glass Safety, based on four clearly defined element safety properties, damage sensitivity, relative resistance, redundancy, and fracture mode. The Element Safety Diagram (ESD) is introduced to provide an easy-to-read graphical

  3. Periodic reviews of structural integrity of gas-cooled reactors

    International Nuclear Information System (INIS)

    Banks, P.J.; Stokoe, T.Y.; Thomas, D.L.

    1995-01-01

    Nuclear Electric operates 12 gas-cooled reactor power stations which have been in service for between 5 and 30 years. Periodically, comprehensive reviews of the safety cases are carried out for each station. The approach followed in these reviews in respect of structural integrity is outlined with the use of illustrative examples. (author)

  4. 16 CFR 1511.5 - Structural integrity tests.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Structural integrity tests. 1511.5 Section 1511.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FEDERAL HAZARDOUS SUBSTANCES ACT... lowest position in the cylinder. If the uppermost edge of the component or fragment is below the plane of...

  5. Integrating structural and mutagenesis data to elucidate GPCR ligand binding

    DEFF Research Database (Denmark)

    Munk, Christian; Harpsøe, Kasper; Hauser, Alexander S

    2016-01-01

    is reported that exhibit activity through multiple receptors, binding in allosteric sites, and bias towards different intracellular signalling pathways. Furthermore, a wealth of single point mutants has accumulated in literature and public databases. Integrating these structural and mutagenesis data will help...

  6. Integration of fluidic jet actuators in composite structures

    Science.gov (United States)

    Schueller, Martin; Lipowski, Mathias; Schirmer, Eckart; Walther, Marco; Otto, Thomas; Geßner, Thomas; Kroll, Lothar

    2015-04-01

    Fluidic Actuated Flow Control (FAFC) has been introduced as a technology that influences the boundary layer by actively blowing air through slots or holes in the aircraft skin or wind turbine rotor blade. Modern wing structures are or will be manufactured using composite materials. In these state of the art systems, AFC actuators are integrated in a hybrid approach. The new idea is to directly integrate the active fluidic elements (such as SJAs and PJAs) and their components in the structure of the airfoil. Consequently, the integration of such fluidic devices must fit the manufacturing process and the material properties of the composite structure. The challenge is to integrate temperature-sensitive active elements and to realize fluidic cavities at the same time. The transducer elements will be provided for the manufacturing steps using roll-to-roll processes. The fluidic parts of the actuators will be manufactured using the MuCell® process that provides on the one hand the defined reproduction of the fluidic structures and, on the other hand, a high light weight index. Based on the first design concept, a demonstrator was developed in order to proof the design approach. The output velocity on the exit was measured using a hot-wire anemometer.

  7. Integration of targeted health interventions into health systems: a conceptual framework for analysis.

    Science.gov (United States)

    Atun, Rifat; de Jongh, Thyra; Secci, Federica; Ohiri, Kelechi; Adeyi, Olusoji

    2010-03-01

    The benefits of integrating programmes that emphasize specific interventions into health systems to improve health outcomes have been widely debated. This debate has been driven by narrow binary considerations of integrated (horizontal) versus non-integrated (vertical) programmes, and characterized by polarization of views with protagonists for and against integration arguing the relative merits of each approach. The presence of both integrated and non-integrated programmes in many countries suggests benefits to each approach. While the terms 'vertical' and 'integrated' are widely used, they each describe a range of phenomena. In practice the dichotomy between vertical and horizontal is not rigid and the extent of verticality or integration varies between programmes. However, systematic analysis of the relative merits of integration in various contexts and for different interventions is complicated as there is no commonly accepted definition of 'integration'-a term loosely used to describe a variety of organizational arrangements for a range of programmes in different settings. We present an analytical framework which enables deconstruction of the term integration into multiple facets, each corresponding to a critical health system function. Our conceptual framework builds on theoretical propositions and empirical research in innovation studies, and in particular adoption and diffusion of innovations within health systems, and builds on our own earlier empirical research. It brings together the critical elements that affect adoption, diffusion and assimilation of a health intervention, and in doing so enables systematic and holistic exploration of the extent to which different interventions are integrated in varied settings and the reasons for the variation. The conceptual framework and the analytical approach we propose are intended to facilitate analysis in evaluative and formative studies of-and policies on-integration, for use in systematically comparing and

  8. Integrating cost information with health management support system: an enhanced methodology to assess health care quality drivers.

    Science.gov (United States)

    Kohli, R; Tan, J K; Piontek, F A; Ziege, D E; Groot, H

    1999-08-01

    Changes in health care delivery, reimbursement schemes, and organizational structure have required health organizations to manage the costs of providing patient care while maintaining high levels of clinical and patient satisfaction outcomes. Today, cost information, clinical outcomes, and patient satisfaction results must become more fully integrated if strategic competitiveness and benefits are to be realized in health management decision making, especially in multi-entity organizational settings. Unfortunately, traditional administrative and financial systems are not well equipped to cater to such information needs. This article presents a framework for the acquisition, generation, analysis, and reporting of cost information with clinical outcomes and patient satisfaction in the context of evolving health management and decision-support system technology. More specifically, the article focuses on an enhanced costing methodology for determining and producing improved, integrated cost-outcomes information. Implementation issues and areas for future research in cost-information management and decision-support domains are also discussed.

  9. Health Monitoring of Composite Material Structures using a Vibrometry Technique

    Science.gov (United States)

    Schulz, Mark J.

    1997-01-01

    Large composite material structures such as aircraft and Reusable Launch Vehicles (RLVS) operate in severe environments comprised of vehicle dynamic loads, aerodynamic loads, engine vibration, foreign object impact, lightning strikes, corrosion, and moisture absorption. These structures are susceptible to damage such as delamination, fiber breaking/pullout, matrix cracking, and hygrothermal strain. To ensure human safety and load-bearing integrity, these structures must be inspected to detect and locate often invisible damage and faults before becoming catastrophic. Moreover, nearly all future structures will need some type of in-service inspection technique to increase their useful life and reduce maintenance and overall costs. Possible techniques for monitoring the health and indicating damage on composite structures include: c-scan, thermography, acoustic emissions using piezoceramic actuators or fiber-optic wires with gratings, laser ultrasound, shearography, holography, x-ray, and others. These techniques have limitations in detecting damage that is beneath the surface of the structure, far away from a sensor location, or during operation of the vehicle. The objective of this project is to develop a more global method for damage detection that is based on structural dynamics principles, and can inspect for damage when the structure is subjected to vibratory loads to expose faults that may not be evident by static inspection. A Transmittance Function Monitoring (TFM) method is being developed in this project for ground-based inspection and operational health monitoring of large composite structures as a RLV. A comparison of the features of existing health monitoring approaches and the proposed TFM method is given.

  10. Integration of clinical research documentation in electronic health records.

    Science.gov (United States)

    Broach, Debra

    2015-04-01

    Clinical trials of investigational drugs and devices are often conducted within healthcare facilities concurrently with clinical care. With implementation of electronic health records, new communication methods are required to notify nonresearch clinicians of research participation. This article reviews clinical research source documentation, the electronic health record and the medical record, areas in which the research record and electronic health record overlap, and implications for the research nurse coordinator in documentation of the care of the patient/subject. Incorporation of clinical research documentation in the electronic health record will lead to a more complete patient/subject medical record in compliance with both research and medical records regulations. A literature search provided little information about the inclusion of clinical research documentation within the electronic health record. Although regulations and guidelines define both source documentation and the medical record, integration of research documentation in the electronic health record is not clearly defined. At minimum, the signed informed consent(s), investigational drug or device usage, and research team contact information should be documented within the electronic health record. Institutional policies should define a standardized process for this integration in the absence federal guidance. Nurses coordinating clinical trials are in an ideal position to define this integration.

  11. Android integrated urea biosensor for public health awareness

    Directory of Open Access Journals (Sweden)

    Pranali P. Naik

    2015-03-01

    Full Text Available Integration of a biosensor with a wireless network on the Android 4.2.1 (Jelly Bean platform has been demonstrated. The present study reports an android integrated user friendly Flow injection analysis-Enzyme thermistor (FIA-ET urea biosensor system. This android-integrated biosensor system will facilitate enhanced consumer health and awareness alongside abridging the gap between the food testing laboratory and the concerned higher authorities. Data received from a flow injection mode urea biosensor has been exploited as an integration point among the analyst, the food consumer and the responsible higher authorities. Using the urea biosensor as an example, an alarm system has also been demonstrated both graphically and through text message on a mobile handset. The presented sensor integrated android system will also facilitate decision making support system in various fields of food quality monitoring and clinical analysis.

  12. Vertical integration and organizational networks in health care.

    Science.gov (United States)

    Robinson, J C; Casalino, L P

    1996-01-01

    This paper documents the growing linkages between primary care-centered medical groups and specialists and between physicians and hospitals under managed care. We evaluate the two alternative forms of organizational coordination: "vertical integration," based on unified ownership, and "virtual integration," based on contractual networks. Excess capacity and the need for investment capital are major short-term determinants of these vertical versus virtual integration decisions in health care. In the longer term, the principal determinants are economies of scale, risk-bearing ability, transaction costs, and the capacity for innovation in methods of managing care.

  13. Ultrasonic guided wave interpretation for structural health inspections

    Science.gov (United States)

    Bingham, Jill Paisley

    Structural Health Management (SHM) combines the use of onboard sensors with artificial intelligence algorithms to automatically identify and monitor structural health issues. A fully integrated approach to SHM systems demands an understanding of the sensor output relative to the structure, along with sophisticated prognostic systems that automatically draw conclusions about structural integrity issues. Ultrasonic guided wave methods allow us to examine the interaction of multimode signals within key structural components. Since they propagate relatively long distances within plate- and shell-like structures, guided waves allow inspection of greater areas with fewer sensors, making this technique attractive for a variety of applications. This dissertation describes the experimental development of automatic guided wave interpretation for three real world applications. Using the guided wave theories for idealized plates we have systematically developed techniques for identifying the mass loading of underwater limpet mines on US Navy ship hulls, characterizing type and bonding of protective coatings on large diameter pipelines, and detecting the thinning effects of corrosion on aluminum aircraft structural stringers. In each of these circumstances the signals received are too complex for interpretation without knowledge of the guided wave physics. We employ a signal processing technique called the Dynamic Wavelet Fingerprint Technique (DFWT) in order to render the guided wave mode information in two-dimensional binary images. The use of wavelets allows us to keep track of both time and scale features from the original signals. With simple image processing we have developed automatic extraction algorithms for features that correspond to the arrival times of the guided wave modes of interest for each of the applications. Due to the dispersive nature of the guided wave modes, the mode arrival times give details of the structure in the propagation path. For further

  14. Integration of priority population, health and nutrition interventions into health systems: systematic review

    Directory of Open Access Journals (Sweden)

    Adeyi Olusoji

    2011-10-01

    Full Text Available Abstract Background Objective of the study was to assess the effects of strategies to integrate targeted priority population, health and nutrition interventions into health systems on patient health outcomes and health system effectiveness and thus to compare integrated and non-integrated health programmes. Methods Systematic review using Cochrane methodology of analysing randomised trials, controlled before-and-after and interrupted time series studies. We defined specific strategies to search PubMed, CENTRAL and the Cochrane Effective Practice and Organisation of Care Group register, considered studies published from January 1998 until September 2008, and tracked references and citations. Two reviewers independently agreed on eligibility, with an additional arbiter as needed, and extracted information on outcomes: primary (improved health, financial protection, and user satisfaction and secondary (improved population coverage, access to health services, efficiency, and quality using standardised, pre-piloted forms. Two reviewers in the final stage of selection jointly assessed quality of all selected studies using the GRADE criteria. Results Of 8,274 citations identified 12 studies met inclusion criteria. Four studies compared the benefits of Integrated Management of Childhood Illnesses in Tanzania and Bangladesh, showing improved care management and higher utilisation of health facilities at no additional cost. Eight studies focused on integrated delivery of mental health and substance abuse services in the United Kingdom and United States of America. Integrated service delivery resulted in better clinical outcomes and greater reduction of substance abuse in specific sub-groups of patients, with no significant difference found overall. Quality of care, patient satisfaction, and treatment engagement were higher in integrated delivery models. Conclusions Targeted priority population health interventions we identified led to improved health

  15. Integration of priority population, health and nutrition interventions into health systems: systematic review.

    Science.gov (United States)

    Atun, Rifat; de Jongh, Thyra E; Secci, Federica V; Ohiri, Kelechi; Adeyi, Olusoji; Car, Josip

    2011-10-10

    Objective of the study was to assess the effects of strategies to integrate targeted priority population, health and nutrition interventions into health systems on patient health outcomes and health system effectiveness and thus to compare integrated and non-integrated health programmes. Systematic review using Cochrane methodology of analysing randomised trials, controlled before-and-after and interrupted time series studies. We defined specific strategies to search PubMed, CENTRAL and the Cochrane Effective Practice and Organisation of Care Group register, considered studies published from January 1998 until September 2008, and tracked references and citations. Two reviewers independently agreed on eligibility, with an additional arbiter as needed, and extracted information on outcomes: primary (improved health, financial protection, and user satisfaction) and secondary (improved population coverage, access to health services, efficiency, and quality) using standardised, pre-piloted forms. Two reviewers in the final stage of selection jointly assessed quality of all selected studies using the GRADE criteria. Of 8,274 citations identified 12 studies met inclusion criteria. Four studies compared the benefits of Integrated Management of Childhood Illnesses in Tanzania and Bangladesh, showing improved care management and higher utilisation of health facilities at no additional cost. Eight studies focused on integrated delivery of mental health and substance abuse services in the United Kingdom and United States of America. Integrated service delivery resulted in better clinical outcomes and greater reduction of substance abuse in specific sub-groups of patients, with no significant difference found overall. Quality of care, patient satisfaction, and treatment engagement were higher in integrated delivery models. Targeted priority population health interventions we identified led to improved health outcomes, quality of care, patient satisfaction and access to care

  16. Frequency Selective Surface for Structural Health Monitoring

    Science.gov (United States)

    Norlyana Azemi, Saidatul; Mustaffa, Farzana Hazira Wan; Faizal Jamlos, Mohd; Abdullah Al-Hadi, Azremi; Soh, Ping Jack

    2018-03-01

    Structural health monitoring (SHM) technologies have attained attention to monitor civil structures. SHM sensor systems have been used in various civil structures such as bridges, buildings, tunnels and so on. However the previous sensor for SHM is wired and encounter with problem to cover large areas. Therefore, wireless sensor was introduced for SHM to reduce network connecting problem. Wireless sensors for Structural Health monitoring are new technology and have many advantages to overcome the drawback of conventional and wired sensor. This project proposed passive wireless SHM sensor using frequency selective surface (FSS) as an alternative to conventional sensors. The electromagnetic wave characteristic of FSS will change by geometrical changes of FSS due to mechanical strain or structural failure. The changes feature is used as a sensing function without any connecting wires. Two type of design which are circular ring and square loop along with the transmission and reflection characteristics of SHM using FSS were discussed in this project. A simulation process has shown that incident angle characteristics can be use as a data for SHM application.

  17. Assessing the value of structural health monitoring

    DEFF Research Database (Denmark)

    Thöns, S.; Faber, Michael Havbro

    2013-01-01

    Structural Health Monitoring (SHM) systems are designed for assisting owners and operators with information and forecasts concerning the fitness for purpose of structures and building systems. The benefit associated with the implementation of SHM may in some cases be intuitively anticipated...... as their responses and performances over their life-cycle. In addition, the quality of monitoring and the performance of possible remedial actions triggered by monitoring results are modeled probabilistically.The consequences accounted for, in principle include all consequences associated with the performance...

  18. Strengthening, modification and repair techniques’ prioritization for structural integrity control of ageing offshore structures

    International Nuclear Information System (INIS)

    Samarakoon, Samindi M.K.; Ratnayake, R.M. Chandima

    2015-01-01

    Structural integrity control is vital for existing ageing as well as newly built offshore and onshore structures. Structural integrity control becomes highly sensitive to interventions under a potential loss of structural integrity when it comes to offshore oil and gas production and process facilities. This is mainly due to the inherent constraints present in carrying out engineering work in the offshore atmosphere. It has been further exacerbated by the ageing offshore structures and the necessity of carrying out life extension toward the end of their design service lives. Local and international regulations demand the implementation of appropriate strengthening, modification and repair plans when significant changes in the structural integrity are revealed. In this context, strengthening, modification and repair techniques such as welding, member removal/reduction of loading, mechanical clamping and grouted repairs play a vital role. This manuscript presents an approach for prioritizing the strengthening, modification and repair techniques using a multi-criteria analysis approach. An analytic hierarchy process has been selected for the analysis via an illustrative case. It also provides a comprehensive overview of currently existing; strengthening, modification and repair techniques and their comparative pros and cons. - Highlights: • Structural integrity control (SIC) of ageing and intact offshore structures. • Strengthening, modification and/or repair (SMR) techniques have been explained. • Application of multi-criteria analysis conserving SI has been illustrated. • SMR techniques prioritization and sensitivity analysis has been performed

  19. Integrated Multidisciplinary Constrained Optimization of Offshore Support Structures

    International Nuclear Information System (INIS)

    Haghi, Rad; Molenaar, David P; Ashuri, Turaj; Van der Valk, Paul L C

    2014-01-01

    In the current offshore wind turbine support structure design method, the tower and foundation, which form the support structure are designed separately by the turbine and foundation designer. This method yields a suboptimal design and it results in a heavy, overdesigned and expensive support structure. This paper presents an integrated multidisciplinary approach to design the tower and foundation simultaneously. Aerodynamics, hydrodynamics, structure and soil mechanics are the modeled disciplines to capture the full dynamic behavior of the foundation and tower under different environmental conditions. The objective function to be minimized is the mass of the support structure. The model includes various design constraints: local and global buckling, modal frequencies, and fatigue damage along different stations of the structure. To show the usefulness of the method, an existing SWT-3.6-107 offshore wind turbine where its tower and foundation are designed separately is used as a case study. The result of the integrated multidisciplinary design optimization shows 12.1% reduction in the mass of the support structure, while satisfying all the design constraints

  20. Manifestations of integrated public health policy in Dutch municipalities.

    Science.gov (United States)

    Peters, Dorothee; Harting, Janneke; van Oers, Hans; Schuit, Jantine; de Vries, Nanne; Stronks, Karien

    2016-06-01

    Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a continuum of less-to-more policy integration, going from intersectoral action (IA) to healthy public policy (HPP) to health in all policies (HiAP). Our case study included 34 municipal projects of the Dutch Gezonde Slagkracht Programme (2009-15), which supports the development and implementation of IPHP on overweight, alcohol and drug abuse, and smoking. Our content analysis of project application forms and interviews with all project leaders used a framework approach involving the policy strategies and the following policy variables: initiator, actors, policy goals, determinants and policy instruments. Most projects showed a combination of policy strategies. However, manifestations of IPHP in overweight projects predominantly involved IA. More policy integration was apparent in alcohol/drugs projects (HPP) and in all-theme projects (HiAP). More policy integration was related to broad goal definitions, which allowed for the involvement of actors representing several policy sectors. This enabled the implementation of a mix of policy instruments. Determinants of health were not explicitly used as a starting point of the policy process. If a policy problem justifies policy integration beyond IA, it might be helpful to start from the determinants of health (epidemiological reality), systematically transform them into policy (policy reality) and set broad policy goals, since this gives actors from other sectors the opportunity to participate. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. IMPLEMENTING AN INTEGRATED HEALTH, SAFETY, AND ENVIRONMENTAL MANAGEMENT SYSTEM: THE CASE OF A CONSTRUCTION COMPANY

    Directory of Open Access Journals (Sweden)

    Filippos Tepaskoualos

    2017-12-01

    Full Text Available Over the past two decades, there has been an increasing trend of organizations implementing simultaneously two or more management systems. The structural similarities of these systems - despite the diversity of their fields of application, such as occupational health and safety for OHSAS 18001, and environmental management for ISO 14001 - have enabled many organizations to integrate different systems into a single one, rather than implementing them separately from one another. The purpose of this paper is to examine in depth a case of integration of the ISO 14001 and OHSAS 18001 systems, using a construction company as a research setting, in order to draw conclusions about the level of integration achieved, as well as the benefits, the problems, and the critical success factors of this endeavour. The findings of this study show that both the company's devotion to the fulfillment of the critical success factors and the identical structure of the two systems under consideration have facilitated the successful outcome of integration. However, this does not automatically imply that the company adopted the idea of full integration. Instead, the maximization of integration benefits and the elimination of related problems was achieved through the company's conscious choice to proceed with partial integration, keeping separate manuals, policies, and risk management procedures for each system. This study will be useful in order to understand that partial integration is a perfectly acceptable and realistic solution that, under certain circumstances, may even have a better cost-benefit ratio than full integration.

  2. Preparing the Workforce for Behavioral Health and Primary Care Integration.

    Science.gov (United States)

    Hall, Jennifer; Cohen, Deborah J; Davis, Melinda; Gunn, Rose; Blount, Alexander; Pollack, David A; Miller, William L; Smith, Corey; Valentine, Nancy; Miller, Benjamin F

    2015-01-01

    To identify how organizations prepare clinicians to work together to integrate behavioral health and primary care. Observational cross-case comparison study of 19 U.S. practices, 11 participating in Advancing Care Together, and 8 from the Integration Workforce Study. Practices varied in size, ownership, geographic location, and experience delivering integrated care. Multidisciplinary teams collected data (field notes from direct practice observations, semistructured interviews, and online diaries as reported by practice leaders) and then analyzed the data using a grounded theory approach. Organizations had difficulty finding clinicians possessing the skills and experience necessary for working in an integrated practice. Practices newer to integration underestimated the time and resources needed to train and organizationally socialize (onboard) new clinicians. Through trial and error, practices learned that clinicians needed relevant training to work effectively as integrated care teams. Training efforts exclusively targeting behavioral health clinicians (BHCs) and new employees were incomplete if primary care clinicians (PCCs) and others in the practice also lacked experience working with BHCs and delivering integrated care. Organizations' methods for addressing employees' need for additional preparation included hiring a consultant to provide training, sending employees to external training programs, hosting residency or practicum training programs, or creating their own internal training program. Onboarding new employees through the development of training manuals; extensive shadowing processes; and protecting time for ongoing education, mentoring, and support opportunities for new and established clinicians and staff were featured in these internal training programs. Insufficient training capacity and practical experience opportunities continue to be major barriers to supplying the workforce needed for effective behavioral health and primary care integration

  3. Structural integrity analyses: can we manage the advances?

    International Nuclear Information System (INIS)

    Sauve, R.

    2006-01-01

    Engineering has been one of a number of disciplines in which significant advances in analysis procedures has taken place in the last two decades. In particular, advances in computer technology and engineering software have revolutionized the assessment of component structural integrity for a wide range of applications. A significant development in computational mechanics directly related to computer technology that has had a profound impact on the field of structural integrity is the finite element method. The finite element method has re-defined and expanded the role of structural integrity assessments by providing comprehensive modelling capabilities to engineers involved in design and failure analyses. As computer processing speeds and capacity have increased, so has the role of computer modelling in assessments of component structural integrity. With new product development cycles shrinking, the role of initial testing is being reduced in favour of computer modelling and simulation to assess component life and durability. For ageing structures, the evaluation of remaining life and the impact of degraded structural integrity becomes tractable with the modern advances in computational methods. The areas of structural integrity that have derived great benefit from the advances in numerical techniques include stress analysis, fracture mechanics, dynamics, heat transfer, structural reliability, probabilistic methods and continuum mechanics in general. One of the salient features of the current methods is the ability to handle large complex steady state or transient dynamic problems that exhibit highly non-linear behaviour. With the ever-increasing usage of these advanced methods, the question is posed: Can we manage the advances? Better still are we managing the advances? As with all technological advances that enter mainstream use, comes the need for education, training and certification in the application of these methods, improved quality assurance procedures and

  4. Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers.

    Science.gov (United States)

    Singer, Judy; Adams, Jon

    2014-05-22

    Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women's health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion of treating the whole person

  5. Effect of high temperature on integrity of concrete containment structures

    International Nuclear Information System (INIS)

    Bhat, P.D.

    1986-01-01

    The effect of high temperature on concrete material properties and structural behavior are studied in order to relate these effects to the performance of concrete containment structures. Salient data obtained from a test program undertaken to study the behavior of a restrained concrete structure under thermal gradient loads up to its ultimate limit are described. The preliminary results indicate that concrete material properties can be considered to remain unaltered up to temperatures of 100 0 C. The presence of thermal gradients did not significantly affect the structures ultimate mechanical load capacity. Relaxation of restraint forces due to creep was found to be an important factor. The test findings are compared with the observations made in available literature. The effect of test findings on the integrity analysis of a containment structure are discussed. The problem is studied from the viewpoint of a CANDU heavy water reactor containment

  6. Should nurses be leaders of integrated health care?

    Science.gov (United States)

    Thomas, Paul; While, Alison

    2007-09-01

    To examine the role of nurses within integrated health care. Healthcare planners are overly concerned with the treatment of diseases and insufficiently focused on social cohesion vertical rather than horizontal integration of healthcare effort. These domains need to be better connected, to avoid medicalization of social problems and socialisation of medical problems. Published literature, related to theories of whole system integration. *When conceptualizing whole system integration it helps to consider research insights to be snapshots of more complex stories-in-evolution, and change to be the result of ongoing community dance where multiple players adapt their steps to each other. *One image that helps to conceptualize integration is that of a railway network. Railway tracks and multiple journeys are equally needed; each requiring a different approach for success. *Traditional nursing values make nurses more attuned to the issues of combined vertical and horizontal integration than medical colleagues. Nurses should lead integration at the interface between horizontal and vertical activities. Nursing managers and universities should support the development of nurses as leaders of whole system integration, in partnership with local healthcare organizations.

  7. The structural integrity safety case for Sizewell B power station

    International Nuclear Information System (INIS)

    Gerachty, J.E.

    1993-01-01

    This paper presents the safety case approach adopted for the components of the Sizewell 'B' Power Station for which a high degree of structural integrity is required. Such components include the Reactor Pressure Vessel, Steam Generator and Pressuriser for which Incredibility of Failure is claimed. The two parts of the case involve achievement and demonstration of integrity. This is achieved by extensive measures involving design, manufacture, materials and inspection. The demonstration has required a fracture mechanics approach. The specific role of inspection validation and its relation to critical defect size is described. (author)

  8. Integration of community health workers into health systems in developing countries: Opportunities and challenges

    Directory of Open Access Journals (Sweden)

    Collins Otieno Asweto

    2016-02-01

    Full Text Available Background: Developing countries have the potential to reach vulnerable and underserved populations marginalized by the country’s health care systems by way of community health workers (CHWs. It is imperative that health care systems focus on improving access to quality continuous primary care through the use of CHWs while paying attention to the factors that impact on CHWs and their effectiveness. Objective: To explore the possible opportunities and challenges of integrating CHWs into the health care systems of developing countries. Methods: Six databases were examined for quantitative, qualitative, and mixed-methods studies that included the integration of CHWs, their motivation and supervision, and CHW policy making and implementation in developing countries. Thirty-three studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programs. Thematic coding was conducted and evidence on the main categories of contextual factors influencing integration of CHWs into the health system was synthesized. Results: CHWs are an effective and appropriate element of a health care team and can assist in addressing health disparities and social determinants of health. Important facilitators of integration of CHWs into health care teams are support from other health workers and inclusion of CHWs in case management meetings. Sustainable integration of CHWs into the health care system requires the formulation and implementation of polices that support their work, as well as financial and nonfinancial incentives, motivation, collaborative and supportive supervision, and a manageable workload. Conclusions: For sustainable integration of CHWs into health care systems, high-performing health systems with sound governance, adequate financing, well-organized service delivery, and adequate supplies and equipment are essential. Similarly, competent communities could contribute to better CHW performance through sound

  9. Global symplectic structure-preserving integrators for spinning compact binaries

    Science.gov (United States)

    Zhong, Shuang-Ying; Wu, Xin; Liu, San-Qiu; Deng, Xin-Fa

    2010-12-01

    This paper deals mainly with the application of the second-order symplectic implicit midpoint rule and its symmetric compositions to a post-Newtonian Hamiltonian formulation with canonical spin variables in relativistic compact binaries. The midpoint rule, as a basic algorithm, is directly used to integrate the completely canonical Hamiltonian system. On the other hand, there are symmetric composite methods based on a splitting of the Hamiltonian into two parts: the Newtonian part associated with a Kepler motion, and a perturbation part involving the orbital post-Newtonian and spin contributions, where the Kepler flow has an analytic solution and the perturbation can be calculated by the midpoint rule. An example is the second-order mixed leapfrog symplectic integrator with one stage integration of the perturbation flow and two semistage computations of the Kepler flow at every integration step. Also, higher-order composite methods such as the Forest-Ruth fourth-order symplectic integrator and its optimized algorithm are applicable. Various numerical tests including simulations of chaotic orbits show that the mixed leapfrog integrator is always superior to the midpoint rule in energy accuracy, while both of them are almost equivalent in computational efficiency. Particularly, the optimized fourth-order algorithm compared with the mixed leapfrog scheme provides good precision and needs no expensive additional computational time. As a result, it is worth performing a more detailed and careful examination of the dynamical structure of chaos and order in the parameter windows and phase space of the binary system.

  10. Probabilistic Structural Health Monitoring of the Orbiter Wing Leading Edge

    Science.gov (United States)

    Yap, Keng C.; Macias, Jesus; Kaouk, Mohamed; Gafka, Tammy L.; Kerr, Justin H.

    2011-01-01

    A structural health monitoring (SHM) system can contribute to the risk management of a structure operating under hazardous conditions. An example is the Wing Leading Edge Impact Detection System (WLEIDS) that monitors the debris hazards to the Space Shuttle Orbiter s Reinforced Carbon-Carbon (RCC) panels. Since Return-to-Flight (RTF) after the Columbia accident, WLEIDS was developed and subsequently deployed on board the Orbiter to detect ascent and on-orbit debris impacts, so as to support the assessment of wing leading edge structural integrity prior to Orbiter re-entry. As SHM is inherently an inverse problem, the analyses involved, including those performed for WLEIDS, tend to be associated with significant uncertainty. The use of probabilistic approaches to handle the uncertainty has resulted in the successful implementation of many development and application milestones.

  11. Integrating human health into environmental impact assessment: an unrealized opportunity for environmental health and justice.

    Science.gov (United States)

    Bhatia, Rajiv; Wernham, Aaron

    2008-08-01

    The National Environmental Policy Act and related state laws require many public agencies to analyze and disclose potentially significant environmental effects of agency actions, including effects on human health. In this paper we review the purpose and procedures of environmental impact assessment (EIA), existing regulatory requirements for health effects analysis, and potential barriers to and opportunities for improving integration of human health concerns within the EIA process. We use statutes, regulations, guidelines, court opinions, and empirical research on EIA along with recent case examples of integrated health impact assessment (HIA)/EIA at both the state and federal level. We extract lessons and recommendations for integrated HIA/EIA practice from both existing practices as well as case studies. The case studies demonstrate the adequacy, scope, and power of existing statutory requirements for health analysis within EIA. The following support the success of integrated HIA/EIA: a proponent recognizing EIA as an available regulatory strategy for public health; the openness of the agency conducting the EIA; involvement of public health institutions; and complementary objectives among community stakeholders and health practitioners. We recommend greater collaboration among institutions responsible for EIA, public health institutions, and affected stakeholders along with guidance, resources, and training for integrated HIA/EIA practice.

  12. Towards an integrated approach to health and medicine in Africa

    African Journals Online (AJOL)

    2016-08-18

    Aug 18, 2016 ... As such, a social approach to health-seeking behaviour questions how decisions ... In conclusion, the paper proposes that medicine and the humanities should engage seriously .... mental questions: What story does the integration or separation .... approach which has taken an interest in traditional healing.

  13. Improving Acceptance, Integration, and Health Among LGBT Service Members

    Science.gov (United States)

    2017-10-01

    through multiple rounds of internal testing and quality assurance procedures. Recruitment for the Phase II survey was initiated on August 25, 2017...Award Numbers: W81XWH-15-1-0701 Title: Improving Acceptance, Integration, and Health Among LGBT Service Members Principal Investigators...burden to Department of Defense, Washington Headquarters Services , Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis

  14. Unraveling care integration: Assessing its dimensions and antecedents in the Italian Health System.

    Science.gov (United States)

    Calciolari, Stefano; Ilinca, Stefania

    2016-01-01

    In recent decades, consensus has grown on the need to organize health systems around the concept of care integration to better confront the challenges associated with demographic trends and financial sustainability. However, care integration remains an imprecise umbrella term in both the academic and policy arenas. In addition, little substantive knowledge exists on the success factors for integration initiatives. We propose a composite measure of care integration and a conceptual framework suggesting its relationships with three types of antecedents: contextual, cultural, and organizational factors. Our framework was tested using data from the Italian National Health System (NHS). We administered an ad-hoc questionnaire to all Italian local health units (LHUs), with a 60.4% response rate, and used structural equation modeling to assess the relationships between the relevant latent constructs. The results validated our measure of care integration and supported the hypothesized relationships. In particular, integration was found to be fostered by results-oriented institutional settings, a professional culture conducive to inclusiveness and shared goals, and organizational arrangements promoting clear expectations among providers. Thus, integration improves care and mediates the effects of specific operating means on care enhancement. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Acoustic Techniques for Structural Health Monitoring

    Science.gov (United States)

    Frankenstein, B.; Augustin, J.; Hentschel, D.; Schubert, F.; Köhler, B.; Meyendorf, N.

    2008-02-01

    Future safety and maintenance strategies for industrial components and vehicles are based on combinations of monitoring systems that are permanently attached to or embedded in the structure, and periodic inspections. The latter belongs to conventional nondestructive evaluation (NDE) and can be enhanced or partially replaced by structural health monitoring systems. However, the main benefit of this technology for the future will consist of systems that can be differently designed based on improved safety philosophies, including continuous monitoring. This approach will increase the efficiency of inspection procedures at reduced inspection times. The Fraunhofer IZFP Dresden Branch has developed network nodes, miniaturized transmitter and receiver systems for active and passive acoustical techniques and sensor systems that can be attached to or embedded into components or structures. These systems have been used to demonstrate intelligent sensor networks for the monitoring of aerospace structures, railway systems, wind energy generators, piping system and other components. Material discontinuities and flaws have been detected and monitored during full scale fatigue testing. This paper will discuss opportunities and future trends in nondestructive evaluation and health monitoring based on new sensor principles and advanced microelectronics. It will outline various application examples of monitoring systems based on acoustic techniques and will indicate further needs for research and development.

  16. Structural integrity analysis of an INPP building under external loading

    International Nuclear Information System (INIS)

    Dundulis, G.; Karalevicius, R.; Uspuras, E.; Kulak, R.F.; Marchertas, A.

    2005-01-01

    After the terrorist attacks in New York and Washington D. C. using civil airplanes, the evaluation of civil airplane crashes into civil and NPP structures has become very important. The interceptions of many terrorists' communications reveal that the use of commandeered commercial aircraft is still a major part of their plans for destruction. Aircraft crash or other flying objects in the territory of the Ignalina Nuclear Power Plant (INPP) represents a concern to the plant. Aircraft traveling at high velocity have a destructive potential. The aircraft crash may damage the roof and walls of buildings, pipelines, electric motors, cases of power supplies, power cables of electricity transmission and other elements and systems, which are important for safety. Therefore, the evaluation of the structural response to an of aircraft crash is important and was selected for analysis. The structural integrity analysis due to the effects of an aircraft crash on an NPP building structure is the subject of this paper. The finite element method was used for the structural analysis of a typical Ignalina NPP building. The structural integrity analysis was performed for a portion of the ALS using the dynamic loading of an aircraft crash impact model. The computer code NEPTUNE was used for this analysis. The local effects caused by impact of the aircraft's engine on the building wall were evaluated independently by using an empirical formula. (authors)

  17. Photonic Structure-Integrated Two-Dimensional Material Optoelectronics

    Directory of Open Access Journals (Sweden)

    Tianjiao Wang

    2016-12-01

    Full Text Available The rapid development and unique properties of two-dimensional (2D materials, such as graphene, phosphorene and transition metal dichalcogenides enable them to become intriguing candidates for future optoelectronic applications. To maximize the potential of 2D material-based optoelectronics, various photonic structures are integrated to form photonic structure/2D material hybrid systems so that the device performance can be manipulated in controllable ways. Here, we first introduce the photocurrent-generation mechanisms of 2D material-based optoelectronics and their performance. We then offer an overview and evaluation of the state-of-the-art of hybrid systems, where 2D material optoelectronics are integrated with photonic structures, especially plasmonic nanostructures, photonic waveguides and crystals. By combining with those photonic structures, the performance of 2D material optoelectronics can be further enhanced, and on the other side, a high-performance modulator can be achieved by electrostatically tuning 2D materials. Finally, 2D material-based photodetector can also become an efficient probe to learn the light-matter interactions of photonic structures. Those hybrid systems combine the advantages of 2D materials and photonic structures, providing further capacity for high-performance optoelectronics.

  18. Integrated Worker Health Protection and Promotion Programs: Overview and Perspectives on Health and Economic Outcomes

    Science.gov (United States)

    Pronk, Nicolaas P.

    2014-01-01

    Objective To describe integrated worker health protection and promotion (IWHPP) program characteristics, to discuss the rationale for integration of OSH and WHP programs, and to summarize what is known about the impact of these programs on health and economic outcomes. Methods A descriptive assessment of the current state of the IWHPP field and a review of studies on the effectiveness of IWHPP programs on health and economic outcomes. Results Sufficient evidence of effectiveness was found for IWHPP programs when health outcomes are considered. Impact on productivity-related outcomes is considered promising, but inconclusive, whereas insufficient evidence was found for health care expenditures. Conclusions Existing evidence supports an integrated approach in terms of health outcomes but will benefit significantly from research designed to support the business case for employers of various company sizes and industry types. PMID:24284747

  19. Governance of health care networks: Assessment of the health care integrating councils in the context of the health sector reform in Chile.

    Directory of Open Access Journals (Sweden)

    Osvaldo Artaza-Barrios

    2013-11-01

    Full Text Available Objective. This paper aims at assessing the contribution of Chile’s Health Care Integrating Councils (CIRA, Spanish acronym to strengthening governance in health. Materials and methods. A literature review on the official documents related to the process of creation and development of CIRA was carried out; an ad hoc questionnaire was applied to all 29 health services of the country; finally, 35 semi-structure in-depth interviews were carried on a sample of six CIRA. Results. The CIRAs have become a tool for functional integration and a valuable space for dialogue, cooperation and learning for all of the actors of the Chilean public health network. Conclusions. In this study, we conclude that there is room for improvements of CIRA’s role regarding governance of the health care network as long as CIRA is authorized to deal with strategic topics, such as investment in infrastructure, technology and human resources, and budgeting.

  20. A Lax integrable hierarchy, bi-Hamiltonian structure and finite-dimensional Liouville integrable involutive systems

    International Nuclear Information System (INIS)

    Xia Tiecheng; Chen Xiaohong; Chen Dengyuan

    2004-01-01

    An eigenvalue problem and the associated new Lax integrable hierarchy of nonlinear evolution equations are presented in this paper. As two reductions, the generalized nonlinear Schroedinger equations and the generalized mKdV equations are obtained. Zero curvature representation and bi-Hamiltonian structure are established for the whole hierarchy based on a pair of Hamiltonian operators (Lenard's operators), and it is shown that the hierarchy of nonlinear evolution equations is integrable in Liouville's sense. Thus the hierarchy of nonlinear evolution equations has infinitely many commuting symmetries and conservation laws. Moreover the eigenvalue problem is nonlinearized as a finite-dimensional completely integrable system under the Bargmann constraint between the potentials and the eigenvalue functions. Finally finite-dimensional Liouville integrable system are found, and the involutive solutions of the hierarchy of equations are given. In particular, the involutive solutions are developed for the system of generalized nonlinear Schroedinger equations

  1. Meanings of health: interrogating structure and culture.

    Science.gov (United States)

    Dutta, Mohan Jyoti; Basu, Ambar

    2008-11-01

    Based on the argument that context ought to be centralized in discourses of health communication, this article applies the culture-centered approach to engage in dialogue about issues of health with 18 men in rural West Bengal. The culture-centered approach is based on dialogue between the researcher and the community members, with the goals of listening to the voices of cultural members in suggesting culture-based health solutions. In this project, our discursive engagement with the participants suggests that health is primarily constructed as an absence, framed in the realm of minimal access to healthcare resources. In a situation where the resources are limited, the participants discussed the importance of trust in their relationship with the local provider. Health was also seen as a collective resource that was both an asset of the collective and a responsibility of the collective. Finally, the participants also pointed out the ways in which corruption in the structure introduced a paradox in policy discourse and the material conditions of the participants.

  2. Tools for integrated sequence-structure analysis with UCSF Chimera

    Directory of Open Access Journals (Sweden)

    Huang Conrad C

    2006-07-01

    Full Text Available Abstract Background Comparing related structures and viewing the structures in the context of sequence alignments are important tasks in protein structure-function research. While many programs exist for individual aspects of such work, there is a need for interactive visualization tools that: (a provide a deep integration of sequence and structure, far beyond mapping where a sequence region falls in the structure and vice versa; (b facilitate changing data of one type based on the other (for example, using only sequence-conserved residues to match structures, or adjusting a sequence alignment based on spatial fit; (c can be used with a researcher's own data, including arbitrary sequence alignments and annotations, closely or distantly related sets of proteins, etc.; and (d interoperate with each other and with a full complement of molecular graphics features. We describe enhancements to UCSF Chimera to achieve these goals. Results The molecular graphics program UCSF Chimera includes a suite of tools for interactive analyses of sequences and structures. Structures automatically associate with sequences in imported alignments, allowing many kinds of crosstalk. A novel method is provided to superimpose structures in the absence of a pre-existing sequence alignment. The method uses both sequence and secondary structure, and can match even structures with very low sequence identity. Another tool constructs structure-based sequence alignments from superpositions of two or more proteins. Chimera is designed to be extensible, and mechanisms for incorporating user-specific data without Chimera code development are also provided. Conclusion The tools described here apply to many problems involving comparison and analysis of protein structures and their sequences. Chimera includes complete documentation and is intended for use by a wide range of scientists, not just those in the computational disciplines. UCSF Chimera is free for non-commercial use and is

  3. Integration Policies of European Cities in Comparative Perspective: Structural Convergence and Substantial Differentiation

    Directory of Open Access Journals (Sweden)

    Rinus Penninx

    2016-08-01

    Full Text Available This article aims to review the comparative study of integration policies of European cities. The first two sections present an analytical framework for the study of immigrants’ integration processes and the policies that intend to steer such processes. The third section outlines how local integration policies have developed in relation to national policies and EU integration policies, particularly after 2003. The fourth and main section analyses the framing and content of integration policies of European cities, looking at their diversity in the legal/political dimension, the socio-economic dimension – including the domains of work, housing, education and health – and the cultural, religious and ethnic dimension. It is concluded that there is a structural convergence, in the sense that in the complex structure of multilevel governance of migration and integration, cities do take a similar position, developing horizontal relations of cooperation and exchange. Cities that develop explicit integration policies tend to do this from a more inclusive and pragmatic framing than national and EU-policies. At the same time, there is great variation in what cities actually do: in the legal/political and in the cultural/religious dimensions, framing, intentions and measures do vary greatly; in the socio-economic dimension this variation is less when it comes to the domains of activity, but more in the intensity of policy intervention.

  4. Lean thinking in health and nursing: an integrative literature review.

    Science.gov (United States)

    Magalhães, Aline Lima Pestana; Erdmann, Alacoque Lorenzini; Silva, Elza Lima da; Santos, José Luís Guedes Dos

    2016-08-08

    to demonstrate the scientific knowledge developed on lean thinking in health, highlighting the impact and contributions in health care and nursing. an integrative literature review in the PubMed, CINAHL, Scopus, Web of Science, Emerald, LILACS and SciELO electronic library databases, from 2006 to 2014, with syntax keywords for each data base, in which 47 articles were selected for analysis. the categories were developed from the quality triad proposed by Donabedian: structure, process and outcome. Lean thinking is on the rise in health surveys, particularly internationally, especially in the USA and UK, improving the structure, process and outcome of care and management actions. However, it is an emerging theme in nursing. this study showed that the use of lean thinking in the context of health has a transforming effect on care and organizational aspects, promoting advantages in terms of quality, safety and efficiency of health care and nursing focused on the patient. evidenciar o conhecimento científico desenvolvido sobre pensamento Lean na área da saúde, destacando o impacto e as contribuições no cuidado em saúde e enfermagem. revisão integrativa da literatura a partir das bases de dados PubMed, CINAHL, Scopus, Web of Science, Emerald, LILACS e na biblioteca eletrônica SciELO, de 2006 a 2014, com sintaxe de palavras-chaves para cada base, selecionados 47 artigos para análise. as categorias foram elaboradas a partir da tríade de qualidade proposta por Donabedian: estrutura, processo e resultado. O pensamento Lean está em ascensão nas pesquisas sobre saúde, principalmente no âmbito internacional, com destaque para os Estados Unidos e Reino Unido, melhorando a estrutura, o processo e o resultado a partir das ações assistenciais e gerenciais. Porém, é uma temática incipiente na enfermagem. por meio desse estudo observou-se que a utilização do pensamento Lean, no contexto da saúde, tem um efeito transformador nos aspectos assistenciais e

  5. An integrable coupling family of Merola-Ragnisco-Tu lattice systems, its Hamiltonian structure and related nonisospectral integrable lattice family

    Energy Technology Data Exchange (ETDEWEB)

    Xu Xixiang, E-mail: xu_xixiang@hotmail.co [College of Science, Shandong University of Science and Technology, Qingdao, 266510 (China)

    2010-01-04

    An integrable coupling family of Merola-Ragnisco-Tu lattice systems is derived from a four-by-four matrix spectral problem. The Hamiltonian structure of the resulting integrable coupling family is established by the discrete variational identity. Each lattice system in the resulting integrable coupling family is proved to be integrable discrete Hamiltonian system in Liouville sense. Ultimately, a nonisospectral integrable lattice family associated with the resulting integrable lattice family is constructed through discrete zero curvature representation.

  6. An integrable coupling family of Merola-Ragnisco-Tu lattice systems, its Hamiltonian structure and related nonisospectral integrable lattice family

    International Nuclear Information System (INIS)

    Xu Xixiang

    2010-01-01

    An integrable coupling family of Merola-Ragnisco-Tu lattice systems is derived from a four-by-four matrix spectral problem. The Hamiltonian structure of the resulting integrable coupling family is established by the discrete variational identity. Each lattice system in the resulting integrable coupling family is proved to be integrable discrete Hamiltonian system in Liouville sense. Ultimately, a nonisospectral integrable lattice family associated with the resulting integrable lattice family is constructed through discrete zero curvature representation.

  7. Organisational Culture Matters for System Integration in Health Care

    Science.gov (United States)

    Munir, Samina K.; Kay, Stephen

    2003-01-01

    This paper illustrates the importance of organisational culture for Clinical Information Systems (CIS) integration. The study is based on data collected in intensive care units in the UK and Denmark. Data were collected using qualitative methods, i.e., observations, interviews and shadowing of health care providers, together with a questionnaire at each site. The data are analysed to extract salient variables for CIS integration, and it is shown that these variables can be separated into two categories that describe the ‘Actual Usefulness’ of the system and the ‘Organisational Culture’. This model is then extended to show that CIS integration directly affects the work processes of the organisation, forming an iterative process of change as a CIS is introduced and integrated. PMID:14728220

  8. Knowledge integration in One Health policy formulation, implementation and evaluation.

    Science.gov (United States)

    Hitziger, Martin; Esposito, Roberto; Canali, Massimo; Aragrande, Maurizio; Häsler, Barbara; Rüegg, Simon R

    2018-03-01

    The One Health concept covers the interrelationship between human, animal and environmental health and requires multistakeholder collaboration across many cultural, disciplinary, institutional and sectoral boundaries. Yet, the implementation of the One Health approach appears hampered by shortcomings in the global framework for health governance. Knowledge integration approaches, at all stages of policy development, could help to address these shortcomings. The identification of key objectives, the resolving of trade-offs and the creation of a common vision and a common direction can be supported by multicriteria analyses. Evidence-based decision-making and transformation of observations into narratives detailing how situations emerge and might unfold in the future can be achieved by systems thinking. Finally, transdisciplinary approaches can be used both to improve the effectiveness of existing systems and to develop novel networks for collective action. To strengthen One Health governance, we propose that knowledge integration becomes a key feature of all stages in the development of related policies. We suggest several ways in which such integration could be promoted.

  9. Changes in Quality of Health Care Delivery after Vertical Integration.

    Science.gov (United States)

    Carlin, Caroline S; Dowd, Bryan; Feldman, Roger

    2015-08-01

    To fill an empirical gap in the literature by examining changes in quality of care measures occurring when multispecialty clinic systems were acquired by hospital-owned, vertically integrated health care delivery systems in the Twin Cities area. Administrative data for health plan enrollees attributed to treatment and control clinic systems, merged with U.S. Census data. We compared changes in quality measures for health plan enrollees in the acquired clinics to enrollees in nine control groups using a differences-in-differences model. Our dataset spans 2 years prior to and 4 years after the acquisitions. We estimated probit models with errors clustered within enrollees. Data were assembled by the health plan's informatics team. Vertical integration is associated with increased rates of colorectal and cervical cancer screening and more appropriate emergency department use. The probability of ambulatory care-sensitive admissions increased when the acquisition caused disruption in admitting patterns. Moving a clinic system into a vertically integrated delivery system resulted in limited increases in quality of care indicators. Caution is warranted when the acquisition causes disruption in referral patterns. © Health Research and Educational Trust.

  10. Integrating GDM management in public health: Pakistan perspective.

    Science.gov (United States)

    Riaz, Musarrat; Basit, Abdul

    2016-09-01

    Pakistan is a developing country with diverse social, economic and cultural dimensions along with limited resources. Non communicable diseases (NCDS) including diabetes are highly prevalent compromising the already challenged health care system. Gestational diabetes mellitus (GDM) with its associated maternal and foetal complications is increasing with rapidly changing lifestyle pattern. Since Pakistan has limited resources and other health issues compete strongly with gestational diabetes initiatives, the most feasible strategy will be the horizontal integration. This will work with the existing primary health care system integrating NCD control programmes with Maternal and Child health (MCH) programmes. Utilizing the existing health care system is the only implementable cost effective strategy. Antenatal screening and treatment of GDM alone is not sufficient but Post-partum screening (PPS) of women with GDM is an important strategy for prevention of diabetes as the conversion rates of GDM to type 2 diabetes are high. Furthermore, instead of perceiving GDM as a temporary reversible clinical entity, it should be considered as a trans-generational prevention of diabetes that needs to be addressed as a public health issue in order to improve maternal and foetal health.

  11. Preliminary Guideline for the High Temperature Structure Integrity Assessment Procedure Part II. High Temperature Structural Integrity Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Han; Kim, J. B.; Lee, H. Y.; Park, C. G.; Joo, Y. S.; Koo, G. H.; Kim, S. H

    2007-02-15

    A high temperature structural integrity assessment belongs to the Part II of a whole preliminary guideline for the high temperature structure. The main contents of this guideline are the evaluation procedures of the creep-fatigue crack initiation and growth in high temperature condition, the high temperature LBB evaluation procedure, and the inelastic evaluations of the welded joints in SFR structures. The methodologies for the proper inelastic analysis of an SFR structures in high temperatures are explained and the guidelines of inelastic analysis options using ANSYS and ABAQUS are suggested. In addition, user guidelines for the developed NONSTA code are included. This guidelines need to be continuously revised to improve the applicability to the design and analysis of the SFR structures.

  12. Integrative Analysis of Metabolic Models – from Structure to Dynamics

    Energy Technology Data Exchange (ETDEWEB)

    Hartmann, Anja, E-mail: hartmann@ipk-gatersleben.de [Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), Gatersleben (Germany); Schreiber, Falk [Monash University, Melbourne, VIC (Australia); Martin-Luther-University Halle-Wittenberg, Halle (Germany)

    2015-01-26

    The characterization of biological systems with respect to their behavior and functionality based on versatile biochemical interactions is a major challenge. To understand these complex mechanisms at systems level modeling approaches are investigated. Different modeling formalisms allow metabolic models to be analyzed depending on the question to be solved, the biochemical knowledge and the availability of experimental data. Here, we describe a method for an integrative analysis of the structure and dynamics represented by qualitative and quantitative metabolic models. Using various formalisms, the metabolic model is analyzed from different perspectives. Determined structural and dynamic properties are visualized in the context of the metabolic model. Interaction techniques allow the exploration and visual analysis thereby leading to a broader understanding of the behavior and functionality of the underlying biological system. The System Biology Metabolic Model Framework (SBM{sup 2} – Framework) implements the developed method and, as an example, is applied for the integrative analysis of the crop plant potato.

  13. Evaluation of structure integrity of the lifting handle of CRB

    Energy Technology Data Exchange (ETDEWEB)

    Wu, S.-Y. [Radiation Protection Association, Taiwan (China); Lin, S.-R. [Radiation Protection Association, Taiwan (China)], E-mail: srlin@iner.gov.tw; Kang, L.-C. [Institute of Nuclear Energy Research, Taiwan (China); Chang, Han-Jou [Department of Nuclear Safety, TPC, Taiwan (China)

    2008-09-15

    Since visual inspection was applied to inspect the control rod blades (CRBs) of nuclear power plants in Taiwan, indications have been found in areas such as roller-pin hole, sheath and tie-rod of CRB. Many preliminary safety analyses with conservative assumptions have been conducted to endorse the continuing operation of the units. The objective of this study is to evaluate the structural integrity of those CRBs during lifting operation. Detailed finite element models of the lifting handle of the CRB are built with emphasis on the postulated crack near the roller-pin hole. Both the D-215 type CRB and the Marathon type CRB are evaluated. It is concluded that the structural integrity is guaranteed even under the worst postulated situation.

  14. An integrated health care standard for the management and prevention of obesity in The Netherlands

    NARCIS (Netherlands)

    Seidell, J.C.; Halberstadt, J.; Noordam, H.; Niemer, S.I.J.

    2012-01-01

    The Partnership Overweight Netherlands (PON) is a collaboration between 18 partners, which are national organizations of health care providers, health insurance companies and patient organizations. The PON published an integrated health care standard for obesity in November 2010.The integrated

  15. Does mental health service integration affect compulsory admissions?

    Directory of Open Access Journals (Sweden)

    André I. Wierdsma

    2009-09-01

    Full Text Available Background: Over recent years, the number of compulsory admissions in many countries has increased, probably as a result of the shift from inpatient to outpatient mental health care. This might be mitigated by formal or collaborative relationships between services. Methods: In a retrospective record linkage study, we compared two neighboring districts, varying in level of service integration. Two periods were combined: 1991–1993 and 2001–2003. We included patients aged 18–60, who had a first emergency compulsory admission (n=830. Their psychiatric history was assessed, and service-use after admission was monitored over a 12-month follow-up. Results: Over a 10-year period, compulsory admission rates increased by 47%. Difference in relative increase between the integrated and non-integrated services was 14%. Patient characteristics showed different profiles in the two districts. Length of stay was >10 days shorter in the integrated district, where the proportion of involuntary readmissions decreased more, and where aftercare was swift and provided to about 10% more patients than in the non-integrated district. Conclusions: Services outcomes showed better results where mental healthcare was more integrated. However, limited effects were found and other factors than integration of services may be more important in preventing compulsory admissions.

  16. Integrating a quantitative risk appraisal in a health impact assessment

    DEFF Research Database (Denmark)

    Adám, Balázs; Molnár, Agnes; Gulis, Gabriel

    2013-01-01

    BACKGROUND: Although the quantification of health outcomes in a health impact assessment (HIA) is scarce in practice, it is preferred by policymakers, as it assists various aspects of the decision-making process. This article provides an example of integrating a quantitative risk appraisal...... in an HIA performed for the recently adopted Hungarian anti-smoking policy which introduced a smoking ban in closed public places, workplaces and public transport vehicles, and is one of the most effective measures to decrease smoking-related ill health. METHODS: A comprehensive, prospective HIA...... to decrease the prevalence of active and passive smoking and result in a considerably positive effect on several diseases, among which lung cancer, chronic pulmonary diseases, coronary heart diseases and stroke have the greatest importance. The health gain calculated for the quantifiable health outcomes...

  17. Integrative structure and functional anatomy of a nuclear pore complex

    Science.gov (United States)

    Kim, Seung Joong; Fernandez-Martinez, Javier; Nudelman, Ilona; Shi, Yi; Zhang, Wenzhu; Raveh, Barak; Herricks, Thurston; Slaughter, Brian D.; Hogan, Joanna A.; Upla, Paula; Chemmama, Ilan E.; Pellarin, Riccardo; Echeverria, Ignacia; Shivaraju, Manjunatha; Chaudhury, Azraa S.; Wang, Junjie; Williams, Rosemary; Unruh, Jay R.; Greenberg, Charles H.; Jacobs, Erica Y.; Yu, Zhiheng; de La Cruz, M. Jason; Mironska, Roxana; Stokes, David L.; Aitchison, John D.; Jarrold, Martin F.; Gerton, Jennifer L.; Ludtke, Steven J.; Akey, Christopher W.; Chait, Brian T.; Sali, Andrej; Rout, Michael P.

    2018-03-01

    Nuclear pore complexes play central roles as gatekeepers of RNA and protein transport between the cytoplasm and nucleoplasm. However, their large size and dynamic nature have impeded a full structural and functional elucidation. Here we determined the structure of the entire 552-protein nuclear pore complex of the yeast Saccharomyces cerevisiae at sub-nanometre precision by satisfying a wide range of data relating to the molecular arrangement of its constituents. The nuclear pore complex incorporates sturdy diagonal columns and connector cables attached to these columns, imbuing the structure with strength and flexibility. These cables also tie together all other elements of the nuclear pore complex, including membrane-interacting regions, outer rings and RNA-processing platforms. Inwardly directed anchors create a high density of transport factor-docking Phe-Gly repeats in the central channel, organized into distinct functional units. This integrative structure enables us to rationalize the architecture, transport mechanism and evolutionary origins of the nuclear pore complex.

  18. Integrative structure and functional anatomy of a nuclear pore complex.

    Science.gov (United States)

    Kim, Seung Joong; Fernandez-Martinez, Javier; Nudelman, Ilona; Shi, Yi; Zhang, Wenzhu; Raveh, Barak; Herricks, Thurston; Slaughter, Brian D; Hogan, Joanna A; Upla, Paula; Chemmama, Ilan E; Pellarin, Riccardo; Echeverria, Ignacia; Shivaraju, Manjunatha; Chaudhury, Azraa S; Wang, Junjie; Williams, Rosemary; Unruh, Jay R; Greenberg, Charles H; Jacobs, Erica Y; Yu, Zhiheng; de la Cruz, M Jason; Mironska, Roxana; Stokes, David L; Aitchison, John D; Jarrold, Martin F; Gerton, Jennifer L; Ludtke, Steven J; Akey, Christopher W; Chait, Brian T; Sali, Andrej; Rout, Michael P

    2018-03-22

    Nuclear pore complexes play central roles as gatekeepers of RNA and protein transport between the cytoplasm and nucleoplasm. However, their large size and dynamic nature have impeded a full structural and functional elucidation. Here we determined the structure of the entire 552-protein nuclear pore complex of the yeast Saccharomyces cerevisiae at sub-nanometre precision by satisfying a wide range of data relating to the molecular arrangement of its constituents. The nuclear pore complex incorporates sturdy diagonal columns and connector cables attached to these columns, imbuing the structure with strength and flexibility. These cables also tie together all other elements of the nuclear pore complex, including membrane-interacting regions, outer rings and RNA-processing platforms. Inwardly directed anchors create a high density of transport factor-docking Phe-Gly repeats in the central channel, organized into distinct functional units. This integrative structure enables us to rationalize the architecture, transport mechanism and evolutionary origins of the nuclear pore complex.

  19. Integrating health promotion and disease prevention interventions with vaccination in Honduras.

    Science.gov (United States)

    Molina-Aguilera, Ida Berenice; Mendoza-Rodríguez, Lourdes Otilia; Palma-Ríos, María Aparicia; Danovaro-Holliday, M Carolina

    2012-03-01

    We sought to review and describe health interventions integrated with immunization delivery, both routine and during national vaccination weeks, in Honduras between 1991 and 2009. We compiled and examined all annual evaluation reports from the national Expanded Program on Immunization and reports from the national vaccination weeks (NVWs) between 1988 and 2009. We held discussions with the persons responsible for immunization and other programs in the Health Secretary of Honduras for the same time period. Since 1991, several health promotion and disease prevention interventions have been integrated with immunization delivery, including vitamin A supplementation (since 1994), folic acid supplementation (2003), early detection of retinoblastoma (since 2003), breastfeeding promotion (2007-2008), and disease control activities during public health emergencies, such as cholera control (1991-1992) and dengue control activities (since 1991, when a dengue emergency coincides with the NVW). Success factors included sufficient funds and supplies to ensure sustainability and joint planning, delivery, and monitoring. Several health interventions have been integrated with vaccination delivery in Honduras for nearly 20 years. The immunization program in Honduras has sufficient structure, organization, acceptance, coverage, and experience to achieve successful integration with health interventions if carefully planned and suitably implemented.

  20. Flexible PCPDTBT:PCBM solar cells with integrated grating structures

    DEFF Research Database (Denmark)

    Oliveira Hansen, Roana Melina de; Liu, Yinghui; Madsen, Morten

    2013-01-01

    We report on development of flexible PCPDTBT:PCBM solar cells with integrated diffraction gratings on the bottom electrodes. The presented results address PCPDTBT:PCBM solar cells in an inverted geometry, which contains implemented grating structures whose pitch is tuned to match the absorption...... spectra of the active layer. This optimized solar cell structure leads to an enhanced absorption in the active layer and thus improved short-circuit currents and power conversion efficiencies in the fabricated devices. Fabrication of the solar cells on thin polyimide substrates which are compatible...

  1. Printing of microstructure strain sensor for structural health monitoring

    Science.gov (United States)

    Le, Minh Quyen; Ganet, Florent; Audigier, David; Capsal, Jean-Fabien; Cottinet, Pierre-Jean

    2017-05-01

    Recent advances in microelectronics and materials should allow the development of integrated sensors with transduction properties compatible with being printed directly onto a 3D substrate, especially metallic and polymer substrates. Inorganic and organic electronic materials in microstructured and nanostructured forms, intimately integrated in ink, offer particularly attractive characteristics, with realistic pathways to sophisticated embodiments. Here, we report on these strategies and demonstrate the potential of 3D-printed microelectronics based on a structural health monitoring (SHM) application for the precision weapon systems. We show that our printed sensors can be employed in non-invasive, high-fidelity and continuous strain monitoring of handguns, making it possible to implement printed sensors on a 3D substrate in either SHM or remote diagnostics. We propose routes to commercialization and novel device opportunities and highlight the remaining challenges for research.

  2. Structural integrity of materials in nuclear service: a bibliography

    International Nuclear Information System (INIS)

    Heddleson, F.A.

    1977-01-01

    This report contains 679 abstracts from the Nuclear Safety Information Center (NSIC) computer file dated 1973 through 1976 covering material properties with respect to structural integrity. All materials important to the nuclear industry (except concrete) are covered for mechanical properties, chemical properties, corrosion, fracture or failure, radiation damage, creep, cracking, and swelling. Keyword, author, and permuted-title indexes are included for the convenience of the user

  3. Structural reasons for vertical integration in the international oil industry

    International Nuclear Information System (INIS)

    Luciani, G.

    1991-01-01

    Once upon a time, the international oil industry was vertically integrated. A small group of companies controlled a very substantial share of international oil flows, extending their operations from the oil well to the gas pump, and relying on intracorporate transfers for most in-between transactions. The historical reasons for vertical disintegration, the market role, and structural reasons for vertical reintegration are examined. (author)

  4. Structural integrity of materials in nuclear service: a bibliography

    Energy Technology Data Exchange (ETDEWEB)

    Heddleson, F.A.

    1977-06-07

    This report contains 679 abstracts from the Nuclear Safety Information Center (NSIC) computer file dated 1973 through 1976 covering material properties with respect to structural integrity. All materials important to the nuclear industry (except concrete) are covered for mechanical properties, chemical properties, corrosion, fracture or failure, radiation damage, creep, cracking, and swelling. Keyword, author, and permuted-title indexes are included for the convenience of the user.

  5. Towards risk-based structural integrity methods for PWRs

    International Nuclear Information System (INIS)

    Chapman, O.J.V.; Lloyd, R.B.

    1992-01-01

    This paper describes the development of risk-based structural integrity assurance methods and their application to Pressurized Water Reactor (PWR) plant. In-service inspection is introduced as a way of reducing the failure probability of high risk sites and the latter are identified using reliability analysis; the extent and interval of inspection can also be optimized. The methodology is illustrated by reference to the aspect of reliability of weldments in PWR systems. (author)

  6. An information integration system for structured documents, Web, and databases

    OpenAIRE

    Morishima, Atsuyuki

    1998-01-01

    Rapid advance in computer network technology has changed the style of computer utilization. Distributed computing resources over world-wide computer networks are available from our local computers. They include powerful computers and a variety of information sources. This change is raising more advanced requirements. Integration of distributed information sources is one of such requirements. In addition to conventional databases, structured documents have been widely used, and have increasing...

  7. Structural Integrity Assessment of Reactor Containment Subjected to Aircraft Crash

    International Nuclear Information System (INIS)

    Kim, Junyong; Chang, Yoonsuk

    2013-01-01

    When an accident occurs at the NPP, containment building which acts as the last barrier should be assessed and analyzed structural integrity by internal loading or external loading. On many occasions that can occur in the containment internal such as LOCA(Loss Of Coolant Accident) are already reflected to design. Likewise, there are several kinds of accidents that may occur from the outside of containment such as earthquakes, hurricanes and strong wind. However, aircraft crash that at outside of containment is not reflected yet in domestic because NPP sites have been selected based on the probabilistic method. After intentional aircraft crash such as World Trade Center and Pentagon accident in US, social awareness for safety of infrastructure like NPP was raised world widely and it is time for assessment of aircraft crash in domestic. The object of this paper is assessment of reactor containment subjected to aircraft crash by FEM(Finite Element Method). In this paper, assessment of structural integrity of containment building subjected to certain aircraft crash was carried out. Verification of structure integrity of containment by intentional severe accident. Maximum stress 61.21MPa of horizontal shell crash does not penetrate containment. Research for more realistic results needed by steel reinforced concrete model

  8. New unified fracture toughness estimation scheme for structural integrity assessment

    Energy Technology Data Exchange (ETDEWEB)

    Wallin, K.; Nevasmaa, P. [VTT, Espoo (Finland); Bannister, A. [Research and Development, British Steel plc., Swinden Technology Centre Rotherham (United Kingdom)

    1998-12-31

    At present, treatment of fracture toughness data varies depending on the type of data (K{sub IC}, J, CTOD) that are available for fracture mechanics analysis. This complicates structural integrity assessment and makes it difficult to apply any single, unified procedure. Within the Brite-Euram project `SINTAP` a fracture toughness estimation scheme has been developed for the unified treatment of data for use in structural integrity assessment. As a procedure, it can be applied to Charpy data, as well as to fracture toughness data, and is suitable for the treatment of data at both single and different temperatures. The data sets may contain results from both homogeneous and inhomogeneous material, making the procedure applicable also to welded joints. The procedure allows fracture toughness assessment with quantified probability and confidence levels. Irrespective of the type of the original data, one material-specific K{sub mat} value representing a conservative estimate of the mean fracture toughness is obtained (with its probability distribution). This information can then be applied to structural integrity assessment. (orig.) 4 refs.

  9. New unified fracture toughness estimation scheme for structural integrity assessment

    Energy Technology Data Exchange (ETDEWEB)

    Wallin, K; Nevasmaa, P [VTT, Espoo (Finland); Bannister, A [Research and Development, British Steel plc., Swinden Technology Centre Rotherham (United Kingdom)

    1999-12-31

    At present, treatment of fracture toughness data varies depending on the type of data (K{sub IC}, J, CTOD) that are available for fracture mechanics analysis. This complicates structural integrity assessment and makes it difficult to apply any single, unified procedure. Within the Brite-Euram project `SINTAP` a fracture toughness estimation scheme has been developed for the unified treatment of data for use in structural integrity assessment. As a procedure, it can be applied to Charpy data, as well as to fracture toughness data, and is suitable for the treatment of data at both single and different temperatures. The data sets may contain results from both homogeneous and inhomogeneous material, making the procedure applicable also to welded joints. The procedure allows fracture toughness assessment with quantified probability and confidence levels. Irrespective of the type of the original data, one material-specific K{sub mat} value representing a conservative estimate of the mean fracture toughness is obtained (with its probability distribution). This information can then be applied to structural integrity assessment. (orig.) 4 refs.

  10. Structural health monitoring of wind turbine blades

    Science.gov (United States)

    Rumsey, Mark A.; Paquette, Joshua A.

    2008-03-01

    As electric utility wind turbines increase in size, and correspondingly, increase in initial capital investment cost, there is an increasing need to monitor the health of the structure. Acquiring an early indication of structural or mechanical problems allows operators to better plan for maintenance, possibly operate the machine in a de-rated condition rather than taking the unit off-line, or in the case of an emergency, shut the machine down to avoid further damage. This paper describes several promising structural health monitoring (SHM) techniques that were recently exercised during a fatigue test of a 9 meter glass-epoxy and carbon-epoxy wind turbine blade. The SHM systems were implemented by teams from NASA Kennedy Space Center, Purdue University and Virginia Tech. A commercial off-the-shelf acoustic emission (AE) NDT system gathered blade AE data throughout the test. At a fatigue load cycle rate around 1.2 Hertz, and after more than 4,000,000 fatigue cycles, the blade was diagnostically and visibly failing at the out-board blade spar-cap termination point at 4.5 meters. For safety reasons, the test was stopped just before the blade completely failed. This paper provides an overview of the SHM and NDT system setups and some current test results.

  11. Integrating health promotion with quality improvement in a Swedish hospital.

    Science.gov (United States)

    Astnell, Sandra; von Thiele Schwarz, Ulrica; Hasson, Henna; Augustsson, Hanna; Stenfors-Hayes, Terese

    2016-09-01

    Integration of workplace employee health promotion (HP) and occupational health and safety (OHS) work into organizational quality improvement systems is suggested as a way to strengthen HP and OHS activities in an organization. The aim of this article was to study what consequences integration of HP, OHS and a quality improvement system called kaizen has on the frequency and type of HP and OHS activities. A quasi-experimental study design was used where an integration of the three systems for HP, OHS respectively kaizen, was performed at six intervention units at a Swedish hospital. The remaining six units served as controls. Document analysis of all employees' written improvement suggestions (kaizen notes) during 2013 was conducted. The findings show that the intervention group had more suggestions concerning HP and OHS (n = 114) when compared with the control group (n = 78) and a greater variety of HP and OHS suggestions. In addition, only the intervention group had included HP aspects. In both groups, most kaizen notes with health consideration had a preventive focus rather than rehabilitative. The intervention, i.e. the integration of HP, OHS and kaizen work, had a favourable effect on HP and OHS work when compared with the controls. The results of the study support that this system can work in practice at hospitals. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Ground Operations Autonomous Control and Integrated Health Management

    Science.gov (United States)

    Daniels, James

    2014-01-01

    The Ground Operations Autonomous Control and Integrated Health Management plays a key role for future ground operations at NASA. The software that is integrated into this system is called G2 2011 Gensym. The purpose of this report is to describe the Ground Operations Autonomous Control and Integrated Health Management with the use of the G2 Gensym software and the G2 NASA toolkit for Integrated System Health Management (ISHM) which is a Computer Software Configuration Item (CSCI). The decision rationale for the use of the G2 platform is to develop a modular capability for ISHM and AC. Toolkit modules include knowledge bases that are generic and can be applied in any application domain module. That way, there's a maximization of reusability, maintainability, and systematic evolution, portability, and scalability. Engine modules are generic, while application modules represent the domain model of a specific application. Furthermore, the NASA toolkit, developed since 2006 (a set of modules), makes it possible to create application domain models quickly, using pre-defined objects that include sensors and components libraries for typical fluid, electrical, and mechanical systems.

  13. An Integrative Behavioral Health Care Model Using Automated SBIRT and Care Coordination in Community Health Care.

    Science.gov (United States)

    Dwinnells, Ronald; Misik, Lauren

    2017-10-01

    Efficient and effective integration of behavioral health programs in a community health care practice emphasizes patient-centered medical home principles to improve quality of care. A prospective, 3-period, interrupted time series study was used to explore which of 3 different integrative behavioral health care screening and management processes were the most efficient and effective in prompting behavioral health screening, identification, interventions, and referrals in a community health practice. A total of 99.5% ( P < .001) of medical patients completed behavioral health screenings; brief intervention rates nearly doubled to 83% ( P < .001) and 100% ( P < .001) of identified at-risk patients had referrals made using a combination of electronic tablets, electronic medical record, and behavioral health care coordination.

  14. [Social constructionism in primary health care: an integrative review].

    Science.gov (United States)

    Cadoná, Eliane; Scarparo, Helena

    2015-09-01

    This study sets out to analyze scientific articles in order to investigate how researchers in the area of Social Constructionism define "health" in Primary Health Care. An integrative review of the literature was conducted along with a decision to concentrate on those works with narrative experiences and research studies. The database researched was the Brazilian Virtual Health Library, with experiences in the scope of Primary Health Care. The effectiveness of this step resulted in 12 articles. Data were analyzed and discussed based on the perspectives of social constructionism, which generated two central themes. They were: citizenship exercises - promoting health in collective spaces; health practices - overcoming the dichotomies and absolute truths. This study revealed the relevance of the notion of shared responsibility on meanings of health contained in the texts analyzed. The researchers claim that it is possible to expand health practices into collective action to facilitate ongoing dialogue between health users and workers. However, the dominance of biomedical discourse is criticized by the researchers, because that paradigm still promotes practices of care focused on illness.

  15. General practice integration in Australia. Primary health services provider and consumer perceptions of barriers and solutions.

    Science.gov (United States)

    Appleby, N J; Dunt, D; Southern, D M; Young, D

    1999-08-01

    To identify practical examples of barriers and possible solutions to improve general practice integration with other health service providers. Twelve focus groups, including one conducted by teleconference, were held across Australia with GPs and non GP primary health service providers between May and September, 1996. Focus groups were embedded within concept mapping sessions, which were used to conceptually explore the meaning of integration in general practice. Data coding, organising and analysis were based on the techniques documented by Huberman and Miles. Barriers to integration were perceived to be principally due to the role and territory disputes between the different levels of government and their services, the manner in which the GP's role is currently defined, and the system of GP remuneration. Suggestions on ways to improve integration involved two types of strategies. The first involves initiatives implemented 'top down' through major government reform to service structures, including the expansion of the role of divisions of general practice, and structural changes to the GP remuneration systems. The second type of strategy suggested involves initiatives implemented from the 'bottom up' involving services such as hospitals (e.g. additional GP liaison positions) and the use of information technology to link services and share appropriate patient data. The findings support the need for further research and evaluation of initiatives aimed at achieving general practice integration at a systems level. There is little evidence to suggest which types of initiatives improve integration. However, general practice has been placed in the centre of the health care debate and is likely to remain central to the success of such initiatives. Clarification of the future role and authority of general practice will therefore be required if such integrative strategies are to be successful at a wider health system level.

  16. Integrated Theory of Health Behavior Change: background and intervention development.

    Science.gov (United States)

    Ryan, Polly

    2009-01-01

    An essential characteristic of advanced practice nurses is the use of theory in practice. Clinical nurse specialists apply theory in providing or directing patient care, in their work as consultants to staff nurses, and as leaders influencing and facilitating system change. Knowledge of technology and pharmacology has far outpaced knowledge of how to facilitate health behavior change, and new theories are needed to better understand how practitioners can facilitate health behavior change. In this article, the Integrated Theory of Health Behavior Change is described, and an example of its use as foundation to intervention development is presented. The Integrated Theory of Health Behavior Change suggests that health behavior change can be enhanced by fostering knowledge and beliefs, increasing self-regulation skills and abilities, and enhancing social facilitation. Engagement in self-management behaviors is seen as the proximal outcome influencing the long-term distal outcome of improved health status. Person-centered interventions are directed to increasing knowledge and beliefs, self-regulation skills and abilities, and social facilitation. Using a theoretical framework improves clinical nurse specialist practice by focusing assessments, directing the use of best-practice interventions, and improving patient outcomes. Using theory fosters improved communication with other disciplines and enhances the management of complex clinical conditions by providing holistic, comprehensive care.

  17. Effects of Integrated Health Management Intervention on Overweight and Obesity

    Directory of Open Access Journals (Sweden)

    Yiting Yang

    2017-01-01

    Full Text Available Overweight or obese adults aged 20~55 years and living in Beijing more than one year were randomly divided into different management groups. A one-year integrated health management intervention was applied in the health management groups. The physical indicators and metabolic indicators changed after one-year intervention on the overweight and obese adults. The annual reduction of the physical indicators was significant in all groups (p<0.05 except the weight loss in the placebo + general management group. The health management and the dietary supplement have statistically significant (p<0.001, p<0.001 effects on the annual reduction of these indicators and interactive effect between them was found on some of these indicators such as bodyweight, body mass index (BMI, body fat ratio (BFR, and hipline (p<0.05. The dietary supplement + health management group had the best annual reduction effects for the indicators among the groups. Integrated health management interventions including both dietary supplements intervention and health management could improve metabolic indicators in overweight and obese adults together with the physical indicators, suggesting the intermediated role of metabolic indictors in controlling obesity.

  18. Integration of a mobile-integrated therapy with electronic health records: lessons learned.

    Science.gov (United States)

    Peeples, Malinda M; Iyer, Anand K; Cohen, Joshua L

    2013-05-01

    Responses to the chronic disease epidemic have predominantly been standardized in their approach to date. Barriers to better health outcomes remain, and effective management requires patient-specific data and disease state knowledge be presented in methods that foster clinical decision-making and patient self-management. Mobile technology provides a new platform for data collection and patient-provider communication. The mobile device represents a personalized platform that is available to the patient on a 24/7 basis. Mobile-integrated therapy (MIT) is the convergence of mobile technology, clinical and behavioral science, and scientifically validated clinical outcomes. In this article, we highlight the lessons learned from functional integration of a Food and Drug Administration-cleared type 2 diabetes MIT into the electronic health record (EHR) of a multiphysician practice within a large, urban, academic medical center. In-depth interviews were conducted with integration stakeholder groups: mobile and EHR software and information technology teams, clinical end users, project managers, and business analysts. Interviews were summarized and categorized into lessons learned using the Architecture for Integrated Mobility® framework. Findings from the diverse stakeholder group of a MIT-EHR integration project indicate that user workflow, software system persistence, environment configuration, device connectivity and security, organizational processes, and data exchange heuristics are key issues that must be addressed. Mobile-integrated therapy that integrates patient self-management data with medical record data provides the opportunity to understand the potential benefits of bidirectional data sharing and reporting that are most valuable in advancing better health and better care in a cost-effective way that is scalable for all chronic diseases. © 2013 Diabetes Technology Society.

  19. Participative mental health consumer research for improving physical health care: An integrative review.

    Science.gov (United States)

    Happell, Brenda; Ewart, Stephanie B; Platania-Phung, Chris; Stanton, Robert

    2016-10-01

    People with mental illness have a significantly lower life expectancy and higher rates of chronic physical illnesses than the general population. Health care system reform to improve access and quality is greatly needed to address this inequity. The inclusion of consumers of mental health services as co-investigators in research is likely to enhance service reform. In light of this, the current paper reviews mental health consumer focussed research conducted to date, addressing the neglect of physical health in mental health care and initiatives with the aim of improving physical health care. The international literature on physical healthcare in the context of mental health services was searched for articles, including mental health consumers in research roles, via Medline, CINAHL and Google Scholar, in October 2015. Four studies where mental health consumers participated as researchers were identified. Three studies involved qualitative research on barriers and facilitators to physical health care access, and a fourth study on developing technologies for more effective communication between GPs and patients. This review found that participatory mental health consumer research in physical health care reform has only become visible in the academic literature in 2015. Heightened consideration of mental health consumer participation in research is required by health care providers and researchers. Mental health nurses can provide leadership in increasing mental health consumer research on integrated care directed towards reducing the health gap between people with and without mental illness. © 2016 Australian College of Mental Health Nurses Inc.

  20. Nursing competency standards in primary health care: an integrative review.

    Science.gov (United States)

    Halcomb, Elizabeth; Stephens, Moira; Bryce, Julianne; Foley, Elizabeth; Ashley, Christine

    2016-05-01

    This paper reports an integrative review of the literature on nursing competency standards for nurses working in primary health care and, in particular, general practice. Internationally, there is growing emphasis on building a strong primary health care nursing workforce to meet the challenges of rising chronic and complex disease. However, there has been limited emphasis on examining the nursing workforce in this setting. Integrative review. A comprehensive search of relevant electronic databases using keywords (e.g. 'competencies', 'competen*' and 'primary health care', 'general practice' and 'nurs*') was combined with searching of the Internet using the Google scholar search engine. Experts were approached to identify relevant grey literature. Key websites were also searched and the reference lists of retrieved sources were followed up. The search focussed on English language literature published since 2000. Limited published literature reports on competency standards for nurses working in general practice and primary health care. Of the literature that is available, there are differences in the reporting of how the competency standards were developed. A number of common themes were identified across the included competency standards, including clinical practice, communication, professionalism and health promotion. Many competency standards also included teamwork, education, research/evaluation, information technology and the primary health care environment. Given the potential value of competency standards, further work is required to develop and test robust standards that can communicate the skills and knowledge required of nurses working in primary health care settings to policy makers, employers, other health professionals and consumers. Competency standards are important tools for communicating the role of nurses to consumers and other health professionals, as well as defining this role for employers, policy makers and educators. Understanding the content

  1. Structural Integrity Evaluation for the IVTM Gripper in PGSFR

    Energy Technology Data Exchange (ETDEWEB)

    Kim, S. H.; Koo, G. H. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    The materials of the gripper used for the analysis are the 316SS in the gripper body parts and the Inconel 718 alloy in the gripper finger parts, respectively. For six sections of the IVTM gripper, the structural integrity according to ASME-NB design rule is checked for the dead weight and refueling load because it is under the low temperature during the refueling operation. As a result of the evaluation, it is reviewed the IVTM gripper design has the structural adequacy. IVTM (In-Vessel Transfer Machine) is the instrument for transferring the core assembly inside the reactor vessel. The IVTM use the gripper finger for the connection and disconnection with the core assembly, which is designed to be possible for the rotation and vertical movement of the gripper. We can see that the IVTM gripper is supported by the gripper guide structure. In the gripper movement, the gripper is lowered to pick up the core assembly with its fingers closed. On contact with the end of the core assembly, the gripper fingers are opened, and then connected with the core assembly. The gripper is then raised with the core assembly. This is the gripper mechanism to handle the core assembly. The purpose of this study is to analyze the gripper stresses and displacements for the design loads applied to the gripper, and also to evaluate the structural integrity of the gripper design for 60 year lifetime.

  2. Lightweight structure design for wind energy by integrating nanostructured materials

    International Nuclear Information System (INIS)

    Li, Ying; Lu, Jian

    2014-01-01

    Highlights: • Integrate high-strength nano-materials into lightweight design. • Lightweight design scheme for wind turbine tower application. • Expand the bending formulae for tapered tubular structures with varying thickness. • We rewrite the Secant Formula for a tapered beam under eccentric compression. - Abstract: Wind power develops very fast nowadays with high expectation. Although at the mean time, the use of taller towers, however, smacks head-on into the issue of transportability. The engineering base and computational tools have to be developed to match machine size and volume. Consequently the research on the light weight structures of tower is carrying out in the main countries which are actively developing wind energy. This paper reports a new design scheme of light weight structure for wind turbine tower. This design scheme is based on the integration of the nanostructured materials produced by the Surface Mechanical Attrition Treatment (SMAT) process. The objective of this study is to accomplish the weight reduction by optimizing the wall thickness of the tapered tubular structure. The basic methods include the identification of the critical zones and the distribution of the high strength materials according to different necessities. The equivalent strength or stiffness design method and the high strength material properties after SMAT process are combined together. Bending and buckling are two main kinds of static loads concerned in consideration. The study results reveal that there is still enough margin for weight reduction in the traditional wind turbine tower design

  3. Care and pedagogical production: integration of Public Health System scenarios

    Directory of Open Access Journals (Sweden)

    Túlio Batista Franco

    2007-01-01

    Full Text Available Throughout Brazilian Public Health System's (Centralized Health System - SUS construction history there has been a reasonable investment in the education for the sector. However, it has been frequently noticed by health professionals and managers the fact that this investment in educational programs has not converted into change of healthcare practices. Assuming that education can be used as a tool for changes in health, the text suggests that the pedagogical practices should be directed towards the production of individuals implied with the care production. Hence it proposes to work on a field of subjectivity in addition to cognition. This work reveals the management of the Brazilian public health system and its flows of permanent education, focusing "micromanagement" to think about the context on which they structuralize the diverse scenarios of care production, treating them as Pedagogical Production Units where it would be possible to develop entailed educational methodologies to a general idea of permanent education in health.

  4. Supporting frail seniors through a family physician and Home Health integrated care model in Fraser Health

    Directory of Open Access Journals (Sweden)

    Grace Haeson Park

    2014-03-01

    Full Text Available Background: A major effort is underway to integrate primary and community care in Canada's western province of British Columbia and in Fraser Health, its largest health authority. Integrated care is a critical component of Fraser Health's planning, to meet the challenges of caring for a growing, elderly population that is presenting more complex and chronic medical conditions. Description of integrated practice: An integrated care model partners family physicians with community-based home health case managers to support frail elderly patients who live at home. It is resulting in faster response times to patient needs, more informed assessments of a patient's state of health and pro-active identification of emerging patient issues. Early results: The model is intended to improve the quality of patient care and maintain the patients’ health status, to help them live at home confidently and safely, as long as possible. Preliminary pilot data measuring changes in home care services is showing positive trends when it comes to extending the length of a person's survival/tenure in the community (living in their home vs. admitted to residential care or deceased. Conclusion: Fraser Health's case manager–general practitioner partnership model is showing promising results including higher quality, appropriate, coordinated and efficient care; improved patient, caregiver and physician interactions with the system; improved health and prevention of acute care visits by senior adult patients.

  5. Fluorescence microscopy for the characterization of structural integrity

    Science.gov (United States)

    Street, Kenneth W.; Leonhardt, Todd A.

    1991-01-01

    The absorption characteristics of light and the optical technique of fluorescence microscopy for enhancing metallographic interpretation are presented. Characterization of thermally sprayed coatings by optical microscopy suffers because of the tendency for misidentification of the microstructure produced by metallographic preparation. Gray scale, in bright field microscopy, is frequently the only means of differentiating the actual structural details of porosity, cracking, and debonding of coatings. Fluorescence microscopy is a technique that helps to distinguish the artifacts of metallographic preparation (pullout, cracking, debonding) from the microstructure of the specimen by color contrasting structural differences. Alternative instrumentation and the use of other dye systems are also discussed. The combination of epoxy vacuum infiltration with fluorescence microscopy to verify microstructural defects is an effective means to characterize advanced materials and to assess structural integrity.

  6. Music and language perception: expectations, structural integration, and cognitive sequencing.

    Science.gov (United States)

    Tillmann, Barbara

    2012-10-01

    Music can be described as sequences of events that are structured in pitch and time. Studying music processing provides insight into how complex event sequences are learned, perceived, and represented by the brain. Given the temporal nature of sound, expectations, structural integration, and cognitive sequencing are central in music perception (i.e., which sounds are most likely to come next and at what moment should they occur?). This paper focuses on similarities in music and language cognition research, showing that music cognition research provides insight into the understanding of not only music processing but also language processing and the processing of other structured stimuli. The hypothesis of shared resources between music and language processing and of domain-general dynamic attention has motivated the development of research to test music as a means to stimulate sensory, cognitive, and motor processes. Copyright © 2012 Cognitive Science Society, Inc.

  7. Experiences with integral microelectronics on smart structures for space

    Science.gov (United States)

    Nye, Ted; Casteel, Scott; Navarro, Sergio A.; Kraml, Bob

    1995-05-01

    One feature of a smart structure implies that some computational and signal processing capability can be performed at a local level, perhaps integral to the controlled structure. This requires electronics with a minimal mechanical influence regarding structural stiffening, heat dissipation, weight, and electrical interface connectivity. The Advanced Controls Technology Experiment II (ACTEX II) space-flight experiments implemented such a local control electronics scheme by utilizing composite smart members with integral processing electronics. These microelectronics, tested to MIL-STD-883B levels, were fabricated with conventional thick film on ceramic multichip module techniques. Kovar housings and aluminum-kapton multilayer insulation was used to protect against harsh space radiation and thermal environments. Development and acceptance testing showed the electronics design was extremely robust, operating in vacuum and at temperature range with minimal gain variations occurring just above room temperatures. Four electronics modules, used for the flight hardware configuration, were connected by a RS-485 2 Mbit per second serial data bus. The data bus was controlled by Actel field programmable gate arrays arranged in a single master, four slave configuration. An Intel 80C196KD microprocessor was chosen as the digital compensator in each controller. It was used to apply a series of selectable biquad filters, implemented via Delta Transforms. Instability in any compensator was expected to appear as large amplitude oscillations in the deployed structure. Thus, over-vibration detection circuitry with automatic output isolation was incorporated into the design. This was not used however, since during experiment integration and test, intentionally induced compensator instabilities resulted in benign mechanical oscillation symptoms. Not too surprisingly, it was determined that instabilities were most detectable by large temperature increases in the electronics, typically

  8. Promoting employee health by integrating health protection, health promotion, and continuous improvement: a longitudinal quasi-experimental intervention study.

    Science.gov (United States)

    von Thiele Schwarz, Ulrica; Augustsson, Hanna; Hasson, Henna; Stenfors-Hayes, Terese

    2015-02-01

    To test the effects of integrating health protection and health promotion with a continuous improvement system (Kaizen) on proximal employee outcomes (health promotion, integration, and Kaizen) and distal outcomes (workability, productivity, self-rated health and self-rated sickness absence). Twelve units in a county hospital in Sweden were randomized to control or intervention groups using a quasiexperimental study design. All staff (approximately 500) provided self-ratings in questionnaires at baseline, and a 12- and 24-month follow-up (response rate, 79% to 87.5%). There was a significant increase in the proximal outcomes over time in the intervention group compared with the control group, and a trend toward improvement in the distal outcomes workability and productivity. Integration seems to promote staff engagement in health protection and promotion, as well as to improve their understanding of the link between work and health.

  9. Role of contamination on the bondline integrity of composite structures

    Energy Technology Data Exchange (ETDEWEB)

    Shang, Xu [Iowa State Univ., Ames, IA (United States)

    2013-01-01

    Adhesively bonding composite structures have many applications in aerospace, automotive and submarine industries. The adhesive bonding joints have substantial advantage over the traditional metallic mechanical bonding joints, such as rivet and welding. However, the adhesive bonding joints require additional steps of surface preparation and cleaning to ensure consistent bond strength. In application, the adhesively bonded joints are exposed to environmental degradation and industrial solvent contaminates. Accordingly, the assurance of reliability of bonded composite structures requires detailed investigation of the role of contaminates on bondline integrity. This dissertation focuses on assessing the contaminates effect on the adhesive bondline integrity. A combined experimental and numerical framework is developed to study the contamination effect on the adhesive mechanical properties and adhesive joint strength. The bondline integrity were examined for a system of adhesive (EA9394) and the carbonfiber system (Hexply IM7/8552), after being subjected to different level of exposures to aviation hydraulic fluids and mold cleaning agents. A testing protocol based on nanoindentation for initial screening is used to predict the interfacial fracture characteristics after exposure to contamination. It is found the adhesive modulus and stiffness dropped by up to 10% for the hydraulic fluid contaminates, suggesting increase of the plastic dissipation within the bondline. However, the trend for the cleaning agent was not clear since the modulus drop while its hardness increased.

  10. The Importance Of Integrating Narrative Into Health Care Decision Making.

    Science.gov (United States)

    Dohan, Daniel; Garrett, Sarah B; Rendle, Katharine A; Halley, Meghan; Abramson, Corey

    2016-04-01

    When making health care decisions, patients and consumers use data but also gather stories from family and friends. When advising patients, clinicians consult the medical evidence but also use professional judgment. These stories and judgments, as well as other forms of narrative, shape decision making but remain poorly understood. Furthermore, qualitative research methods to examine narrative are rarely included in health science research. We illustrate how narratives shape decision making and explain why it is difficult but necessary to integrate qualitative research on narrative into the health sciences. We draw on social-scientific insights on rigorous qualitative research and our ongoing studies of decision making by patients with cancer, and we describe new tools and approaches that link qualitative research findings with the predominantly quantitative health science scholarship. Finally, we highlight the benefits of more fully integrating qualitative research and narrative analysis into the medical evidence base and into evidence-based medical practice. Project HOPE—The People-to-People Health Foundation, Inc.

  11. Integrative holism in psychiatric-mental health nursing.

    Science.gov (United States)

    Zahourek, Rothlyn P

    2008-10-01

    In this era of high-tech care, many Americans seek more holistic approaches and alternative and complementary treatments for health problems, including mental illness. Psychiatric-mental health (PMH) nurses need to be aware of these approaches as they assess clients, maintain a holistic approach, and in some cases, provide skilled, specific modalities. This article reviews holistic philosophy and integrative approaches relevant to PMH nurses. The emphasis is that whichever modality PMH nurses practice, a holistic framework is essential for providing optimal PMH care.

  12. Preliminary Outcomes from an Integrated Pediatric Mental Health Outpatient Clinic.

    Science.gov (United States)

    Maslow, Gary R; Banny, Adrienne; Pollock, McLean; Stefureac, Kristen; Rosa, Kendra; Walter, Barbara Keith; Hobbs Knutson, Katherine; Lucas, Joseph; Heilbron, Nicole

    2017-10-01

    An estimated 1 in 5 children in the United States meet criteria for a diagnosable mental disorder, yet fewer than 20% receive mental health services. Unmet need for psychiatric treatment may contribute to patterns of increasing use of the emergency department. This article describes an integrated pediatric evaluation center designed to prevent the need for treatment in emergency settings by increasing access to timely and appropriate care for emergent and critical mental health needs. Preliminary results showed that the center provided rapid access to assessment and treatment services for children and adolescents presenting with a wide range of psychiatric concerns. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Integrating the Principles of Socioecology and Critical Pedagogy for Health Promotion Health Literacy Interventions.

    Science.gov (United States)

    Dawkins-Moultin, Lenna; McDonald, Andrea; McKyer, Lisako

    2016-01-01

    While health literacy research has experienced tremendous growth in the last two decades, the field still struggles to devise interventions that lead to lasting change. Most health literacy interventions are at the individual level and focus on resolving clinician-patient communication difficulties. As a result, the interventions use a deficit model that treats health literacy as a patient problem that needs to be fixed or circumvented. We propose that public health health literacy interventions integrate the principles of socioecology and critical pedagogy to develop interventions that build capacity and empower individuals and communities. Socioecology operates on the premise that health outcome is hinged on the interplay between individuals and their environment. Critical pedagogy assumes education is inherently political, and the ultimate goal of education is social change. Integrating these two approaches will provide a useful frame in which to develop interventions that move beyond the individual level.

  14. A future task for Health Promotion research: Integration of Health Promotion and sustainable development

    DEFF Research Database (Denmark)

    Jelsøe, Erling; Thualagant, Nicole; Holm, Jesper

    2018-01-01

    Based on previous studies and reflections collected from participants in a workshop at the 8th Nordic Health Promotion Research Network conference, we reveal current tendencies and discuss future challenges for health promotion research regarding integration of sustainable development principles....... Despite obvious interfaces and interactions between the two, our contention is that strategies for health promotion are not sufficiently integrated with strategies for sustainable development and that policies aimed at solving health or sustainability problems may therefore cause new, undesired...... and unforeseen environmental and health problems. As illustrated in previous research and as deliberated in the above-mentioned workshop, a number of barriers are identified: these are believed to be related to historical segregation, the conceptual understandings of health promotion and sustainable development...

  15. The health terminology project glossaries` structure

    Directory of Open Access Journals (Sweden)

    Sátia Marini

    2014-04-01

    Full Text Available Current paper was motivated by a Master´s degree in Translation Studies on one of the glossaries of the Health Terminology Project (PTS of the Ministry of Health (MS inBrazil, by which the products developed by the project were analyzed. The authors would like to forward their experience earned from the development of these instruments and from the evolution of the glossary´s layout and structure. Although within the same institution, each instrument is made suitable to the specific purpose of each area and the terminology project accumulates experience by the constant improvement of previously developed glossaries (adding new terms; providing the equivalent word in other languages for terms already defined and by the establishment of new ones. The evolution of the structure of the glossaries was qualitatively analyzed; remarks on the types of cross references were made; a quantitative survey of their main features was undertaken. Finally, the importance of this type of work should be underscored either within the government, or in the academy or in private companies, for the sharing of intellectual knowledge.

  16. Integrated failure probability estimation based on structural integrity analysis and failure data: Natural gas pipeline case

    International Nuclear Information System (INIS)

    Dundulis, Gintautas; Žutautaitė, Inga; Janulionis, Remigijus; Ušpuras, Eugenijus; Rimkevičius, Sigitas; Eid, Mohamed

    2016-01-01

    In this paper, the authors present an approach as an overall framework for the estimation of the failure probability of pipelines based on: the results of the deterministic-probabilistic structural integrity analysis (taking into account loads, material properties, geometry, boundary conditions, crack size, and defected zone thickness), the corrosion rate, the number of defects and failure data (involved into the model via application of Bayesian method). The proposed approach is applied to estimate the failure probability of a selected part of the Lithuanian natural gas transmission network. The presented approach for the estimation of integrated failure probability is a combination of several different analyses allowing us to obtain: the critical crack's length and depth, the failure probability of the defected zone thickness, dependency of the failure probability on the age of the natural gas transmission pipeline. A model's uncertainty analysis and uncertainty propagation analysis are performed, as well. - Highlights: • Degradation mechanisms of natural gas transmission pipelines. • Fracture mechanic analysis of the pipe with crack. • Stress evaluation of the pipe with critical crack. • Deterministic-probabilistic structural integrity analysis of gas pipeline. • Integrated estimation of pipeline failure probability by Bayesian method.

  17. Integration services to enable regional shared electronic health records.

    Science.gov (United States)

    Oliveira, Ilídio C; Cunha, João P S

    2011-01-01

    eHealth is expected to integrate a comprehensive set of patient data sources into a coherent continuum, but implementations vary and Portugal is still lacking on electronic patient data sharing. In this work, we present a clinical information hub to aggregate multi-institution patient data and bridge the information silos. This integration platform enables a coherent object model, services-oriented applications development and a trust framework. It has been instantiated in the Rede Telemática de Saúde (www.RTSaude.org) to support a regional Electronic Health Record approach, fed dynamically from production systems at eight partner institutions, providing access to more than 11,000,000 care episodes, relating to over 350,000 citizens. The network has obtained the necessary clearance from the Portuguese data protection agency.

  18. Integrating national community-based health worker programmes into health systems: a systematic review identifying lessons learned from low-and middle-income countries.

    Science.gov (United States)

    Zulu, Joseph Mumba; Kinsman, John; Michelo, Charles; Hurtig, Anna-Karin

    2014-09-22

    Despite the development of national community-based health worker (CBHW) programmes in several low- and middle-income countries, their integration into health systems has not been optimal. Studies have been conducted to investigate the factors influencing the integration processes, but systematic reviews to provide a more comprehensive understanding are lacking. We conducted a systematic review of published research to understand factors that may influence the integration of national CBHW programmes into health systems in low- and middle-income countries. To be included in the study, CBHW programmes should have been developed by the government and have standardised training, supervision and incentive structures. A conceptual framework on the integration of health innovations into health systems guided the review. We identified 3410 records, of which 36 were finally selected, and on which an analysis was conducted concerning the themes and pathways associated with different factors that may influence the integration process. Four programmes from Brazil, Ethiopia, India and Pakistan met the inclusion criteria. Different aspects of each of these programmes were integrated in different ways into their respective health systems. Factors that facilitated the integration process included the magnitude of countries' human resources for health problems and the associated discourses about how to address these problems; the perceived relative advantage of national CBHWs with regard to delivering health services over training and retaining highly skilled health workers; and the participation of some politicians and community members in programme processes, with the result that they viewed the programmes as legitimate, credible and relevant. Finally, integration of programmes within the existing health systems enhanced programme compatibility with the health systems' governance, financing and training functions. Factors that inhibited the integration process included a rapid

  19. Innovation in health service delivery: integrating community health assistants into the health system at district level in Zambia.

    Science.gov (United States)

    Zulu, Joseph Mumba; Hurtig, Anna-Karin; Kinsman, John; Michelo, Charles

    2015-01-28

    To address the huge human resources for health gap in Zambia, the Ministry of Health launched the National Community Health Assistant Strategy in 2010. The strategy aims to integrate community-based health workers into the health system by creating a new group of workers, called community health assistants (CHAs). However, literature suggests that the integration process of national community-based health worker programmes into health systems has not been optimal. Conceptually informed by the diffusion of innovations theory, this paper qualitatively aimed to explore the factors that shaped the acceptability and adoption of CHAs into the health system at district level in Zambia during the pilot phase. Data gathered through review of documents, 6 focus group discussions with community leaders, and 12 key informant interviews with CHA trainers, supervisors and members of the District Health Management Team were analysed using thematic analysis. The perceived relative advantage of CHAs over existing community-based health workers in terms of their quality of training and scope of responsibilities, and the perceived compatibility of CHAs with existing groups of health workers and community healthcare expectations positively facilitated the integration process. However, limited integration of CHAs in the district health governance system hindered effective programme trialability, simplicity and observability at district level. Specific challenges at this level included a limited information flow and sense of programme ownership, and insufficient documentation of outcomes. The district also had difficulties in responding to emergent challenges such as delayed or non-payment of CHA incentives, as well as inadequate supervision and involvement of CHAs in the health posts where they are supposed to be working. Furthermore, failure of the health system to secure regular drug supplies affected health service delivery and acceptability of CHA services at community level. The

  20. Technology integration performance assessment using lean principles in health care.

    Science.gov (United States)

    Rico, Florentino; Yalcin, Ali; Eikman, Edward A

    2015-01-01

    This study assesses the impact of an automated infusion system (AIS) integration at a positron emission tomography (PET) center based on "lean thinking" principles. The authors propose a systematic measurement system that evaluates improvement in terms of the "8 wastes." This adaptation to the health care context consisted of performance measurement before and after integration of AIS in terms of time, utilization of resources, amount of materials wasted/saved, system variability, distances traveled, and worker strain. The authors' observations indicate that AIS stands to be very effective in a busy PET department, such as the one in Moffitt Cancer Center, owing to its accuracy, pace, and reliability, especially after the necessary adjustments are made to reduce or eliminate the source of errors. This integration must be accompanied by a process reengineering exercise to realize the full potential of AIS in reducing waste and improving patient care and worker satisfaction. © The Author(s) 2014.

  1. Lagrangian structures, integrability and chaos for 3D dynamical equations

    International Nuclear Information System (INIS)

    Bustamante, Miguel D; Hojman, Sergio A

    2003-01-01

    In this paper, we consider the general setting for constructing action principles for three-dimensional first-order autonomous equations. We present the results for some integrable and non-integrable cases of the Lotka-Volterra equation, and show Lagrangian descriptions which are valid for systems satisfying Shil'nikov criteria on the existence of strange attractors, though chaotic behaviour has not been verified up to now. The Euler-Lagrange equations we get for these systems usually present 'time reparametrization' invariance, though other kinds of invariance may be found according to the kernel of the associated symplectic 2-form. The formulation of a Hamiltonian structure (Poisson brackets and Hamiltonians) for these systems from the Lagrangian viewpoint leads to a method of finding new constants of the motion starting from known ones, which is applied to some systems found in the literature known to possess a constant of the motion, to find the other and thus showing their integrability. In particular, we show that the so-called ABC system is completely integrable if it possesses one constant of the motion

  2. Structural integrated sensor and actuator systems for active flow control

    Science.gov (United States)

    Behr, Christian; Schwerter, Martin; Leester-Schädel, Monika; Wierach, Peter; Dietzel, Andreas; Sinapius, Michael

    2016-04-01

    An adaptive flow separation control system is designed and implemented as an essential part of a novel high-lift device for future aircraft. The system consists of MEMS pressure sensors to determine the flow conditions and adaptive lips to regulate the mass flow and the velocity of a wall near stream over the internally blown Coanda flap. By the oscillating lip the mass flow in the blowing slot changes dynamically, consequently the momentum exchange of the boundary layer over a high lift flap required mass flow can be reduced. These new compact and highly integrated systems provide a real-time monitoring and manipulation of the flow conditions. In this context the integration of pressure sensors into flow sensing airfoils of composite material is investigated. Mechanical and electrical properties of the integrated sensors are investigated under mechanical loads during tensile tests. The sensors contain a reference pressure chamber isolated to the ambient by a deformable membrane with integrated piezoresistors connected as a Wheatstone bridge, which outputs voltage signals depending on the ambient pressure. The composite material in which the sensors are embedded consists of 22 individual layers of unidirectional glass fiber reinforced plastic (GFRP) prepreg. The results of the experiments are used for adapting the design of the sensors and the layout of the laminate to ensure an optimized flux of force in highly loaded structures primarily for future aeronautical applications. It can be shown that the pressure sensor withstands the embedding process into fiber composites with full functional capability and predictable behavior under stress.

  3. Integral membrane protein structure determination using pseudocontact shifts

    Energy Technology Data Exchange (ETDEWEB)

    Crick, Duncan J.; Wang, Jue X. [University of Cambridge, Department of Biochemistry (United Kingdom); Graham, Bim; Swarbrick, James D. [Monash University, Monash Institute of Pharmaceutical Sciences (Australia); Mott, Helen R.; Nietlispach, Daniel, E-mail: dn206@cam.ac.uk [University of Cambridge, Department of Biochemistry (United Kingdom)

    2015-04-15

    Obtaining enough experimental restraints can be a limiting factor in the NMR structure determination of larger proteins. This is particularly the case for large assemblies such as membrane proteins that have been solubilized in a membrane-mimicking environment. Whilst in such cases extensive deuteration strategies are regularly utilised with the aim to improve the spectral quality, these schemes often limit the number of NOEs obtainable, making complementary strategies highly beneficial for successful structure elucidation. Recently, lanthanide-induced pseudocontact shifts (PCSs) have been established as a structural tool for globular proteins. Here, we demonstrate that a PCS-based approach can be successfully applied for the structure determination of integral membrane proteins. Using the 7TM α-helical microbial receptor pSRII, we show that PCS-derived restraints from lanthanide binding tags attached to four different positions of the protein facilitate the backbone structure determination when combined with a limited set of NOEs. In contrast, the same set of NOEs fails to determine the correct 3D fold. The latter situation is frequently encountered in polytopical α-helical membrane proteins and a PCS approach is thus suitable even for this particularly challenging class of membrane proteins. The ease of measuring PCSs makes this an attractive route for structure determination of large membrane proteins in general.

  4. Supporting Fernald Site Closure with Integrated Health and Safety Plans as Documented Safety Analyses

    International Nuclear Information System (INIS)

    Kohler, S.; Brown, T.; Fisk, P.; Krach, F.; Klein, B.

    2004-01-01

    At the Fernald Closure Project (FCP) near Cincinnati, Ohio, environmental restoration activities are supported by Documented Safety Analyses (DSAs) that combine the required project-specific Health and Safety Plans, Safety Basis Requirements (SBRs), and Process Requirements (PRs) into single Integrated Health and Safety Plans (I-HASPs). These integrated DSAs employ Integrated Safety Management methodology in support of simplified restoration and remediation activities that, so far, have resulted in the decontamination and demolition (D and D) of over 200 structures, including eight major nuclear production plants. There is one of twelve nuclear facilities still remaining (Silos containing uranium ore residues) with its own safety basis documentation. This paper presents the status of the FCP's safety basis documentation program, illustrating that all of the former nuclear facilities and activities have now replaced. Basis of Interim Operations (BIOs) with I-HASPs as their safety basis during the closure process

  5. Simplifying documentation while approaching site closure: integrated health and safety plans as documented safety analysis

    International Nuclear Information System (INIS)

    Brown, Tulanda

    2003-01-01

    At the Fernald Closure Project (FCP) near Cincinnati, Ohio, environmental restoration activities are supported by Documented Safety Analyses (DSAs) that combine the required project-specific Health and Safety Plans, Safety Basis Requirements (SBRs), and Process Requirements (PRs) into single Integrated Health and Safety Plans (I-HASPs). By isolating any remediation activities that deal with Enriched Restricted Materials, the SBRs and PRs assure that the hazard categories of former nuclear facilities undergoing remediation remain less than Nuclear. These integrated DSAs employ Integrated Safety Management methodology in support of simplified restoration and remediation activities that, so far, have resulted in the decontamination and demolition (D and D) of over 150 structures, including six major nuclear production plants. This paper presents the FCP method for maintaining safety basis documentation, using the D and D I-HASP as an example

  6. Structural Health Monitoring for Impact Damage in Composite Structures.

    Energy Technology Data Exchange (ETDEWEB)

    Roach, Dennis P.; Raymond Bond (Purdue); Doug Adams (Purdue)

    2014-08-01

    context of structural stiffness reductions and impact damage. A method by which the sensitivity to damage could be increased for simple structures was presented, and the challenges of applying that technique to a more complex structure were identi fi ed. The structural dynamic changes in a weak adhesive bond were investigated, and the results showed promise for identifying weak bonds that show little or no static reduction in stiffness. To address these challenges in identifying highly localized impact damage, the possi- bility of detecting damage through nonlinear dynamic characteristics was also identi fi ed, with a proposed technique which would leverage impact location estimates to enable the detection of impact damage. This nonlinear damage identi fi cation concept was evaluated on a composite panel with a substructure disbond, and the results showed that the nonlinear dynamics at the damage site could be observed without a baseline healthy reference. By further developing impact load identi fi cation technology and combining load and damage estimation techniques into an integrated solution, the challenges associated with impact detection in composite struc- tures can be effectively solved, thereby reducing costs, improving safety, and enhancing the operational readiness and availability of high value assets.

  7. Pesticides and public health: integrated methods of mosquito management.

    OpenAIRE

    Rose, R. I.

    2001-01-01

    Pesticides have a role in public health as part of sustainable integrated mosquito management. Other components of such management include surveillance, source reduction or prevention, biological control, repellents, traps, and pesticide-resistance management. We assess the future use of mosquito control pesticides in view of niche markets, incentives for new product development, Environmental Protection Agency registration, the Food Quality Protection Act, and improved pest management strate...

  8. Community-Based Rehabilitation in Bangladesh, Health Components Need to be Integrated with Primary Health Care

    Directory of Open Access Journals (Sweden)

    Md Shahidur Rahman

    2018-01-01

    Full Text Available Community-based rehabilitation (CBR is defined as a strategy within general community development for the rehabilitation, equalization of opportunities, poverty reduction and social inclusion of people with disabilities. The role of CBR is to work closely with the health sector to ensure that the needs of people with disabilities and their family members are addressed in the areas of health promotion, prevention, medical care, rehabilitation and assistive devices. CBR also needs to work with individuals and their families to facilitate their access to health services and to work with other sectors to ensure that all aspects of health are addressed. Health components of CBR as per WHO guidelines are grossly neglected in Bangladesh. Some government and non-government organizations are working independently, but health components are inadequately addressed. We observed that primary health care, if integrated with medical rehabilitation of disabled, will better address the need and help bring disabled into mainstream of development. Health care providers at grass root level need to be trained in CBR activities which can be arranged centrally with health ministry, social welfare ministry and rehabilitation specialists. In this review we have tried to reveal the health components of CBR in global and Bangladesh context and importance of integrating health components of CBR with primary health care.

  9. Strengthening Rehabilitation in Health Systems Worldwide by Integrating Information on Functioning in National Health Information Systems.

    Science.gov (United States)

    Stucki, Gerold; Bickenbach, Jerome; Melvin, John

    2017-09-01

    A complete understanding of the experience of health requires information relevant not merely to the health indicators of mortality and morbidity but also to functioning-that is, information about what it means to live in a health state, "the lived experience of health." Not only is functioning information relevant to healthcare and the overall objectives of person-centered healthcare but to the successful operation of all components of health systems.In light of population aging and major epidemiological trends, the health strategy of rehabilitation, whose aim has always been to optimize functioning and minimize disability, will become a key health strategy. The increasing prominence of the rehabilitative strategy within the health system drives the argument for the integration of functioning information as an essential component in national health information systems.Rehabilitation professionals and researchers have long recognized in WHO's International Classification of Functioning, Disability and Health the best prospect for an internationally recognized, sufficiently complete and powerful information reference for the documentation of functioning information. This paper opens the discussion of the promise of integrating the ICF as an essential component in national health systems to secure access to functioning information for rehabilitation, across health systems and countries.

  10. Historic Bim: a New Repository for Structural Health Monitoring

    Science.gov (United States)

    Banfi, F.; Barazzetti, L.; Previtali, M.; Roncoroni, F.

    2017-05-01

    Recent developments in Building Information Modelling (BIM) technologies are facilitating the management of historic complex structures using new applications. This paper proposes a generative method combining the morphological and typological aspects of the historic buildings (H-BIM), with a set of monitoring information. This combination of 3D digital survey, parametric modelling and monitoring datasets allows for the development of a system for archiving and visualizing structural health monitoring (SHM) data (Fig. 1). The availability of a BIM database allows one to integrate a different kind of data stored in different ways (e.g. reports, tables, graphs, etc.) with a representation directly connected to the 3D model of the structure with appropriate levels of detail (LoD). Data can be interactively accessed by selecting specific objects of the BIM, i.e. connecting the 3D position of the sensors installed with additional digital documentation. Such innovative BIM objects, which form a new BIM family for SHM, can be then reused in other projects, facilitating data archiving and exploitation of data acquired and processed. The application of advanced modeling techniques allows for the reduction of time and costs of the generation process, and support cooperation between different disciplines using a central workspace. However, it also reveals new challenges for parametric software and exchange formats. The case study presented is the medieval bridge Azzone Visconti in Lecco (Italy), in which multi-temporal vertical movements during load testing were integrated into H-BIM.

  11. HISTORIC BIM: A NEW REPOSITORY FOR STRUCTURAL HEALTH MONITORING

    Directory of Open Access Journals (Sweden)

    F. Banfi

    2017-05-01

    Full Text Available Recent developments in Building Information Modelling (BIM technologies are facilitating the management of historic complex structures using new applications. This paper proposes a generative method combining the morphological and typological aspects of the historic buildings (H-BIM, with a set of monitoring information. This combination of 3D digital survey, parametric modelling and monitoring datasets allows for the development of a system for archiving and visualizing structural health monitoring (SHM data (Fig. 1. The availability of a BIM database allows one to integrate a different kind of data stored in different ways (e.g. reports, tables, graphs, etc. with a representation directly connected to the 3D model of the structure with appropriate levels of detail (LoD. Data can be interactively accessed by selecting specific objects of the BIM, i.e. connecting the 3D position of the sensors installed with additional digital documentation. Such innovative BIM objects, which form a new BIM family for SHM, can be then reused in other projects, facilitating data archiving and exploitation of data acquired and processed. The application of advanced modeling techniques allows for the reduction of time and costs of the generation process, and support cooperation between different disciplines using a central workspace. However, it also reveals new challenges for parametric software and exchange formats. The case study presented is the medieval bridge Azzone Visconti in Lecco (Italy, in which multi-temporal vertical movements during load testing were integrated into H-BIM.

  12. Collaboration process for integrated social and health care strategy implementation.

    Science.gov (United States)

    Korpela, Jukka; Elfvengren, Kalle; Kaarna, Tanja; Tepponen, Merja; Tuominen, Markku

    2012-01-01

    To present a collaboration process for creating a roadmap for the implementation of a strategy for integrated health and social care. The developed collaboration process includes multiple phases and uses electronic group decision support system technology (GDSS). A case study done in the South Karelia District of Social and Health Services in Finland during 2010-2011. An expert panel of 13 participants was used in the planning process of the strategy implementation. The participants were interviewed and observed during the case study. As a practical result, a roadmap for integrated health and social care strategy implementation has been developed. The strategic roadmap includes detailed plans of several projects which are needed for successful integration strategy implementation. As an academic result, a collaboration process to create such a roadmap has been developed. The collaboration process and technology seem to suit the planning process well. The participants of the meetings were satisfied with the collaboration process and the GDSS technology. The strategic roadmap was accepted by the participants, which indicates satisfaction with the developed process.

  13. Collaboration process for integrated social and health care strategy implementation

    Directory of Open Access Journals (Sweden)

    Jukka Korpela

    2012-05-01

    Full Text Available Objective:  To present collaboration process for creating a roadmap for the implementation of a strategy for integrated health and social care. The developed collaboration process includes multiple phases and uses electronic group decision support system technology (GDSS.Method: A case study done in the South Karelia District of Social and Health Services in Finland during 2010 - 2011. An expert panel of 13 participants was used in the planning process of the strategy implementation. The participants were interviewed and observed during the case study.Results: As a practical result, a roadmap for integrated health and social care strategy implementation has been developed. The strategic roadmap includes detailed plans of several projects which are needed for successful integration strategy implementation. As an academic result, a collaboration process to create such a roadmap has been developed.Conclusions: The collaboration process and technology seem to suit the planning process well. The participants of the meetings were satisfied with the collaboration process and the GDSS technology. The strategic roadmap was accepted by the participants, which indicates satisfaction with the developed process.

  14. Approaches to integrating paediatric diabetes care and structured education

    DEFF Research Database (Denmark)

    Murphy, H. R.; Wadham, C.; Rayman, G.

    2007-01-01

    .11% in non-attenders (P = 0.04). Conclusion: This family-centred education programme has been integrated into paediatric diabetes care with potential benefits on parental involvement and glycaemic control, but further study is warranted before routine application into clinical care.......Aims: The Families, Adolescents and Children's Teamwork Study (FACTS) is a family-centred structured education programme for children and adolescents with Type 1 diabetes. It aims to integrate group-based diabetes education into routine care, enhance parental responsibility for self management...... and improve glycaemic control. Methods: A randomized wait-list control group study allocated participants to either the immediate (four educational sessions during year 1) or delayed intervention (four educational sessions during year 2). In both groups, glycated haemoglobin (HbA1c) was measured 3-monthly...

  15. Indicators and measurement tools for health system integration : a knowledge synthesis protocol

    OpenAIRE

    Oelke, Nelly Donszelmann; Suter, Esther; Lima, Maria Alice Dias da Silva; Vliet-Brown, Cheryl Van

    2015-01-01

    Background: Health system integration is a key component of health system reform with the goal of improving outcomes for patients, providers, and the health system. Although health systems continue to strive for better integration, current delivery of health services continues to be fragmented. A key gap in the literature is the lack of information on what successful integration looks like and how to measure achievement towards an integrated system. This multi-site study protocol builds on a ...

  16. A future task for health-promotion research: Integration of health promotion and sustainable development.

    Science.gov (United States)

    Jelsøe, Erling; Thualagant, Nicole; Holm, Jesper; Kjærgård, Bente; Andersen, Heidi Myglegård; From, Ditte-Marie; Land, Birgit; Pedersen, Kirsten Bransholm

    2018-02-01

    Based on previous studies and reflections collected from participants in a workshop at the 8th Nordic Health Promotion Research Network conference, we reveal current tendencies and discuss future challenges for health-promotion research regarding integration of sustainable development principles. Despite obvious interfaces and interactions between the two, our contention is that strategies for health promotion are not sufficiently integrated with strategies for sustainable development and that policies aimed at solving health or sustainability problems may therefore cause new, undesired and unforeseen environmental and health problems. As illustrated in previous research and as deliberated in the above-mentioned workshop, a number of barriers are identified. These are believed to be related to historical segregation, the conceptual understandings of health promotion and sustainable development, as well as the politics and implementation of policy goals in both areas. Three focal points are proposed as important challenges to address in future research: (a) the duality of health promotion and sustainability and how it can be handled in order to enhance mutually supportive processes between them; (b) the social dimension of sustainability and how it can be strengthened in the development of strategies for health promotion and sustainable development; and (c) exploring and identifying policy approaches and strategies for integrating health promotion and sustainable development.

  17. Structural integrity evaluation of PWR nuclear reactor pressure vessels

    International Nuclear Information System (INIS)

    Cruz, Julio R.B.; Mattar Neto, Miguel

    1999-01-01

    The reactor pressure vessel (RPV) is the most important structural component of a PWR nuclear power plant. It contains the reactor core and is the main component of the primary system pressure boundary, the system responsible for removing the heat generated by the nuclear reactions. It is considered not replaceable and, therefore, its lifetime is a key element to define the plant life as a whole. Three critical issues related to the reliability of the RPV structural integrity come out by reason of the radiation damage imposed to the vessel material during operation. These issues concern the definition of pressure versus temperature limits for reactor heatup and cooldown, pressurized thermal shock evaluation and assessment of reactor vessels with low upper shelf Charpy impact energy levels. This work aims to present the major aspects related to these topics. The requirements for preventing fracture of the RPV are reviewed as well as the available technology for assessing the safety margins. For each mentioned problem, the several steps for structural integrity evaluation are described and the analysis methods are discussed. (author)

  18. Integrity analysis of an upper guide structure flange

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ki Hyoung; Kang, Sung Sik; Jhung, Myung Jo [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2015-10-15

    The integrity assessment of reactor vessel internals should be conducted in the design process to secure the safety of nuclear power plants. Various loads such as self-weight, seismic load, flow-induced load, and preload are applied to the internals. Therefore, the American Society of Mechanical Engineers (ASME) Code, Section III, defines the stress limit for reactor vessel internals. The present study focused on structural response analyses of the upper guide structure upper flange. The distributions of the stress intensity in the flange body were analyzed under various design load cases during normal operation. The allowable stress intensities along the expected sections of stress concentration were derived from the results of the finite element analysis for evaluating the structural integrity of the flange design. Furthermore, seismic analyses of the upper flange were performed to identify dynamic behavior with respect to the seismic and impact input. The mode superposition and full transient methods were used to perform time–history analyses, and the displacement at the lower end of the flange was obtained. The effect of the damping ratio on the response of the flange was also evaluated, and the acceleration was obtained. The results of elastic and seismic analyses in this study will be used as basic information to judge whether a flange design meets the acceptance criteria.

  19. Crossover integral equation theory for the liquid structure study

    International Nuclear Information System (INIS)

    Lai, S.K.; Chen, H.C.

    1994-08-01

    The main purpose of this work is to report on a calculation that describes the role of the long-range bridge function [H. Iyetomi and S. Ichimaru, Phys. Rev. A 25, 2434 (1982)] as applied to the study of structure of simple liquid metals. It was found here that this bridge function accounts pretty well for the major part of long-range interactions but is physically inadequate for describing the short-range part of liquid structure. To improve on the theory we have drawn attention to the crossover integral equation method which, in essence, amounts to adding to the above bridge function a short-range correction of bridge diagrams. The suggested crossover procedure has been tested for the case of liquid metal Cs. Remarkably good agreement with experiment was obtained confirming our conjecture that the crossover integral equation approach as stressed in this work is potentially an appropriate theory for an accurate study of liquid structure possibly for the supercooled liquid regime. (author). 21 refs, 3 figs

  20. Structure health assessment and warning system (SHAWS)

    Science.gov (United States)

    Bock, Daniel M.; Kim, Keehoon; Mapar, Jalal

    2008-03-01

    We are developing a Structure Health Assessment and Warning System (SHAWS) based on building displacement measurements and wireless communication. SHAWS will measure and predict the stability/instability of a building, determine whether it is safe for emergency responders to enter during an emergency, and provide individual warnings on the condition of the structure. SHAWS incorporates remote sensing nodes (RSNs) installed on the exterior frame of a building. Each RSN includes a temperature sensor, a three-axis accelerometer making static-acceleration measurements, and a ZigBee wireless system (IEEE 802.15.4). The RSNs will be deployed remotely using an air cannon delivery system, with each RSN having an innovative adhesive structure for fast (<10 min) and strong installation under emergency conditions. Once the building has moved past a threshold (~0.25 in./building story), a warning will be issued to emergency responders. In addition to the RSNs, SHAWS will include a base station located on an emergency responder's primary vehicle, a PDA for mobile data display to guide responders, and individual warning modules that can be worn by each responder. The individual warning modules will include visual and audio indicators with a ZigBee receiver to provide the proper degree of warning to each responder.

  1. Non-destructive testing and evaluation for structural integrity

    International Nuclear Information System (INIS)

    Baldev Raj; Jayakumar, T.; Rao, B.P.C.

    1995-01-01

    In this paper, a brief description of the physical concepts of non-destructive evaluation (NDE) methods and the physical/derived parameters that are used for assessing defects, stresses and microstructures are given. A few case studies highlighting the importance of non-destructive testing and evaluation for structural integrity assessment are also discussed based on the investigations carried out. Emerging concepts like intelligent processing of materials, expert systems, neural networks, use of multisensors with fusion of data and exploitation of signal analysis and imaging approaches are also addressed in this paper. (author). 92 refs., 1 tab

  2. Integrating health impact assessment into the triple bottom line concept

    International Nuclear Information System (INIS)

    Mahoney, Mary; Potter, Jenny-Lynn

    2004-01-01

    This theoretical study explores the links between the Triple Bottom Line (TBL) concept and the principles of HIA and considers the potential role of HIA to provide a mechanism for integrating health concerns within a broader agenda of government and business. TBL is a framework linked to the broader sustainability agenda that underpins and reviews environmental, economic and social performance of organizations. In its simplest form, TBL acts as a tool for reporting to stakeholders/shareholders organizational performance and the nature of the impacts on the community. The links to HIA are clear as both seek to determine the impact (potential and actual) on the health and well-being of the population. The study found that TBL can operate at four levels within organizations ranging from reporting through to full integration with the organization's goals and practices. Health is narrowly defined and there are tensions about how to undertake the social accountability functions. The study shows the potential role for HIA within the broader policy and accountability agenda. As health is one of the main outcomes of an organization's activities it needs to be taken into account at all levels of activity

  3. Operational integration in primary health care: patient encounters and workflows.

    Science.gov (United States)

    Sifaki-Pistolla, Dimitra; Chatzea, Vasiliki-Eirini; Markaki, Adelais; Kritikos, Kyriakos; Petelos, Elena; Lionis, Christos

    2017-11-29

    Despite several countrywide attempts to strengthen and standardise the primary healthcare (PHC) system, Greece is still lacking a sustainable, policy-based model of integrated services. The aim of our study was to identify operational integration levels through existing patient care pathways and to recommend an alternative PHC model for optimum integration. The study was part of a large state-funded project, which included 22 randomly selected PHC units located across two health regions of Greece. Dimensions of operational integration in PHC were selected based on the work of Kringos and colleagues. A five-point Likert-type scale, coupled with an algorithm, was used to capture and transform theoretical framework features into measurable attributes. PHC services were grouped under the main categories of chronic care, urgent/acute care, preventive care, and home care. A web-based platform was used to assess patient pathways, evaluate integration levels and propose improvement actions. Analysis relied on a comparison of actual pathways versus optimal, the latter ones having been identified through literature review. Overall integration varied among units. The majority (57%) of units corresponded to a basic level. Integration by type of PHC service ranged as follows: basic (86%) or poor (14%) for chronic care units, poor (78%) or basic (22%) for urgent/acute care units, basic (50%) for preventive care units, and partial or basic (50%) for home care units. The actual pathways across all four categories of PHC services differed from those captured in the optimum integration model. Certain similarities were observed in the operational flows between chronic care management and urgent/acute care management. Such similarities were present at the highest level of abstraction, but also in common steps along the operational flows. Existing patient care pathways were mapped and analysed, and recommendations for an optimum integration PHC model were made. The developed web

  4. The potential of ecological theory for building an integrated framework to develop the public health contribution of health visiting.

    Science.gov (United States)

    Bryans, Alison; Cornish, Flora; McIntosh, Jean

    2009-11-01

    In line with recent UK and Scottish policy imperatives, there is increasing pressure for the health visiting service to assume an enhanced role in improving public health. Although health visiting has so far maintained its unique position as a primarily preventive service within the UK health service, its distinctive contribution now appears under threat. The continuing absence of a comprehensive and integrated conceptual basis for practice has a negative impact on the profession's ability to respond to current challenges. Establishing an integrative framework to conceptualise health visiting practice would enable more sensitive, focused and appropriate research, education and evaluation in relation to practice. Work in this area could thus usefully contribute to the future development of the service at a difficult time. Our paper aims to make such a contribution. In support of our conceptual aims, we draw on a study of health visiting practice undertaken within a large conurbation in central Scotland. The study used a mixed method, collaborative approach involving 12 audio-recorded and observed health visitor-client interactions, semi-structured interviews with the 12 HVs and 12 clients, examination of related documentation and workshops with the HV participants. We critically consider prevalent models of health visiting practice and describe the more integrative conceptual approach provided by Bronfenbrenner's ecological, 'person-in-context' framework. The paper subsequently explores relationships between this framework and understandings of need demonstrated by health visitors who participated in our study. Current policy emphasises the need to focus on public health and social inclusion in order to improve health. However, if this policy is to be translated into practice, we must develop a more adequate understanding of how practitioners work effectively with families and individuals in a sensitive and context-specific manner. Bronfenbrenner's framework appears

  5. An expert system for integrated structural analysis and design optimization for aerospace structures

    Science.gov (United States)

    1992-04-01

    The results of a research study on the development of an expert system for integrated structural analysis and design optimization is presented. An Object Representation Language (ORL) was developed first in conjunction with a rule-based system. This ORL/AI shell was then used to develop expert systems to provide assistance with a variety of structural analysis and design optimization tasks, in conjunction with procedural modules for finite element structural analysis and design optimization. The main goal of the research study was to provide expertise, judgment, and reasoning capabilities in the aerospace structural design process. This will allow engineers performing structural analysis and design, even without extensive experience in the field, to develop error-free, efficient and reliable structural designs very rapidly and cost-effectively. This would not only improve the productivity of design engineers and analysts, but also significantly reduce time to completion of structural design. An extensive literature survey in the field of structural analysis, design optimization, artificial intelligence, and database management systems and their application to the structural design process was first performed. A feasibility study was then performed, and the architecture and the conceptual design for the integrated 'intelligent' structural analysis and design optimization software was then developed. An Object Representation Language (ORL), in conjunction with a rule-based system, was then developed using C++. Such an approach would improve the expressiveness for knowledge representation (especially for structural analysis and design applications), provide ability to build very large and practical expert systems, and provide an efficient way for storing knowledge. Functional specifications for the expert systems were then developed. The ORL/AI shell was then used to develop a variety of modules of expert systems for a variety of modeling, finite element analysis, and

  6. Towards "Zero" False Positive in Structural Health Monitoring

    National Research Council Canada - National Science Library

    Chiu, Wing K; Chang, F. K; Tian, Daniel T

    2007-01-01

    Structural Health Monitoring (SHM) is one aspect of a revolution based on the use of Smart Materials and Structures technologies that have the potential to provide major gains in structural performance and cost-efficient life management...

  7. IVHM Framework for Intelligent Integration for Vehicle Health Management

    Science.gov (United States)

    Paris, Deidre; Trevino, Luis C.; Watson, Michael D.

    2005-01-01

    Integrated Vehicle Health Management (IVHM) systems for aerospace vehicles, is the process of assessing, preserving, and restoring system functionality across flight and techniques with sensor and communication technologies for spacecraft that can generate responses through detection, diagnosis, reasoning, and adapt to system faults in support of Integrated Intelligent Vehicle Management (IIVM). These real-time responses allow the IIVM to modify the affected vehicle subsystem(s) prior to a catastrophic event. Furthermore, this framework integrates technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce costs of operations. Recent investments in avionics, health management, and controls have been directed towards IIVM. As this concept has matured, it has become clear that IIVM requires the same sensors and processing capabilities as the real-time avionics functions to support diagnosis of subsystem problems. New sensors have been proposed, in addition to augment the avionics sensors to support better system monitoring and diagnostics. As the designs have been considered, a synergy has been realized where the real-time avionics can utilize sensors proposed for diagnostics and prognostics to make better real-time decisions in response to detected failures. IIVM provides for a single system allowing modularity of functions and hardware across the vehicle. The framework that supports IIVM consists of 11 major on-board functions necessary to fully manage a space vehicle maintaining crew safety and mission objectives. These systems include the following: Guidance and Navigation; Communications and Tracking; Vehicle Monitoring; Information Transport and Integration; Vehicle Diagnostics; Vehicle Prognostics; Vehicle Mission Planning, Automated Repair and Replacement; Vehicle Control; Human Computer Interface; and Onboard Verification and Validation. Furthermore, the presented

  8. The evolving organizational structure of academic health centers: the case of the University of Florida.

    Science.gov (United States)

    Barrett, Douglas J

    2008-09-01

    The organizational structures of academic health centers (AHCs) vary widely, but they all exist along a continuum of integration--that is, the degree to which the academic and clinical missions operate under a single administrative and governance structure. This author provides a brief overview of the topic of AHC integration, including the pros and cons of more integrated or less integrated models. He then traces the evolution of the University of Florida (UF) Health Science Center, which was created in the 1950s as a fully integrated AHC and which now operates under a more distributed management and governance model. Starting as a completely integrated AHC, UF's Health Science Center reached a time of maximal nonintegration (or dys-integration) in the late 1990s and at the beginning of this decade. Circumstances are now pushing the expanding clinical and academic enterprises to be more together as they face the challenges of market competition, federal research budget constraints, and reengineering clinical operations to reduce costs, enhance access, and improve quality and patient safety. Although formal organizational integration may not be possible or appropriate for any number of legal or political reasons, the author suggests that AHCs should strive for "functional integration" to be successful in the current turbulent environment.

  9. Host Proteins Determine MRSA Biofilm Structure and Integrity

    DEFF Research Database (Denmark)

    Dreier, Cindy; Nielsen, Astrid; Jørgensen, Nis Pedersen

    Human extracellular matrix (hECM) proteins aids the initial attachment and initiation of an infection, by specific binding to bacterial cell surface proteins. However, the importance of hECM proteins in structure, integrity and antibiotic resilience of a biofilm is unknown. This study aims...... to determine how specific hECM proteins affect S. aureus USA300 JE2 biofilms. Biofilms were grown in the presence of synovial fluid from rheumatoid arteritis patients to mimic in vivo conditions, where bacteria incorporate hECM proteins into the biofilm matrix. Difference in biofilm structure, with and without...... addition of hECM to growth media, was visualized by confocal laser scanning microscopy. Two enzymatic degradation experiments were used to study biofilm matrix composition and importance of hECM proteins: enzymatic removal of specific hECM proteins from growth media, before biofilm formation, and enzymatic...

  10. NET European Network on Neutron Techniques Standardization for Structural Integrity

    International Nuclear Information System (INIS)

    Youtsos, A.

    2004-01-01

    Improved performance and safety of European energy production systems is essential for providing safe, clean and inexpensive electricity to the citizens of the enlarged EU. The state of the art in assessing internal stresses, micro-structure and defects in welded nuclear components -as well as their evolution due to complex thermo-mechanical loads and irradiation exposure -needs to be improved before relevant structural integrity assessment code requirements can safely become less conservative. This is valid for both experimental characterization techniques and predictive numerical algorithms. In the course of the last two decades neutron methods have proven to be excellent means for providing valuable information required in structural integrity assessment of advanced engineering applications. However, the European industry is hampered from broadly using neutron research due to lack of harmonised and standardized testing methods. 35 European major industrial and research/academic organizations have joined forces, under JRC coordination, to launch the NET European Network on Neutron Techniques Standardization for Structural Integrity in May 2002. The NET collaborative research initiative aims at further development and harmonisation of neutron scattering methods, in support of structural integrity assessment. This is pursued through a number of testing round robin campaigns on neutron diffraction and small angle neutron scattering - SANS and supported by data provided by other more conventional destructive and non-destructive methods, such as X-ray diffraction and deep and surface hole drilling. NET also strives to develop more reliable and harmonized simulation procedures for the prediction of residual stress and damage in steel welded power plant components. This is pursued through a number of computational round robin campaigns based on advanced FEM techniques, and on reliable data obtained by such novel and harmonized experimental methods. The final goal of

  11. Electronic Health Record in Occupational Medicine: Specific Aspects and Requirements of Data Structuring and Standardization

    Directory of Open Access Journals (Sweden)

    Dorin TRIFF

    2009-07-01

    Full Text Available The service of occupational medicine of a specific economic agent, as integrated part of the System of Labor Health and Safety, requires efficient, well-organized information management through standardized and computerized data processing and exploitation. Legal requirements and practical aspects of information management in occupational medicine trigger necessary operational modifications in the Electronic Health File. The goal of the paper is to present basic requirements of structuring the electronic health file and the necessary standards in recording specific data.

  12. 78 FR 69853 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2013-11-21

    ... Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the Assistant Secretary for Health, Office of the Secretary, Department... Integrative and Public Health (the ``Advisory Group''). The meeting will be open to the public. Information...

  13. 76 FR 67731 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2011-11-02

    ... Promotion, and Integrative and Public Health AGENCY: Department of Health and Human Services, Office of the... Public Health Service. ACTION: Notice. SUMMARY: In accordance with Section 10(a) of the Federal Advisory... scheduled to be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

  14. 78 FR 48877 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2013-08-12

    ... Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the Assistant Secretary for Health, Office of the Secretary, Department... Integrative and Public Health (the ``Advisory Group''). The meeting will be open to the public. Information...

  15. 76 FR 26300 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2011-05-06

    ... Promotion, and Integrative and Public Health AGENCY: Department of Health and Human Services, Office of the... Public Health Service. ACTION: Notice. SUMMARY: In accordance with Section 10(a) of the Federal Advisory... scheduled to be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

  16. 77 FR 33220 - Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice of Meeting

    Science.gov (United States)

    2012-06-05

    ... Integrative and Public Health; Notice of Meeting AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the Assistant Secretary for Health, Office of the Secretary, Department... Integrative and Public Health (the ``Advisory Group''). The web meeting will be open to the public. The agenda...

  17. 78 FR 38345 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2013-06-26

    ... Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the Assistant Secretary for Health, Office of the Secretary, Department... Integrative and Public Health (the ``Advisory Group''). The meeting will be open to the public. [[Page 38346...

  18. 76 FR 58007 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2011-09-19

    ... Promotion, and Integrative and Public Health AGENCY: Department of Health and Human Services, Office of the... Public Health Service. ACTION: Notice. SUMMARY: In accordance with Section 10(a) of the Federal Advisory... scheduled to be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

  19. 77 FR 15372 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2012-03-15

    ... Promotion, and Integrative and Public Health AGENCY: Department of Health and Human Services, Office of the... Public Health Service. ACTION: Notice. SUMMARY: In accordance with Section 10(a) of the Federal Advisory... scheduled to be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

  20. Brazilian Air Force aircraft structural integrity program: An overview

    Directory of Open Access Journals (Sweden)

    Alberto W. S. Mello Junior

    2009-01-01

    Full Text Available This paper presents an overview of the activities developed by the Structural Integrity Group at the Institute of Aeronautics and Space - IAE, Brazil, as well as the status of ongoing work related to the life extension program for aircraft operated by the Brazilian Air Force BAF. The first BAF-operated airplane to undergo a DTA-based life extension was the F-5 fighter, in the mid 1990s. From 1998 to 2001, BAF worked on a life extension project for the BAF AT- 26 Xavante trainer. All analysis and tests were performed at IAE. The fatigue critical locations (FCLs were presumed based upon structural design and maintenance data and also from exchange of technical information with other users of the airplane around the world. Following that work, BAF started in 2002 the extension of the operational life of the BAF T-25 “Universal”. The T-25 is the basic training airplane used by AFA - The Brazilian Air Force Academy. This airplane was also designed under the “safe-life” concept. As the T-25 fleet approached its service life limit, the Brazilian Air Force was questioning whether it could be kept in flight safely. The answer came through an extensive Damage Tolerance Analysis (DTA program, briefly described in this paper. The current work on aircraft structural integrity is being performed for the BAF F-5 E/F that underwent an avionics and weapons system upgrade. Along with the increase in weight, new configurations and mission profiles were established. Again, a DTA program was proposed to be carried out in order to establish the reliability of the upgraded F-5 fleet. As a result of all the work described, the BAF has not reported any accident due to structural failure on aircraft submitted to Damage Tolerance Analysis.

  1. A job analysis of community health workers in the context of integrated nutrition and early child development.

    Science.gov (United States)

    Phuka, John; Maleta, Kenneth; Thomas, Mavuto; Gladstone, Melisa

    2014-01-01

    Stunting and poor child development are major public health concerns in Malawi. Integrated nutrition and early child development (ECD) interventions have shown potential to reduce stunting, but it is not known how these integrated approaches can be implemented in Malawi. In this paper, we aimed to evaluate the current jobs status of community health workers and their potential to implement integrated approaches. This was accomplished by a desk review of nutrition and ECD policy documents, as well as interviews with key informants, community health workers, and community members. We found that Malawi has comprehensive policies and well-outlined coordination structures for nutrition and ECD that advocate for integrated approaches. Strong multidisciplinary interaction exists at central levels but not at the community level. Integration of community health workers from different sectors is limited by workload, logistics, and a lack of synchronized work schedules. Favorable, sound policies and well-outlined coordination structures alone are not enough for the establishment of integrated nutrition and ECD activities. Balanced bureaucratic structures, improved task allocation, and synchronization of work schedules across all relevant sectors are needed for integrated intervention in Malawi. © 2014 New York Academy of Sciences.

  2. Developing health science students into integrated health professionals: a practical tool for learning

    Directory of Open Access Journals (Sweden)

    Duncan Madeleine

    2007-11-01

    Full Text Available Abstract Background An integrated sense of professionalism enables health professionals to draw on relevant knowledge in context and to apply a set of professional responsibilities and ethical principles in the midst of changing work environments 12. Inculcating professionalism is therefore a critical goal of health professional education. Two multi-professional courses for first year Health Science students at the University of Cape Town, South Africa aim to lay the foundation for becoming an integrated health professional 3. In these courses a diagram depicting the domains of the integrated health professional is used to focus the content of small group experiential exercises towards an appreciation of professionalism. The diagram serves as an organising framework for conceptualising an emerging professional identity and for directing learning towards the domains of 'self as professional' 45. Objective This paper describes how a diagrammatic representation of the core elements of an integrated health professional is used as a template for framing course content and for organising student learning. Based on the assumption that all health care professionals should be knowledgeable, empathic and reflective, the diagram provides students and educators with a visual tool for investigating the subjective and objective dimensions of professionalism. The use of the diagram as an integrating point of reference for individual and small group learning is described and substantiated with relevant literature. Conclusion The authors have applied the diagram with positive impact for the past six years with students and educators reporting that "it just makes sense". The article includes plans for formal evaluation. Evaluation to date is based on preliminary, informal feedback on the value of the diagram as a tool for capturing the domains of professionalism at an early stage in the undergraduate education of health professional students.

  3. Structural health monitoring system/method using electroactive polymer fibers

    Science.gov (United States)

    Scott-Carnell, Lisa A. (Inventor); Siochi, Emilie J. (Inventor)

    2013-01-01

    A method for monitoring the structural health of a structure of interest by coupling one or more electroactive polymer fibers to the structure and monitoring the electroactive responses of the polymer fiber(s). Load changes that are experienced by the structure cause changes in the baseline responses of the polymer fiber(s). A system for monitoring the structural health of the structure is also provided.

  4. The process flow and structure of an integrated stroke strategy

    Directory of Open Access Journals (Sweden)

    Emma F. van Bussel

    2013-06-01

    Full Text Available Introduction: In the Canadian province of Alberta access and quality of stroke care were suboptimal, especially in remote areas. The government introduced the Alberta Provincial Stroke Strategy (APSS in 2005, an integrated strategy to improve access to stroke care, quality and efficiency which utilizes telehealth. Research question: What is the process flow and the structure of the care pathways of the APSS? Methodology: Information for this article was obtained using documentation, archival APSS records, interviews with experts, direct observation and participant observation. Results: The process flow is described. The APSS integrated evidence-based practice, multidisciplinary communication, and telestroke services. It includes regular quality evaluation and improvement. Conclusion: Access, efficiency and quality of care improved since the start of the APSS across many domains, through improvement of expertise and equipment in small hospitals, accessible consultation of stroke specialists using telestroke, enhancing preventive care, enhancing multidisciplinary collaboration, introducing uniform best practice protocols and bypass-protocols for the emergency medical services. Discussion: The APSS overcame substantial obstacles to decrease discrepancies and to deliver integrated higher quality care. Telestroke has proven itself to be safe and feasible. The APSS works efficiently, which is in line to other projects worldwide, and is, based on limited results, cost effective. Further research on cost-effectiveness is necessary.

  5. Integrated Modeling for the James Webb Space Telescope (JWST) Project: Structural Analysis Activities

    Science.gov (United States)

    Johnston, John; Mosier, Mark; Howard, Joe; Hyde, Tupper; Parrish, Keith; Ha, Kong; Liu, Frank; McGinnis, Mark

    2004-01-01

    This paper presents viewgraphs about structural analysis activities and integrated modeling for the James Webb Space Telescope (JWST). The topics include: 1) JWST Overview; 2) Observatory Structural Models; 3) Integrated Performance Analysis; and 4) Future Work and Challenges.

  6. Health System Creation and Integration at a Health Sciences University: A Five-Year Follow-up.

    Science.gov (United States)

    Slade, Catherine P; Azziz, Ricardo; Levin, Steven; Caughman, Gretchen B; Hefner, David S; Halbur, Kimberly V; Tingen, Martha S; James, Susan

    Shifting healthcare market forces and regulation have exerted near-constant pressure on U.S. academic health centers (AHCs) attempting to successfully execute their traditional tripartite mission. A governance structure and organizational alignment that works well under one set of conditions is rarely optimal when conditions change. Thus, the degree and type of alignment of an AHC's clinical, educational, and faculty practice organizations have changed regularly within the sector, typically landing near one end or the other on a continuum from fully aligned with centralized governance to largely independent with separate governance. The authors examine the case of Georgia Regents University and Health System in this context. In step with industry trends, the institution's governance structure swung from fully aligned/centralized governance in the early 1990s to essentially separate and decentralized by 2000. In 2010, the Georgia Regents University organizations achieved rapid realignment by creating a governance structure of sufficient strength and flexibility to absorb and adjust to continuing external upheaval. The hospitals, clinics, and physician-faculty practice group were combined into one integrated health system, then aligned with the university to form the state's only public AHC under aligned, but distinct, corporate and management structures. The years since reorganization have seen significant growth in patient volumes and complexity, improved service quality, and enhanced faculty physician satisfaction, while also significantly increasing economic contributions from the health system to the academic mission. This case study offers observations and lessons learned that may be useful to other higher education institutions considering reorganization.

  7. Structured Matrix Completion with Applications to Genomic Data Integration.

    Science.gov (United States)

    Cai, Tianxi; Cai, T Tony; Zhang, Anru

    2016-01-01

    Matrix completion has attracted significant recent attention in many fields including statistics, applied mathematics and electrical engineering. Current literature on matrix completion focuses primarily on independent sampling models under which the individual observed entries are sampled independently. Motivated by applications in genomic data integration, we propose a new framework of structured matrix completion (SMC) to treat structured missingness by design. Specifically, our proposed method aims at efficient matrix recovery when a subset of the rows and columns of an approximately low-rank matrix are observed. We provide theoretical justification for the proposed SMC method and derive lower bound for the estimation errors, which together establish the optimal rate of recovery over certain classes of approximately low-rank matrices. Simulation studies show that the method performs well in finite sample under a variety of configurations. The method is applied to integrate several ovarian cancer genomic studies with different extent of genomic measurements, which enables us to construct more accurate prediction rules for ovarian cancer survival.

  8. Improving occupational safety and health by integration into product development

    DEFF Research Database (Denmark)

    Broberg, Ole

    1996-01-01

    A cross-sectional case study was performed in a large company producing electro-mechanical products for industrial application. The objectives were: (i) to study the product development process and the role of key actors', (ii) to identify current practice on integrating occupational safety and h...... and studies of documents. A questionnaire regarding product development tasks and occupational safety and health were distributed to 30 design and production engineers. A total of 27 completed the questionnaire corresponding to a response rate of 90 per cent.......A cross-sectional case study was performed in a large company producing electro-mechanical products for industrial application. The objectives were: (i) to study the product development process and the role of key actors', (ii) to identify current practice on integrating occupational safety...... and health into the development process, especially the efforts and attitudes of design and production engineers', and (iii) to identify key actors'reflections on how to improve this integration. The study was based on qualitative as well as quantitative methods including interviews, questionnaires...

  9. Experimental evaluation of structural integrity of scram release electromagnet

    International Nuclear Information System (INIS)

    Patri, Sudheer; Ruhela, S.P.; Punniyamoorthy, R.; Vijayashree, R.; Chandramouli, S.; Kumar, P. Madan; Rajendraprasad, R.; Rao, P. Vijayamohana; Narmadha, S.; Sreedhar, B.K.; Rajan, K.K.

    2014-01-01

    Highlights: • The structural integrity of scram release electromagnet is evaluated against thermal shocks. • A simple test facility, employed for simulating the thermal shocks in a typical FBR, is presented. • The cold shock experienced by electromagnet during scram is simulated. • The testing qualified electromagnet for 11.6 yr of reactor operation. - Abstract: Prototype fast breeder reactor (PFBR), under construction at Kalpakkam, India, plays an important role in the commercialisation of fast breeder reactors (FBR) in India. It consists of two independent, fast acting and diverse shutdown systems. An electromagnet (EM) immersed in sodium acts as scram release device for the second shutdown system of prototype fast breeder reactor. The inside of EM is sealed from the sodium to achieve the required response time and to prevent the exposure of EM coil to sodium. As the EM response time is an important parameter for reactor safety, the integrity of EM is to be maintained under all anticipated loadings. The EM experiences thermal shocks and thermal stresses during reactor transients such as scram. The dissimilar weld joint present in EM is more susceptible to fatigue failure due to these thermal stresses. Failure of weld joint results in the entry of sodium into the EM, increasing its response time with associated safety implications. In this connection, the structural integrity of EM against thermal shocks was experimentally evaluated in Thermal Shock Test Facility. The EM was subjected to 1000 cycles of thermal shocks, which constitutes 29% of total number of shocks required to qualify the EM for 40 years of reactor operation, thus qualifying it for 11.6 yr of reactor operation. The testing has enhanced the confidence level for safe and reliable operation of EM of DSRDM in PFBR. The testing not only qualified the EM for use in reactor but also provided input for licensing the erection of DSRDM on reactor pile. Moreover, it provided a direction for

  10. Integrating cancer genomic data into electronic health records

    Directory of Open Access Journals (Sweden)

    Jeremy L. Warner

    2016-10-01

    Full Text Available Abstract The rise of genomically targeted therapies and immunotherapy has revolutionized the practice of oncology in the last 10–15 years. At the same time, new technologies and the electronic health record (EHR in particular have permeated the oncology clinic. Initially designed as billing and clinical documentation systems, EHR systems have not anticipated the complexity and variety of genomic information that needs to be reviewed, interpreted, and acted upon on a daily basis. Improved integration of cancer genomic data with EHR systems will help guide clinician decision making, support secondary uses, and ultimately improve patient care within oncology clinics. Some of the key factors relating to the challenge of integrating cancer genomic data into EHRs include: the bioinformatics pipelines that translate raw genomic data into meaningful, actionable results; the role of human curation in the interpretation of variant calls; and the need for consistent standards with regard to genomic and clinical data. Several emerging paradigms for integration are discussed in this review, including: non-standardized efforts between individual institutions and genomic testing laboratories; “middleware” products that portray genomic information, albeit outside of the clinical workflow; and application programming interfaces that have the potential to work within clinical workflow. The critical need for clinical-genomic knowledge bases, which can be independent or integrated into the aforementioned solutions, is also discussed.

  11. Health information technology: integration of clinical workflow into meaningful use of electronic health records.

    Science.gov (United States)

    Bowens, Felicia M; Frye, Patricia A; Jones, Warren A

    2010-10-01

    This article examines the role that clinical workflow plays in successful implementation and meaningful use of electronic health record (EHR) technology in ambulatory care. The benefits and barriers of implementing EHRs in ambulatory care settings are discussed. The researchers conclude that widespread adoption and meaningful use of EHR technology rely on the successful integration of health information technology (HIT) into clinical workflow. Without successful integration of HIT into clinical workflow, clinicians in today's ambulatory care settings will continue to resist adoption and implementation of EHR technology.

  12. Healthcare professionals' use of health clouds: Integrating technology acceptance and status quo bias perspectives.

    Science.gov (United States)

    Hsieh, Pi-Jung

    2015-07-01

    Cloud computing technology has recently been seen as an important milestone in medical informatics development. Despite its great potential, there are gaps in our understanding of how users evaluate change in relation to the health cloud and how they decide to resist it. Integrating technology acceptance and status quo bias perspectives, this study develops an integrated model to explain healthcare professionals' intention to use the health cloud service and their intention to resist it. A field survey was conducted in Taiwan to collect data from healthcare professionals; a structural equation model was used to examine the data. A valid sample of 209 healthcare professionals was collected for data analysis. The results show that healthcare professionals' resistance to the use of the health cloud is the result of regret avoidance, inertia, perceived value, switching costs, and perceived threat. Attitude, subjective norm, and perceived behavior control are shown to have positive and direct effects on healthcare professionals' intention to use the health cloud. The results also indicate a significant negative effect in the relationship between healthcare professionals' intention and resistance to using the health cloud. Our study illustrates the importance of incorporating user resistance in technology acceptance studies in general and in health technology usage studies in particular. This study also identifies key factors for practitioners and hospitals to make adoption decisions in relation to the health cloud. Further, the study provides a useful reference for future studies in this subject field. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Project INTEGRATE - a common methodological approach to understand integrated health care in Europe

    Directory of Open Access Journals (Sweden)

    Lucinda Cash-Gibson

    2014-12-01

    Full Text Available Background: The use of case studies in health services research has proven to be an excellent methodology for gaining in-depth understanding of the organisation and delivery of health care. This is particularly relevant when looking at the complexity of integrated healthcare programmes, where multifaceted interactions occur at the different levels of care and often without a clear link between the interventions (new and/or existing and their impact on outcomes (in terms of patients health, both patient and professional satisfaction and cost-effectiveness. Still, integrated care is seen as a core strategy in the sustainability of health and care provision in most societies in Europe and beyond. More specifically, at present, there is neither clear evidence on transferable factors of integrated care success nor a method for determining how to establish these specific success factors. The drawback of case methodology in this case, however, is that the in-depth results or lessons generated are usually highly context-specific and thus brings the challenge of transferability of findings to other settings, as different health care systems and different indications are often not comparable. Project INTEGRATE, a European Commission-funded project, has been designed to overcome these problems; it looks into four chronic conditions in different European settings, under a common methodology framework (taking a mixed-methods approach to try to overcome the issue of context specificity and limited transferability. The common methodological framework described in this paper seeks to bring together the different case study findings in a way that key lessons may be derived and transferred between countries, contexts and patient-groups, where integrated care is delivered in order to provide insight into generalisability and build on existing evidence in this field.Methodology: To compare the different integrated care experiences, a mixed-methods approach has

  14. Integrity management of offshore structures and its implication on computation of structural action effects and resistance

    Science.gov (United States)

    Moan, T.

    2017-12-01

    An overview of integrity management of offshore structures, with emphasis on the oil and gas energy sector, is given. Based on relevant accident experiences and means to control the associated risks, accidents are categorized from a technical-physical as well as human and organizational point of view. Structural risk relates to extreme actions as well as structural degradation. Risk mitigation measures, including adequate design criteria, inspection, repair and maintenance as well as quality assurance and control of engineering processes, are briefly outlined. The current status of risk and reliability methodology to aid decisions in the integrity management is briefly reviewed. Finally, the need to balance the uncertainties in data, methods and computational efforts and the cautious use and quality assurance and control in applying high fidelity methods to avoid human errors, is emphasized, and with a plea to develop both high fidelity as well as efficient, simplified methods for design.

  15. Integrated medication management in mHealth applications.

    Science.gov (United States)

    Ebner, Hubert; Modre-Osprian, Robert; Kastner, Peter; Schreier, Günter

    2014-01-01

    Continuous medication monitoring is essential for successful management of heart failure patients. Experiences with the recently established heart failure network HerzMobil Tirol show that medication monitoring limited to heart failure specific drugs could be insufficient, in particular for general practitioners. Additionally, some patients are confused about monitoring only part of their prescribed drugs. Sometimes medication will be changed without informing the responsible physician. As part of the upcoming Austrian electronic health record system ELGA, the eMedication system will collect prescription and dispensing data of drugs and these data will be accessible to authorized healthcare professionals on an inter-institutional level. Therefore, we propose two concepts on integrated medication management in mHealth applications that integrate ELGA eMedication and closed-loop mHealth-based telemonitoring. As a next step, we will implement these concepts and analyze--in a feasibility study--usability and practicability as well as legal aspects with respect to automatic data transfer from the ELGA eMedication service.

  16. Integrated approach to assess ecosystem health in harbor areas.

    Science.gov (United States)

    Bebianno, M J; Pereira, C G; Rey, F; Cravo, A; Duarte, D; D'Errico, G; Regoli, F

    2015-05-01

    Harbors are critical environments with strategic economic importance but with potential environmental impact: health assessment criteria are a key issue. An ecosystem health status approach was carried out in Portimão harbor as a case-study. Priority and specific chemical levels in sediments along with their bioavailability in mussels, bioassays and a wide array of biomarkers were integrated in a biomarker index (IBR index) and the overall data in a weight of evidence (WOE) model. Metals, PAHs, PCBs and HCB were not particularly high compared with sediment guidelines and standards for dredging. Bioavailability was evident for Cd, Cu and Zn. Biomarkers proved more sensitive namely changes of antioxidant responses, metallothioneins and vittellogenin-like proteins. IBR index indicated that site 4 was the most impacted area. Assessment of the health status by WOE approach highlighted the importance of integrating sediment chemistry, bioaccumulation, biomarkers and bioassays and revealed that despite some disturbance in the harbor area, there was also an impact of urban effluents from upstream. Environmental quality assessment in harbors. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Instrument Development of Integrative Health and Wellness Assessment™.

    Science.gov (United States)

    McElligott, Deborah; Eckardt, Sarah; Montgomery Dossey, Barbara; Luck, Susan; Eckardt, Patricia

    2017-12-01

    The nurse coach role was developed to address the needs of our nation and the world for health and wellbeing. The Theory of Integrative Nurse Coaching provides a foundation for coaching interventions supporting health promotion, and a framework for the development of the Integrative Health and Wellness Assessment (IHWA) short form. This 36-question Likert-type scale self-reporting tool assists participants in assessing healthy behaviors through a self-reflection process, provides information for the coaching relationship, and may be an outcome measurement. This article describes the history of the IHWA tool and the development and pilot testing of the IHWA short form using guidelines provided by DeVellis. Results of the Kaiser-Meyer-Olkin test yielded a value of .520, and the Bartlett's test of sphericity was significant. Cronbach's alpha overall scale internal consistency was .88 ( n = 36). Pilot study results indicate that the scale could be improved through additional revision, and an ongoing study is in progress.

  18. [The hospital perspective: disease management and integrated health care].

    Science.gov (United States)

    Schrappe, Matthias

    2003-06-01

    Disease Management is a transsectoral, population-based form of health care, which addresses groups of patients with particular clinical entities and risk factors. It refers both to an evidence-based knowledge base and corresponding guidelines, evaluates outcome as a continuous quality improvement process and usually includes active participation of patients. In Germany, the implementation of disease management is associated with financial transactions for risk adjustment between health care assurances [para. 137 f, Book V of Social Code (SGB V)] and represents the second kind of transsectoral care, besides a program designed as integrated health care according to para. 140 a ff f of Book V of Social Code. While in the USA and other countries disease management programs are made available by several institutions involved in health care, in Germany these programs are offered by health care insurers. Assessment of disease management from the hospital perspective will have to consider three questions: How large is the risk to compensate inadequate quality in outpatient care? Are there synergies in internal organisational development? Can the risk of inadequate funding of the global "integrated" budget be tolerated? Transsectoral quality assurance by valid performance indicators and implementation of a quality improvement process are essential. Internal organisational changes can be supported, particularly in the case of DRG introduction. The economic risk and financial output depends on the kind of disease being focussed by the disease management program. In assessing the underlying scientific evidence of their cost effectiveness, societal costs will have to be precisely differentiated from hospital-associated costs.

  19. Health Systems Integration of Sexual and Reproductive Health and HIV Services in Sub-Saharan Africa: A Scoping Study

    Science.gov (United States)

    Kendall, Tamil; Langer, Ana; Bärnighausen, Till

    2014-01-01

    Objective: Both sexual and reproductive health (SRH) services and HIV programs in sub-Saharan Africa are typically delivered vertically, operating parallel to national health systems. The objective of this study was to map the evidence on national and international strategies for integration of SRH and HIV services in sub-Saharan Africa and to develop a research agenda for future health systems integration. Methods: We examined the literature on national and international strategies to integrate SRH and HIV services using a scoping study methodology. Current policy frameworks, national HIV strategies and research, and gray literature on integration were mapped. Five countries in sub-Saharan Africa with experience of integrating SRH and HIV services were purposively sampled for detailed thematic analysis, according to the health systems functions of governance, policy and planning, financing, health workforce organization, service organization, and monitoring and evaluation. Results: The major international health policies and donor guidance now support integration. Most integration research has focused on linkages of SRH and HIV front-line services. Yet, the common problems with implementation are related to delayed or incomplete integration of higher level health systems functions: lack of coordinated leadership and unified national integration policies; separate financing streams for SRH and HIV services and inadequate health worker training, supervision and retention. Conclusions: Rigorous health systems research on the integration of SRH and HIV services is urgently needed. Priority research areas include integration impact, performance, and economic evaluation to inform the planning, financing, and coordination of integrated service delivery. PMID:25436826

  20. [European integration and health policies: repercussions of the internal European Market on access to health services].

    Science.gov (United States)

    Guimarães, Luisa; Giovanella, Lígia

    2006-09-01

    This article explores the health policy repercussions of countries' regional integration into the European Union. The aim is to review the regulation of access in other countries, with the conclusion of the single European market and the free circulation of persons, services, goods, and capital. The article begins by reviewing the various forms of integration and describes the expansion and institutionalization of Community agencies. The repercussions of European integration on health policies and regulation of access are analyzed. Market impacts on health result from Treaty directives and internal policy adjustments to free circulation. Health services access is gradually regulated and granted by rulings. Projects along borders illustrate the dynamics where differences are used to achieve comprehensive care. In the oldest integration experience, the market regulation has generated intentional and non-intentional impacts on the health policies of member states, regardless of the organizational model. Knowledge and analysis of this experience signals challenges for the Southern Cone Common Market (Mercosur) and adds to future debates and decisions.

  1. Specialty pharmaceuticals care management in an integrated health care delivery system with electronic health records.

    Science.gov (United States)

    Monroe, C Douglas; Chin, Karen Y

    2013-05-01

    The specialty pharmaceuticals market is expanding more rapidly than the traditional pharmaceuticals market. Specialty pharmacy operations have evolved to deliver selected medications and associated clinical services. The growing role of specialty drugs requires new approaches to managing the use of these drugs. The focus, expectations, and emphasis in specialty drug management in an integrated health care delivery system such as Kaiser Permanente (KP) can vary as compared with more conventional health care systems. The KP Specialty Pharmacy (KP-SP) serves KP members across the United States. This descriptive account addresses the impetus for specialty drug management within KP, the use of tools such as an electronic health record (EHR) system and process management software, the KP-SP approach for specialty pharmacy services, and the emphasis on quality measurement of services provided. Kaiser Permanente's integrated system enables KP-SP pharmacists to coordinate the provision of specialty drugs while monitoring laboratory values, physician visits, and most other relevant elements of the patient's therapy. Process management software facilitates the counseling of patients, promotion of adherence, and interventions to resolve clinical, logistic, or pharmacy benefit issues. The integrated EHR affords KP-SP pharmacists advantages for care management that should become available to more health care systems with broadened adoption of EHRs. The KP-SP experience may help to establish models for clinical pharmacy services as health care systems and information systems become more integrated.

  2. Integrating Social Media Monitoring Into Public Health Emergency Response Operations.

    Science.gov (United States)

    Hadi, Tamer A; Fleshler, Keren

    2016-10-01

    Social media monitoring for public health emergency response and recovery is an essential response capability for any health department. The value of social media for emergency response lies not only in the capacity to rapidly communicate official and critical incident information, but as a rich source of incoming data that can be gathered to inform leadership decision-making. Social media monitoring is a function that can be formally integrated into the Incident Command System of any response agency. The approach to planning and required resources, such as staffing, logistics, and technology, is flexible and adaptable based on the needs of the agency and size and scope of the emergency. The New York City Department of Health and Mental Hygiene has successfully used its Social Media Monitoring Team during public health emergency responses and planned events including major Ebola and Legionnaires' disease responses. The concepts and implementations described can be applied by any agency, large or small, interested in building a social media monitoring capacity. (Disaster Med Public Health Preparedness. 2016;page 1 of 6).

  3. Emotional labour in mental health nursing: An integrative systematic review.

    Science.gov (United States)

    Edward, Karen-Leigh; Hercelinskyj, Gylo; Giandinoto, Jo-Ann

    2017-06-01

    Emotional labour is the effort consumed by suppressing one's own emotions to care for others effectively while also caring for oneself. Mental health nurses are required to engage in effective therapeutic interactions in emotionally-intense situations. The aim of the present integrative systematic review was to investigate the emotional labour of mental health work and how this manifested, the impacts, and the ways to mitigate these impacts. In June 2016, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, a systematic search of the bibliographic databases was undertaken to identify relevant literature. Screening, data extraction, and synthesis were performed by three reviewers. The inclusion criteria included any original research that investigated the emotional work of mental health nurses. We identified a total of 20 papers to be included in this review. Thematic synthesis of the findings revealed three emergent themes: emotional labour and caring, emotional exhaustion, and self-protection (expressed as emotional intelligence). Emotional labour, emotional exhaustion, and emotional intelligence were considered to be intrinsically linked, where they were both the influencing factor for burnout and a contributor to attrition. The results highlighted that emotional labour could inspire the development and personal growth of emotional intelligence in mental health nurses. In light of these findings, recommendations for clinical practice were considered; they included supportive work environments, involving nurses in shared decision-making, and the provision of ongoing professional development opportunities that facilitate the development of emotional intelligence and resilience. © 2017 Australian College of Mental Health Nurses Inc.

  4. Simulation tools for guided wave based structural health monitoring

    Science.gov (United States)

    Mesnil, Olivier; Imperiale, Alexandre; Demaldent, Edouard; Baronian, Vahan; Chapuis, Bastien

    2018-04-01

    Structural Health Monitoring (SHM) is a thematic derived from Non Destructive Evaluation (NDE) based on the integration of sensors onto or into a structure in order to monitor its health without disturbing its regular operating cycle. Guided wave based SHM relies on the propagation of guided waves in plate-like or extruded structures. Using piezoelectric transducers to generate and receive guided waves is one of the most widely accepted paradigms due to the low cost and low weight of those sensors. A wide range of techniques for flaw detection based on the aforementioned setup is available in the literature but very few of these techniques have found industrial applications yet. A major difficulty comes from the sensitivity of guided waves to a substantial number of parameters such as the temperature or geometrical singularities, making guided wave measurement difficult to analyze. In order to apply guided wave based SHM techniques to a wider spectrum of applications and to transfer those techniques to the industry, the CEA LIST develops novel numerical methods. These methods facilitate the evaluation of the robustness of SHM techniques for multiple applicative cases and ease the analysis of the influence of various parameters, such as sensors positioning or environmental conditions. The first numerical tool is the guided wave module integrated to the commercial software CIVA, relying on a hybrid modal-finite element formulation to compute the guided wave response of perturbations (cavities, flaws…) in extruded structures of arbitrary cross section such as rails or pipes. The second numerical tool is based on the spectral element method [2] and simulates guided waves in both isotropic (metals) and orthotropic (composites) plate like-structures. This tool is designed to match the widely accepted sparse piezoelectric transducer array SHM configuration in which each embedded sensor acts as both emitter and receiver of guided waves. This tool is under development and

  5. A Standards-Based Architecture Proposal for Integrating Patient mHealth Apps to Electronic Health Record Systems.

    Science.gov (United States)

    Marceglia, S; Fontelo, P; Rossi, E; Ackerman, M J

    2015-01-01

    Mobile health Applications (mHealth Apps) are opening the way to patients' responsible and active involvement with their own healthcare management. However, apart from Apps allowing patient's access to their electronic health records (EHRs), mHealth Apps are currently developed as dedicated "island systems". Although much work has been done on patient's access to EHRs, transfer of information from mHealth Apps to EHR systems is still low. This study proposes a standards-based architecture that can be adopted by mHealth Apps to exchange information with EHRs to support better quality of care. Following the definition of requirements for the EHR/mHealth App information exchange recently proposed, and after reviewing current standards, we designed the architecture for EHR/mHealth App integration. Then, as a case study, we modeled a system based on the proposed architecture aimed to support home monitoring for congestive heart failure patients. We simulated such process using, on the EHR side, OpenMRS, an open source longitudinal EHR and, on the mHealth App side, the iOS platform. The integration architecture was based on the bi-directional exchange of standard documents (clinical document architecture rel2 - CDA2). In the process, the clinician "prescribes" the home monitoring procedures by creating a CDA2 prescription in the EHR that is sent, encrypted and de-identified, to the mHealth App to create the monitoring calendar. At the scheduled time, the App alerts the patient to start the monitoring. After the measurements are done, the App generates a structured CDA2-compliant monitoring report and sends it to the EHR, thus avoiding local storage. The proposed architecture, even if validated only in a simulation environment, represents a step forward in the integration of personal mHealth Apps into the larger health-IT ecosystem, allowing the bi-directional data exchange between patients and healthcare professionals, supporting the patient's engagement in self

  6. Structural characterisation of medically relevant protein assemblies by integrating mass spectrometry with computational modelling.

    Science.gov (United States)

    Politis, Argyris; Schmidt, Carla

    2018-03-20

    Structural mass spectrometry with its various techniques is a powerful tool for the structural elucidation of medically relevant protein assemblies. It delivers information on the composition, stoichiometries, interactions and topologies of these assemblies. Most importantly it can deal with heterogeneous mixtures and assemblies which makes it universal among the conventional structural techniques. In this review we summarise recent advances and challenges in structural mass spectrometric techniques. We describe how the combination of the different mass spectrometry-based methods with computational strategies enable structural models at molecular levels of resolution. These models hold significant potential for helping us in characterizing the function of protein assemblies related to human health and disease. In this review we summarise the techniques of structural mass spectrometry often applied when studying protein-ligand complexes. We exemplify these techniques through recent examples from literature that helped in the understanding of medically relevant protein assemblies. We further provide a detailed introduction into various computational approaches that can be integrated with these mass spectrometric techniques. Last but not least we discuss case studies that integrated mass spectrometry and computational modelling approaches and yielded models of medically important protein assembly states such as fibrils and amyloids. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  7. Structural Health Monitoring of Nuclear Spent Fuel Storage Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Lingyu

    2018-04-10

    Interim storage of spent nuclear fuel from reactor sites has gained additional importance and urgency for resolving waste-management-related technical issues. To ensure that nuclear power remains clean energy, monitoring has been identified by DOE as a high priority cross-cutting need, necessary to determine and predict the degradation state of the systems, structures, and components (SSCs) important to safety (ITS). Therefore, nondestructive structural condition monitoring becomes a need to be installed on existing or to be integrated into future storage system to quantify the state of health or to guarantee the safe operation of nuclear power plants (NPPs) during their extended life span. In this project, the lead university and the collaborating national laboratory teamed to develop a nuclear structural health monitoring (n-SHM) system based on in-situ piezoelectric sensing technologies that can monitor structural degradation and aging for nuclear spent fuel DCSS and similar structures. We also aimed to identify and quantify possible influences of nuclear spent fuel environment (temperature and radiation) to the piezoelectric sensor system and come up with adequate solutions and guidelines therefore. We have therefore developed analytical model for piezoelectric based n-SHM methods, with considerations of temperature and irradiation influence on the model of sensing and algorithms in acoustic emission (AE), guided ultrasonic waves (GUW), and electromechanical impedance spectroscopy (EMIS). On the other side, experimentally the temperature and irradiation influence on the piezoelectric sensors and sensing capabilities were investigated. Both short-term and long-term irradiation investigation with our collaborating national laboratory were performed. Moreover, we developed multi-modal sensing, validated in laboratory setup, and conducted the testing on the We performed multi-modal sensing development, verification and validation tests on very complex structures

  8. Preparing Social Work Students for Integrated Health Care: Results from a National Study

    Science.gov (United States)

    Held, Mary Lehman; Mallory, Kim Crane; Cummings, Sherry

    2017-01-01

    Integrated health care serves a vital role in addressing interrelated physical and behavioral health conditions, but social work graduates often lack sufficient training to work on integrated teams. We surveyed 94 deans of master's of social work programs to assess the current and planned integrated health care curricula and the aptitude of…

  9. Integrated System Health Management: Foundational Concepts, Approach, and Implementation.

    Science.gov (United States)

    Figueroa, Fernando; Schmalzel, John; Walker, Mark; Venkatesh, Meera; Kapadia, Ravi; Morris, Jon; Turowski, Mark; Smith, Harvey

    2009-01-01

    Implementation of integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive to an accurate and reliable assessment of its health. We present concepts, procedures, and a specific approach as a foundation for implementing a credible ISHM capability. The capability stresses integration of DIaK from all elements of a system. The intent is also to make possible implementation of on-board ISHM capability, in contrast to a remote capability. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems (rocket engine test facilities). The paper will address the following topics: 1. ISHM Model of a system 2. Detection of anomaly indicators. 3. Determination and confirmation of anomalies. 4. Diagnostic of causes and determination of effects. 5. Consistency checking cycle. 6. Management of health information 7. User Interfaces 8. Example implementation ISHM has been defined from many perspectives. We define it as a capability that might be achieved by various approaches. We describe a specific approach that has been matured throughout many years of development, and pilot implementations. ISHM is a capability that is achieved by integrating data, information, and knowledge (DIaK) that might be distributed throughout the system elements (which inherently implies capability to manage DIaK associated with distributed sub-systems). DIaK must be available to any element of a system at the right time and in accordance with a meaningful context. ISHM Functional Capability Level (FCL) is measured by how well a system performs the following

  10. Proof of Concept of Integrated Load Measurement in 3D Printed Structures

    Directory of Open Access Journals (Sweden)

    Michaël Hinderdael

    2017-02-01

    Full Text Available Currently, research on structural health monitoring systems is focused on direct integration of the system into a component or structure. The latter results in a so-called smart structure. One example of a smart structure is a component with integrated strain sensing for continuous load monitoring. Additive manufacturing, or 3D printing, now also enables such integration of functions inside components. As a proof-of-concept, the Fused Deposition Modeling (FDM technique was used to integrate a strain sensing element inside polymer (ABS tensile test samples. The strain sensing element consisted of a closed capillary filled with a fluid and connected to an externally mounted pressure sensor. The volumetric deformation of the integrated capillary resulted in pressure changes in the fluid. The obtained pressure measurements during tensile testing are reported in this paper and compared to state-of-the-art extensometer measurements. The sensitivity of the 3D printed pressure-based strain sensor is primarily a function of the compressibility of the capillary fluid. Air- and watertightness are of critical importance for the proper functioning of the 3D printed pressure-based strain sensor. Therefore, the best after-treatment procedure was selected on basis of a comparative analysis. The obtained pressure measurements are linear with respect to the extensometer readings, and the uncertainty on the strain measurement of a capillary filled with water (incompressible fluid is ±3.1 µstrain, which is approximately three times less sensitive than conventional strain gauges (±1 µstrain, but 32 times more sensitive than the same sensor based on air (compressible fluid (±101 µstrain.

  11. Structural Health Management of Damaged Aircraft Structures Using the Digital Twin Concept

    Science.gov (United States)

    Seshadri, Banavara R.; Krishnamurthy, Thiagarajan

    2017-01-01

    The development of multidisciplinary integrated Structural Health Management (SHM) tools will enable accurate detection, and prognosis of damaged aircraft under normal and adverse conditions during flight. As part of the digital twin concept, methodologies are developed by using integrated multiphysics models, sensor information and input data from an in-service vehicle to mirror and predict the life of its corresponding physical twin. SHM tools are necessary for both damage diagnostics and prognostics for continued safe operation of damaged aircraft structures. The adverse conditions include loss of control caused by environmental factors, actuator and sensor faults or failures, and structural damage conditions. A major concern in these structures is the growth of undetected damage/cracks due to fatigue and low velocity foreign object impact that can reach a critical size during flight, resulting in loss of control of the aircraft. To avoid unstable, catastrophic propagation of damage during a flight, load levels must be maintained that are below a reduced load-carrying capacity for continued safe operation of an aircraft. Hence, a capability is needed for accurate real-time predictions of damage size and safe load carrying capacity for structures with complex damage configurations. In the present work, a procedure is developed that uses guided wave responses to interrogate damage. As the guided wave interacts with damage, the signal attenuates in some directions and reflects in others. This results in a difference in signal magnitude as well as phase shifts between signal responses for damaged and undamaged structures. Accurate estimation of damage size, location, and orientation is made by evaluating the cumulative signal responses at various pre-selected sensor locations using a genetic algorithm (GA) based optimization procedure. The damage size, location, and orientation is obtained by minimizing the difference between the reference responses and the

  12. A sequential model for the structure of health care utilization.

    NARCIS (Netherlands)

    Herrmann, W.J.; Haarmann, A.; Baerheim, A.

    2017-01-01

    Traditional measurement models of health care utilization are not able to represent the complex structure of health care utilization. In this qualitative study, we, therefore, developed a new model to represent the health care utilization structure. In Norway and Germany, we conducted episodic

  13. Integrative mental health care: from theory to practice, part 1.

    Science.gov (United States)

    Lake, James

    2007-01-01

    Integrative approaches will lead to more accurate and different understandings of mental illness. Beneficial responses to complementary and alternative therapies provide important clues about the phenomenal nature of the human body in space-time and disparate biological, informational, and energetic factors associated with normal and abnormal psychological functioning. The conceptual framework of contemporary Western psychiatry includes multiple theoretical viewpoints, and there is no single best explanatory model of mental illness. Future theories of mental illness causation will not depend exclusively on empirical verification of strictly biological processes but will take into account both classically described biological processes and non-classical models, including complexity theory, resulting in more complete explanations of the characteristics and causes of symptoms and mechanisms of action that result in beneficial responses to treatments. Part 1 of this article examines the limitations of the theory and contemporary clinical methods employed in Western psychiatry and discusses implications of emerging paradigms in physics and the biological sciences for the future of psychiatry. In part 2, a practical methodology for planning integrative assessment and treatment strategies in mental health care is proposed. Using this methodology the integrative management of moderate and severe psychiatric symptoms is reviewed in detail. As the conceptual framework of Western medicine evolves toward an increasingly integrative perspective, novel understandings of complex relationships between biological, informational, and energetic processes associated with normal psychological functioning and mental illness will lead to more effective integrative assessment and treatment strategies addressing the causes or meanings of symptoms at multiple hierarchic levels of body-brain-mind.

  14. Integrative mental health care: from theory to practice, Part 2.

    Science.gov (United States)

    Lake, James

    2008-01-01

    Integrative approaches will lead to more accurate and different understandings of mental illness. Beneficial responses to complementary and alternative therapies provide important clues about the phenomenal nature of the human body in space-time and disparate biological, informational, and energetic factors associated with normal and abnormal psychological functioning. The conceptual framework of contemporary Western psychiatry includes multiple theoretical viewpoints, and there is no single best explanatory model of mental illness. Future theories of mental illness causation will not depend exclusively on empirical verification of strictly biological processes but will take into account both classically described biological processes and non-classical models, including complexity theory, resulting in more complete explanations of the characteristics and causes of symptoms and mechanisms of action that result in beneficial responses to treatments. Part 1 of this article examined the limitations of the theory and contemporary clinical methods employed in Western psychiatry and discussed implications of emerging paradigms in physics and the biological sciences for the future of psychiatry. In part 2, a practical methodology, for planning integrative assessment and treatment strategies in mental health care is proposed. Using this methodology the integrative management of moderate and severe psychiatric symptoms is reviewed in detail. As the conceptual framework of Western medicine evolves toward an increasingly integrative perspective, novel understanding of complex relationships between biological, informational, and energetic processes associated with normal psychological functioning and mental illness will lead to more effective integrative assessment and treatment strategies addressing the causes or meanings of symptoms at multiple hierarchic levels of body-brain-mind.

  15. Does Integrated Behavioral Health Care Reduce Mental Health Disparities for Latinos? Initial Findings

    Science.gov (United States)

    Bridges, Ana J.; Andrews, Arthur R.; Villalobos, Bianca T.; Pastrana, Freddie A.; Cavell, Timothy A.; Gomez, Debbie

    2014-01-01

    Integrated behavioral health care (IBHC) is a model of mental health care service delivery that seeks to reduce stigma and service utilization barriers by embedding mental health professionals into the primary care team. This study explored whether IBHC service referrals, utilization, and outcomes were comparable for Latinos and non-Latino White primary care patients. Data for the current study were collected from 793 consecutive patients (63.8% Latino; M age = 29.02 years [SD = 17.96]; 35.1% under 18 years; 65.3% women; 54.3% uninsured) seen for behavioral health services in 2 primary care clinics during a 10.5 month period. The most common presenting concerns were depression (21.6%), anxiety (18.5%), adjustment disorder (13.0%), and externalizing behavior problems (9.8%). Results revealed that while Latino patients had significantly lower self-reported psychiatric distress, significantly higher clinician-assigned global assessment of functioning scores, and fewer received a psychiatric diagnosis at their initial visit compared to non-Latino White patients, both groups had comparable utilization rates, comparable and clinically significant improvements in symptoms (Cohen’s d values > .50), and expressed high satisfaction with integrated behavioral services. These data provide preliminary evidence suggesting integration of behavioral health services into primary care clinics may help reduce mental health disparities for Latinos. PMID:25309845

  16. Working toward financial sustainability of integrated behavioral health services in a public health care system.

    Science.gov (United States)

    Monson, Samantha Pelican; Sheldon, J Christopher; Ivey, Laurie C; Kinman, Carissa R; Beacham, Abbie O

    2012-06-01

    The need, benefit, and desirability of behavioral health integration in primary care is generally accepted and has acquired widespread positive regard. However, in many health care settings the economics, business aspects, and financial sustainability of practice in integrated care settings remains an unsolved puzzle. Organizational administrators may be reluctant to expand behavioral health services without evidence that such programs offer clear financial benefits and financial sustainability. The tendency among mental health professionals is to consider positive clinical outcomes (e.g., reduced depression) as being globally valued indicators of program success. Although such outcomes may be highly valued by primary care providers and patients, administrative decision makers may require demonstration of more tangible financial outcomes. These differing views require program developers and evaluators to consider multiple outcome domains including clinical/psychological symptom reduction, potential cost benefit, and cost offset. The authors describe a process by which a pilot demonstration project is being implemented to demonstrate programmatic outcomes with a focus on the following: 1) clinician efficiency, 2) improved health outcomes, and 3) direct revenue generation associated with the inclusion of integrated primary care in a public health care system. The authors subsequently offer specific future directions and commentary regarding financial evaluation in each of these domains.

  17. Integration of health and environment through health impact assessment: cases from three continents.

    Science.gov (United States)

    Negev, Maya; Levine, Hagai; Davidovitch, Nadav; Bhatia, Rajiv; Mindell, Jennifer

    2012-04-01

    Despite the strong linkage between environment and health, institutions responsible for these fields operate in largely fragmented ways with limited interaction. As illustrated in the recent engagement between health and urban planning institutions, inter-institutional cooperation could support more effective and politically acceptable solutions for both local and global problems. Analysis of three case-studies, from three different continents, shows that HIA might serve to promote synergies among health and environmental disciplines in different local contexts, and could lead to institutional and procedural changes that promote health. Case examples provided supportive evidence for these effects, despite differences in approaches to HIA and governance levels. Obstacles to the use of HIA for inter-institutional integration also differed between countries. Lessons learned could support cooperation in other common interests of health and environment disciplines such as research, training and preparedness, and mitigation of public health emergencies related to the environment. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Opportunities for Launch Site Integrated System Health Engineering and Management

    Science.gov (United States)

    Waterman, Robert D.; Langwost, Patricia E.; Waterman, Susan J.

    2005-01-01

    The launch site processing flow involves operations such as functional verification, preflight servicing and launch. These operations often include hazards that must be controlled to protect human life and critical space hardware assets. Existing command and control capabilities are limited to simple limit checking durig automated monitoring. Contingency actions are highly dependent on human recognition, decision making, and execution. Many opportunities for Integrated System Health Engineering and Management (ISHEM) exist throughout the processing flow. This paper will present the current human-centered approach to health management as performed today for the shuttle and space station programs. In addition, it will address some of the more critical ISHEM needs, and provide recommendations for future implementation of ISHEM at the launch site.

  19. A real nonlinear integrable couplings of continuous soliton hierarchy and its Hamiltonian structure

    International Nuclear Information System (INIS)

    Yu Fajun

    2011-01-01

    Some integrable coupling systems of existing papers are linear integrable couplings. In the Letter, beginning with Lax pairs from special non-semisimple matrix Lie algebras, we establish a scheme for constructing real nonlinear integrable couplings of continuous soliton hierarchy. A direct application to the AKNS spectral problem leads to a novel nonlinear integrable couplings, then we consider the Hamiltonian structures of nonlinear integrable couplings of AKNS hierarchy with the component-trace identity. - Highlights: → We establish a scheme to construct real nonlinear integrable couplings. → We obtain a novel nonlinear integrable couplings of AKNS hierarchy. → Hamiltonian structure of nonlinear integrable couplings AKNS hierarchy is presented.

  20. Identification of similar regions of protein structures using integrated sequence and structure analysis tools

    Directory of Open Access Journals (Sweden)

    Heiland Randy

    2006-03-01

    Full Text Available Abstract Background Understanding protein function from its structure is a challenging problem. Sequence based approaches for finding homology have broad use for annotation of both structure and function. 3D structural information of protein domains and their interactions provide a complementary view to structure function relationships to sequence information. We have developed a web site http://www.sblest.org/ and an API of web services that enables users to submit protein structures and identify statistically significant neighbors and the underlying structural environments that make that match using a suite of sequence and structure analysis tools. To do this, we have integrated S-BLEST, PSI-BLAST and HMMer based superfamily predictions to give a unique integrated view to prediction of SCOP superfamilies, EC number, and GO term, as well as identification of the protein structural environments that are associated with that prediction. Additionally, we have extended UCSF Chimera and PyMOL to support our web services, so that users can characterize their own proteins of interest. Results Users are able to submit their own queries or use a structure already in the PDB. Currently the databases that a user can query include the popular structural datasets ASTRAL 40 v1.69, ASTRAL 95 v1.69, CLUSTER50, CLUSTER70 and CLUSTER90 and PDBSELECT25. The results can be downloaded directly from the site and include function prediction, analysis of the most conserved environments and automated annotation of query proteins. These results reflect both the hits found with PSI-BLAST, HMMer and with S-BLEST. We have evaluated how well annotation transfer can be performed on SCOP ID's, Gene Ontology (GO ID's and EC Numbers. The method is very efficient and totally automated, generally taking around fifteen minutes for a 400 residue protein. Conclusion With structural genomics initiatives determining structures with little, if any, functional characterization

  1. Organizing integrated health-care services to meet older people's needs.

    Science.gov (United States)

    Araujo de Carvalho, Islene; Epping-Jordan, JoAnne; Pot, Anne Margriet; Kelley, Edward; Toro, Nuria; Thiyagarajan, Jotheeswaran A; Beard, John R

    2017-11-01

    In most countries, a fundamental shift in the focus of clinical care for older people is needed. Instead of trying to manage numerous diseases and symptoms in a disjointed fashion, the emphasis should be on interventions that optimize older people's physical and mental capacities over their life course and that enable them to do the things they value. This, in turn, requires a change in the way services are organized: there should be more integration within the health system and between health and social services. Existing organizational structures do not have to merge; rather, a wide array of service providers must work together in a more coordinated fashion. The evidence suggests that integrated health and social care for older people contributes to better health outcomes at a cost equivalent to usual care, thereby giving a better return on investment than more familiar ways of working. Moreover, older people can participate in, and contribute to, society for longer. Integration at the level of clinical care is especially important: older people should undergo comprehensive assessments with the goal of optimizing functional ability and care plans should be shared among all providers. At the health system level, integrated care requires: (i) supportive policy, plans and regulatory frameworks; (ii) workforce development; (iii) investment in information and communication technologies; and (iv) the use of pooled budgets, bundled payments and contractual incentives. However, action can be taken at all levels of health care from front-line providers through to senior leaders - everyone has a role to play.

  2. Structural integrity analysis of the 224U elevator mothballing

    Energy Technology Data Exchange (ETDEWEB)

    Boehnke, W.M.

    1994-11-18

    As part of the preparation of Building 224U for turnover to Decontamination and Decommissioning, it is necessary to place the elevator in a mothballed condition so that it can be reactivated for use after 10 to 25 years. This mothballing is going to be accomplished by landing the counterweight on wooden timbers and suspending the elevator cab with wire rope or chain slings. This will take the load off the cables and make it relatively easy to reactive. The objective of this Supporting Document is to verify the structural integrity of all of the load bearing components involved in mothballing the 224U Building elevator. Building 224U is part of the UO{sub 3} Plant where uranyl nitrates from the PUREX Plant was converted to UO{sub 3} powder.

  3. Modelling Machine Tools using Structure Integrated Sensors for Fast Calibration

    Directory of Open Access Journals (Sweden)

    Benjamin Montavon

    2018-02-01

    Full Text Available Monitoring of the relative deviation between commanded and actual tool tip position, which limits the volumetric performance of the machine tool, enables the use of contemporary methods of compensation to reduce tolerance mismatch and the uncertainties of on-machine measurements. The development of a primarily optical sensor setup capable of being integrated into the machine structure without limiting its operating range is presented. The use of a frequency-modulating interferometer and photosensitive arrays in combination with a Gaussian laser beam allows for fast and automated online measurements of the axes’ motion errors and thermal conditions with comparable accuracy, lower cost, and smaller dimensions as compared to state-of-the-art optical measuring instruments for offline machine tool calibration. The development is tested through simulation of the sensor setup based on raytracing and Monte-Carlo techniques.

  4. Health coaching to improve healthy lifestyle behaviors: an integrative review.

    Science.gov (United States)

    Olsen, Jeanette M; Nesbitt, Bonnie J

    2010-01-01

    Chronic diseases account for 70% of U.S. deaths. Health coaching may help patients adopt healthy lifestyle behaviors that prevent and control diseases. This integrative review analyzed health coaching studies for evidence of effectiveness and to identify key program features. Multiple electronic databases were utilized, yielding a final sample of 15 documents. The search was limited to peer-reviewed research articles published between 1999 and 2008. Studies were further analyzed if they (1) specifically cited coaching as a program intervention, and (2) applied the intervention to research. Articles describing various quantitative and qualitative methodologies were critically analyzed using a systematic method. Data were synthesized using a matrix format according to purpose, method, intervention, findings, critique, and quality rating. All 15 studies utilized nonprobability sampling, 7 (47%) with randomized intervention and control groups. Significant improvements in one or more of the behaviors of nutrition, physical activity, weight management, or medication adherence were identified in six (40%) of the studies. Common features of effective programs were goal setting (73%), motivational interviewing (27%), and collaboration with health care providers (20%). Health coaching studies with well-specified methodologies and more rigorous designs are needed to strengthen findings; however, this behavioral change intervention suggests promise.

  5. Towards an integrated management of health physics and medical physics

    International Nuclear Information System (INIS)

    Mommaert, Chantal; Rogge, Frank; Cortenbosch, Geert; Schmitz, Frederic

    2007-01-01

    AVN is a licensed body that performs health physics control in different types of installations, from large nuclear facilities to small dentist cabinets. AVN can also provide medical physics services for the quality control of, for instance, medical devices used in a radiology or nuclear medicine department. Radiation protection for personnel and environment (health physics) and radiation protection for the patient (medical physics) are usually treated separately, using different referential documents, such as the European Directives 96/29/Euratom for health physics and 97/43/Euratom for medical physics. This difference is also clearly reflected in the Belgium legislation (two types of accreditation/licence for inspectors, different chapters in the law,..) From a practical point of view it is sometimes rather difficult to split the task 'on site' during an inspection. An RX system not complying with radiation protection criteria can definitively affect the patient as well as the workers. On the other hand, the hospitals, cannot easily differentiate these two tasks because they are not fully aware of the legislation and they are mixing both. Taking into account the health physics guidelines as well as medical physics guidelines, we have decided to move to an integrated approach of these two concepts. (orig.)

  6. On the structural integrity evaluation about aged components

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-08-15

    About one third of the nuclear power plants in Japan have been operated more than 30 years and flaws due to age-related degradation mechanisms have been detected in some components such as piping systems or core shrouds these years. Moreover, several severe earthquakes such as the Tohoku District - off the Pacific Ocean Earthquake or the Niigata-ken Chuetsu-oki Earthquake have struck some nuclear power plants in Japan recent years. Therefore, the structural integrity evaluation about nuclear installations and components considering seismic loads and aging mechanisms has become more and more important. In this study, several evaluation methods were proposed to assess the crack growth rate under the seismic loading conditions, to assess the failure conditions or the realistic failure capacities of the aged piping systems considering seismic or general loading conditions. Furthermore, analysis codes were developed considering aging mechanisms to carry out the integrity evaluation, or the failure probability evaluation which is useful in the seismic PSA evaluation. All of these assessment methods and analysis codes are being used and will be used more and more in the cross-check analyses or the safety reviews about nuclear installations and components. (author)

  7. Effect of age on the structural integrity of HEPA filters

    International Nuclear Information System (INIS)

    Johnson, J.S.; Beason, D.G.; Smith, P.R.; Gregory, W.S.

    1989-01-01

    All of the controls on high-efficiency particulate air (HEPA) filters are based on rigid manufacturing standards with regard to filtration efficiency, temperature performance, pressure integrity, and strength. Third-party inspection and testing by the US Department of Energy increases the reliability of new HEPA filters, but only routine in-place testing is used to assure that an aging filter performs adequately. In 1980 the Lawrence Livermore National Laboratory initiated a small evaluation to determine if age has a significant effect on the structural integrity of HEPA filters. A series of used uncontaminated filters dating back to 1965 was obtained for these tests. Tensile strength tests on the old media indicated a decrease in strength. To provide additional measurement of the filters' overall strength, several of these aged filters were subjected to pressure pulses equivalent to the NRC Region I tornado pulses and shock wave over pressures. Data from these tests indicate a decrease in breaking pressure of from 25-50%. A large increase in complete filter pack blow-out during the simulated NRC Region I tornado tests was also observed. The preliminary results indicate the need for an administrative lifetime for HEPA filters used in critical nuclear facilities. Due to the unique conditions in each facility, different administrative lifetimes may be necessary

  8. Wireless sensor networks for structural health monitoring

    CERN Document Server

    Cao, Jiannong

    2016-01-01

    This brief covers the emerging area of wireless sensor network (WSN)-based structural health monitoring (SHM) systems, and introduces the authors’ WSN-based platform called SenetSHM. It helps the reader differentiate specific requirements of SHM applications from other traditional WSN applications, and demonstrates how these requirements are addressed by using a series of systematic approaches. The brief serves as a practical guide, explaining both the state-of-the-art technologies in domain-specific applications of WSNs, as well as the methodologies used to address the specific requirements for a WSN application. In particular, the brief offers instruction for problem formulation and problem solving based on the authors’ own experiences implementing SenetSHM. Seven concise chapters cover the development of hardware and software design of SenetSHM, as well as in-field experiments conducted while testing the platform. The brief’s exploration of the SenetSHM platform is a valuable feature for civil engine...

  9. Integrated System Health Management: Foundational Concepts, Approach, and Implementation

    Science.gov (United States)

    Figueroa, Fernando

    2009-01-01

    A sound basis to guide the community in the conception and implementation of ISHM (Integrated System Health Management) capability in operational systems was provided. The concept of "ISHM Model of a System" and a related architecture defined as a unique Data, Information, and Knowledge (DIaK) architecture were described. The ISHM architecture is independent of the typical system architecture, which is based on grouping physical elements that are assembled to make up a subsystem, and subsystems combine to form systems, etc. It was emphasized that ISHM capability needs to be implemented first at a low functional capability level (FCL), or limited ability to detect anomalies, diagnose, determine consequences, etc. As algorithms and tools to augment or improve the FCL are identified, they should be incorporated into the system. This means that the architecture, DIaK management, and software, must be modular and standards-based, in order to enable systematic augmentation of FCL (no ad-hoc modifications). A set of technologies (and tools) needed to implement ISHM were described. One essential tool is a software environment to create the ISHM Model. The software environment encapsulates DIaK, and an infrastructure to focus DIaK on determining health (detect anomalies, determine causes, determine effects, and provide integrated awareness of the system to the operator). The environment includes gateways to communicate in accordance to standards, specially the IEEE 1451.1 Standard for Smart Sensors and Actuators.

  10. Technology management: case study of an integrated health system.

    Science.gov (United States)

    Dahl, D H; McFarlan, T K

    1994-12-01

    Technology management has assumed a role of vital importance in today's health care environment. Capital reserves and operating income have been stretched by pervasive and expensive technologies, while overall reimbursement has been reduced. It is imperative for hospitals to develop and consistently use technology management processes that begin prior to a technology's introduction in the hospital and continue throughout its life cycle. At Samaritan Health System (SHS), an integrated health care delivery system based in Phoenix, technology management provides tools to improve decision making and assist in the system's integration strategy as well as control expenses. SHS uses a systemwide technology-specific plan to guide acquisition and/or funding decisions. This plan describes how particular technologies can help achieve SHS' organizational goals such as promoting system integration and/or improving patient outcomes while providing good economic value. After technologies are targeted in this systemwide plan they are prioritized using a two-stage capital prioritization process. The first stage of the capital prioritization process considers the quantitative and qualitative factors critical for equitable capital distribution across the system. The second stage develops a sense of ownership among the parties that affect and are affected by the allocation at a facility level. This process promotes an efficient, effective, equitable, and defensible approach to resource allocation and technology decision making. Minimizing equipment maintenance expenditures is also an integral part of technology management at SHS. The keys to reducing maintenance expenditures are having a process in place that supports a routine fiscal evaluation of maintenance coverage options and ensuring that manufacturers are obligated to provide critical maintenance resources at the time of equipment purchase. Maintenance service options under consideration in this report include full

  11. A decade of integration and collaboration: the development of integrated health care in Sweden 2000-2010

    Directory of Open Access Journals (Sweden)

    Bengt Ahgren

    2011-03-01

    Full Text Available Introduction: The recent history of integrated health care in Sweden is explored in this article, focusing on the first decade of the 2000s. In addition, there are some reflections about successes and setbacks in this development and challenges for the next decade.     Description of policy and practice: The first efforts to integrate health care in Sweden appeared in the beginning of the 1990s. The focus was on integration of intra-organisational processes, aiming at a more cost-effective health care provision. Partly as a reaction to the increasing economism at that time, there was also a growing interest in quality improvement. Out of this work emerged the "chains of care", integrating all health care providers involved in the care of specific patient groups. During the 2000s, many county councils have also introduced inter-organisational systems of "local health care". There has also been increasing collaboration between health professionals and other professional groups in different health and welfare services.  Discussion and conclusion: Local health care meant that the chains of care and other forms of integration and collaboration became embedded in a more integrative context. At the same time, however, policy makers have promoted free patient choice in primary health care and also mergers of hospitals and clinical departments. These policies tend to fragment the provision of health care and have an adverse effect on the development of integrated care. As a counterbalance, more efforts should be put into evaluation of integrated health care, in order to replace political convictions with evidence concerning the benefits of such health care provision.

  12. Structural Health Monitoring: Numerical Damage Predictor for Composite Structures

    National Research Council Canada - National Science Library

    Lannamann, Daniel

    2001-01-01

    .... Wide use of composites is found in aircraft, armored vehicles, ships and civil structures This present research demonstrates the ability to numerically detect damage in a composite sandwich structure...

  13. Structure-preserving integrators in nonlinear structural dynamics and flexible multibody dynamics

    CERN Document Server

    2016-01-01

    This book focuses on structure-preserving numerical methods for flexible multibody dynamics, including nonlinear elastodynamics and geometrically exact models for beams and shells. It also deals with the newly emerging class of variational integrators as well as Lie-group integrators. It discusses two alternative approaches to the discretization in space of nonlinear beams and shells. Firstly, geometrically exact formulations, which are typically used in the finite element community and, secondly, the absolute nodal coordinate formulation, which is popular in the multibody dynamics community. Concerning the discretization in time, the energy-momentum method and its energy-decaying variants are discussed. It also addresses a number of issues that have arisen in the wake of the structure-preserving discretization in space. Among them are the parameterization of finite rotations, the incorporation of algebraic constraints and the computer implementation of the various numerical methods. The practical application...

  14. Organizational Structure and Management in Romanian Health System

    OpenAIRE

    Boldureanu Daniel; Boldureanu Gabriela

    2010-01-01

    The health system in Romania in a continuous transformation from a centralized system (type Semashko) exists before 1989 year to one based on social health insurance (type Bismark). This paper examines the management and the organizational structure of the health system in Romania, and the relations between them in the context of the Health Reform Law.

  15. Children’s Environmental Health Faculty Champions Initiative: A Successful Model for Integrating Environmental Health into Pediatric Health Care

    Science.gov (United States)

    Rogers, Bonnie; McCurdy, Leyla Erk; Slavin, Katie; Grubb, Kimberly; Roberts, James R.

    2009-01-01

    Background Pediatric medical and nursing education lack the environmental health content needed to properly prepare health care professionals to prevent, recognize, manage, and treat environmental exposure–related diseases. The need for improvements in health care professionals’ environmental health knowledge has been expressed by leading institutions. However, few studies have evaluated the effectiveness of programs that incorporate pediatric environmental health (PEH) into curricula and practice. Objective We evaluated the effectiveness of the National Environmental Education Foundation’s (NEEF) Children’s Environmental Health Faculty Champions Initiative, which is designed to build environmental health capacity among pediatric health care professionals. Methods Twenty-eight pediatric health care professionals participated in a train-the-trainer workshop, in which they were educated to train other health care professionals in PEH and integrate identified PEH competencies into medical and nursing practice and curricula. We evaluated the program using a workshop evaluation tool, action plan, pre- and posttests, baseline and progress assessments, and telephone interviews. Results During the 12 months following the workshop, the faculty champions’ average pretest score of 52% was significantly elevated (p < 0.0001) to 65.5% on the first posttest and to 71.5% on the second posttest, showing an increase and retention of environmental health knowledge. Faculty champions trained 1,559 health care professionals in PEH, exceeding the goal of 280 health care professionals trained. Ninety percent of faculty champions reported that PEH had been integrated into the curricula at their institution. Conclusion The initiative was highly effective in achieving its goal of building environmental health capacity among health care professionals. The faculty champions model is a successful method and can be replicated in other arenas. PMID:19478972

  16. Integrated approach for managing health risks at work--the role of occupational health nurses.

    Science.gov (United States)

    Marinescu, Luiza G

    2007-02-01

    Currently, many organizations are using a department-centered approach to manage health risks at work. In such a model, segregated departments are providing employee benefits such as health insurance, workers' compensation, and short- and long-term disability or benefits addressing work-life issues. In recent years, a new model has emerged: health and productivity management (HPM). This is an employee-centered, integrated approach, designed to increase efficiency, reduce competition for scarce resources, and increase employee participation in prevention activities. Evidence suggests that corporations using integrated HPM programs achieve better health outcomes for their employees, with consequent increased productivity and decreased absenteeism. Occupational health nurses are well positioned to assume leadership roles in their organizations by coordinating efforts and programs across departments that offer health, wellness, and safety benefits. To assume their role as change agents to improve employees' health, nurses should start using the language of business more often by improving their communication skills, computer skills, and ability to quantify and articulate results of programs and services to senior management.

  17. Structural integrity and fatigue crack propagation life assessment of welded and weld-repaired structures

    Science.gov (United States)

    Alam, Mohammad Shah

    2005-11-01

    Structural integrity is the science and technology of the margin between safety and disaster. Proper evaluation of the structural integrity and fatigue life of any structure (aircraft, ship, railways, bridges, gas and oil transmission pipelines, etc.) is important to ensure the public safety, environmental protection, and economical consideration. Catastrophic failure of any structure can be avoided if structural integrity is assessed and necessary precaution is taken appropriately. Structural integrity includes tasks in many areas, such as structural analysis, failure analysis, nondestructive testing, corrosion, fatigue and creep analysis, metallurgy and materials, fracture mechanics, fatigue life assessment, welding metallurgy, development of repairing technologies, structural monitoring and instrumentation etc. In this research fatigue life assessment of welded and weld-repaired joints is studied both in numerically and experimentally. A new approach for the simulation of fatigue crack growth in two elastic materials has been developed and specifically, the concept has been applied to butt-welded joint in a straight plate and in tubular joints. In the proposed method, the formation of new surface is represented by an interface element based on the interface potential energy. This method overcomes the limitation of crack growth at an artificial rate of one element length per cycle. In this method the crack propagates only when the applied load reaches the critical bonding strength. The predicted results compares well with experimental results. The Gas Metal Arc welding processes has been simulated to predict post-weld distortion, residual stresses and development of restraining forces in a butt-welded joint. The effect of welding defects and bi-axial interaction of a circular porosity and a solidification crack on fatigue crack propagation life of butt-welded joints has also been investigated. After a weld has been repaired, the specimen was tested in a universal

  18. From Foucault to Freire through Facebook: Toward an Integrated Theory of mHealth

    Science.gov (United States)

    Bull, Sheana; Ezeanochie, Nnamdi

    2016-01-01

    Objective: To document the integration of social science theory in literature on mHealth (mobile health) and consider opportunities for integration of classic theory, health communication theory, and social networking to generate a relevant theory for mHealth program design. Method: A secondary review of research syntheses and meta-analyses…

  19. On the Value of Monitoring Information for the Structural Integrity and Risk Management

    DEFF Research Database (Denmark)

    Thöns, Sebastian

    2018-01-01

    facilitates the assessment of the value of information associated with SHM. The principal approach for the quantification of the value of SHM is formulated by modeling the fundamental decision of performing SHM or not in conjunction with their expected utilities. The expected utilities are calculated....... The calculation of the expected utilities necessitates a comprehensive and rigorous modeling, which is introduced close to the original formulations and for which analysis characteristics and simplifications are described and derived. The framework provides the basis for the optimization of the structural risk......This article introduces an approach and framework for the quantification of the value of structural health monitoring (SHM) in the context of the structural risk and integrity management for systems.The quantification of the value of SHM builds upon the Bayesian decision and utility theory, which...

  20. Multilevel examination of facility characteristics, social integration, and health for older adults living in nursing homes.

    Science.gov (United States)

    Leedahl, Skye N; Chapin, Rosemary K; Little, Todd D

    2015-01-01

    Testing a model based on past research and theory, this study assessed relationships between facility characteristics (i.e., culture change efforts, social workers) and residents' social networks and social support across nursing homes; and examined relationships between multiple aspects of social integration (i.e., social networks, social capital, social engagement, social support) and mental and functional health for older adults in nursing homes. Data were collected at nursing homes using a planned missing data design with random sampling techniques. Data collection occurred at the individual-level through in-person structured interviews with older adult nursing home residents (N = 140) and at the facility-level (N = 30) with nursing home staff. The best fitting multilevel structural equation model indicated that the culture change subscale for relationships significantly predicted differences in residents' social networks. Additionally, social networks had a positive indirect relationship with mental and functional health among residents primarily via social engagement. Social capital had a positive direct relationship with both health outcomes. To predict better social integration and mental and functional health outcomes for nursing homes residents, study findings support prioritizing that close relationships exist among staff, residents, and the community as well as increased resident social engagement and social trust. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Reframing measurement for structural health monitoring: a full-field strategy for structural identification

    Science.gov (United States)

    Dizaji, Mehrdad S.; Harris, Devin K.; Alipour, Mohamad; Ozbulut, Osman E.

    2018-03-01

    Structural health monitoring (SHM) describes a decision-making framework that is fundamentally guided by state change detection of structural systems. This framework typically relies on the use of continuous or semi-continuous monitoring of measured response to quantify this state change in structural system behavior, which is often related to the initiation of some form of damage. Measurement approaches used for traditional SHM are numerous, but most are limited to either describing localized or global phenomena, making it challenging to characterize operational structural systems which exhibit both. In addition to these limitations in sensing, SHM has also suffered from the inherent robustness inherent to most full-scale structural systems, making it challenging to identify local damage. These challenges highlight the opportunity for alternative strategies for SHM, strategies that are able to provide data suitable to translate into rich information. This paper describes preliminary results from a refined structural identification (St-ID) approach using fullfield measurements derived from high-speed 3D Digital Image Correlation (HSDIC) to characterize uncertain parameters (i.e. boundary and constitutive properties) of a laboratory scale structural component. The St-ID approach builds from prior work by supplementing full-field deflection and strain response with vibration response derived from HSDIC. Inclusion of the modal characteristics within a hybrid-genetic algorithm optimization scheme allowed for simultaneous integration of mechanical and modal response, thus enabling a more robust St-ID strategy than could be achieved with traditional sensing techniques. The use of full-field data is shown to provide a more comprehensive representation of the global and local behavior, which in turn increases the robustness of the St-Id framework. This work serves as the foundation for a new paradigm in SHM that emphasizes characterizing structural performance using a

  2. Aging Evaluation Programs for Jet Transport Aircraft Structural Integrity

    Directory of Open Access Journals (Sweden)

    Borivoj Galović

    2012-10-01

    Full Text Available The paper deals with criteria and procedures in evaluationof timely preventive maintenance recommendations that willsupport continued safe operation of aging jet transports untiltheir retirement from service. The active service life of commercialaircraft has increased in recent years as a result of low fuelcost, and increasing costs and delivery times for fleet replacements.Air transport industry consensus is that older jet transportswill continue in service despite anticipated substantial increasesin required maintenance. Design concepts, supportedby testing, have worked well due to the system that is used to ensureflying safety. Continuing structural integrity by inspectionand overhaul recommendation above the level contained inmaintenance and service bulletins is additional requirement, insuch cases. Airplane structural safety depends on the performanceof all participants in the system and the responsibility forsafety cannot be delegated to a single participant. This systemhas three major participants: the manufacturers who design,build and support airplanes in service, the airlines who operate,inspect and mantain airplanes and the airworthiness authoritieswho establish rules and regulations, approve the design andpromote airline maintenance performance.

  3. Structural Integrity of an Electron Beam Melted Titanium Alloy

    Directory of Open Access Journals (Sweden)

    Robert Lancaster

    2016-06-01

    Full Text Available Advanced manufacturing encompasses the wide range of processes that consist of “3D printing” of metallic materials. One such method is Electron Beam Melting (EBM, a modern build technology that offers significant potential for lean manufacture and a capability to produce fully dense near-net shaped components. However, the manufacture of intricate geometries will result in variable thermal cycles and thus a transient microstructure throughout, leading to a highly textured structure. As such, successful implementation of these technologies requires a comprehensive assessment of the relationships of the key process variables, geometries, resultant microstructures and mechanical properties. The nature of this process suggests that it is often difficult to produce representative test specimens necessary to achieve a full mechanical property characterisation. Therefore, the use of small scale test techniques may be exploited, specifically the small punch (SP test. The SP test offers a capability for sampling miniaturised test specimens from various discrete locations in a thin-walled component, allowing a full characterisation across a complex geometry. This paper provides support in working towards development and validation strategies in order for advanced manufactured components to be safely implemented into future gas turbine applications. This has been achieved by applying the SP test to a series of Ti-6Al-4V variants that have been manufactured through a variety of processing routes including EBM and investigating the structural integrity of each material and how this controls the mechanical response.

  4. Smart fastener for KC-135 structural integrity monitoring

    Science.gov (United States)

    Schoess, Jeffrey N.; Seifert, Greg

    1997-06-01

    Hidden and inaccessible corrosion in aircraft structures is the number-one logistics problem for the U.S. Air Force, with an estimated maintenance cost in excess of $DOL1.0 billion per year in 1990-equivalent dollars. The Smart Aircraft Fastener Evaluation (SAFE) system is being developed to provide early warning detection of corrosion- related symptoms in hidden locations of aircraft structures. The SAFE incorporates an in situ measurement approach that measures and autonomously records several environmental conditions (i.e., pH, temperature, chloride, free potential, time-of-wetness) within a Hi-Lok aircraft fastener that could cause corrosion to occur. The SAFE system integrates a miniature electrochemical microsensor array and a time-of- wetness sensor with an ultra-low-power 8-bit microcontroller and 5-Mbyte solid-state FLASH archival memory to measure the evidence of active corrosion. A summary of the technical approach, system design definition, software architecture, and future field test plans will be presented.

  5. Structural Integrity of an Electron Beam Melted Titanium Alloy.

    Science.gov (United States)

    Lancaster, Robert; Davies, Gareth; Illsley, Henry; Jeffs, Spencer; Baxter, Gavin

    2016-06-14

    Advanced manufacturing encompasses the wide range of processes that consist of "3D printing" of metallic materials. One such method is Electron Beam Melting (EBM), a modern build technology that offers significant potential for lean manufacture and a capability to produce fully dense near-net shaped components. However, the manufacture of intricate geometries will result in variable thermal cycles and thus a transient microstructure throughout, leading to a highly textured structure. As such, successful implementation of these technologies requires a comprehensive assessment of the relationships of the key process variables, geometries, resultant microstructures and mechanical properties. The nature of this process suggests that it is often difficult to produce representative test specimens necessary to achieve a full mechanical property characterisation. Therefore, the use of small scale test techniques may be exploited, specifically the small punch (SP) test. The SP test offers a capability for sampling miniaturised test specimens from various discrete locations in a thin-walled component, allowing a full characterisation across a complex geometry. This paper provides support in working towards development and validation strategies in order for advanced manufactured components to be safely implemented into future gas turbine applications. This has been achieved by applying the SP test to a series of Ti-6Al-4V variants that have been manufactured through a variety of processing routes including EBM and investigating the structural integrity of each material and how this controls the mechanical response.

  6. Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership.

    Science.gov (United States)

    Drobac, Peter C; Basinga, Paulin; Condo, Jeanine; Farmer, Paul E; Finnegan, Karen E; Hamon, Jessie K; Amoroso, Cheryl; Hirschhorn, Lisa R; Kakoma, Jean Baptise; Lu, Chunling; Murangwa, Yusuf; Murray, Megan; Ngabo, Fidele; Rich, Michael; Thomson, Dana; Binagwaho, Agnes

    2013-01-01

    Nationally, health in Rwanda has been improving since 2000, with considerable improvement since 2005. Despite improvements, rural areas continue to lag behind urban sectors with regard to key health outcomes. Partners In Health (PIH) has been supporting the Rwanda Ministry of Health (MOH) in two rural districts in Rwanda since 2005. Since 2009, the MOH and PIH have spearheaded a health systems strengthening (HSS) intervention in these districts as part of the Rwanda Population Health Implementation and Training (PHIT) Partnership. The partnership is guided by the belief that HSS interventions should be comprehensive, integrated, responsive to local conditions, and address health care access, cost, and quality. The PHIT Partnership represents a collaboration between the MOH and PIH, with support from the National University of Rwanda School of Public Health, the National Institute of Statistics, Harvard Medical School, and Brigham and Women's Hospital. The PHIT Partnership's health systems support aligns with the World Health Organization's six health systems building blocks. HSS activities focus across all levels of the health system - community, health center, hospital, and district leadership - to improve health care access, quality, delivery, and health outcomes. Interventions are concentrated on three main areas: targeted support for health facilities, quality improvement initiatives, and a strengthened network of community health workers. The impact of activities will be assessed using population-level outcomes data collected through oversampling of the demographic and health survey (DHS) in the intervention districts. The overall impact evaluation is complemented by an analysis of trends in facility health care utilization. A comprehensive costing project captures the total expenditures and financial inputs of the health care system to determine the cost of systems improvement. Targeted evaluations and operational research pieces focus on specific

  7. On Line Service Composition in the Integrated Clinical Environment for eHealth and Medical Systems.

    Science.gov (United States)

    García-Valls, Marisol; Touahria, Imad Eddine

    2017-06-08

    Medical and eHealth systems are progressively realized in the context of standardized architectures that support safety and ease the integration of the heterogeneous (and often proprietary) medical devices and sensors. The Integrated Clinical Environment (ICE) architecture appeared recently with the goal of becoming a common framework for defining the structure of the medical applications as concerns the safe integration of medical devices and sensors. ICE is simply a high level architecture that defines the functional blocks that should be part of a medical system to support interoperability. As a result, the underlying communication backbone is broadly undefined as concerns the enabling software technology (including the middleware) and associated algorithms that meet the ICE requirements of the flexible integration of medical devices and services. Supporting the on line composition of services in a medical system is also not part of ICE; however, supporting this behavior would enable flexible orchestration of functions (e.g., addition and/or removal of services and medical equipment) on the fly. iLandis one of the few software technologies that supports on line service composition and reconfiguration, ensuring time-bounded transitions across different service orchestrations; it supports the design, deployment and on line reconfiguration of applications, which this paper applies to service-based eHealth domains. This paper designs the integration between ICE architecture and iLand middleware to enhance the capabilities of ICE with on line service composition and the time-bounded reconfiguration of medical systems based on distributed services. A prototype implementation of a service-based eHealth system for the remote monitoring of patients is described; it validates the enhanced capacity of ICE to support dynamic reconfiguration of the application services. Results show that the temporal cost of the on line reconfiguration of the eHealth application is bounded

  8. [Declared dead? Recommendations regarding integrated care from the perspective of German statutory health insurance].

    Science.gov (United States)

    Amelung, Volker; Wolf, S; Ozegowski, S; Eble, S; Hildebrandt, H; Knieps, F; Lägel, R; Schlenker, R-U; Sjuts, R

    2015-04-01

    The traditional separation of health care into sectors in Germany causes communication problems that hinder continuous, patient-oriented care. This is most evident in the transition from inpatient to outpatient care. That said, there are also breaks in the flow of information, a lack of supply, or even incorrect information flowing within same-sector care. The transition from a division of functions into sectors to a patient-oriented process represents a change in the paradigm of health care that can only be successfully completed with considerable effort. Germany's statutory health insurance (SHI) funds play a key role here, as they are the contracting parties as well as the financiers of integrated care, and are strategically located at the center of the development process.The objective of this article is to explore how Germany's SHI funds view integrated care, what they regard as being the drivers of and barriers to transitioning to such a system, and what recommendations they can provide with regard to the further development of integrated care. For this purpose semi-structured interviews with board members and those responsible for implementing integrated care into the operations of ten SHI funds representing more than half of Germany's SHI-insured population were conducted. According to the interviewees, a better framework for integrated care urgently needs to be developed and rendered more receptive to innovation.Only in this way will the widespread stagnation of the past several years be overcome. The deregulation of § 140a-d SGB V and the establishment of a uniform basis for new forms of care in terms of a new innovation clause are among the central recommendations of this article. The German federal government's innovation fund was met with great hope, but also implied risks. Nonetheless, the new law designed to strengthen health care overall generated high expectations.

  9. Implementation of Integrated Service Networks under the Quebec Mental Health Reform: Facilitators and Barriers associated with Different Territorial Profiles.

    Science.gov (United States)

    Fleury, Marie-Josée; Grenier, Guy; Vallée, Catherine; Aubé, Denise; Farand, Lambert

    2017-03-10

    This study evaluates implementation of the Quebec Mental Health Reform (2005-2015), which promoted the development of integrated service networks, in 11 local service networks organized into four territorial groups according to socio-demographic characteristics and mental health services offered. Data were collected from documents concerning networks; structured questionnaires completed by 90 managers and by 16 respondent-psychiatrists; and semi-structured interviews with 102 network stakeholders. Factors associated with implementation and integration were organized according to: 1) reform characteristics; 2) implementation context; 3) organizational characteristics; and 4) integration strategies. While local networks were in a process of development and expansion, none were fully integrated at the time of the study. Facilitators and barriers to implementation and integration were primarily associated with organizational characteristics. Integration was best achieved in larger networks including a general hospital with a psychiatric department, followed by networks with a psychiatric hospital. Formalized integration strategies such as service agreements, liaison officers, and joint training reduced some barriers to implementation in networks experiencing less favourable conditions. Strategies for the implementation of healthcare reform and integrated service networks should include sustained support and training in best-practices, adequate performance indicators and resources, formalized integration strategies to improve network coordination and suitable initiatives to promote staff retention.

  10. Health system preparedness for integration of mental health services in rural Liberia.

    Science.gov (United States)

    Gwaikolo, Wilfred S; Kohrt, Brandon A; Cooper, Janice L

    2017-07-27

    There are increasing efforts and attention focused on the delivery of mental health services in primary care in low resource settings (e.g., mental health Gap Action Programme, mhGAP). However, less attention is devoted to systematic approaches that identify and address barriers to the development and uptake of mental health services within primary care in low-resource settings. Our objective was to prepare for optimal uptake by identifying barriers in rural Liberia. The country's need for mental health services is compounded by a 14-year history of political violence and the largest Ebola virus disease outbreak in history. Both events have immediate and lasting mental health effects. A mixed-methods approach was employed, consisting of qualitative interviews with 22 key informants and six focus group discussions. Additional qualitative data as well as quantitative data were collected through semi-structured assessments of 19 rural primary care health facilities. Data were collected from March 2013 to March 2014. Potential barriers to development and uptake of mental health services included lack of mental health knowledge among primary health care staff; high workload for primary health care workers precluding addition of mental health responsibilities; lack of mental health drugs; poor physical infrastructure of health facilities including lack of space for confidential consultation; poor communication support including lack of electricity and mobile phone networks that prevent referrals and phone consultation with supervisors; absence of transportation for patients to facilitate referrals; negative attitudes and stigma towards people with severe mental disorders and their family members; and stigma against mental health workers. To develop and facilitate effective primary care mental health services in a post-conflict, low resource setting will require (1) addressing the knowledge and clinical skills gap in the primary care workforce; (2) improving physical

  11. Towards an integrated approach to health and medicine in Africa.

    Science.gov (United States)

    Batisai, Kezia

    2016-12-01

    This article frames the intersections of medicine and humanities as intrinsic to understanding the practice of health care in Africa. Central to this manuscript, which draws on empirical findings on the interplay between HIV and AIDS and alternative medicine in Zimbabwe is the realisation that very limited research has been undertaken to examine 'HIV/AIDS patient behaviour' with respect to choice of therapy on the continent [Bene, M. & Darkoh, M. B. K. (2014). The Constraints of Antiretroviral Uptake in Rural Areas: The Case of Thamaga and Surrounding Villages, Botswana. Journal of Social Aspects of HIV/AIDS, 11(1), 167-177. doi: 10.1080/17290376.2014.972057 ; Chavunduka, G. (1998). Professionalisation of Traditional Medicine in Zimbabwe, Harare, Jongwe Printers; O'Brien, S. & Broom, A. (2014). HIV in (and out of) the Clinic: Biomedicine, Traditional Medicine and Spiritual Healing in Harare. Journal of Social Aspects of HIV/AIDS, 11(1), 94-104. doi: 10.1080/17290376.2014.938102 ]. As such, a social approach to health-seeking behaviour questions how decisions about alternative therapies including herbal remedies, traditional healing and faith healing are made. The paper unpacks the realities around how people living with HIV and AIDS - who span different age groups and profess various religious backgrounds, faced with an insurmountable health challenge against a background of limited resources and no cure for the virus - often experience shifts in health-seeking behaviour. Grappling with seemingly simple questions about 'when, where and how to seek medical attention', the paper provides pointers to therapy choices and health-seeking behaviour; and it serves as a route into deeper and intense healthcare practice explorations. In conclusion, the paper proposes that medicine and the humanities should engage seriously with those social aspects of HIV and AIDS which call for an integrated approach to healthcare practice in Africa. If combined, medicine and the humanities

  12. Promoting better integration of health information systems: best practices and challenges

    NARCIS (Netherlands)

    Michelsen, K.; Brand, H.; Achterberg, P.; Wilkinson, J.

    2015-01-01

    Health Evidence Network Synthesis Report [Promoting better integration of health information systems: best practices and challenges K Michelsen, H Brand, P Achterberg, J Wilkinson - 2015 ... Authors Kai Michelsen Department of International Health, Maastricht University Maastricht,

  13. Direct Integration of Dynamic Emissive Displays into Knitted Fabric Structures

    Science.gov (United States)

    Bellingham, Alyssa

    Smart textiles are revolutionizing the textile industry by combining technology into fabric to give clothing new abilities including communication, transformation, and energy conduction. The advent of electroluminescent fibers, which emit light in response to an applied electric field, has opened the door for fabric-integrated emissive displays in textiles. This thesis focuses on the development of a flexible and scalable emissive fabric display with individually addressable pixels disposed within a fabric matrix. The pixels are formed in areas where a fiber supporting the dielectric and phosphor layers of an electroluminescent structure contacts a conductive surface. This conductive surface can be an external conductive fiber, yarn or wire, or a translucent conductive material layer deposited at set points along the electroluminescent fibers. Different contacting methods are introduced and the different ways the EL yarns can be incorporated into the knitted fabric are discussed. EL fibers were fabricated using a single yarn coating system with a custom, adjustable 3D printed slot die coater for even distribution of material onto the supporting fiber substrates. These fibers are mechanically characterized inside of and outside of a knitted fabric matrix to determine their potential for various applications, including wearables. A 4-pixel dynamic emissive display prototype is fabricated and characterized. This is the first demonstration of an all-knit emissive display with individually controllable pixels. The prototype is composed of a grid of fibers supporting the dielectric and phosphor layers of an electroluminescent (EL) device structure, called EL fibers, and conductive fibers acting as the top electrode. This grid is integrated into a biaxial weft knit structure where the EL fibers make up the rows and conductive fibers make up the columns of the reinforcement yarns inside the supporting weft knit. The pixels exist as individual segments of

  14. Dynamic Analysis with Fibre Optic Sensors for Structural Health Monitoring

    National Research Council Canada - National Science Library

    Paolozzi, Antonio; Gasbarri, Paolo

    2006-01-01

    Structural Health Monitoring (SHM) is a new frontier of non destructing testing. Often SHM is associated with fibre optic sensors whose signals can be used to identify the structure and consequently its damage...

  15. Analysis of decision fusion algorithms in handling uncertainties for integrated health monitoring systems

    Science.gov (United States)

    Zein-Sabatto, Saleh; Mikhail, Maged; Bodruzzaman, Mohammad; DeSimio, Martin; Derriso, Mark; Behbahani, Alireza

    2012-06-01

    It has been widely accepted that data fusion and information fusion methods can improve the accuracy and robustness of decision-making in structural health monitoring systems. It is arguably true nonetheless, that decision-level is equally beneficial when applied to integrated health monitoring systems. Several decisions at low-levels of abstraction may be produced by different decision-makers; however, decision-level fusion is required at the final stage of the process to provide accurate assessment about the health of the monitored system as a whole. An example of such integrated systems with complex decision-making scenarios is the integrated health monitoring of aircraft. Thorough understanding of the characteristics of the decision-fusion methodologies is a crucial step for successful implementation of such decision-fusion systems. In this paper, we have presented the major information fusion methodologies reported in the literature, i.e., probabilistic, evidential, and artificial intelligent based methods. The theoretical basis and characteristics of these methodologies are explained and their performances are analyzed. Second, candidate methods from the above fusion methodologies, i.e., Bayesian, Dempster-Shafer, and fuzzy logic algorithms are selected and their applications are extended to decisions fusion. Finally, fusion algorithms are developed based on the selected fusion methods and their performance are tested on decisions generated from synthetic data and from experimental data. Also in this paper, a modeling methodology, i.e. cloud model, for generating synthetic decisions is presented and used. Using the cloud model, both types of uncertainties; randomness and fuzziness, involved in real decision-making are modeled. Synthetic decisions are generated with an unbiased process and varying interaction complexities among decisions to provide for fair performance comparison of the selected decision-fusion algorithms. For verification purposes

  16. MUNI Ways and Structures Building Integrated Solar Membrane Project

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Randall

    2014-07-03

    The initial goal of the MUNI Ways and Structures Building Integrated Solar Membrane Installation Project was for the City and County of San Francisco (CCSF) to gain experience using the integrated higher efficiency solar photovoltaic (PV) single-ply membrane product, as it differs from the conventional, low efficiency, thin-film PV products, to determine the feasibility of success of larger deployment. As several of CCSF’s municipal rooftops are constrained with respect to weight restrictions, staff of the Energy Generation Group of the San Francisco Public Utilities Commission (SFPUC) proposed to install a solar PV system using single-ply membrane The installation of the 100 kW (DC-STC) lightweight photo voltaic (PV) system at the MUNI Ways and Structures Center (700 Pennsylvania Ave., San Francisco) is a continuation of the commitment of the City and County of San Francisco (CCSF) to increase the pace of municipal solar development, and serve its municipal facilities with clean renewable energy. The fourteen (14) solar photovoltaic systems that have already been installed at CCSF municipal facilities are assisting in the reduction of fossil-fuel use, and reduction of greenhouse gases from fossil combustion. The MUNI Ways & Structures Center roof has a relatively low weight-bearing capacity (3.25 pounds per square foot) and use of traditional crystalline panels was therefore rejected. Consequently it was decided to use the best available highest efficiency Building-Integrated PV (BIPV) technology, with consideration for reliability and experience of the manufacturer which can meet the low weight-bearing capacity criteria. The original goal of the project was to provide an opportunity to monitor the results of the BIPV technology and compare these results to other City and County of San Francisco installed PV systems. The MUNI Ways and Structures Center was acquired from the Cookson Doors Company, which had run the Center for many decades. The building was

  17. Administrative Challenges to the Integration of Oral Health With Primary Care

    Science.gov (United States)

    Maxey, Hannah L.; Randolph, Courtney; Gano, Laura; Kochhar, Komal

    2017-01-01

    Inadequate access to preventive oral health services contributes to oral health disparities and is a major public health concern in the United States. Federally Qualified Health Centers play a critical role in improving access to care for populations affected by oral health disparities but face a number of administrative challenges associated with implementation of oral health integration models. We conducted a SWOT (strengths, weaknesses, opportunities, and threats) analysis with health care executives to identify strengths, weaknesses, opportunities, and threats of successful oral health integration in Federally Qualified Health Centers. Four themes were identified: (1) culture of health care organizations; (2) operations and administration; (3) finance; and (4) workforce. PMID:27218701

  18. Integrative Health and Healing as the New Health Care Paradigm for the Military.

    Science.gov (United States)

    Petri, Richard P

    2015-10-01

    Background: The field of integrative health and healing (IH 2 ) is emerging out of the dark recesses of "voodoo" stereotypes and into the light as a new and much needed health care paradigm. It is a philosophy of health and healing that seeks to place patients as the preeminent players in health management, disease prevention, and injury recovery. There is an emphasis of patient responsibility, which includes a holistic approach that merges allopathic with complementary medicine. Objective: The aim of this article is to explore the historical origins of integrative medicine and investigate the future role of the IH 2 paradigm. Methods: This article reviews current available data and information regarding complementary and alternative medicine utilized in civilian and military populations as the basis for a new paradigm for a system of care-a system that empowers patients. Conclusions: The current U.S. health care system is reactive and disease-based, with a focus on reductionism. This system is not serving us well. IH 2 is a new model of cost-effective patient-centered health care.

  19. The integration of behavioral health interventions in children's health care: services, science, and suggestions.

    Science.gov (United States)

    Kolko, David J; Perrin, Ellen

    2014-01-01

    Because the integration of mental or behavioral health services in pediatric primary care is a national priority, a description and evaluation of the interventions applied in the healthcare setting is warranted. This article examines several intervention research studies based on alternative models for delivering behavioral health care in conjunction with comprehensive pediatric care. This review describes the diverse methods applied to different clinical problems, such as brief mental health skills, clinical guidelines, and evidence-based practices, and the empirical outcomes of this research literature. Next, several key treatment considerations are discussed to maximize the efficiency and effectiveness of these interventions. Some practical suggestions for overcoming key service barriers a