Concurrent Engineering Approaches for Sustainable Product Development in a Multi-Disciplinary Environment : Proceedings of the 19th ISPE International Conference on Concurrent Engineering

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Rock, Georg; Bil, Cees

2013-01-01

The CE Conference series is organized annually by the International Society for Productivity Enhancement (ISPE) and constitutes an important forum for international scientific exchange on concurrent and collaborative enterprise engineering. These international conferences attract a significant number of researchers, industrialists and students, as well as government representatives, who are interested in the recent advances in concurrent engineering research and applications. Concurrent Engineering Approaches for Sustainable Product Development in a Multi-Disciplinary Environment: Proceedings of the 19th ISPE International Conference on Concurrent Engineering contains papers accepted, peer reviewed and presented at the annual conference held  at the University of Applied Sciences in Trier, Germany, from 3rd-7th of September 2012. This covers a wide range of cutting-edge topics including: •Systems Engineering and Innovation •Design for Sustainability •Knowledge Engineering and Management •Managing pro...

Clinical Trials Management | Division of Cancer Prevention

Science.gov (United States)

Information for researchers about developing, reporting, and managing NCI-funded cancer prevention clinical trials. Protocol Information Office The central clearinghouse for clinical trials management within the Division of Cancer Prevention.Read more about the Protocol Information Office. | Information for researchers about developing, reporting, and managing NCI-funded

Refeeding syndrome – awareness, prevention and management

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Mehanna, Hisham; Nankivell, Paul C; Moledina, Jamil; Travis, Jane

2009-01-01

Background Refeeding syndrome is an important, yet commonly overlooked condition affecting patients. It occurs when feeding is commenced after a period of starvation. Head and neck cancer patients are at particular risk owing to prolonged periods of poor nutritional intake. This may be from general effects such as cancer anorexia or from more specific problems of dysphagia associated with this group of patients. Awareness of the condition is crucial in identifying patients at risk and taking measures to prevent its occurrence. Objectives The aims of this review are to: 1) Highlight the condition and stress the importance of its consideration when admitting head and neck cancer patients. 2) Discuss the pathophysiology behind refeeding syndrome. 3) Review the literature for the best available evidence and guidelines. 4) Highlight the need for further high quality research. Conclusion Refeeding syndrome is potentially fatal, yet is preventable. Awareness and identification of at-risk patients is crucial to improving management. Refeeding syndrome is caused by rapid refeeding after a period of under-nutrition, characterised by hypophosphataemia, electrolyte shifts and has metabolic and clinical complications. High risk patients include the chronically under-nourished and those with little intake for greater than 10 days. Patients with dysphagia are at particular risk. Refeeding should commence at 10 kcal/kg per day in patients at risk, and increased slowly. Thiamine, vitamin B complex and multi-vitamin supplements should be started with refeeding. New NICE guidelines state that pre-feeding correction of electrolyte and fluid deficits is unnecessary, but should be done concurrently with re-feeding. More research in this field is needed as the evidence base is lacking. PMID:19284691

Attitudes to malaria, prevention, treatment and management ...

African Journals Online (AJOL)

SERVER

2007-11-05

Nov 5, 2007 ... consequences of malaria treatment pattern and management strategies in an urban center. Questionnaires were issued ... anopheles mosquitoes as malaria vector are some of the factors militating against prevention and proper management of the .... bush clearing, drainage and gutter control in preventing.

Concurrency in product realization

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Kelly, Michael J.

1994-03-01

Technology per se does not provide a competitive advantage. Timely exploitation of technology is what gives the competitive edge, and this demands a major shift in the product development process and management of the industrial enterprise. `Teaming to win' is more than a management theme; it is the disciplined engineering practice that is essential to success in today's global marketplace. Teaming supports the concurrent engineering practices required to integrate the activities of people responsible for product realization through achievement of shorter development cycles, lower costs, and defect-free products.

Institutional Preventive Stress Management.

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Quick, James C.

1987-01-01

Stress is an inevitable characteristic of academic life, but colleges and universities can introduce stress management activities at the organizational level to avert excessive tension. Preventive actions are described, including flexible work schedules and social supports. (Author/MSE)

Partnership duration, concurrency, and HIV in sub-Saharan Africa.

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Sawers, Larry; Isaac, Alan

2017-07-01

A widely accepted explanation for the exceptionally high HIV prevalence in sub-Saharan Africa is the practice of long-term overlapping heterosexual partnering. This article shows that long-duration concurrent partnering can be protective against HIV transmission rather than promoting it. Monogamous partnering prevents sexual transmission to anyone outside the partnership and, in an initially concordant-seronegative partnership, prevents sexual acquisition of HIV by either partner. Those protections against transmission and acquisition last as long as the partnership persists without new outside partnerships. Correspondingly, these two protective effects characterise polygynous partnerships, whether or not the polygyny is formal or informal, until a partner initiates a new partnership. Stable and exclusive unions of any size protect against HIV transmission, and more durable unions provide a longer protective effect. Survey research provides little information on partnership duration in sub-Saharan Africa and sheds no light on the interaction of duration, concurrency, and HIV. This article shows how assumptions about partnership duration in individual-based sexual-network models affect the contours of simulated HIV epidemics. Longer mean partnership duration slows the pace at which simulated epidemics grow. With plausible assumptions about partnership duration and at levels of concurrency found in the region, simulated HIV epidemics grow slowly or not at all. Those results are consistent with the hypothesis that long-duration partnering is protective against HIV and inconsistent with the hypothesis that long-term concurrency drives the HIV epidemics in sub-Saharan Africa.

Preventing Stress in Organizations How to Develop Positive Managers

CERN Document Server

Donaldson-Feilder, Emma; Yarker, Joanna

2011-01-01

Preventing Stress in Organizations:How to Develop Positive Managersoffers an innovative, evidence-based approach to help managers prevent and reduce workplace stress in their staff.Provides information on the critical skills managers must develop in order to prevent stress in their staff, and the key ongoing behaviours that promote a healthy work environmentShows practitioners in occupational psychology, HR, Health and Safety and related professions how positive management can be integrated into an organization???s existing practices and processesServes as an essential guide for managers thems

Concurrent negotiation and coordination for grid resource coallocation.

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Sim, Kwang Mong; Shi, Benyun

2010-06-01

Bolstering resource coallocation is essential for realizing the Grid vision, because computationally intensive applications often require multiple computing resources from different administrative domains. Given that resource providers and consumers may have different requirements, successfully obtaining commitments through concurrent negotiations with multiple resource providers to simultaneously access several resources is a very challenging task for consumers. The impetus of this paper is that it is one of the earliest works that consider a concurrent negotiation mechanism for Grid resource coallocation. The concurrent negotiation mechanism is designed for 1) managing (de)commitment of contracts through one-to-many negotiations and 2) coordination of multiple concurrent one-to-many negotiations between a consumer and multiple resource providers. The novel contributions of this paper are devising 1) a utility-oriented coordination (UOC) strategy, 2) three classes of commitment management strategies (CMSs) for concurrent negotiation, and 3) the negotiation protocols of consumers and providers. Implementing these ideas in a testbed, three series of experiments were carried out in a variety of settings to compare the following: 1) the CMSs in this paper with the work of others in a single one-to-many negotiation environment for one resource where decommitment is allowed for both provider and consumer agents; 2) the performance of the three classes of CMSs in different resource market types; and 3) the UOC strategy with the work of others [e.g., the patient coordination strategy (PCS )] for coordinating multiple concurrent negotiations. Empirical results show the following: 1) the UOC strategy achieved higher utility, faster negotiation speed, and higher success rates than PCS for different resource market types; and 2) the CMS in this paper achieved higher final utility than the CMS in other works. Additionally, the properties of the three classes of CMSs in

Management and Surgical Outcomes of Concurrent Tuberculosis and Lung Cancer.

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Evman, Serdar; Baysungur, Volkan; Alpay, Levent; Uskul, Bahadir; Misirlioglu, Aysun Kosif; Kanbur, Serda; Dogruyol, Talha

2017-10-01

Background  Concurrent pulmonary tuberculosis (TB) and lung cancer are rarely encountered in Western countries; however, it is more common in developing countries. We aim to share the diagnostic and treatment approaches in this study. Materials and Methods  Clinical files of all patients undergoing lung resection for non-small cell carcinoma with concurrent pulmonary TB between February 2006 and December 2012 were investigated retrospectively in terms of patient characteristics, operation methods, definite pathology and stage of tumor, postoperative treatment schemes, and associated complications. Results  TB was detected in 17 (1.3%) of 1,266 operated carcinoma patients. Eleven had squamous cell carcinoma and six had adenocarcinoma. Mean age was 54.9 years. Two patients received anti-TB treatment preoperatively. Fifteen patients were given anti-TB treatment postoperatively, as soon as definite microbiological confirmation was obtained, and concurrently given adjuvant therapy after 3 weeks of sole four-drug TB treatment. Pneumonectomy was performed in four (23.5%), sleeve lobectomy in three (17.6%), lobectomy in eight (47%), and bilobectomy in two (11.7%) patients. Postoperative complications occurred in four (23.5%) patients, with bronchopleural fistula being seen in only one pneumonectomy patient. No postoperative mortality or reactivation of TB was seen. Mean survival time was 32 ± 2 months. Conclusion  Resection following a 3-week anti-TB treatment or concurrent anti-TB and postoperative adjuvant chemotherapy does not constitute an additional postoperative risk for patients with concomitant lung malignancy and pulmonary TB. The determination of optimum treatment for these patients presents a challenge in developing countries, where TB is still a common disease. Georg Thieme Verlag KG Stuttgart · New York.

Measuring and modelling concurrency

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Sawers, Larry

2013-01-01

This article explores three critical topics discussed in the recent debate over concurrency (overlapping sexual partnerships): measurement of the prevalence of concurrency, mathematical modelling of concurrency and HIV epidemic dynamics, and measuring the correlation between HIV and concurrency. The focus of the article is the concurrency hypothesis – the proposition that presumed high prevalence of concurrency explains sub-Saharan Africa's exceptionally high HIV prevalence. Recent surveys using improved questionnaire design show reported concurrency ranging from 0.8% to 7.6% in the region. Even after adjusting for plausible levels of reporting errors, appropriately parameterized sexual network models of HIV epidemics do not generate sustainable epidemic trajectories (avoid epidemic extinction) at levels of concurrency found in recent surveys in sub-Saharan Africa. Efforts to support the concurrency hypothesis with a statistical correlation between HIV incidence and concurrency prevalence are not yet successful. Two decades of efforts to find evidence in support of the concurrency hypothesis have failed to build a convincing case. PMID:23406964

[Construction of the addiction prevention core competency model for preventing addictive behavior in adolescents].

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Park, Hyun Sook; Jung, Sun Young

2013-12-01

This study was done to provide fundamental data for the development of competency reinforcement programs to prevent addictive behavior in adolescents through the construction and examination of an addiction prevention core competency model. In this study core competencies for preventing addictive behavior in adolescents through competency modeling were identified, and the addiction prevention core competency model was developed. It was validated methodologically. Competencies for preventing addictive behavior in adolescents as defined by the addiction prevention core competency model are as follows: positive self-worth, self-control skill, time management skill, reality perception skill, risk coping skill, and positive communication with parents and with peers or social group. After construction, concurrent cross validation of the addiction prevention core competency model showed that this model was appropriate. The study results indicate that the addiction prevention core competency model for the prevention of addictive behavior in adolescents through competency modeling can be used as a foundation for an integral approach to enhance adolescent is used as an adjective and prevent addictive behavior. This approach can be a school-centered, cost-efficient strategy which not only reduces addictive behavior in adolescents, but also improves the quality of their resources.

Integrated forest management to prevent wildfires under Mediterranean environments

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Piermaria Corona

2015-02-01

Full Text Available This review presents a multidisciplinary framework for integrating the ecological, regulatory, procedural and technical aspects of forest management for fires prevention under Mediterranean environments. The aims are to: i provide a foreground of wildfire scenario; ii illustrate the theoretical background of forest fuel management; iii describe the available fuel management techniques and mechanical operations for fire prevention in forest and wildland-urban interfaces, with exemplification of case-studies; iv allocate fire prevention activities under the hierarchy of forest planning. The review is conceived as an outline commentary discussion targeted to professionals, technicians and government personnel involved in forestry and environmental management.

Crisis prevention and management during SARS outbreak, Singapore.

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Quah, Stella R; Hin-Peng, Lee

2004-02-01

We discuss crisis prevention and management during the first 3 months of the severe acute respiratory syndrome (SARS) outbreak in Singapore. Four public health issues were considered: prevention measures, self-health evaluation, SARS knowledge, and appraisal of crisis management. We conducted telephone interviews with a representative sample of 1,201 adults, > or = 21 years of age. We found that sex, age, and attitude (anxiety and perception of open communication with authorities) were associated with practicing preventive measures. Analysis of Singapore's outbreak improves our understanding of the social dimensions of infectious disease outbreaks.

Automata and concurrency

Energy Technology Data Exchange (ETDEWEB)

Priese, L

1983-07-01

The author presents a precise notion of a realization (or simulation) of one concurrent system by another, and studies the relations of modular concurrent systems and non-persistent (i.e. With conflicts) concurrent systems in an automata theoretical style. He introduces a conception of realization that obeys three requirements: it allows for proper hierarchies in certain classes of concurrent systems; it allows for normal-form theorems, and the standard constructions of the literature remain realizations in formal concept; and it clarifies some counterintuitive examples. Further, although this realization conception is developed to translate the computational aspects of concurrent systems, it also gives a formal tool for the handling of synchronization problems. 38 references.

Concurrent Complementary and Alternative Medicine CAM and Conventional Rehabilitation Therapy in the Management of Children with Developmental Disorders

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Soo Yeon Kim

2013-01-01

Full Text Available Background. We investigated the concurrent use of conventional rehabilitations and complementary and alternative medicine (CAM therapies for the long-term management of children with developmental disorders (DDs. Methods. The parents or caregivers of 533 children with DDs (age range, 1–19 years who visited the rehabilitation centers were surveyed using in depth face-to-face interviews. Results. Of the 533 patients enrolled, 520 completed the questionnaire (97% response rate. A total of 292 (56% children were receiving multiple therapies, more than two conventional rehabilitations and CAM, at the time of the interview. A total of 249 (48% children reported lifetime CAM use, 23% used CAM at the time of the interview, and 62% of the patients planned to use CAM therapy in the future. Conventional rehabilitation therapies used at the time of the interview included physical therapy (30%, speech therapy (28%, and occupational therapy (19%, and the CAM therapies included herbal medicine (5% and acupuncture or moxibustion (3%. The respondents indicated that in the future they planned to use acupuncture or moxibustion (57%, occupational therapy (18%, cognitive behavioral therapy (16%, speech therapy (10%, and physical therapy (8%. Conclusion. Concurrent management as conventional rehabilitations and CAM therapies is widely used by children with DDs.

Short-term Mobility and Increased Partnership Concurrency among Men in Zimbabwe.

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Susan Cassels

Full Text Available Migration has long been understood as an underlying factor for HIV transmission, and sexual partner concurrency has been increasingly studied as an important component of HIV transmission dynamics. However, less work has examined the role of short-term mobility in sexual partner concurrency using a network approach. Short-term mobility may be a risk for HIV for the migrant's partner as well either through the partner's risk behaviors while the migrant is away, such as the partner having additional partners, or via exposure to the return migrant.Using data from the 2010-11 Zimbabwe Demographic and Health Survey, weighted generalized linear regression models were used to investigate the associations between short-term mobility and partnership concurrency at the individual and partnership levels.At the individual level, we find strong evidence of an association between short-term mobility and concurrency. Men who traveled were more likely to have concurrent partnerships compared to men who did not travel and the relationship was non-linear: each trip was associated with a 2% higher probability of concurrency, with a diminishing risk at 60 trips (p<0.001. At the partnership level, short-term mobility by the male only or both partners was associated with male concurrency. Couples in which the female only traveled exhibited less male concurrency.Short-term mobility has the ability to impact population-level transmission dynamics by facilitating partnership concurrency and thus onward HIV transmission. Short-term migrants may be an important population to target for HIV testing, treatment, or social and behavioral interventions to prevent the spread of HIV.

The TRIDEC System-of-Systems; Choreography of large-scale concurrent tasks in Natural Crisis Management

Science.gov (United States)

Häner, R.; Wächter, J.

2012-04-01

The project Collaborative, Complex, and Critical Decision-Support in Evolving Crises (TRIDEC), co-funded by the European Commission in its Seventh Framework Programme aims at establishing a network of dedicated, autonomous legacy systems for large-scale concurrent management of natural crises utilising heterogeneous information resources. TRIDEC's architecture reflects the System-of- Systems (SoS) approach which is based on task-oriented systems, cooperatively interacting as a collective in a common environment. The design of the TRIDEC-SoS follows the principles of service-oriented and event-driven architectures (SOA & EDA) exceedingly focusing on a loose coupling of the systems. The SoS approach in combination with SOA and EDA has the distinction of being able to provide novel and coherent behaviours and features resulting from a process of dynamic self-organisation. Self-organisation is a process without the need for a central or external coordinator controlling it through orchestration. It is the result of enacted concurrent tasks in a collaborative environment of geographically distributed systems. Although the individual systems act completely autonomously, their interactions expose emergent structures of evolving nature. Particularly, the fact is important that SoS are inherently able to evolve on all facets of intelligent information management. This includes adaptive properties, e.g. seamless integration of new resource types or the adoption of new fields in natural crisis management. In the case of TRIDEC with various heterogeneous participants involved, concurrent information processing is of fundamental importance because of the achievable improvements regarding cooperative decision making. Collaboration within TRIDEC will be implemented with choreographies and conversations. Choreographies specify the expected behaviour between two or more participants; conversations describe the message exchange between all participants emphasising their logical

The prevention research centers' managing epilepsy well network.

Science.gov (United States)

DiIorio, Colleen K; Bamps, Yvan A; Edwards, Ariele L; Escoffery, Cam; Thompson, Nancy J; Begley, Charles E; Shegog, Ross; Clark, Noreen M; Selwa, Linda; Stoll, Shelley C; Fraser, Robert T; Ciechanowski, Paul; Johnson, Erica K; Kobau, Rosemarie; Price, Patricia H

2010-11-01

The Managing Epilepsy Well (MEW) Network was created in 2007 by the Centers for Disease Control and Prevention's (CDC) Prevention Research Centers and Epilepsy Program to promote epilepsy self-management research and to improve the quality of life for people with epilepsy. MEW Network membership comprises four collaborating centers (Emory University, University of Texas Health Science Center at Houston, University of Michigan, and University of Washington), representatives from CDC, affiliate members, and community stakeholders. This article describes the MEW Network's background, mission statement, research agenda, and structure. Exploratory and intervention studies conducted by individual collaborating centers are described, as are Network collaborative projects, including a multisite depression prevention intervention and the development of a standard measure of epilepsy self-management. Communication strategies and examples of research translation programs are discussed. The conclusion outlines the Network's role in the future development and dissemination of evidence-based epilepsy self-management programs. Copyright © 2010 Elsevier Inc. All rights reserved.

Concurrent analysis: towards generalisable qualitative research.

Science.gov (United States)

Snowden, Austyn; Martin, Colin R

2011-10-01

This study develops an original method of qualitative analysis coherent with its interpretivist principles. The objective is to increase the likelihood of achieving generalisability and so improve the chance of the findings being translated into practice. Good qualitative research depends on coherent analysis of different types of data. The limitations of existing methodologies are first discussed to justify the need for a novel approach. To illustrate this approach, primary evidence is presented using the new methodology. The primary evidence consists of a constructivist grounded theory of how mental health nurses with prescribing authority integrate prescribing into practice. This theory is built concurrently from interviews, reflective accounts and case study data from the literature. Concurrent analysis. Ten research articles and 13 semi-structured interviews were sampled purposively and then theoretically and analysed concurrently using constructivist grounded theory. A theory of the process of becoming competent in mental health nurse prescribing was generated through this process. This theory was validated by 32 practising mental health nurse prescribers as an accurate representation of their experience. The methodology generated a coherent and generalisable theory. It is therefore claimed that concurrent analysis engenders consistent and iterative treatment of different sources of qualitative data in a manageable manner. This process supports facilitation of the highest standard of qualitative research. Concurrent analysis removes the artificial delineation of relevant literature from other forms of constructed data. This gives researchers clear direction to treat qualitative data consistently raising the chances of generalisability of the findings. Raising the generalisability of qualitative research will increase its chances of informing clinical practice. © 2010 Blackwell Publishing Ltd.

Predictors of perceived male partner concurrency among women at risk for HIV and STI acquisition in Durban, South Africa.

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Gaffoor, Zakir; Wand, Handan; Street, Renée A; Abbai, Nathlee; Ramjee, Gita

2016-01-01

Women in sub-Saharan Africa continue to be at greater risk for HIV acquisition than men. Concurrency, viz. multiple sexual partnerships that overlap over time, has been studied as a possible risk factor for HIV transmission. The aim of this study was to identify predictors of perceived male partner concurrency among sexually active, HIV negative women. Socio-demographic and behavioural data from women enrolled in a biomedical HIV prevention clinical trial were assessed in relation to perceived male partner concurrency using the Chi squared test. Univariate and multivariate logistic regression was performed to assess the independent predictors of perceived male partner concurrency. Kaplan-Meier survival estimates were obtained for HIV and STI incidence in relation to male partner concurrency. A Cox Proportional Hazards model was used to assess the association between perceived male partner concurrency and HIV and STI incidence. The results revealed that 29 % of women reported their male partners to be in concurrent sexual relationships, 22 % reported partners that were not engaging in concurrency, whilst 49 % reported not knowing their partners concurrency status. Older women, having never married, experiencing economic abuse, and women reporting individual concurrency, were found to be significant predictors of perceived male partner concurrency in the studied population. Perceived male partner concurrency was not found to be a significantly associated with incident HIV and STI infections in this analysis. The study provides insight into predictors of perceived male partner concurrency among women at high risk for STI and HIV acquisition. These results may inform the design of behavioural and biomedical interventions, to address the role of multiple sexual partnerships in HIV prevention.

Concurrent weighted logic

DEFF Research Database (Denmark)

Xue, Bingtian; Larsen, Kim Guldstrand; Mardare, Radu Iulian

2015-01-01

We introduce Concurrent Weighted Logic (CWL), a multimodal logic for concurrent labeled weighted transition systems (LWSs). The synchronization of LWSs is described using dedicated functions that, in various concurrency paradigms, allow us to encode the compositionality of LWSs. To reflect these......-completeness results for this logic. To complete these proofs we involve advanced topological techniques from Model Theory....

Sexually transmitted infections: prevention and management.

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Jackson, Denis; Dallabetta, Gina; Steen, Richard

2004-02-01

In the early 21st century, STI and HIV have been linked inextricably. Although the focus of this article is STI, some discussion on the diagnosis and management of individuals with HIV infection is necessary. The history of HIV diagnosis in the workplace is checkered. The authors have seen cases of prospective workers being subjected to HIV testing without their knowledge as part of a pre-employment medical examination. If the test came back positive, the men were told that they would not be employed without explanation. This approach is a breech of the human rights of the individual being tested and cannot be condoned. Any HIV testing must be done with the full and informed consent of the individual, with counseling given before and after testing to enable individuals with HIV infection to seek care and protect their families and to give individuals without HIV infection counseling on risk reduction. Men and women who present with an STI are at risk for HIV infection. With increasing options for management and secondary prevention, it is important to recognize people who are at risk. This identification should be done through HIV VCT. The location, funding, and supervision of VCT sites related to workplace populations should be a subject for serious debate. Although fears of mass layoffs after HIV testing largely have been unfounded, it is natural for workers to be fearful, unless there is a clearly articulated policy stating that the company observes and enforces nondiscriminatory practices. The workplace examples show that syndromic STI management, allied to comprehensive prevention programs, can have a genuine and measurable impact on STI prevalence. The potential interventions and partners are listed in Table 2. A community-based, randomized study in Tanzania showed that the institution of a well-managed STI syndromic management program can reduce HIV incidence by up to 40%, in the context of a rising HIV epidemic. Presumptive STI treatment for female sex

Prevention of overuse injuries by a concurrent exercise program in subjects exposed to an increase in training load: a randomized controlled trial of 1020 army recruits

DEFF Research Database (Denmark)

Brushøj, Christoffer; Larsen, Klaus; Albrecht-Beste, Elisabeth

2008-01-01

on a literature review of intrinsic risk factors, and performed concurrent with an increase in physical activity, can reduce the incidence of overuse knee injuries and medial tibial stress syndrome, as well as increase running distance. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS...... no significant differences in incidence of injury between the prevention group and the placebo group (incidence, 0.22 vs 0.19; P = .162; relative risk = 1.05 [range, 0.98-1.11]). The soldiers in the prevention group had the greater improvement in running distance in 12-minute run tests (82 vs 43 m; P = .037......BACKGROUND: It is unknown whether an exercise program can prevent overuse injuries in the lower extremity. An often encountered and important risk factor for the development of lower extremity overuse injuries is an abrupt increase in activity level. HYPOTHESIS: A preventive training program based...

Understanding the role of waste prevention in local waste management: A literature review.

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Zacho, Kristina O; Mosgaard, Mette A

2016-10-01

Local waste management has so far been characterised by end-of-pipe solutions, landfilling, incineration, and recycling. End-of-pipe solutions build on a different mind-set than life cycle-based approaches, and for this reason, local waste managers are reluctant to consider strategies for waste prevention. To accelerate the transition of waste and resource management towards a more integrated management, waste prevention needs to play a larger role in the local waste management. In this review article, we collect knowledge from the scientific community on waste prevention of relevance to local waste management. We analyse the trends in the waste prevention literature by organising the literature into four categories. The results indicate an increasing interest in waste prevention, but not much literature specifically concerns the integration of prevention into the local waste management. However, evidence from the literature can inform local waste management on the prevention potential; the environmental and social effects of prevention; how individuals in households can be motivated to reduce waste; and how the effects of prevention measures can be monitored. Nevertheless, knowledge is still lacking on local waste prevention, especially regarding the methods for monitoring and how local waste management systems can be designed to encourage waste reduction in the households. We end the article with recommendations for future research. The literature review can be useful for both practitioners in the waste sector and for academics seeking an overview of previous research on waste prevention. © The Author(s) 2016.

Concurrent chemoradiation for vaginal cancer.

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David T Miyamoto

Full Text Available BACKGROUND: It is not known whether the addition of chemotherapy to radiation therapy improves outcomes in primary vaginal cancer. Here, we review clinical outcomes in patients with primary vaginal cancer treated with radiation therapy (RT or concurrent chemoradiation therapy (CRT. METHODS: Seventy-one patients with primary vaginal cancer treated with definitive RT with or without concurrent chemotherapy at a single institution were identified and their records reviewed. A total of 51 patients were treated with RT alone; 20 patients were treated with CRT. Recurrences were analyzed. Overall survival (OS and disease-free survival (DFS rates were estimated using the Kaplan-Meier method. Cox regression analysis was performed. RESULTS: The median age at diagnosis was 61 years (range, 18-92 years and the median follow-up time among survivors was 3.0 years. Kaplan-Meier estimates for OS and DFS differed significantly between the RT and CRT groups (3-yr OS = 56% vs. 79%, log-rank p = 0.037; 3-yr DFS = 43% vs. 73%, log-rank p = 0.011. Twenty-three patients (45% in the RT group had a relapse at any site compared to 3 (15% in the CRT group (p = 0.027. With regard to the sites of first relapse, 10 patients (14% had local only, 4 (6% had local and regional, 9 (13% had regional only, 1 (1% had regional and distant, and 2 (3% had distant only relapse. On univariate analysis, the use of concurrent chemotherapy, FIGO stage, tumor size, and date of diagnosis were significant predictors of DFS. On multivariate analysis, the use of concurrent chemotherapy remained a significant predictor of DFS (hazard ratio 0.31 (95% CI, 0.10-0.97; p = 0.04. CONCLUSIONS: Vaginal cancer results in poor outcomes. Adequate radiation dose is essential to ensure curative management. Concurrent chemotherapy should be considered for vaginal cancer patients.

Characterizing Distributed Concurrent Engineering Teams: A Descriptive Framework for Aerospace Concurrent Engineering Design Teams

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Chattopadhyay, Debarati; Hihn, Jairus; Warfield, Keith

2011-01-01

As aerospace missions grow larger and more technically complex in the face of ever tighter budgets, it will become increasingly important to use concurrent engineering methods in the development of early conceptual designs because of their ability to facilitate rapid assessments and trades in a cost-efficient manner. To successfully accomplish these complex missions with limited funding, it is also essential to effectively leverage the strengths of individuals and teams across government, industry, academia, and international agencies by increased cooperation between organizations. As a result, the existing concurrent engineering teams will need to increasingly engage in distributed collaborative concurrent design. This paper is an extension of a recent white paper written by the Concurrent Engineering Working Group, which details the unique challenges of distributed collaborative concurrent engineering. This paper includes a short history of aerospace concurrent engineering, and defines the terms 'concurrent', 'collaborative' and 'distributed' in the context of aerospace concurrent engineering. In addition, a model for the levels of complexity of concurrent engineering teams is presented to provide a way to conceptualize information and data flow within these types of teams.

Tips for Disaster Responders: Preventing and Managing Stress

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... actions to prevent stress and to strengthen your stress management skills is before your disaster assignment. Responder stress ... the disaster role, developing a personal toolkit of stress management skills, and preparing yourself and your loved ones. ...

Dimetrodon: Processor-level Preventive Thermal Management via Idle Cycle Injection

OpenAIRE

Reddi, Vijay Janapa; Gandhi, Sanjay; Brooks, David M.; Seltzer, Margo I.; Bailis, Peter

2011-01-01

Processor-level dynamic thermal management techniques have long targeted worst-case thermal margins. We examine the thermal-performance trade-offs in average-case, preventive thermal management by actively degrading application performance to achieve long-term thermal control. We propose Dimetrodon, the use of idle cycle injection, a flexible, per-thread technique, as a preventive thermal management mechanism and demonstrate its efficiency compared to hardware techniques in a commodity operatin...

Concurrent alcohol and medication poisoning hospital admissions among older rural and urban residents.

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Zanjani, Faika; Smith, Rachel; Slavova, Svetla; Charnigo, Richard; Schoenberg, Nancy; Martin, Catherine; Clayton, Richard

2016-07-01

Alcohol and medication interactions are projected to increase due to the growth of older adults that are unsafely consuming alcohol and medications. Plus, aging adults who reside in rural areas are at the highest risk of experiencing medication interactions. Estimate concurrent alcohol and medication (alcohol/medication) hospitalizations in adults 50+ years, comparing age groups and rural/urban regions. Kentucky nonfederal, acute care inpatient hospital discharge electronic records for individuals aged 50+ years from 2001 to 2012 were examined. Rate differences were estimated across age and regional strata. Differences in the underlying principal diagnosis, intent, and medications were also examined. There were 2168 concurrent alcohol/medication hospitalizations among 50+ year olds identified. There was a 187% increase in alcohol/medication hospitalizations from 2001 (n = 104) to 2012 (n = 299). The per capita alcohol/medication hospitalization rate increased from 8.91 (per 100,000) in 2001 to 19.98 (per 100,000) in 2012, a 124% increase. The characteristics of the hospitalizations included 75% principal diagnosis as medication poisoning, self-harm as the primary intent (55%) in 50-64-year olds, and unintentional intent (41%) in 65+ adults. Benzodiazepines were most often involved in the poisonings (36.5%). Concurrent alcohol/medication hospitalizations in Kentucky are increasing among aging adults. Greater increases in rural areas and the 65+ aged adults were seen, although there were also higher alcohol/medication hospitalizations in urban and 50-64 aged adults. These findings indicate the need for public-health prevention and clinical intervention to better educate and manage alcohol consuming older adults on safe medication and alcohol practices.

Building Safe Concurrency Abstractions

DEFF Research Database (Denmark)

Madsen, Ole Lehrmann

2014-01-01

Concurrent object-oriented programming in Beta is based on semaphores and coroutines and the ability to define high-level concurrency abstractions like monitors, and rendezvous-based communication, and their associated schedulers. The coroutine mechanism of SIMULA has been generalized into the no......Concurrent object-oriented programming in Beta is based on semaphores and coroutines and the ability to define high-level concurrency abstractions like monitors, and rendezvous-based communication, and their associated schedulers. The coroutine mechanism of SIMULA has been generalized...

The Concert system - Compiler and runtime technology for efficient concurrent object-oriented programming

Science.gov (United States)

Chien, Andrew A.; Karamcheti, Vijay; Plevyak, John; Sahrawat, Deepak

1993-01-01

Concurrent object-oriented languages, particularly fine-grained approaches, reduce the difficulty of large scale concurrent programming by providing modularity through encapsulation while exposing large degrees of concurrency. Despite these programmability advantages, such languages have historically suffered from poor efficiency. This paper describes the Concert project whose goal is to develop portable, efficient implementations of fine-grained concurrent object-oriented languages. Our approach incorporates aggressive program analysis and program transformation with careful information management at every stage from the compiler to the runtime system. The paper discusses the basic elements of the Concert approach along with a description of the potential payoffs. Initial performance results and specific plans for system development are also detailed.

Apple-CORE: Microgrids of SVP cores: flexible, general-purpose, fine-grained hardware concurrency management

NARCIS (Netherlands)

Poss, R.; Lankamp, M.; Yang, Q.; Fu, J.; van Tol, M.W.; Jesshope, C.; Nair, S.

2012-01-01

To harness the potential of CMPs for scalable, energy-efficient performance in general-purpose computers, the Apple-CORE project has co-designed a general machine model and concurrency control interface with dedicated hardware support for concurrency control across multiple cores. Its SVP interface

Distributed Management of Concurrent Web Service Transactions

DEFF Research Database (Denmark)

Alrifai, Mohammad; Dolog, Peter; Balke, Wolf-Tilo

2009-01-01

Business processes involve dynamic compositions of interleaved tasks. Therefore, ensuring reliable transactional processing of Web services is crucial for the success of Web service-based B2B and B2C applications. But the inherent autonomy and heterogeneity of Web services render the applicability...... of conventional ACID transaction models for Web services far from being straightforward. Current Web service transaction models relax the isolation property and rely on compensation mechanisms to ensure atomicity of business transactions in the presence of service failures. However, ensuring consistency...... in the open and dynamic environment of Web services, where interleaving business transactions enter and exit the system independently, remains an open issue. In this paper, we address this problem and propose an architecture that supports concurrency control on the Web services level. An extension...

Use of quality management methods in the transition from efficacious prevention programs to effective prevention services.

Science.gov (United States)

Daniels, Vicki-Smith; Sandler, Irwin; Wolchik, Sharlene

2008-06-01

This paper applies concepts and methods developed in management to translate efficacious prevention programs into effective prevention services. The paper describes Quality Function Deployment (QFD) as a method for structured planning and development that connects the needs and wants of the consumer with the design of the product or service. The paper describes basic tools used in quality management, and discusses how they might be applied to prepare a prevention program for implementation by community agencies. Prevention programs are conceptualized as having multiple consumers (i.e., stakeholders), including the participants who receive the service, the service providers, the organizations that deliver the program, and the researchers who evaluate the programs. As an illustration of one step in the application of QFD to translate efficacious prevention programs into effective prevention services, analysis of the needs and preferences of Family Courts for the implementation of an the New Beginnings Program is presented.

Indirubin-3-Oxime Prevents H2O2-Induced Neuronal Apoptosis via Concurrently Inhibiting GSK3β and the ERK Pathway.

Science.gov (United States)

Yu, Jie; Zheng, Jiacheng; Lin, Jiajia; Jin, Linlu; Yu, Rui; Mak, Shinghung; Hu, Shengquan; Sun, Hongya; Wu, Xiang; Zhang, Zaijun; Lee, Mingyuen; Tsim, Wahkeung; Su, Wei; Zhou, Wenhua; Cui, Wei; Han, Yifan; Wang, Qinwen

2017-05-01

Oxidative stress-induced neuronal apoptosis plays an important role in many neurodegenerative disorders. In this study, we have shown that indirubin-3-oxime, a derivative of indirubin originally designed for leukemia therapy, could prevent hydrogen peroxide (H 2 O 2 )-induced apoptosis in both SH-SY5Y cells and primary cerebellar granule neurons. H 2 O 2 exposure led to the increased activities of glycogen synthase kinase 3β (GSK3β) and extracellular signal-regulated kinase (ERK) in SH-SY5Y cells. Indirubin-3-oxime treatment significantly reversed the altered activity of both the PI3-K/Akt/GSK3β cascade and the ERK pathway induced by H 2 O 2 . In addition, both GSK3β and mitogen-activated protein kinase inhibitors significantly prevented H 2 O 2 -induced neuronal apoptosis. Moreover, specific inhibitors of the phosphoinositide 3-kinase (PI3-K) abolished the neuroprotective effects of indirubin-3-oxime against H 2 O 2 -induced neuronal apoptosis. These results strongly suggest that indirubin-3-oxime prevents H 2 O 2 -induced apoptosis via concurrent inhibiting GSK3β and the ERK pathway in SH-SY5Y cells, providing support for the use of indirubin-3-oxime to treat neurodegenerative disorders caused or exacerbated by oxidative stress.

Conflict management, prevention, and resolution in medical settings.

Science.gov (United States)

Andrew, L B

1999-01-01

Everything about conflict is difficult for physicians, who are by nature and conditioning quite confrontation adverse. But conflict is inevitable, and conflict management skills are essential life skills for effective people. The keys to conflict management are prevention, effective communication, and anger management, skills that can be learned and polished. Conflict management skills can enhance all aspects of life for physicians, as well as those who work or live with them.

Transactions Concurrency Control in Web Service Environment

DEFF Research Database (Denmark)

Alrifai, Mohammad; Dolog, Peter; Nejdl, Wolfgang

2006-01-01

an engineering point of view as it does not change the way consumers or clients of web services have to be programmed. Furthermore, it avoids direct communication between transaction coordinators which preserves security by keeping the information about business transactions restricted to the coordinators which......Business transactions in web service environments run with relaxed isolation and atomicity property. In such environments, transactions can commit and roll back independently on each other. Transaction management has to reflect this issue and address the problems which result for example from...... concurrent access to web service resources and data. In this paper we propose an extension to the WS-Transaction Protocol which ensures the consistency of the data when independent business transactions access the data concurrently under the relaxed transaction properties. Our extension is based...

Diagnosis, Prevention and Management of Postoperative ...

African Journals Online (AJOL)

Diagnosis, Prevention and Management of Postoperative Pulmonary Edema. ... period or it can be negative pressure pulmonary edema (NPPE). NPPE is an important clinical entity in immediate post.extubation period and occurs due to acute upper airway obstruction and creation of acute negative intrathoracic pressure.

Concurrent sexual partnerships among African American women in Philadelphia: results from a qualitative study.

Science.gov (United States)

Nunn, Amy; Dickman, Samuel; Cornwall, Alexandra; Kwakwa, Helena; Mayer, Kenneth H; Rana, Aadia; Rosengard, Cynthia

2012-07-01

African American women are disproportionately affected by HIV/AIDS. Concurrent sexual partnerships may contribute to racial disparities in HIV infection. Little is known about attitudes and practices related to concurrency among African American women, or the social, structural and behavioural factors influencing concurrency. We recruited 19 heterosexual African American women engaging in concurrent sexual partnerships from a public clinic in Philadelphia in 2009. We conducted interviews exploring social norms, attitudes and practices about concurrency, and the structural, social and behavioural factors influencing concurrent sexual partnerships, guided by grounded theory. Seventeen women reported one main and one or more non-main partners; two reported no main partners. Many women used condoms more frequently with non-main than main partners, noting they trust main partners more than non-main partners. Social factors included social normalisation of concurrency, inability to negotiate partners' concurrent partnerships, being unmarried, and not trusting partners. Lack of trust was the most commonly cited reason that women engaged in concurrent partnerships. Structural factors included economic dependence on partners, partners' dependence on women for economic support and incarceration that interrupted partnerships. Behavioural factors included alcohol and cocaine use. Social, structural and behavioural factors strongly influenced these African American women's concurrent sexual partnerships. Many HIV interventions disseminated by the CDC focus largely on behavioural factors and may fail to address the social and structural factors influencing African American women's sexual networks. Novel HIV prevention interventions that address the social determinants of African American women's HIV risks are urgently needed.

Criteria for inhalation exposure systems utilizing concurrent flow spirometry

International Nuclear Information System (INIS)

Raabe, O.G.; Yeh, H.C.

1974-01-01

Principles are given for the design and operation of a new class of inhalation exposure systems utilizing concurrent flow spirometry (CFS), a simple method for providing realtime measurement of respiratory volumes and rates during inhalation exposure by mouth or nose of individual experimental animals or man to aerosols or gases. This technique is especially useful for inhalation exposure of larger experimental animals, such as horses, where whole-body plethysmography is usually impractical. Difficulties encountered with conventional exposure systems in maintenance of uniform aerosol or gas concentrations and prevention of large pressure excursions in the exposure chamber during breathing are obviated by systems utilizing the principles of concurrent flow spirometry. For illustration, two exposure units with CFS are described, one for exposure of Beagle dogs and one for ponies. (U.S.)

Knowledge management: an application to wildfire prevention planning

Science.gov (United States)

Daniel L Schmoldt

1989-01-01

Residential encroachment into wildland areas places an additional burden on fire management activities. Prevention programs, fuel management efforts, and suppression strategies, previously employed in wildland areas, require modification for protection of increased values at risk in this interface area. Knowledge-based computer systems are being investigated as...

Channel's Concurrence and Quantum Teleportation

Institute of Scientific and Technical Information of China (English)

LING Yin-Sheng

2005-01-01

Concurrence can measure the entanglement property of a system. If the channel is a pure state, positive concurrence state can afford the good performance in the teleportation process. If the channel ia a mixed state, positive concurrence state cannot assure the good performance in the teleportation. The conditions of the positive concurrence and the quantum teleportation in the Heisenberg spin ring is derived.

Managed care, consumerism, preventive medicine: does a causal connection exist?

Science.gov (United States)

Rizzo, John A; Xie, Yang

2006-07-01

Managed care plans, and HMOs in particular, have long touted that their emphasis is on preventive care, to avoid expensive illness later in life. However, few articles in the contemporary literature adequately address this claim. The available evidence seems to support that HMOs do, in fact, provide greater access to preventive services, but the limitations of this research are substantial. This article discusses the scientific evidence on the relationships between managed care arrangements and the implications for preventive care in the current era, emphasizing consumer choices and less-restrictive plan structures.

Locally-regionally advanced tonsillar squamous cell carcinoma treated with concurrent chemoradiotherapy

International Nuclear Information System (INIS)

Krstevska, Valentina; Stojkovski, Igor

2013-01-01

Purpose: To perform a retrospective review of stage III-IV squamous cell carcinoma of the tonsil managed by definitive concurrent chemoradiotherapy (CCRT) in order to analyze the patients’ outcome and to evaluate the acute and late toxic effects of this treatment modality. Material and methods: Between January 2005 and December 2010, 36 patients with locally and/or regionally advanced tonsillar cancer underwent three dimensional conformal radiotherapy (3DCRT) with concurrent platinum-based chemotherapy. The dose prescription of the planning target volume for gross tumor and low-risk subclinical disease was 70 Gy and 50 Gy, respectively. Conventional fractionation with a daily dose of 2.0 Gy, 5 times per week was used. Concurrent chemotherapy consisted of cisplatin 30 mg/m2 given on a weekly basis. Acute and late radiotherapy-related toxicities were recorded using European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group (EORTC/RTOG) grading system. The 3-year locoregional relapse-free survival (LRRFS), disease-free survival (DFS), and overall survival (OS) rates were calculated using the Kaplan-Meier method. Results: The median follow-up of all patients was 20.5 months (range, 5 to 90 months). The median followup of living patients was 59 months (range, 30 to 90 months). Complete response rates of the primary tumor and of the nodal disease were 72.2% and 64.0%, respectively. A complete composite response was present in 25 patients (69.4%). Treatment failure occurred in 15 out of 25 patients who achieved complete composite response following CCRT. The 3-year LRRFS, DFS, and OS rate was 38.8%, 27.8%, and 27.3%, respectively. Grade 3 mucositis occurred in 58.3% of patients. Xerostomia grade 2 was revealed in 72.2% of patients. Conclusion: Taking into account the low 3-year survival rates observed in our study and the high percentage of grade 2 xerostomia, it can be concluded that in the future, instead of 3DCRT with concurrent

Concurrent tubercular and staphylococcus meningitis in a child

Institute of Scientific and Technical Information of China (English)

Amit Agrawal

2009-01-01

Spontaneous,non-surgical haematogenous Staphylococcus aureus meningitis is rare and associated with high mortality.Mixed infection causing meningitis (pyogenic and tubercular)is further rarer,poses a difficult diag-nostic and management challenge,which warrants early diagnosis and aggressive therapy.We present a case of concurrent pyogenic and tubercular meningitis in a child managed successfully.It seems that in present case initial pyogenic infection resulted in the immunocompromised state for the child that would had lead to the acti-vation of tubercular foci resulting in tubercular meningitis.

AEGIS: a wildfire prevention and management information system

Science.gov (United States)

Kostas Kalabokidis; Alan Ager; Mark Finney; Nikos Athanasis; Palaiologos Palaiologou; Christos Vasilakos

2016-01-01

We describe a Web-GIS wildfire prevention and management platform (AEGIS) developed as an integrated and easy-to-use decision support tool to manage wildland fire hazards in Greece (http://aegis.aegean.gr). The AEGIS platform assists with early fire warning, fire planning, fire control and coordination of firefighting forces by providing online access to...

Economic explanations for concurrent sourcing

DEFF Research Database (Denmark)

Mols, Niels Peter

2010-01-01

Concurrent sourcing is a phenomenon where firms simultaneously make and buy the same good, i.e. they simultaneously use the governance modes of market and hierarchy. Though concurrent sourcing seems to be widespread, few studies of sourcing have focused on this phenomenon. This paper reviews...... different economic explanations for why firms use concurrent sourcing. The distinctive features of the explanations are compared, and it is discussed how they may serve as a springboard for research on concurrent sourcing. Managerial implications are also offered....

Generalization of concurrence vectors

International Nuclear Information System (INIS)

Yu Changshui; Song Heshan

2004-01-01

In this Letter, based on the generalization of concurrence vectors for bipartite pure state with respect to employing tensor product of generators of the corresponding rotation groups, we generalize concurrence vectors to the case of mixed states; a new criterion of separability of multipartite pure states is given out, for which we define a concurrence vector; we generalize the vector to the case of multipartite mixed state and give out a good measure of free entanglement

Pressure ulcer prevention and management strategies in Turkey.

Science.gov (United States)

Acaroglu, Rengin; Sendir, Merdiye

2005-01-01

Pressure ulcers are a serious problem that can lead to pain and delayed recovery. In Turkey, the selection of dressing products is usually left to the nurse managing the patient and depends on several factors, including the condition of the wound, the nurse's knowledge, and the nurse's experience. The aim of this study was to determine prevention and management strategies for pressure ulcer care in hospitalized patients in Turkey and to identify the factors that influence the selection of products by nurses. The descriptive study was carried out in various departments (orthopedic, neurological, oncology, and intensive care) where bedridden patients were found. A total of 110 nurses volunteered to participate. Data were collected by means of a questionnaire developed after a review of the literature. Only 32% of the nurses made use of a pressure ulcer care risk evaluation scale (Norton scale), and air mattresses were used by 89% as a preventive measure with patients who were at risk. When pressure ulcers occurred, advanced wound care products were preferred by most of the nurses. Seventy four percent of nurses considered the condition of wound for selection of products. Despite correctly noting several strategies for prevention of pressure ulcers, 9% of nurses also described massage around boney prominence and the use of inflatable rings as effective preventive strategies. This descriptive study shows that nurses in Turkey are primarily responsible for prevention and management of pressure ulcer care and that both traditional dressing products and advanced wound care products are used in the care of all stages of pressure ulcers in Turkey. It also illustrates the need for ongoing pressure ulcer education to promote evidence-based practice and reduce the use of ineffective (or harmful) strategies.

Concurrency Control for Transactional Drago

OpenAIRE

Patiño-Martinez, Marta; Jiménez-Peris, Ricardo; Kienzle, Jörg; Arévalo, Sergio

2002-01-01

The granularity of concurrency control has a big impact on the performance of transactional systems. Concurrency control granu- larity and data granularity (data size) are usually the same. The e ect of this coupling is that if a coarse granularity is used, the overhead of data access (number of disk accesses) is reduced, but also the degree of concurrency. On the other hand, if a ne granularity is chosen to achieve a higher degree of concurrency (there are less con icts), the cost of data ac...

Temporal Concurrent Constraint Programming

DEFF Research Database (Denmark)

Nielsen, Mogens; Valencia Posso, Frank Dan

2002-01-01

The ntcc calculus is a model of non-deterministic temporal concurrent constraint programming. In this paper we study behavioral notions for this calculus. In the underlying computational model, concurrent constraint processes are executed in discrete time intervals. The behavioral notions studied...... reflect the reactive interactions between concurrent constraint processes and their environment, as well as internal interactions between individual processes. Relationships between the suggested notions are studied, and they are all proved to be decidable for a substantial fragment of the calculus...

Preventing and managing awareness during general anesthesia

Directory of Open Access Journals (Sweden)

Jelena Berger

2014-03-01

Full Text Available Background: General anesthesia is a reversible state of a temporary loss of consciousness, analgesia, muscle paralysis, blunted autonomic responses and amnesia. To achieve this, an adequate depth of anesthesia should be maintained throughout the surgery. Awareness is a serious complication of general anesthesia, which occurs when the depth of anesthesia is not appropriate due to various causes.In this paper the underlying neurobiology of intraoperative awareness is presented, as well as risk factors for awareness and methods for assessing the depth of anesthesia. Possible psychological consequences of awareness and their management are also discussed. At the end, the recommendations for preventing intraoperative awareness are given.Conclusions: Awareness during general anesthesia may have adverse psychological sequelae in individual patients, therefore guidelines for preventing and managing of intraoperative awareness need to be adopted. In case of a possible awareness, the recommendations for offering a psychological support should also be followed.

Diagnosis, management and prevention of ischemic stroke for non-neurologists

Directory of Open Access Journals (Sweden)

Kavian Ghandehari

2011-07-01

Full Text Available Background: Stroke is the third common cause of disability and death. Diagnosis of stroke is based on its clinical manifestations and/or observation of infarct in the neuroimaging. Standard battery of diagnostic investigations and classification criteria is required for detection of stroke etiology. Materials and Method: This review article deals with the diagnosis and management of brain infarction particularly in our country and is provided for non-neurologists. Using online scientific search engines and in some parts referring to laboratory archives constituted base of this review article.Results: Acute stroke management is almost similar in its various etiologies. Neuroprotective drugs have little value in acute stroke management. At present time, a few Iranian medical centers have infrastructure of thrombolysis therapy. Prevention of stroke is based on the detection and control of its risk factors. Aspirin, 80 mg per day is the most common drug for stroke prevention. Co-administration of aspirin 80 mg/d and Dipyridamole 200-400 mg/d increases the preventive effects of aspirin. Clopidogrel 75 mg/d is the stroke preventive drug of choice in patients with peptic ulcer and coronary artery disease. Co-administration of aspirin and clopidogrel is more effective in stroke prevention but has more hemorrhagic complications. Using warfarin for stroke prevention is suggested only in patients who have facilities for repetitive coagulation tests. Carotid endarterectomy is indicated in symptomatic patients with more than 70% stenosis of extracranial internal carotid artery, if performed only by vascular surgeons experienced in carotid surgery.Conclusion: Many stroke patients are managed by general practitioners and non-neurologists, e.g. internists, cardiologists and neurosurgeons. This review article provides continuous medical education according to Iranian medical curriculum

Temporal Concurrent Constraint Programming

DEFF Research Database (Denmark)

Nielsen, Mogens; Palamidessi, Catuscia; Valencia, Frank Dan

2002-01-01

The ntcc calculus is a model of non-deterministic temporal concurrent constraint programming. In this paper we study behavioral notions for this calculus. In the underlying computational model, concurrent constraint processes are executed in discrete time intervals. The behavioral notions studied...

SAGES Guidelines: Prevention and management of gastro ...

African Journals Online (AJOL)

SAGES Guidelines: Prevention and management of gastro-oesophageal varices and variceal haemorrhage in cirrhosis. J F Botha. Abstract. No Abstract South African Gastroenterology Review Vol. 6 (1) 2008: pp. 23-25. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

Oral Mucositis Prevention By Low-Level Laser Therapy in Head-and-Neck Cancer Patients Undergoing Concurrent Chemoradiotherapy: A Phase III Randomized Study

Energy Technology Data Exchange (ETDEWEB)

Gouvea de Lima, Aline [Departamento de Radiologia, Disciplina de Oncologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP (Brazil); Villar, Rosangela Correa [Instituto de Radiologia, Servico de Radioterapia, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP (Brazil); Castro, Gilberto de, E-mail: gilberto.castro@usp.br [Department of Clinical Oncology, Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, SP (Brazil); Antequera, Reynaldo [Divisao de Odontologia, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP (Brazil); Gil, Erlon; Rosalmeida, Mauro Cabral [Instituto de Radiologia, Servico de Radioterapia, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP (Brazil); Federico, Miriam Hatsue Honda; Snitcovsky, Igor Moises Longo [Departamento de Radiologia, Disciplina de Oncologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP (Brazil)

2012-01-01

Purpose: Oral mucositis is a major complication of concurrent chemoradiotherapy (CRT) in head-and-neck cancer patients. Low-level laser (LLL) therapy is a promising preventive therapy. We aimed to evaluate the efficacy of LLL therapy to decrease severe oral mucositis and its effect on RT interruptions. Methods and Materials: In the present randomized, double-blind, Phase III study, patients received either gallium-aluminum-arsenide LLL therapy 2.5 J/cm{sup 2} or placebo laser, before each radiation fraction. Eligible patients had to have been diagnosed with squamous cell carcinoma or undifferentiated carcinoma of the oral cavity, pharynx, larynx, or metastases to the neck with an unknown primary site. They were treated with adjuvant or definitive CRT, consisting of conventional RT 60-70 Gy (range, 1.8-2.0 Gy/d, 5 times/wk) and concurrent cisplatin. The primary endpoints were the oral mucositis severity in Weeks 2, 4, and 6 and the number of RT interruptions because of mucositis. The secondary endpoints included patient-reported pain scores. To detect a decrease in the incidence of Grade 3 or 4 oral mucositis from 80% to 50%, we planned to enroll 74 patients. Results: A total of 75 patients were included, and 37 patients received preventive LLL therapy. The mean delivered radiation dose was greater in the patients treated with LLL (69.4 vs. 67.9 Gy, p = .03). During CRT, the number of patients diagnosed with Grade 3 or 4 oral mucositis treated with LLL vs. placebo was 4 vs. 5 (Week 2, p = 1.0), 4 vs. 12 (Week 4, p = .08), and 8 vs. 9 (Week 6, p = 1.0), respectively. More of the patients treated with placebo had RT interruptions because of mucositis (6 vs. 0, p = .02). No difference was detected between the treatment arms in the incidence of severe pain. Conclusions: LLL therapy was not effective in reducing severe oral mucositis, although a marginal benefit could not be excluded. It reduced RT interruptions in these head-and-neck cancer patients, which might

Ozone therapy in the management and prevention of caries

Directory of Open Access Journals (Sweden)

Merve Erkmen Almaz

2015-01-01

Full Text Available The purpose of this article was to assess the effectiveness of ozone therapy in the management and prevention of caries, reviewing clinical and in vitro studies. Ozone has proven to be effective against gram-negative and gram-positive bacteria, viruses, and fungi. In dentistry, most of the published articles are based on ozone's antimicrobial effects and the treatment of caries. Most of the clinical studies reported ozone to be a promising alternative to conventional methods for caries management. However, a few studies have shown ozone to be insufficient for preventing caries and reducing microorganisms in open occlusal carious lesions. Ozone might be a useful tool to reduce and control oral infectious microorganisms in dental plaque and dental cavity. However, the results of in vitro studies are controversial; while some researchers reported that ozone therapy had a minimal or no effect on the viability of microorganisms, others suggested ozone to be highly effective in killing both gram-positive and gram-negative oral microorganisms. Therefore, more evidence is required before ozone can be accepted as an alternative to present methods for the management and prevention of caries.

[Role and integration of technical prevention figures in the management system].

Science.gov (United States)

Bartolucci, G B; Santantonio, P; Casciani, M; Dagazzini, I

2010-01-01

The multifarious issues of health and safety at work require multi-disciplinary skills, both in the risk assessment and in the subsequent definition and management of preventive measures, and this requires a renewed operational protocol that supports integration and co-operation between the technical prevention figures. Thus, between occupational physicians and technical advisers there should be a concrete and fruitful interaction, which should not be episodic or occasional, but a modus operandi systematic and constant. In this contribution is discussed as the technical prevention figures should be included in the Health and Safety Management System and should make a specific contribution in defining corporate policies on prevention. In particular it is outlined the role that the occupational physician may play in the development of prevention and health promotion activities within the strategies of corporate social responsibility.

Concurrent engineering: effective deployment strategies

Directory of Open Access Journals (Sweden)

Unny Menon

1996-12-01

Full Text Available This paper provides a comprehensive insight into current trends and developments in Concurrent Engineering for integrated development of products and processes with the goal of completing the entire cycle in a shorter time, at lower overall cost and with fewer engineering design changes after product release. The evolution and definition of Concurrent Engineering are addressed first, followed by a concise review of the following elements of the concurrent engineering approach to product development: Concept Development: The Front-End Process, identifying Customer Needs and Quality Function Deployment, Establishing Product Specifications, Concept Selection, Product Architecture, Design for Manufacturing, Effective Rapid Prototyping, and The Economics of Product Development. An outline of a computer-based tutorial developed by the authors and other graduate students funded by NASA ( accessible via the world-wide-web . is provided in this paper. A brief discussion of teamwork for successful concurrent engineering is included, t'ase histories of concurrent engineering implementation at North American and European companies are outlined with references to textbooks authored by Professor Menon and other writers. A comprehensive bibliography on concurrent engineering is included in the paper.

The Safety Prevention in the Theater Management and Operation

Institute of Scientific and Technical Information of China (English)

WU Sheng

2015-01-01

Take the operation and management experience as examples, the author discussed how to formulate a set of complete and effective equipment management system, operating rules, procedures and standards, as well as the safety prevention and control measures, according to the national or trade related laws and regulations and combining the operation and performance characteristics of theatre management, in order to ensure the safe operation of theatre and stage equipment.

Rethinking serializable multiversion concurrency control

OpenAIRE

Faleiro, Jose M.; Abadi, Daniel J.

2014-01-01

Multi-versioned database systems have the potential to significantly increase the amount of concurrency in transaction processing because they can avoid read-write conflicts. Unfortunately, the increase in concurrency usually comes at the cost of transaction serializability. If a database user requests full serializability, modern multi-versioned systems significantly constrain read-write concurrency among conflicting transactions and employ expensive synchronization patterns in their design....

The Application of Concurrent Engineering in Infrastructure Projects

OpenAIRE

Wolden, Sigurd

2017-01-01

The construction industry today is considered to be lagging competitively behind in comparison to other industries. The reason for this is thought of by many researchers to be the fragmented project process, the traditional principles and the, sometimes adversarial environment. In order to solve some of these obstacles and at the same time enhance productivity, the Norwegian infrastructure sector has recently developed an interest towards the project management method Concurrent Engineering (...

Impredicative concurrent abstract predicates

DEFF Research Database (Denmark)

Svendsen, Kasper; Birkedal, Lars

2014-01-01

We present impredicative concurrent abstract predicates { iCAP { a program logic for modular reasoning about concurrent, higher- order, reentrant, imperative code. Building on earlier work, iCAP uses protocols to reason about shared mutable state. A key novel feature of iCAP is the ability to dene...

Measuring coherence with entanglement concurrence

Science.gov (United States)

Qi, Xianfei; Gao, Ting; Yan, Fengli

2017-07-01

Quantum coherence is a fundamental manifestation of the quantum superposition principle. Recently, Baumgratz et al (2014 Phys. Rev. Lett. 113 140401) presented a rigorous framework to quantify coherence from the view of theory of physical resource. Here we propose a new valid quantum coherence measure which is a convex roof measure, for a quantum system of arbitrary dimension, essentially using the generalized Gell-Mann matrices. Rigorous proof shows that the proposed coherence measure, coherence concurrence, fulfills all the requirements dictated by the resource theory of quantum coherence measures. Moreover, strong links between the resource frameworks of coherence concurrence and entanglement concurrence is derived, which shows that any degree of coherence with respect to some reference basis can be converted to entanglement via incoherent operations. Our work provides a clear quantitative and operational connection between coherence and entanglement based on two kinds of concurrence. This new coherence measure, coherence concurrence, may also be beneficial to the study of quantum coherence.

Quantify entanglement by concurrence hierarchy

OpenAIRE

Fan, Heng; Matsumoto, Keiji; Imai, Hiroshi

2002-01-01

We define the concurrence hierarchy as d-1 independent invariants under local unitary transformations in d-level quantum system. The first one is the original concurrence defined by Wootters et al in 2-level quantum system and generalized to d-level pure quantum states case. We propose to use this concurrence hierarchy as measurement of entanglement. This measurement does not increase under local quantum operations and classical communication.

Concurrent Models for Object Execution

OpenAIRE

Diertens, Bob

2012-01-01

In previous work we developed a framework of computational models for the concurrent execution of functions on different levels of abstraction. It shows that the traditional sequential execution of function is just a possible implementation of an abstract computational model that allows for the concurrent execution of functions. We use this framework as base for the development of abstract computational models that allow for the concurrent execution of objects.

Understanding heterogeneity of social preferences for fire prevention management

DEFF Research Database (Denmark)

Varela, Elsa; Jacobsen, Jette Bredahl; Soliño, Mario

2014-01-01

The forest area burnt annually in the European Mediterranean region has more than doubled since the 1970s. In these forests, the main preventive action consists of forest compartmentalization by fuel break networks, which entail high costs and sometimes significant negative impacts. While many...... studies look at public preferences for fire suppression, this study analyses the heterogeneity of social preferences for fire prevention. The visual characteristics of fire prevention structures are very familiar to respondents, but their management is unfamiliar, which raises specific attention in terms...... for the density of fuel breaks. These results are important for designing fire prevention policies that are efficient and acceptable by the population....

Management and Prevention of Dystocia.

Science.gov (United States)

Funnell, Bethany J; Hilton, W Mark

2016-07-01

Dystocia is an inevitable challenge in the livestock industries, particularly with primiparous female animals. Prevention and appropriate management will decrease cow and calf morbidity and mortality, which will improve the economic status of the beef or dairy operation. Early identification and proper intervention improves outcomes, and the use of selection tools to decrease the potential for dystocia will have positive returns. Assisted reproductive technologies present a unique set of challenges to the calving process that both the producer and practitioner should be prepared to address. Published by Elsevier Inc.

Production software that works a guide to the concurrent development of realtime manufacturing systems

CERN Document Server

Courtright, Ann; Behuniak, John

1991-01-01

This useful reference addresses the key tasks that are integral to realtime software development in manufacturing plants: managing the design of the system, setting up and coordinating a development organization, and implementing tools for successfulcompletion and management. Both new and experienced project managers will discover how to use concurrent methodologies to create realtime systems in half the time it usually takes.

Concurrent central diabetes insipidus and panhypopituitarism in a German shepherd dog.

Science.gov (United States)

Ramsey, I K; Dennis, R; Herrtage, M E

1999-06-01

This report describes a German shepherd dog that was presented with proportionate dwarfism and coat changes typical of hypopituitarism but that was also profoundly polydipsic and polyuric. Investigations established a diagnosis of concurrent central diabetes insipidus. Treatment with desmopressin was successful in managing the polyuria and polydipsia.

Incorporating economic valuation into fire prevention planning and management in Southern European countries

Directory of Open Access Journals (Sweden)

Elsa Varela

2015-08-01

Full Text Available Aim of study: This article describes and analyzes the links between the fire-based scientific knowledge, the social perception of fire prevention and forest fires and the economic valuation requirements to assess social preferences for fire prevention measures. Area of study: Southern European countries. Material and Methods: For that purpose, we develop a critical revision of the existing literature on economic valuation of social preferences for fire risk reduction and fire prevention in terms of its links with fire science and social perceptions and the applicability of these results in fire management policies. Research highlights: The assessment of social preferences for fire related issues is challenging due to the difficulty of setting sound valuation scenarios that can simultaneously be relevant for the respondents and derive conclusions useful for fire management. Most of the revised studies set up valuation scenarios focused on the final management outcome e.g. number of burnt hectares, what is easier for the respondents to evaluate but weakens the scientific relationship with fire management, making difficult reaching conclusions for sound management advice. A more recent set of valuation studies has been developed where risk perception of homeowners is further assessed as a key variable determining their preferences in valuation scenarios. These studies are relevant for mangers setting fire prevention programs in wildland urban interface areas as understanding the factors that may promote or hinder the enrolment of these homeowners in fire prevention activities may have direct implication in addressing communication programs to promote fire prevention management.

Effective behaviour change techniques in the prevention and management of childhood obesity.

Science.gov (United States)

Martin, J; Chater, A; Lorencatto, F

2013-10-01

Rates of childhood obesity are increasing, and it is essential to identify the active components of interventions aiming to prevent and manage obesity in children. A systematic review of behaviour change interventions was conducted to find evidence of behaviour change techniques (BCTs) that are most effective in changing physical activity and/or eating behaviour for the prevention or management of childhood obesity. An electronic search was conducted for randomised controlled trials published between January 1990 and December 2009. Of 4309 titles and abstracts screened, full texts of 135 articles were assessed, of which 17 published articles were included in this review. Intervention descriptions were coded according to the behaviour-specific CALO-RE taxonomy of BCTs. BCTs were identified and compared across obesity management (n=9) vs prevention (n=8) trials. To assess the effectiveness of individual BCTs, trials were further divided into those that were effective (defined as either a group reduction of at least 0.13 body mass index (BMI) units or a significant difference in BMI between intervention and control groups at follow-up) vs non-effective (reported no significant differences between groups). We reliably identified BCTs utilised in effective and non-effective prevention and management trials. To illustrate the relative effectiveness of each BCT, effectiveness ratios were calculated as the ratio of the number of times each BCT was a component of an intervention in an effective trial divided by the number of times they were a component of all trials. Results indicated six BCTs that may be effective components of future management interventions (provide information on the consequences of behaviour to the individual, environmental restructuring, prompt practice, prompt identification as role model/position advocate, stress management/emotional control training and general communication skills training), and one that may be effective in prevention

Improving Construction Process through Integration and Concurrent Engineering

Directory of Open Access Journals (Sweden)

Malik Khalfan

2012-11-01

Full Text Available In an increasingly competitive business environment, improvedtime-to-market, reduced production cost, quality of the productand customer involvement are rapidly becoming the key successfactors for any product development process. Consequently, mostorganisations are moving towards the adoption of latest technologyand new management concepts and philosophies such as totalquality management and concurrent engineering (CE to bringimprovement in their product development process. This paperdiscusses the adoption of integrated processes and CE withinthe construction industry to enable construction organisations toimprove their project development process. It also discusses aproposed integrated database model for the construction projects,which should enable the construction process to improve, becomemore effective and more efficient.

Brand crisis management: the use of information for prevention, identification and management

Directory of Open Access Journals (Sweden)

Alexandre Borba Salvador

2018-01-01

Full Text Available Purpose – To understand, from the management perspective, the use of information on brand crisis management in moments involving prevention, identification and management. Design/methodology/approach – This article is the result of an exploratory, qualitative study. Primary data was collected through interviews with marketing executives and crisis management specialists. Findings – We concluded that managers use information in very different ways, and, taking possession of information and decisionmaking attitudes into account, four groups of crisis managers were found. Originality/value – In order to contribute to the expansion of academic knowledge in the field of marketing administration and brand crisis management, this study presented the crossing of three different fields (information systems, brand crisis management and organizational development to structure knowledge concerning brand crisis management. From the managerial perspective, certain crises could be avoided by monitoring internal and external information, and by identifying problems in their early stages. From the social perspective, reducing brand crisis cases positively affects society as a whole (organizations and individuals.

Nutritional strategies to support concurrent training.

Science.gov (United States)

Perez-Schindler, Joaquin; Hamilton, D Lee; Moore, Daniel R; Baar, Keith; Philp, Andrew

2015-01-01

Concurrent training (the combination of endurance exercise to resistance training) is a common practice for athletes looking to maximise strength and endurance. Over 20 years ago, it was first observed that performing endurance exercise after resistance exercise could have detrimental effects on strength gains. At the cellular level, specific protein candidates have been suggested to mediate this training interference; however, at present, the physiological reason(s) behind the concurrent training effect remain largely unknown. Even less is known regarding the optimal nutritional strategies to support concurrent training and whether unique nutritional approaches are needed to support endurance and resistance exercise during concurrent training approaches. In this review, we will discuss the importance of protein supplementation for both endurance and resistance training adaptation and highlight additional nutritional strategies that may support concurrent training. Finally, we will attempt to synergise current understanding of the interaction between physiological responses and nutritional approaches into practical recommendations for concurrent training.

Concurrent engineering design and management knowledge capture

Science.gov (United States)

1990-01-01

The topics are presented in viewgraph form and include the following: real-time management, personnel management, project management, conceptual design and decision making; the SITRF design problem; and the electronic-design notebook.

Cholera - management and prevention.

Science.gov (United States)

Davies, Hannah G; Bowman, Conor; Luby, Stephen P

2017-06-01

Cholera is an acute secretory diarrhoeal infection caused by the bacterium Vibrio cholerae. It is likely to have originated in the Indian sub-continent; however, it spread to cause six worldwide pandemics between 1817-1923. The ongoing seventh worldwide pandemic of cholera began in 1961. The intensity, duration and severity of cholera epidemics have been increasing, signaling the need for more effective control and prevention measures. The response to the cholera pandemics of the 19th century led to the development of safe and effective sanitation and water systems which have effectively removed the risk of cholera in many settings. However, such systems are not in place to protect billions of people worldwide. Although some progress has been made in expanding access to water in recent years, achieving optimal infrastructure will, in the most optimistic scenario, take decades. Climate change, extreme weather events and rapid urbanisation suggests that alternatives to the current paradigm of providing large centralised water and sanitation systems should be considered, including smaller decentralised systems. The aim of this review paper is to provide an overview of current knowledge regarding management of cholera with a focus on prevention measures including vaccination and water and sanitation interventions. © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Concurrence of three Jaynes-Cummings systems

Science.gov (United States)

Qiang, Wen-Chao; Sun, Guo-Hua; Dong, Qian; Camacho-Nieto, Oscar; Dong, Shi-Hai

2018-04-01

We apply genuine multipartite concurrence to investigate entanglement properties of three Jaynes-Cummings systems. Three atoms are initially put in GHZ-like state and locally interact with three independent cavities, respectively. We present analytical concurrence expressions for various subsystems including three-atom, three-cavity and some atom-cavity mixed systems. We also examine the global system and illustrate the evolution of its concurrence. Except for the sudden death of entanglement, we find for some initial entanglement parameter θ , the concurrence of the global system may maintain unchanged in some time intervals.

Is Case Management Effective for Long-Lasting Suicide Prevention?

Science.gov (United States)

Wang, Liang-Jen; Wu, Ya-Wen; Chen, Chih-Ken

2015-01-01

Case management services have been implemented in suicide prevention programs. To investigate whether case management is an effective strategy for reducing the risks of repeated suicide attempts and completed suicides in a city with high suicide rates in northern Taiwan. The Suicide Prevention Center of Keelung City (KSPC) was established in April 2005. Subjects included a consecutive sample of individuals (N = 2,496) registered in KSPC databases between January 1, 2006, and December 31, 2011, with at least one episode of nonfatal self-harm. Subjects were tracked for the duration of the study. Of all the subjects, 1,013 (40.6%) received case management services; 416 (16.7%) had at least one other deliberate self-harm episode and 52 (2.1%) eventually died by suicide. No significant differences were found in the risks of repeated self-harm and completed suicides between suicide survivors who received case management and those who refused the services. However, a significant reduction in suicide rates was found after KSPC was established. Findings suggest that case management services might not reduce the risks of suicide repetition among suicide survivors during long-term follow-up. Future investigation is warranted to determine factors impacting the downward trend of suicide rates.

Concurrent LISP and its interpreter

Energy Technology Data Exchange (ETDEWEB)

Tabata, K; Sugimoto, S; Ohno, Y

1981-01-01

In the research field of artificial intelligence many languages have been developed based on LISP, such as Planner, Conniver and so on. They have been developed to give users many useful facilities, especially for describing flexible control structures. Backtracking and coroutine facilities are typical ones introduced into these languages. Compared with backtracking and coroutine facilities, multi-process description facilities are considered to be a better alternative for writing well-structured programs. This paper describes concurrent LISP, a new concurrent programming language based on LISP. Concurrent LISP is designed to provide simple and flexible facilities for multi-process description without changing the original language features of LISP. This paper also describes the concurrent LISP interpreter which has been implemented on a FACOM M-200 at the Data Processing Center of Kyoto University. 19 references.

Evaluating Environmental Management Approaches to Alcohol and Other Drug Abuse Prevention. Prevention Updates

Science.gov (United States)

DeJong, William; Langford, Linda M.

2006-01-01

Recent years have seen an upsurge in prevention work focused on changing the campus and community environments in which college students make decisions about alcohol and other drug (AOD) use. This approach, called "environmental management," is based on three fundamental premises: (1) Substance use problems are aggravated by a physical, social,…

Developing eLearning for pressure ulcer prevention and management.

Science.gov (United States)

Cameron, Rosie; Rodgers, Angela; Welsh, Lynn; McGown, Katrina

2014-08-12

The impact of pressure ulcers is psychologically, physically and clinically challenging for both patients and NHS staff. NHS Greater Glasgow and Clyde (NHS GGC), in line with the Scottish Best Practice Statement for the Prevention and Management of Pressure Ulcers ( Quality Improvement Scotland, 2009 ), and the NHS Health Improvement Scotland (2011) Preventing Pressure Ulcers Change Package, launched an awareness campaign throughout the organisation in April 2012 and has more recently adopted a 'zero-tolerance' approach to pressure damage. The tissue viability service in NHS GGC recognised that in order to achieve this aim, education of front-line staff is essential. An educational framework for pressure ulcer prevention was developed for all levels of healthcare staff involved in the delivery of patient care. As a means to support the framework, an initiative to develop web-based eLearning modules has been taken forward. This has resulted in the creation of an accessible, cost-effective, stimulating, relevant, and evidence-based education programme designed around the educational needs of all healthcare staff. In conjunction with the organisation's 'top ten tools' for pressure ulcer prevention and management, the modular online education programme addresses the aims of quality improvement and zero tolerance by supporting the provision of safe and effective person-centered care.

The HSE Management Standards Indicator Tool: concurrent and construct validity.

Science.gov (United States)

Marcatto, F; Colautti, L; Larese Filon, F; Luis, O; Ferrante, D

2014-07-01

The Health & Safety Executive Management Standards Indicator Tool (HSE-MS IT) is a questionnaire commonly used to assess work-related stress risks at an organizational level. A critical factor in determining whether this instrument is actually useful is that higher levels of stress risk in the work-design domains should predict higher levels of stress and stress-related outcomes in workers. Only a few studies, however, have addressed this issue. To test both the concurrent and construct validity of the HSE-MS IT, by relating it with another widely used instrument, the Job Content Questionnaire (JCQ), and by examining its relationships with a set of work-related stress outcomes. An anonymous cross-sectional questionnaire was administered to a sample of employees in an Italian municipality. The questionnaire included the HSE-MS IT, self-reported measures of job satisfaction, job motivation and stress at work, the Satisfaction with Life Scale and the reduced form of the JCQ. A total of 760 out of 779 employees completed the questionnaire. Results showed moderate to strong correlation among the corresponding HSE-MS IT and JCQ scales. Hierarchical regression highlighted the specific contribution of each of the HSE-MS IT scales in predicting three relevant work-related stress outcomes (self-reported stress, job satisfaction and job motivation), after controlling for gender, age and life satisfaction. Our findings consolidated the HSE-MS IT validity and showed the specific sensitivity of its scales to assess different aspects of work-related distress, including self-perception of stress at work. These results can have practical implications for the occupational well-being of employees. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Reference Framework for Concurrent Engineering

Institute of Scientific and Technical Information of China (English)

无

2001-01-01

Considering the diversity of methods and tools offered to concurrent engineering, the aspects playing important roles in the concurrent engineering c ontext have been pinpointed as being four core elements which are Activity, Meth od, Object and Information. Based on these four elements, a reference framework called AMOI is proposed to be the guideline for the systematic concurrent produc t design. Using the AMOI reference framework, concurrent product development sys tem can be structured into four function models (including the activity model, m ethod model, object model and information model) which are interconnected with e ach other.

Oral Mucositis Prevention By Low-Level Laser Therapy in Head-and-Neck Cancer Patients Undergoing Concurrent Chemoradiotherapy: A Phase III Randomized Study

International Nuclear Information System (INIS)

Gouvêa de Lima, Aline; Villar, Rosângela Correa; Castro, Gilberto de; Antequera, Reynaldo; Gil, Erlon; Rosalmeida, Mauro Cabral; Federico, Miriam Hatsue Honda; Snitcovsky, Igor Moisés Longo

2012-01-01

Purpose: Oral mucositis is a major complication of concurrent chemoradiotherapy (CRT) in head-and-neck cancer patients. Low-level laser (LLL) therapy is a promising preventive therapy. We aimed to evaluate the efficacy of LLL therapy to decrease severe oral mucositis and its effect on RT interruptions. Methods and Materials: In the present randomized, double-blind, Phase III study, patients received either gallium-aluminum-arsenide LLL therapy 2.5 J/cm 2 or placebo laser, before each radiation fraction. Eligible patients had to have been diagnosed with squamous cell carcinoma or undifferentiated carcinoma of the oral cavity, pharynx, larynx, or metastases to the neck with an unknown primary site. They were treated with adjuvant or definitive CRT, consisting of conventional RT 60–70 Gy (range, 1.8–2.0 Gy/d, 5 times/wk) and concurrent cisplatin. The primary endpoints were the oral mucositis severity in Weeks 2, 4, and 6 and the number of RT interruptions because of mucositis. The secondary endpoints included patient-reported pain scores. To detect a decrease in the incidence of Grade 3 or 4 oral mucositis from 80% to 50%, we planned to enroll 74 patients. Results: A total of 75 patients were included, and 37 patients received preventive LLL therapy. The mean delivered radiation dose was greater in the patients treated with LLL (69.4 vs. 67.9 Gy, p = .03). During CRT, the number of patients diagnosed with Grade 3 or 4 oral mucositis treated with LLL vs. placebo was 4 vs. 5 (Week 2, p = 1.0), 4 vs. 12 (Week 4, p = .08), and 8 vs. 9 (Week 6, p = 1.0), respectively. More of the patients treated with placebo had RT interruptions because of mucositis (6 vs. 0, p = .02). No difference was detected between the treatment arms in the incidence of severe pain. Conclusions: LLL therapy was not effective in reducing severe oral mucositis, although a marginal benefit could not be excluded. It reduced RT interruptions in these head-and-neck cancer patients, which might

Risk assessment and management to prevent preterm birth

NARCIS (Netherlands)

Koullali, B.; Oudijk, M. A.; Nijman, T. A. J.; Mol, B. W. J.; Pajkrt, E.

2016-01-01

Preterm birth is the most important cause of neonatal mortality and morbidity worldwide. In this review, we review potential risk factors associated with preterm birth and the subsequent management to prevent preterm birth in low and high risk women with a singleton or multiple pregnancy. A history

Prevention and management of cochlear implant infections.

Science.gov (United States)

Gluth, Michael B; Singh, Rajesh; Atlas, Marcus D

2011-11-01

Understanding the issues of infection related to an implantable medical device is crucial to all cochlear implant teams. Furthermore, given the risk of central nervous system complications and the relatively high quantity of underlying resource investment associated with cochlear implantation, the stakes of infection are high. The optimal strategies to prevent and manage such infections are still evolving as good-quality prospective data to guide such management decisions are not yet abundant within the medical literature and many recommendations are based on retrospective reviews or anecdotal evidence. We will outline a general strategy to deal with cochlear implant-related infection based on both the authors' experience and the published literature.

Interventions to prevent and manage psychosocial risks and work-related stress

NARCIS (Netherlands)

Klein Hesselink, J.; Jain, A.

2014-01-01

Prevention is the cornerstone of the European approach to managing occupational safety and health. Prevention means anticipating and analysing the various aspects of work to identify short and long term risks, and then taking action to eliminate or mitigate those risks; that is identifying and

Predictors of perceived male partner concurrency among women at risk for HIV and STI acquisition in Durban, South Africa

OpenAIRE

Gaffoor, Zakir; Wand, Handan; Street, Ren?e A.; Abbai, Nathlee; Ramjee, Gita

2016-01-01

Background Women in sub-Saharan Africa continue to be at greater risk for HIV acquisition than men. Concurrency, viz. multiple sexual partnerships that overlap over time, has been studied as a possible risk factor for HIV transmission. The aim of this study was to identify predictors of perceived male partner concurrency among sexually active, HIV negative women. Methods Socio-demographic and behavioural data from women enrolled in a biomedical HIV prevention clinical trial were assessed in r...

Time-varying Concurrent Risk of Extreme Droughts and Heatwaves in California

Science.gov (United States)

Sarhadi, A.; Diffenbaugh, N. S.; Ausin, M. C.

2016-12-01

Anthropogenic global warming has changed the nature and the risk of extreme climate phenomena such as droughts and heatwaves. The concurrent of these nature-changing climatic extremes may result in intensifying undesirable consequences in terms of human health and destructive effects in water resources. The present study assesses the risk of concurrent extreme droughts and heatwaves under dynamic nonstationary conditions arising from climate change in California. For doing so, a generalized fully Bayesian time-varying multivariate risk framework is proposed evolving through time under dynamic human-induced environment. In this methodology, an extreme, Bayesian, dynamic copula (Gumbel) is developed to model the time-varying dependence structure between the two different climate extremes. The time-varying extreme marginals are previously modeled using a Generalized Extreme Value (GEV) distribution. Bayesian Markov Chain Monte Carlo (MCMC) inference is integrated to estimate parameters of the nonstationary marginals and copula using a Gibbs sampling method. Modelled marginals and copula are then used to develop a fully Bayesian, time-varying joint return period concept for the estimation of concurrent risk. Here we argue that climate change has increased the chance of concurrent droughts and heatwaves over decades in California. It is also demonstrated that a time-varying multivariate perspective should be incorporated to assess realistic concurrent risk of the extremes for water resources planning and management in a changing climate in this area. The proposed generalized methodology can be applied for other stochastic nature-changing compound climate extremes that are under the influence of climate change.

Concurrent sexual partnerships among female sex workers and their non-commercial male partners in Tijuana and Ciudad Juarez, Mexico.

Science.gov (United States)

Robertson, Angela Marie; Syvertsen, Jennifer L; Rangel, M Gudelia; Staines, Hugo S; Morris, Martina; Patterson, Thomas L; Ulibarri, Monica D; Strathdee, Steffanie A

2013-06-01

To investigate the prevalence and correlates of concurrent (overlapping) sexual partnerships among female sex workers (FSWs) and their non-commercial male partners in two Mexico-US border cities. A cross-sectional survey of FSWs and their non-commercial male partners was conducted in Tijuana and Ciudad Juárez, Mexico (2010-2011). Eligible FSWs and verified non-commercial partners were aged ≥18 years; FSWs had ever used hard drugs (lifetime) and recently exchanged sex for money, drugs or other goods (past month). Participants underwent baseline questionnaires obtaining dates of sex and condom use with ≤5 other recurring partners, including FSWs' regular clients. These dates were compared with dates of sex with enrolled study partners to determine overlap (ie, 'recurring' concurrency). Bivariate probit regression identified recurring concurrency correlates. Among 428 individuals (214 couples), past-year recurring concurrency prevalence was 16% and was higher among women than their non-commercial male partners (26% vs 6%). In 10 couples (5%), both partners reported recurring concurrency. The majority of couples (64%) always had unprotected sex, and most of the individuals (70%) with recurring concurrency 'sometimes' or 'never' used condoms with their concurrent partners. Recurring concurrency was positively associated with FSWs' income, men's caballerismo (a form of traditional masculinity) and men's belief that their FSW partners had sexually transmitted infections (STIs). Recurring concurrency, representing sustained periods of overlapping partnerships in which unprotected sex was common, should be addressed by couple-based STI prevention interventions.

Reconciling pairs of concurrently used clinical practice guidelines using Constraint Logic Programming.

Science.gov (United States)

Wilk, Szymon; Michalowski, Martin; Michalowski, Wojtek; Hing, Marisela Mainegra; Farion, Ken

2011-01-01

This paper describes a new methodological approach to reconciling adverse and contradictory activities (called points of contention) occurring when a patient is managed according to two or more concurrently used clinical practice guidelines (CPGs). The need to address these inconsistencies occurs when a patient with more than one disease, each of which is a comorbid condition, has to be managed according to different treatment regimens. We propose an automatic procedure that constructs a mathematical guideline model using the Constraint Logic Programming (CLP) methodology, uses this model to identify and mitigate encountered points of contention, and revises the considered CPGs accordingly. The proposed procedure is used as an alerting mechanism and coupled with a guideline execution engine warns the physician about potential problems with the concurrent application of two or more guidelines. We illustrate the operation of our procedure in a clinical scenario describing simultaneous use of CPGs for duodenal ulcer and transient ischemic attack.

Stress-Preventive Management Competencies, Psychosocial Work Environments, and Affective Well-Being: A Multilevel, Multisource Investigation

Science.gov (United States)

Balducci, Cristian

2018-01-01

The Management Competencies for Preventing and Reducing Stress at Work framework represents one of the few tailored models of leadership for work stress prevention purposes, but it has never been empirically evaluated. The aim of this study was to investigate whether supervisors’ stress-preventive management competencies, as measured by the Stress Management Competencies Indicator Tool (SMCIT), are related to employees’ affective well-being through psychosocial work environmental factors. To this end, multilevel structural equation modelling (MSEM) was developed and tested, including data provided by both supervisors and employees. Supervisors (n = 84) self-assessed their stress-preventive management competencies (i.e., being respectful and responsible, managing and communicating existing and future work, reasoning and managing difficult situations, and managing the individual within the team) with a previously validated reduced version of the SMCIT. The supervised employees (n = 584) rated job content (e.g., job demands) and work context (e.g., role clarity) psychosocial factors and their job-related affective well-being. Supervisors’ job-related affective well-being was also included in the tested model. The results revealed that the stress-preventive competencies factor was related to employees’ affective well-being through the psychosocial work environment only when the latter was operationalized by means of contextual work factors. Supervisors’ affective well-being was related to their stress-preventive competencies, but it was not related to employees’ affective well-being. We discuss the implications of the results obtained. PMID:29495360

Stress-Preventive Management Competencies, Psychosocial Work Environments, and Affective Well-Being: A Multilevel, Multisource Investigation.

Science.gov (United States)

Toderi, Stefano; Balducci, Cristian

2018-02-26

The Management Competencies for Preventing and Reducing Stress at Work framework represents one of the few tailored models of leadership for work stress prevention purposes, but it has never been empirically evaluated. The aim of this study was to investigate whether supervisors' stress-preventive management competencies, as measured by the Stress Management Competencies Indicator Tool (SMCIT), are related to employees' affective well-being through psychosocial work environmental factors. To this end, multilevel structural equation modelling (MSEM) was developed and tested, including data provided by both supervisors and employees. Supervisors ( n = 84) self-assessed their stress-preventive management competencies (i.e., being respectful and responsible, managing and communicating existing and future work, reasoning and managing difficult situations, and managing the individual within the team) with a previously validated reduced version of the SMCIT. The supervised employees ( n = 584) rated job content (e.g., job demands) and work context (e.g., role clarity) psychosocial factors and their job-related affective well-being. Supervisors' job-related affective well-being was also included in the tested model. The results revealed that the stress-preventive competencies factor was related to employees' affective well-being through the psychosocial work environment only when the latter was operationalized by means of contextual work factors. Supervisors' affective well-being was related to their stress-preventive competencies, but it was not related to employees' affective well-being. We discuss the implications of the results obtained.

Medical negligence--prevention and management.

Science.gov (United States)

Chao, T C

1987-04-01

The rising spate of malpractice cases against doctors appearing in the press and annual reports of medical insurance companies causes concern. Are our doctors more careless or is the public more conscious of litigation? A well publicized malpractice case can ruin the doctor's career and practice. It is well worth a doctor's while to know the pitfalls and learn how to prevent them, and if a mistake happens, how to manage it. Not all mistakes amount to negligence. How will the court view these cases? Some local cases are cited to illustrate the difference between misadventure and negligence. They will serve as guidelines for good medical practice.

Application of virtual reality methods to obesity prevention and management research.

Science.gov (United States)

Persky, Susan

2011-03-01

There is a great need for empirical evidence to inform clinical prevention and management of overweight and obesity. Application of virtual reality (VR) methods to this research agenda could present considerable advantages. Use of VR methods in basic and applied obesity prevention and treatment research is currently extremely limited. However, VR has been employed for social and behavioral research in many other domains where it has demonstrated validity and utility. Advantages of VR technologies as research tools include the ability to situate hypothetical research scenarios in realistic settings, tight experimental control inherent in virtual environments, the ability to manipulate and control any and all scenario elements, and enhanced behavioral measurement opportunities. The means by which each of these features could enhance obesity prevention and management research is discussed and illustrated in the context of an example research study. Challenges associated with the application of VR methods, such as technological limitations and cost, are also considered. By employing experimental VR methods to interrogate clinical encounters and other health-related situations, researchers may be able to elucidate causal relationships, strengthen theoretical models, and identify potential targets for intervention. In so doing, researchers stand to make important contributions to evidence-based practice innovation in weight management and obesity prevention. © 2011 Diabetes Technology Society.

Overview, prevention and management of chemotherapy extravasation

OpenAIRE

Kreidieh, Firas Y; Moukadem, Hiba A; El Saghir, Nagi S

2016-01-01

Chemotherapy extravasation remains an accidental complication of chemotherapy administration and may result in serious damage to patients. We review in this article the clinical aspects of chemotherapy extravasation and latest advances in definitions, classification, prevention, management and guidelines. We review the grading of extravasation and tissue damage according to various chemotherapeutic drugs and present an update on treatment and new antidotes including dexrazoxane for anthracycl...

Preventive maintenance - An important element in the `risk management` philosophy

Energy Technology Data Exchange (ETDEWEB)

Gullev, Lars [VEKS (Denmark)

1996-11-01

The contents of the paper is a presentation of the company VEKS with particular focus on the connection between preventive maintenance and the `Risk Management` philosophy. Implementation of Risk Management was preferred instead of an ISO-9000 certification of the company. The experience is that the responsibility in the organisation has been increased. (au)

Concurrence classes for general pure multipartite states

International Nuclear Information System (INIS)

Heydari, Hoshang

2005-01-01

We propose concurrence classes for general pure multipartite states based on an orthogonal complement of a positive operator-valued measure on quantum phase. In particular, we construct W m class, GHZ m , and GHZ m-1 class concurrences for general pure m-partite states. We give explicit expressions for W 3 and GHZ 3 class concurrences for general pure three-partite states and for W 4 , GHZ 4 and GHZ 3 class concurrences for general pure four-partite states

Prevention and management of noncommunicable disease: the IOC Consensus Statement, Lausanne 2013.

Science.gov (United States)

Matheson, Gordon O; Klügl, Martin; Engebretsen, Lars; Bendiksen, Fredrik; Blair, Steven N; Börjesson, Mats; Budgett, Richard; Derman, Wayne; Erdener, Uğur; Ioannidis, John P A; Khan, Karim M; Martinez, Rodrigo; van Mechelen, Willem; Mountjoy, Margo; Sallis, Robert E; Schwellnus, Martin; Shultz, Rebecca; Soligard, Torbjørn; Steffen, Kathrin; Sundberg, Carl Johan; Weiler, Richard; Ljungqvist, Arne

2013-11-01

Morbidity and mortality from preventable, noncommunicable chronic disease (NCD) threatens the health of our populations and our economies. The accumulation of vast amounts of scientific knowledge has done little to change this. New and innovative thinking is essential to foster new creative approaches that leverage and integrate evidence through the support of big data, technology, and design thinking. The purpose of this paper is to summarize the results of a consensus meeting on NCD prevention sponsored by the International Olympic Committee (IOC) in April 2013. Within the context of advocacy for multifaceted systems change, the IOC's focus is to create solutions that gain traction within health care systems. The group of participants attending the meeting achieved consensus on a strategy for the prevention and management of chronic disease that includes the following: 1. Focus on behavioral change as the core component of all clinical programs for the prevention and management of chronic disease. 2. Establish actual centers to design, implement, study, and improve preventive programs for chronic disease. 3. Use human-centered design (HCD) in the creation of prevention programs with an inclination to action, rapid prototyping and multiple iterations. 4. Extend the knowledge and skills of Sports and Exercise Medicine (SEM) professionals to build new programs for the prevention and treatment of chronic disease focused on physical activity, diet, and lifestyle. 5. Mobilize resources and leverage networks to scale and distribute programs of prevention. True innovation lies in the ability to align thinking around these core strategies to ensure successful implementation of NCD prevention and management programs within health care. The IOC and SEM community are in an ideal position to lead this disruptive change. The outcome of the consensus meeting was the creation of the IOC Non-Communicable Diseases ad hoc Working Group charged with the responsibility of moving this

Using risk-informed asset management for feedwater system preventative maintenance optimization

International Nuclear Information System (INIS)

Kee, Ernest; Sun, Alice; Richards, Andrew; Grantom, Rick; Liming, James; Salter, James

2004-01-01

The initial development of a South Texas Project Nuclear Operating Company process for supporting preventative maintenance optimization by applying the Balance-Of-Plant model and Risk-Informed Asset Management alpha-level software applications is presented. Preventative maintenance activities are evaluated in the South Texas Project Risk-Informed Asset Management software while the plant maintains or improves upon high levels of nuclear safety. In the Balance-Of-Plant availability application, the level of detail in the feedwater system is enhanced to support plant decision-making at the component failure mode and human error mode level of indenture by elaborating on the current model at the super-component level of indenture. The enhanced model and modeling techniques are presented. Results of case studies in feedwater system preventative maintenance optimization sing plant-specific data are also presented. (author)

Steps in Modular Specifications for Concurrent Modules

DEFF Research Database (Denmark)

Da Rocha Pinto, Pedro; Dinsdale-Young, Thomas; Gardner, Philippa

2015-01-01

The specification of a concurrent program module is a difficult problem. The specifications must be strong enough to enable reasoning about the intended clients without reference to the underlying module implementation. We survey a range of verification techniques for specifying concurrent module......, in particular highlighting four key concepts: auxiliary state, interference abstraction, resource ownership and atomicity. We show how these concepts combine to provide powerful approaches to specifying concurrent modules.......The specification of a concurrent program module is a difficult problem. The specifications must be strong enough to enable reasoning about the intended clients without reference to the underlying module implementation. We survey a range of verification techniques for specifying concurrent modules...

Major accident prevention through applying safety knowledge management approach.

Science.gov (United States)

Kalatpour, Omid

2016-01-01

Many scattered resources of knowledge are available to use for chemical accident prevention purposes. The common approach to management process safety, including using databases and referring to the available knowledge has some drawbacks. The main goal of this article was to devise a new emerged knowledge base (KB) for the chemical accident prevention domain. The scattered sources of safety knowledge were identified and scanned. Then, the collected knowledge was formalized through a computerized program. The Protégé software was used to formalize and represent the stored safety knowledge. The domain knowledge retrieved as well as data and information. This optimized approach improved safety and health knowledge management (KM) process and resolved some typical problems in the KM process. Upgrading the traditional resources of safety databases into the KBs can improve the interaction between the users and knowledge repository.

[INTERVENTIONS FOR PREVENTION AND MANAGEMENT OF CHILD AND YOUTH OBESITY].

Science.gov (United States)

Pérez Morente, Ma Angeles; Sánchez Ocón, Ma Teresa; Mingorance Ruiz, Ma Visitación; Pérez Robles, Angustias; Munoz de la Fuente, José Manuel; Sánchez De Arias, Celia

2015-02-01

To determine the current epidemiological situation, prevention and management of child and youth obesity based on the best scientific evidence available. Literature search in PubMed, Cochrane, Science Direct, ENFISPO, Lilacs and SciELO, selecting articles about child and youth obesity, its prevention and treatment. Child and youth obesity is a multifactorial chronic disease that it has been increasing, tending to stay in adolescence and adulthood with greater intensity than more early starts. The data vary from country to country, although most articles are governed by body mass index (BMI). Pediatric overweight is defined by a BMI percentiles located between 91-98 and obesity by a percentile equal or greater than 99. Its prevalence varies according to time, geography, age, gender and race. The prevalence rates of obesity in Spain are one of the highest around the world. The overweight prevalence is lower slightly and there is no difference in gender. Its implications include the metabolic syndrome and diabetes mellitus II. Unanimously, the combination of interventions on life and dietary habits and physical activity is important for the management of obesity and overweight. Currently, the obesity management requires a generalized approach, with changes in lifestyle, diet and physical activity. The best solution for reducing this epidemic lies in prevention rather than treatment.

Simple concurrent garbage collection almost without synchronization

NARCIS (Netherlands)

Hesselink, Wim H.; Lali, M.I.

We present two simple mark and sweep algorithms, A and B, for concurrent garbage collection by a single collector running concurrently with a number of mutators that concurrently modify shared data. Both algorithms are based on the ideas of Ben-Ari's classical algorithm for on-the-fly garbage

Randomized control trial of benzydamine HCl versus sodium bicarbonate for prophylaxis of concurrent chemoradiation-induced oral mucositis.

Science.gov (United States)

Chitapanarux, Imjai; Tungkasamit, Tharatorn; Petsuksiri, Janjira; Kannarunimit, Danita; Katanyoo, Kanyarat; Chakkabat, Chakkapong; Setakornnukul, Jiraporn; Wongsrita, Somying; Jirawatwarakul, Naruemon; Lertbusayanukul, Chawalit; Sripan, Patumrat; Traisathit, Patrinee

2018-03-01

The purpose of the study is to compare the efficacy of benzydamine HCl with sodium bicarbonate in the prevention of concurrent chemoradiation-induced oral mucositis in head and neck cancer patients. Sixty locally advanced head and neck cancer patients treated with high-dose radiotherapy concurrently with platinum-based chemotherapy were randomly assigned to receive either benzydamine HCl or sodium bicarbonate from the first day of treatment to 2 weeks after the completion of treatment. The total score for mucositis, based on the Oral Mucositis Assessment Scale (OMAS), was used for the assessment, conducted weekly during the treatment period and at the fourth week of the follow-up. Pain score, all prescribed medications, and tube feeding needs were also recorded and compared. The median of total OMAS score was statistically significant lower in patients who received benzydamine HCl during concurrent chemo-radiotherapy (CCRT) than in those who received sodium bicarbonate, (p value < 0.001). There was no difference in median pain score, (p value = 0.52). Nineteen percent of patients in sodium bicarbonate arm needed oral antifungal agents whereas none in the benzydamine HCl arm required such medications, (p value = 0.06). Tube feeding needs and the compliance of CCRT were not different between the two study arms. For patients undergoing high-dose radiotherapy concurrently with platinum-based chemotherapy, using benzydamine HCl mouthwash as a preventive approach was superior to basic oral care using sodium bicarbonate mouthwash in terms of reducing the severity of oral mucositis and encouraging trend for the less need of oral antifungal drugs.

Functional Foods and Lifestyle Approaches for Diabetes Prevention and Management

Directory of Open Access Journals (Sweden)

Ahmad Alkhatib

2017-12-01

Full Text Available Functional foods contain biologically active ingredients associated with physiological health benefits for preventing and managing chronic diseases, such as type 2 diabetes mellitus (T2DM. A regular consumption of functional foods may be associated with enhanced anti-oxidant, anti-inflammatory, insulin sensitivity, and anti-cholesterol functions, which are considered integral to prevent and manage T2DM. Components of the Mediterranean diet (MD—such as fruits, vegetables, oily fish, olive oil, and tree nuts—serve as a model for functional foods based on their natural contents of nutraceuticals, including polyphenols, terpenoids, flavonoids, alkaloids, sterols, pigments, and unsaturated fatty acids. Polyphenols within MD and polyphenol-rich herbs—such as coffee, green tea, black tea, and yerba maté—have shown clinically-meaningful benefits on metabolic and microvascular activities, cholesterol and fasting glucose lowering, and anti-inflammation and anti-oxidation in high-risk and T2DM patients. However, combining exercise with functional food consumption can trigger and augment several metabolic and cardiovascular protective benefits, but it is under-investigated in people with T2DM and bariatric surgery patients. Detecting functional food benefits can now rely on an “omics” biological profiling of individuals’ molecular, genetics, transcriptomics, proteomics, and metabolomics, but is under-investigated in multi-component interventions. A personalized approach for preventing and managing T2DM should consider biological and behavioral models, and embed nutrition education as part of lifestyle diabetes prevention studies. Functional foods may provide additional benefits in such an approach.

An Innovative Partnership Approach for Environmental Management and Pollution Prevention.

Science.gov (United States)

Erten-Unal, Mujde; Aydlett, Guy M.

1997-01-01

A partnership between a university and a government regulatory agency sought to assist industries with pollution prevention and waste management. Economic incentives were developed to promote waste minimization. (SK)

A Concurrent Logical Relation

DEFF Research Database (Denmark)

Birkedal, Lars; Sieczkowski, Filip; Thamsborg, Jacob Junker

2012-01-01

We present a logical relation for showing the correctness of program transformations based on a new type-and-effect system for a concurrent extension of an ML-like language with higher-order functions, higher-order store and dynamic memory allocation. We show how to use our model to verify a number....... To the best of our knowledge, this is the first such result for a concurrent higher-order language with higher-order store and dynamic memory allocation....

Effect of HMB/Arg/Gln on the prevention of radiation dermatitis in head and neck cancer patients treated with concurrent chemoradiotherapy.

Science.gov (United States)

Imai, Takayuki; Matsuura, Kazuto; Asada, Yukinori; Sagai, Shun; Katagiri, Katsunori; Ishida, Eiichi; Saito, Daisuke; Sadayasu, Rei; Wada, Hitoshi; Saijo, Shigeru

2014-05-01

This prospective randomized Phase II study was designed to evaluate the preventive effect of an oral nutrition supplement composed of beta-hydroxy-beta-methylbutyrate, arginine and glutamine (beta-hydroxy-beta-methylbutyrate/arginine/glutamine) on radiation dermatitis in head and neck cancer patients. Forty patients with histologically proven head and neck cancer, treated with concurrent chemoradiotherapy involving cisplatin were recruited. They were randomly assigned to the beta-hydroxy-beta-methylbutyrate/arginine/glutamine supplement treatment group (Group A) or the control group that received no supplement (Group B). The primary endpoint of this study was the percentage of patients developing ≥Grade 3 dermatitis. The secondary endpoints were the percentage of patients developing ≥Grade 2 dermatitis, and the duration of each grade of dermatitis relative to the observation period. The incidence of ≥Grade 3 dermatitis did not differ between the two groups. However, as secondary endpoints of this study, the incidence of ≥Grade 2 dermatitis was lower in Group A than B (62.6 vs. 94.4%; P < 0.05), and the duration of ≥Grade 1 dermatitis was shorter in Group A than B (44.8 vs. 56.7%; P < 0.01), as was the duration of ≥Grade 2 dermatitis (16.5 vs. 26.5%; P < 0.05). Our study indicated that beta-hydroxy-beta-methylbutyrate/arginine/glutamine supplementation was potentially effective in the prevention of radiation dermatitis in head and neck cancer patients.

Effect of HMB/Arg/Gln on the prevention of radiation dermatitis in head and neck cancer patients treated with concurrent chemoradiotherapy

International Nuclear Information System (INIS)

Imai, Takayuki; Matsuura, Kazuto; Asada, Yukinori

2014-01-01

This prospective randomized Phase 2 study was designed to evaluate the preventive effect of an oral nutrition supplement composed of beta-hydroxy-beta-methylbutyrate, arginine and glutamine (beta-hydroxy-beta-methylbutyrate/arginine/glutamine) on radiation dermatitis in head and neck cancer patients. Forty patients with histologically proven head and neck cancer, treated with concurrent chemoradiotherapy involving cisplatin were recruited. They were randomly assigned to the beta-hydroxy-beta-methylbutyrate/arginine/glutamine supplement treatment group (Group A) or the control group that received no supplement (Group B). The primary endpoint of this study was the percentage of patients developing ≥Grade 3 dermatitis. The secondary endpoints were the percentage of patients developing ≥Grade 2 dermatitis, and the duration of each grade of dermatitis relative to the observation period. The incidence of ≥Grade 3 dermatitis did not differ between the two groups. However, as secondary endpoints of this study, the incidence of ≥Grade 2 dermatitis was lower in Group A than B (62.6 vs. 94.4%; P < 0.05), and the duration of ≥Grade 1 dermatitis was shorter in Group A than B (44.8 vs. 56.7%; P < 0.01), as was the duration of ≥Grade 2 dermatitis (16.5 vs. 26.5%; P < 0.05). Our study indicated that beta-hydroxy-beta-methylbutyrate/arginine/glutamine supplementation was potentially effective in the prevention of radiation dermatitis in head and neck cancer patients. (author)

Model-Based Systems Engineering in Concurrent Engineering Centers

Science.gov (United States)

Iwata, Curtis; Infeld, Samantha; Bracken, Jennifer Medlin; McGuire, Melissa; McQuirk, Christina; Kisdi, Aron; Murphy, Jonathan; Cole, Bjorn; Zarifian, Pezhman

2015-01-01

Concurrent Engineering Centers (CECs) are specialized facilities with a goal of generating and maturing engineering designs by enabling rapid design iterations. This is accomplished by co-locating a team of experts (either physically or virtually) in a room with a narrow design goal and a limited timeline of a week or less. The systems engineer uses a model of the system to capture the relevant interfaces and manage the overall architecture. A single model that integrates other design information and modeling allows the entire team to visualize the concurrent activity and identify conflicts more efficiently, potentially resulting in a systems model that will continue to be used throughout the project lifecycle. Performing systems engineering using such a system model is the definition of model-based systems engineering (MBSE); therefore, CECs evolving their approach to incorporate advances in MBSE are more successful in reducing time and cost needed to meet study goals. This paper surveys space mission CECs that are in the middle of this evolution, and the authors share their experiences in order to promote discussion within the community.

[Postoperative Chylotholax;Intraoperative Prevention and Postoperative Management].

Science.gov (United States)

Saito, Tomohito; Kariya, Shuji; Murakawa, Tomohiro

2017-07-01

Postoperative chylothorax is a relatively rare but potentially fatal complication caused by iatrogenic injury to thoracic duct system, with an incidence ranging from 2 to 4% after major lung surgery or esophagectomy. The pathophysiologic features of chylothorax include dehydration, loss of nutrients and immunological components. Intraopreative prevention is the first step for the management, and treatment options include conservative therapy, percutaneous intervention, and redo-operation. Although the treatment algorithm has not been standardized, chylothorax which is refractory to conservative treatment, or that with high output greater than 1,000 ml/day should be treated aggressively with thoracic duct embolization or redo-operation in a timely fashion. We herein review the anatomy and physiology of thoracic duct system and describe the overview of prevention and each theapeutic options of postoperative chylothorax.

Pollution prevention opportunity assessment: Foundation of pollution prevention for waste management

International Nuclear Information System (INIS)

Damewood, R.W.

1994-01-01

The objective of this paper is to promote the Pollution Prevention Opportunity Assessment (PPOA) technique as a fundamental of pollution prevention for waste management. All key elements of an effective PPOA program are presented. These key elements include impacts of environmental laws on pollution prevention, PPOA concepts and overview, waste minimization opportunities assessment, reporting and monitoring waste minimization progress, and PPOA program implementation. As environmental laws evolve the focus is shifting from end-of-pipe pollution control to front-end source reduction. Waste minimization was mistakenly interpreted to mean the reduction of hazardous waste after generation in the past. The Pollution Prevention Act of 1990 has clearly defined its requirement on resource reduction. Waste reduction can be viewed as a criterion to assess all industrial processes and operations. The fundamental approach of PPOA focuses on a mass balance concept. This concept deals with tracking of chemicals from the point of purchase, through storage, utilization in the process, and waste generation at the end of process. In other words, PPOA is a technique to analyze this input/output process. By applying PPOA techniques, the framework of applicable compliance requirements to the current operation process is established. Furthermore, documentation of PPOA itself can meet as documentation requirements for environmental compliance. In general, the PPOA process consists of two phases. The first phase involves input and output process description and waste characterization. The second phase is an opportunities assessment for waste minimization from input/output waste characterization. These two phases are explained in detail in the paper

Preventing postpartum haemorrhage: active management of the third stage of labour.

Science.gov (United States)

de Castro Parreira, Maria V B; Gomes, Nádia C Ferreira

2013-12-01

To review scientific publications on health to identify the main practices used for the active management of the third stage of vaginal labour and to assess their effectiveness in preventing postpartum haemorrhage. According to the World Health Organization (WHO Recommendations for the Prevention of Postpartum Haemorrhage, 2007. WHO Document Production Services, Geneva), postpartum haemorrhage is considered to be the cause of a quarter of maternal morbidity and mortality rates worldwide. In an attempt to reduce the risk of haemorrhage, a group of interventions have been introduced into clinical practice that constitute active management conduct during the third stage of labour and are recommended by the international organisations. An integrative literature review of studies on the subject in question, indexed in databases of health between the years 2006-2012, was conducted. The analysis included 13 articles, six of which were original articles and seven of which were literature reviews. Based on our data analysis, we found that most studies supported the effectiveness of active management in reducing the risk of haemorrhage, in the immediate postpartum period. Despite the fact that active management practices for the third stage of labour differ in their specific elements, in the majority of the selected studies, the interventions followed those recommended by the international organisations. The results of this review of management practices supported active management of the third stage of labour to prevent postpartum haemorrhage, with five main forms of intervention: administration of oxytocin, delayed clamping of umbilical cord, draining of placental blood, controlled cord traction and uterine massage. There is a need to determine gaps in the clinical practices of midwives in regard to the active management of third stage of labour, to update knowledge and practices with the latest scientific evidence. © 2013 John Wiley & Sons Ltd.

Prevention of musculoskeletal disorders within management systems: A scoping review of practices, approaches, and techniques.

Science.gov (United States)

Yazdani, Amin; Neumann, W Patrick; Imbeau, Daniel; Bigelow, Philip; Pagell, Mark; Wells, Richard

2015-11-01

The purpose of this study was to identify and summarize the current research evidence on approaches to preventing musculoskeletal disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS). Databases in business, engineering, and health and safety were searched and 718 potentially relevant publications were identified and examined for their relevance. Twenty-one papers met the selection criteria and were subjected to thematic analysis. There was very little literature describing the integration of MSD risk assessment and prevention into management systems. This lack of information may isolate MSD prevention, leading to difficulties in preventing these disorders at an organizational level. The findings of this review argue for further research to integrate MSD prevention into management systems and to evaluate the effectiveness of the approach. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Prevention and management of postoperative nausea and vomiting: a look at complementary techniques.

Science.gov (United States)

Mamaril, Myrna E; Windle, Pamela E; Burkard, Joseph F

2006-12-01

Complementary modalities, used alone or in combination with pharmacologic therapies, play an important role in the prevention and management of postoperative nausea and vomiting (PONV) and post discharge nausea and vomiting (PDNV). This article will review the evidence for the effective use of complementary modalities: acupuncture and related techniques, aromatherapy, and music therapy that may be integrated in the perianesthesia nurse's plan of care to prevent or manage PONV.

Tackling stress management, addiction, and suicide prevention in a predoctoral dental curriculum.

Science.gov (United States)

Brondani, Mario A; Ramanula, Dhorea; Pattanaporn, Komkhamn

2014-09-01

Health care professionals, particularly dentists, are subject to high levels of stress. Without proper stress management, problems related to mental health and addiction and, to a lesser extent, deliberate self-harm such as suicide may arise. There is a lack of information on teaching methodologies employed to discuss stress management and suicide prevention in dental education. The purpose of this article is to describe a University of British Columbia Faculty of Dentistry module designed to address stress management and suicide prevention, using students' personal reflections to illustrate the impact of the pedagogies used. The module enrolls more than 200 students per year and has sessions tailored to the discussion of stress management and suicide prevention. The pedagogies include standardized patients, invited guest lectures, in-class activities, video presentation, and self-reflections. More than 500 students' self-reflections collected over the past five years illustrate the seriousness of the issues discussed and the level of discomfort students experience when pondering such issues. The instructors hope to have increased students' awareness of the stressors in their profession. Further studies are needed to unravel the extent to which such pedagogy influences a balanced practice of dentistry.

Interventions Using Social Media for Cancer Prevention and Management: A Systematic Review.

Science.gov (United States)

Han, Claire Jungyoun; Lee, Young Ji; Demiris, George

2017-07-27

Regarding cancer awareness, social media effectively promotes health and supports self-management. Given the diverse study designs, methodologies, and approaches of social media interventions in oncology, it is difficult to determine the effects of social media on cancer prevention and management. We aim to systematically review intervention studies using social media for cancer care. A systematic search, using 7 electronic databases (PubMed, Web of Science, CINAHL, Cochrane Library, Scopus, EMBASE, and PsycINFO), was conducted to identify surveys and interventions using contemporary social media tools with a focus on cancer. Of the 18 selected studies, 7 were randomized controlled trials. Most studies were conducted for all types of cancer, and some were conducted for breast cancer in the United States, with mostly white female participants. Facebook was the most frequently used platform. Most studies targeted healthy participants providing cancer prevention education. With social media platforms as part of a larger intervention, or the main component of interventions, interventions were overall feasible and showed a significant improvement in cancer prevention and management. Social media tools have the potential to be effective in delivering interventions for cancer prevention and management. However, there was a dearth of studies with rigorous study methodologies to test social media effects on various cancer-related clinical outcomes. Social media use in cancer care will facilitate improved communication and support among patients, caregivers, and clinicians and, ultimately, improved patient care. Clinicians need to carefully harness social media to enhance patient care and clinical outcomes.

A nuclear training simulator implementing a capability for multiple, concurrent-training sessions

International Nuclear Information System (INIS)

Groeneveld, B.J.; Nannister, D.G.; Estes, K.R.; Johnsen, M.R.

1996-01-01

The Advanced Test Reactor (ATR) Simulator at the Test Reactor Area of the Idaho National Engineering Laboratory (INEL) has recently been upgraded to reflect plant installation of a distributed control system (DCS). The ATR Simulator re-design implements traditional needs for software extensibility and plant installation prototyping, but the driving force behind its new design was an instruction requirement for multiple, concurrent-training sessions. Support is provided for up to three concurrent, independent or interacting, training sessions of reactor, balance of plant, and experiment loop operators. This capability has been achieved by modifying the existing design to consistently apply client-server, parent-child, and peer-to-peer processing technologies, and then to encapsulate concurrency software into all interfaces. When the resulting component-oriented design is linked with build and runtime flexibility in a distributed computing environment, traditional needs for extensibility and parallel software and scenario development are satisfied with minimal additional effort. Sensible configuration management practices coupled with the ability to perform piecewise system builds also greatly facilitate prototyping of plant changes prior to installation

Risk management through concurrency

International Nuclear Information System (INIS)

Childress, J.R.; Briant, V.B.

1991-01-01

More than ever before, management and technical professionals are concerned with the subtle and dynamic relationships between safety and performance in complex and hazardous industries. This is certainly true in the nuclear power industry. With the US electric energy industry on the verge of deregulation and increased competition, and with a virtual stoppage on building new nuclear power plants, the increasing demand for reliable sources of efficient electric energy is pressing the nuclear utilities to increase production. At the same time, public sentiment and regulatory pressures are increasing their focus on safety at all costs. The purpose of this paper is to present a proven approach to creating a new work culture for improved nuclear safety and performance. The concepts and material which make up this paper have been taken from both authors experience, research, and consulting in the nuclear industry for several years, as well as from over 20 years of consulting work on the relationships between organizational behavior, culture, and productivity

Computer technologies for industrial risk prevention and emergency management

International Nuclear Information System (INIS)

Balduccelli, C.; Bologna, S.; Di Costanzo, G.; Vicoli, G.

1996-07-01

This document provides an overview about problems related to the engineering of computer based systems for industrial risk prevention and emergency management. Such systems are rather complex and subject to precise reliability and safety requirements. With the evolution of informatic technologies, such systems are becoming to be the means for building protective barriers for reduction of risk associated with plant operations. For giving more generality to this document, and for not concentrating on only a specific plant, the emergency management systems will be dealt with more details than ones for accident prevention. The document is organized in six chapters. Chapter one is an introduction to the problem and to its state of art, with particular emphasis to the aspects of safety requirements definition. Chapter two is an introduction to the problems related to the emergency management and to the training of operators in charge of this task. Chapter three deals in details the topic of the Training Support Systems, in particular about MUSTER (multi-user system for training and evaluation of environmental emergency response) system. Chapter four deals in details the topic of decision support systems, in particular about ISEM (information technology support for emergency management) system. Chapter five illustrates an application of support to the operators of Civil Protection Department for the management of emergencies in the fields of industrial chemical. Chapter six is about a synthesis of the state of art and the future possibilities, identifying some research and development activities more promising for the future

Modality planning for preventing tunnel vision in crisis management

NARCIS (Netherlands)

Cao, Y.; Nijholt, Antinus; Theune, Mariët; van der Sluis, Ielka; Bachvarova, Yulia; Andre, Elisabeth

2008-01-01

Crisis management is a time-critical task with high uncertainty and high risk. Stress and cognitive overload often result in a set of bias in crisis manager’s situation understanding and information confirming processes, known as 'tunnel vision'. Aiming at preventing tunnel vision, we propose an

Prevention and management of non-communicable disease: the IOC consensus statement, Lausanne 2013.

Science.gov (United States)

Matheson, Gordon O; Klügl, Martin; Engebretsen, Lars; Bendiksen, Fredrik; Blair, Steven N; Börjesson, Mats; Budgett, Richard; Derman, Wayne; Erdener, Uğur; Ioannidis, John P A; Khan, Karim M; Martinez, Rodrigo; van Mechelen, Willem; Mountjoy, Margo; Sallis, Robert E; Schwellnus, Martin; Shultz, Rebecca; Soligard, Torbjørn; Steffen, Kathrin; Sundberg, Carl Johan; Weiler, Richard; Ljungqvist, Arne

2013-11-01

Morbidity and mortality from preventable, non-communicable chronic disease (NCD) threatens the health of our populations and our economies. The accumulation of vast amounts of scientific knowledge has done little to change this. New and innovative thinking is essential to foster new creative approaches that leverage and integrate evidence through the support of big data, technology, and design thinking. The purpose of this paper is to summarize the results of a consensus meeting on NCD prevention sponsored by the International Olympic Committee (IOC) in April, 2013. Within the context of advocacy for multifaceted systems change, the IOC's focus is to create solutions that gain traction within health care systems. The group of participants attending the meeting achieved consensus on a strategy for the prevention and management of chronic disease that includes the following: 1. Focus on behavioural change as the core component of all clinical programs for the prevention and management of chronic disease. 2. Establish actual centres to design, implement, study, and improve preventive programs for chronic disease. 3. Use human-centered design in the creation of prevention programs with an inclination to action, rapid prototyping and multiple iterations. 4. Extend the knowledge and skills of Sports and Exercise Medicine (SEM) professionals to build new programs for the prevention and treatment of chronic disease focused on physical activity, diet and lifestyle. 5. Mobilize resources and leverage networks to scale and distribute programs of prevention. True innovation lies in the ability to align thinking around these core strategies to ensure successful implementation of NCD prevention and management programs within health care. The IOC and SEM community are in an ideal position to lead this disruptive change. The outcome of the consensus meeting was the creation of the IOC Non-Communicable Diseases ad-hoc Working Group charged with the responsibility of moving this

Preventing Medication Error Based on Knowledge Management Against Adverse Event

OpenAIRE

Hastuti, Apriyani Puji; Nursalam, Nursalam; Triharini, Mira

2017-01-01

Introductions: Medication error is one of many types of errors that could decrease the quality and safety of healthcare. Increasing number of adverse events (AE) reflects the number of medication errors. This study aimed to develop a model of medication error prevention based on knowledge management. This model is expected to improve knowledge and skill of nurses to prevent medication error which is characterized by the decrease of adverse events (AE). Methods: This study consisted of two sta...

Algebraic topology and concurrency

DEFF Research Database (Denmark)

Fajstrup, Lisbeth; Raussen, Martin; Goubault, Eric

2006-01-01

We show in this article that some concepts from homotopy theory, in algebraic topology,are relevant for studying concurrent programs. We exhibit a natural semantics of semaphore programs, based on partially ordered topological spaces, which are studied up to “elastic deformation” or homotopy...... differences between ordinary and directed homotopy through examples. We also relate the topological view to a combinatorial view of concurrent programs closer to transition systems, through the notion of a cubical set. Finally we apply some of these concepts to the proof of the safeness of a two...

Managing workplace stress in community pharmacy organisations: lessons from a review of the wider stress management and prevention literature.

Science.gov (United States)

Jacobs, Sally; Johnson, Sheena; Hassell, Karen

2018-02-01

Workplace stress in community pharmacy is increasing internationally due, in part, to pharmacists' expanding roles and escalating workloads. Whilst the business case for preventing and managing workplace stress by employers is strong, there is little evidence for the effectiveness of organisational stress management interventions in community pharmacy settings. To identify and synthesise existing evidence for the effectiveness of organisational solutions to workplace stress from the wider organisational literature which may be adaptable to community pharmacies. A secondary synthesis of existing reviews. Publications were identified through keyword searches of electronic databases and the internet; inclusion and exclusion criteria were applied; data about setting, intervention, method of evaluation, effectiveness and conclusions (including factors for success) were extracted and synthesised. Eighteen reviews of the stress management and prevention literature were identified. A comprehensive list of organisational interventions to prevent or manage workplace stress, ordered by prevalence of evidence of effectiveness, was produced, together with an ordered list of the benefits both to the individual and employing organisation. An evidence-based model of best practice was derived specifying eight factors for success: top management support, context-specific interventions, combined organisational and individual interventions, a participative approach, clearly delineated tasks and responsibilities, buy-in from middle management, change agents as facilitators and change in organisational culture. This literature review provides community pharmacy organisations with evidence from which to develop effective and successful stress management strategies to support pharmacists and pharmacy staff. Well-designed trials of stress management interventions in community pharmacy organisations are still required. © 2017 Royal Pharmaceutical Society.

75 FR 40845 - Preventing Deaths and Injuries of Fire Fighters Using Risk Management Principles at Structure Fires

Science.gov (United States)

2010-07-14

... NIOSH 141-A] Preventing Deaths and Injuries of Fire Fighters Using Risk Management Principles at... publication entitled ``Preventing Deaths and Injuries of Fire Fighters Using Risk Management Principles at... fires in unoccupied structures to using established risk management principles at all structure fires...

Risk prevention and management in cooperatives: An instrument to eliminate it or reduce it

Directory of Open Access Journals (Sweden)

María de Jesús Ribet-Cuadot

2015-06-01

Full Text Available The article exposes a methodological proposal that covers aspects to consider in the process of managing and preventing risks, which must be developed in any business or business association, for it constitutes an indispensable instrument for risk elimination or reduction that will further aid to achieve the desired goals.  This methodology comes from an investigation that had a precise question as starting point: How to contribute to the risk management and prevention in cooperatives? This was its fundamental problem. The idea comes, of course, from the sudden awakening and ever –growing use of this type of association in a difficult economical and financial context. Its general goal is to expose a methodology for risk management and prevention in cooperatives. The methodology has the necessary flexibility to be adjusted to the peculiarities of each cooperative. Its main advantage consists of assuring a systematic approach to management and prevention that begins with a diagnostic and later elaboration of a map of risks in each area, which will all ease into constant check up and reviewing. Furthermore, it allows to assess the positive impact regarding economics, society and ecology.

A Temporal Concurrent Constraint Programming Calculus

DEFF Research Database (Denmark)

Palamidessi, Catuscia; Valencia Posso, Frank Darwin

2001-01-01

The tcc model is a formalism for reactive concurrent constraint programming. In this paper we propose a model of temporal concurrent constraint programming which adds to tcc the capability of modeling asynchronous and non-deterministic timed behavior. We call this tcc extension the ntcc calculus...

Global Consensus Recommendations on Prevention and Management of Nutritional Rickets.

Science.gov (United States)

Munns, Craig F; Shaw, Nick; Kiely, Mairead; Specker, Bonny L; Thacher, Tom D; Ozono, Keiichi; Michigami, Toshimi; Tiosano, Dov; Mughal, M Zulf; Mäkitie, Outi; Ramos-Abad, Lorna; Ward, Leanne; DiMeglio, Linda A; Atapattu, Navoda; Cassinelli, Hamilton; Braegger, Christian; Pettifor, John M; Seth, Anju; Idris, Hafsatu Wasagu; Bhatia, Vijayalakshmi; Fu, Junfen; Goldberg, Gail; Sävendahl, Lars; Khadgawat, Rajesh; Pludowski, Pawel; Maddock, Jane; Hyppönen, Elina; Oduwole, Abiola; Frew, Emma; Aguiar, Magda; Tulchinsky, Ted; Butler, Gary; Högler, Wolfgang

2016-02-01

Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describe the strength of the recommendation and the quality of supporting evidence. Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required.

Phase III trial of low-level laser therapy to prevent oral mucositis in head and neck cancer patients treated with concurrent chemoradiation

International Nuclear Information System (INIS)

Antunes, Heliton S.; Herchenhorn, Daniel; Small, Isabele A.; Araújo, Carlos M.M.; Viégas, Celia Maria Pais; Cabral, Elida; Rampini, Mariana P.; Rodrigues, Pedro C.; Silva, Tereza G.P.; Ferreira, Elza M.S.; Dias, Fernando L.; Ferreira, Carlos G.

2013-01-01

Background: Oral mucositis (OM) is a complication of chemoradiotherapy treatment of head and neck squamous cell carcinoma (HNSCC) patients with no effective therapy. This study was designed to assess the efficacy of preventive low-level laser therapy (LLLT) in reducing the incidence of grade 3–4 OM. Material and methods: From June 2007 to December 2010, 94 HNSCC patients entered a prospective, randomized, double-blind, placebo-controlled phase III trial. Chemoradiotherapy consisted of conventional radiotherapy plus concurrent cisplatin every 3 weeks. A diode InGaAlP (660 nm–100 mW–1 J–4 J/cm 2 ) was used. OM evaluation was performed by WHO and OMAS scales and quality of life by EORTC questionnaires (QLQ). Results: A six-fold decrease in the incidence of grades 3–4 OM was detected in the LLLT group compared to the placebo; (6.4% versus 40.5%). LLLT impacted the incidence of grades 3–4 OM to a relative risk ratio of 0.158 (CI 95% 0.050–0.498). After treatment QLQ-C30 showed, differences favoring LLLT in physical, emotional functioning, fatigue, and pain; while the QLQ-H and N35 showed improvements in LLLT arm for pain, swallowing, and trouble with social eating. Conclusion: Preventive LLLT in HNSCC patients receiving chemoradiotherapy is an effective tool for reducing the incidence of grade 3–4 OM. Efficacy data were corroborated by improvements seen in quality of life

Neonatal diabetes mellitus and congenital diaphragmatic hernia: coincidence or concurrent etiology?

Directory of Open Access Journals (Sweden)

Topiol Emmanuelle S

2012-07-01

Full Text Available Abstract Neonatal diabetes mellitus (NDM is a rare metabolic disorder, affecting approximately 1 in 500,000 live births. The management of NDM is challenging, as the benefits of controlling hyperglycemia must be balanced with the risks of iatrogenic hypoglycemia. NDM occurs in both permanent and transient forms, which have been genetically and phenotypically well characterized. Herein, we present the previously unreported combination of transient NDM (TNDM and congenital diaphragmatic hernia (CDH. In addition to reviewing the management and genetics of NDM we discuss the potential for overlapping genetic or embryologic abnormalities to explain the concurrence of CDH and NDM.

Assistive technologies for self-managed pressure ulcer prevention in spinal cord injury: a scoping review.

Science.gov (United States)

Tung, James Y; Stead, Brent; Mann, William; Ba'Pham; Popovic, Milos R

2015-01-01

Pressure ulcers (PUs) in individuals with spinal cord injury (SCI) present a persistent and costly problem. Continuing effort in developing new technologies that support self-managed care is an important prevention strategy. Specifically, the aims of this scoping review are to review the key concepts and factors related to self-managed prevention of PUs in individuals with SCI and appraise the technologies available to assist patients in self-management of PU prevention practices. There is broad consensus that sustaining long-term adherence to prevention regimens is a major concern. Recent literature highlights the interactions between behavioral and physiological risk factors. We identify four technology categories that support self-management: computer-based educational technologies demonstrated improved short-term gains in knowledge (2 studies), interface pressure mapping technologies demonstrated improved adherence to pressure-relief schedules up to 3 mo (5 studies), electrical stimulation confirmed improvements in tissue tolerance after 8 wk of training (3 studies), and telemedicine programs demonstrated improvements in independence and reduced hospital visits over 6 mo (2 studies). Overall, self-management technologies demonstrated low-to-moderate effectiveness in addressing a subset of risk factors. However, the effectiveness of technologies in preventing PUs is limited due to a lack of incidence reporting. In light of the key findings, we recommend developing integrated technologies that address multiple risk factors.

Pattern Of Occurrence, Management And Prevention Of Trauma In ...

African Journals Online (AJOL)

OBJECTIVE: The purpose of this paper is to review the occurrence, management and prevention of trauma in industry in Nigeria with particular reference to the oil industry. The type of injuries, their causes and relative frequency in the Nigerian oil industry has been discussed. First aid facilities, evacuation procedures and ...

Primary prevention of periodontitis: managing gingivitis.

Science.gov (United States)

Chapple, Iain L C; Van der Weijden, Fridus; Doerfer, Christof; Herrera, David; Shapira, Lior; Polak, David; Madianos, Phoebus; Louropoulou, Anna; Machtei, Eli; Donos, Nikos; Greenwell, Henry; Van Winkelhoff, Ari J; Eren Kuru, Bahar; Arweiler, Nicole; Teughels, Wim; Aimetti, Mario; Molina, Ana; Montero, Eduardo; Graziani, Filippo

2015-04-01

Periodontitis is a ubiquitous and irreversible inflammatory condition and represents a significant public health burden. Severe periodontitis affects over 11% of adults, is a major cause of tooth loss impacting negatively upon speech, nutrition, quality of life and self-esteem, and has systemic inflammatory consequences. Periodontitis is preventable and treatment leads to reduced rates of tooth loss and improved quality of life. However, successful treatment necessitates behaviour change in patients to address lifestyle risk factors (e.g. smoking) and, most importantly, to attain and sustain high standards of daily plaque removal, lifelong. While mechanical plaque removal remains the bedrock of successful periodontal disease management, in high-risk patients it appears that the critical threshold for plaque accumulation to trigger periodontitis is low, and such patients may benefit from adjunctive agents for primary prevention of periodontitis. The aims of this working group were to systematically review the evidence for primary prevention of periodontitis by preventing gingivitis via four approaches: 1) the efficacy of mechanical self-administered plaque control regimes; 2) the efficacy of self-administered inter-dental mechanical plaque control; 3) the efficacy of adjunctive chemical plaque control; and 4) anti-inflammatory (sole or adjunctive) approaches. Two meta-reviews (mechanical plaque removal) and two traditional systematic reviews (chemical plaque control/anti-inflammatory agents) formed the basis of this consensus. Data support the belief that professionally administered plaque control significantly improves gingival inflammation and lowers plaque scores, with some evidence that reinforcement of oral hygiene provides further benefit. Re-chargeable power toothbrushes provide small but statistically significant additional reductions in gingival inflammation and plaque levels. Flossing cannot be recommended other than for sites of gingival and periodontal

Why Weight? An Analytic Review of Obesity Management, Diabetes Prevention, and Cardiovascular Risk Reduction.

Science.gov (United States)

Igel, L I; Saunders, K H; Fins, J J

2018-05-21

In this review, we examine one of the ironies of American health care-that we pay more for disease management than disease prevention. Instead of preventing type 2 diabetes (T2DM) by treating its precursor, obesity, we fail to provide sufficient insurance coverage for weight management only to fund the more costly burden of overt T2DM. There is a vital need for expanded insurance coverage to help foster a weight-centric approach to T2DM management. This includes broader coverage of anti-diabetic medications with evidence of cardiovascular risk reduction and mortality benefit, anti-obesity pharmacotherapy, bariatric surgery, weight loss devices, endoscopic bariatric therapies, and lifestyle interventions for the treatment of obesity. The fundamental question to ask is why weight? Why wait to go after obesity until its end-stage sequelae cause intractable conditions? Instead of managing the complications of T2DM, consider preventing them by tackling obesity.

Reference Capabilities for Concurrency Control

OpenAIRE

Castegren, Elias; Wrigstad, Tobias

2016-01-01

The proliferation of shared mutable state in object-oriented programming complicates software development as two seemingly unrelated operations may interact via an alias and produce unexpected results. In concurrent programming this manifests itself as data-races. Concurrent object-oriented programming further suffers from the fact that code that warrants synchronisation cannot easily be distinguished from code that does not. The burden is placed solely on the programmer to reason ab...

The Optimization of Corruption Prevention Towards Indonesia Corruption-free

OpenAIRE

Nugroho, Hibnu; Raharjo, Agus; Pranoto

2015-01-01

Prevention and eraducation of corruption case are the strategy which can't be implemented separatly it should be done synergistically, integrated and concurrently to prevent a new corruptor generation and other new corruptor. So the problem comes on how the strategy which are prevention and eraducation corruption by Indonesian goverment to reach Indonesia free from corruption and what the obsacles in order to reach strategy prevention and eraducation of corruption that already done by Indones...

Concurrent Engineering Working Group White Paper Distributed Collaborative Design: The Next Step in Aerospace Concurrent Engineering

Science.gov (United States)

Hihn, Jairus; Chattopadhyay, Debarati; Karpati, Gabriel; McGuire, Melissa; Panek, John; Warfield, Keith; Borden, Chester

2011-01-01

As aerospace missions grow larger and more technically complex in the face of ever tighter budgets, it will become increasingly important to use concurrent engineering methods in the development of early conceptual designs because of their ability to facilitate rapid assessments and trades of performance, cost and schedule. To successfully accomplish these complex missions with limited funding, it is essential to effectively leverage the strengths of individuals and teams across government, industry, academia, and international agencies by increased cooperation between organizations. As a result, the existing concurrent engineering teams will need to increasingly engage in distributed collaborative concurrent design. The purpose of this white paper is to identify a near-term vision for the future of distributed collaborative concurrent engineering design for aerospace missions as well as discuss the challenges to achieving that vision. The white paper also documents the advantages of creating a working group to investigate how to engage the expertise of different teams in joint design sessions while enabling organizations to maintain their organizations competitive advantage.

Concurrent and Distributed Applications with ActoDeS

Directory of Open Access Journals (Sweden)

Bergenti Federico

2016-01-01

Full Text Available ActoDeS is a software framework for the development of large concurrent and distributed systems. This software framework takes advantage of the actor model and of an its implementation that makes easy the development of the actor code by delegating the management of events (i.e., the reception of messages to the execution environment. Moreover, it allows the development of scalable and efficient applications through the possibility of using different implementations of the components that drive the execution of actors. In particular, the paper introduces the software framework and presents the results of its experimentation.

Crisis management and crisis prevention

International Nuclear Information System (INIS)

Wallensteen, P.

1988-01-01

This paper reports that many proposals have come forth to ease the tension between East and West. Some focus on arms developments, others take up diplomatic issues. In addition, some have raised the question of crisis management and crisis prevention. Can crises be prevented even before they have taken place? The Palme Commission on Disarmament and Security suggested, in its 1982 report, ways of restraining superpower involvement in Third World conflicts. Such conflicts, it was argued, could escalate and ultimately result in nuclear confrontation between the United States and the Soviet Union. Certainly, the commission also paid attention to conflicts over issues in Europe and to problems in Eastern or in Western Europe. However, the commission raised a question that lately has received increasing attention: the dangers of superpower confrontation over Third World issues. In his statement to the United Nations on 24 October 1985, President Regan pointed to the need for settling regional conflicts as they play a large role in building suspicions and tensions. Regan's initiative explicitly concerned Afghanistan, Cambodia, Ethiopia, Angola and Nicaragua. It included negotiations with the Soviet Union over Afghanistan, and, at a later stage, also over other issues. The goal, he the, was not to force a settlement on the parties. The initiative concerned issues that have for the American public, justified armaments and reduced Soviet credibility

Overview of surgical scar prevention and management.

Science.gov (United States)

Son, Daegu; Harijan, Aram

2014-06-01

Management of incisional scar is intimately connected to stages of wound healing. The management of an elective surgery patient begins with a thorough informed consent process in which the patient is made aware of personal and clinical circumstances that cannot be modified, such as age, ethnicity, and previous history of hypertrophic scars. In scar prevention, the single most important modifiable factor is wound tension during the proliferative and remodeling phases, and this is determined by the choice of incision design. Traditional incisions most often follow relaxed skin tension lines, but no such lines exist in high surface tension areas. If such incisions are unavoidable, the patient must be informed of this ahead of time. The management of a surgical incision does not end when the sutures are removed. Surgical scar care should be continued for one year. Patient participation is paramount in obtaining the optimal outcome. Postoperative visits should screen for signs of scar hypertrophy and has a dual purpose of continued patient education and reinforcement of proper care. Early intervention is a key to control hyperplastic response. Hypertrophic scars that do not improve by 6 months are keloids and should be managed aggressively with intralesional steroid injections and alternate modalities.

Optimal diagnosis, prevention, and management of periprosthetic joint infection

Directory of Open Access Journals (Sweden)

Tafer N

2015-01-01

Full Text Available Nathalie Tafer,1 Wilson Belaieff,1 Céline Cuérel,1 Matthieu Zingg,1 Pierre Hoffmeyer,1 Ilker Uçkay1,2 1Orthopedic Surgery Department, 2Division of Infectious Diseases, University of Geneva Hospitals and Medical School, Geneva, Switzerland Abstract: The pace of the aging population is steadily rising worldwide with a parallel increase in the demand for joint replacement procedures. With the increasing number of patients undergoing arthroplasty, there is also an increased risk for arthroplasty infection that may lead to severe complications, poorer outcome, and substantial extra costs for health care systems. Current rates of prosthetic joint infection are not dramatically different from the 1960s or 1970s, but some general principles are now better defined, and their management has been studied extensively during the past decades, thus resulting in a change in clinical practice. The purpose of this review is to summarize important principles of prosthetic joint infection to guide the clinician and to contribute to the optimal diagnosis, prevention, and management of periprosthetic joint infections. Keywords: arthroplasty infection, antibiotic therapy, biofilm, surgery, prevention

PRIMARY PREVENTION IS? A GLOBAL PERSPECTIVE ON HOW ORGANIZATIONS ENGAGING MEN IN PREVENTING GENDER-BASED VIOLENCE CONCEPTUALIZE AND OPERATIONALIZE THEIR WORK

OpenAIRE

Storer, Heather L.; Casey, Erin A.; Carlson, Juliana; Edleson, Jeffrey L.; Tolman, Richard M.

2015-01-01

© 2015, The Author(s) 2015. Engaging men in addressing violence against women (VAW) has become a strategy in the global prevention of gender-based violence. Concurrently, Western public health frameworks have been utilized to guide prevention agendas worldwide. Using qualitative methods, this study describes how global anti-violence organizations that partner with men conceptualize primary prevention in their work. Findings suggest that “primary prevention” is not a fixed term in the context ...

PRIMARY PREVENTION IS? A GLOBAL PERSPECTIVE ON HOW ORGANIZATIONS ENGAGING MEN IN PREVENTING GENDER-BASED VIOLENCE CONCEPTUALIZE AND OPERATIONALIZE THEIR WORK

Science.gov (United States)

Storer, Heather L.; Casey, Erin A.; Carlson, Juliana; Edleson, Jeffrey L.; Tolman, Richard M.

2014-01-01

Engaging men in addressing violence against women (VAW) has become a strategy in the global prevention of gender-based violence. Concurrently, Western public health frameworks have been utilized to guide prevention agendas worldwide. Using qualitative methods, this study describes how global anti-violence organizations that partner with men conceptualize primary prevention in their work. Findings suggest that ‘primary prevention’ is not a fixed term in the context of VAW and that front-line prevention work challenges rigidly delineated distinctions between levels of prevention. Much can be learned from global organizations’ unique and contextualized approaches to the prevention of VAW. PMID:26333283

Improving Obesity Prevention and Management in Primary Care in Canada.

Science.gov (United States)

Campbell-Scherer, Denise; Sharma, Arya Mitra

2016-09-01

Obesity is a major risk factor for chronic diseases with significant morbidity, mortality and health care cost. There is concern due to the dramatic increase in overweight and obesity in Canada in the last 20 years. The causes of obesity are multifactorial, with underestimation by patients and healthcare providers of the long-term nature of the condition, and its complexity. Solutions related to prevention and management will require multifaceted strategies involving education, health policy, public health and health systems across the care continuum. We believe that to support such strategies we need to have a strong primary care workforce equipped with appropriate knowledge, skills and attitudes to support persons at risk for, or with, obesity. To achieve this end, significant skills building is required to improve primary care obesity prevention and management efforts. This review will first examine the current state, and then will outline how we can improve.

Architecture-based Model for Preventive and Operative Crisis Management

National Research Council Canada - National Science Library

Jungert, Erland; Derefeldt, Gunilla; Hallberg, Jonas; Hallberg, Niklas; Hunstad, Amund; Thuren, Ronny

2004-01-01

.... A system that should support activities of this type must not only have a high capacity, with respect to the dataflow, but also have suitable tools for decision support. To overcome these problems, an architecture for preventive and operative crisis management is proposed. The architecture is based on models for command and control, but also for risk analysis.

Strategy and Management Guideline on Preventive School Maintenance in Eritrea

DEFF Research Database (Denmark)

Vagnby, Bo Hellisen

An action-oriented and practical guideline for the planning, organisation and management of preventive school maintenance in Eritrea. The manual is the result of a participatory planning process which has involved actors at the school and community level, district levels and the national policy...

Prevention and management of maternal obesity in pregnancy

OpenAIRE

E. Alexopoulou; N. Giannousi; I. K. Thanasas

2017-01-01

Nowadays obesity is one of the most important nutritional problems with features contemporary epidemic which concerns not only the developed but also the developing countries. Obesity during pregnancy associate with maternal and perinatal risks that make the management of obesity, before and during pregnancy imperative. The best and most effective treatment of obesity in pregnancy is prevention. A healthy diet and regular exercise of pregnant woman is crucial for the normal dev...

Nursing Care Model Based on Knowledge Management in Preventing Nosocomial Infection After Caesarean Section in Hospital

Directory of Open Access Journals (Sweden)

Ahsan Ahsan

2016-09-01

Full Text Available Introduction: Nosocomial infection is one indicator of the quality of health services in the community, which also determines the image of health care institutions becauseit was a major cause of morbidityand death rate (mortality in hospital. Nursing care based on knowledge management is established from identification knowledge which is required, prevention performance of nosocomial infections post section caesarea. Nosocomial infections component consists of wound culture result. Method: This study was an observational study with a quasi experimental design. The population was all of nursing staff who working in obstetrics installation in hospitals A and B as much as 46 people. Sample was the total population. Data was collected through questionnaire, observation sheets and examination of the wound culture. Data was analyzed using t test B 1.274 dan p=0.028 Result: The result showed that 1 there was difference in knowledge management implementation before and after training; 2 there was difference in nurse’s performance in preventing nosocomial infection before and after training; 3 there is significant relationship between nurse’s performance in preventing nosocomial infection and infection incidence; 4 there is no significant difference of nursing care impementation on nosocomial incidence. Discussion: In conclusion, the development of nursing care based on knowledge management as a synthesis or induction of findings directed at 1 nurses’ knowledge does not affect the performance of the prevention of nosocomial infections; 2 knowledge management has a positive effect on the performance of the prevention of nosocomial infections; 3 implementation of infection prevention is integrated capabilities between knowledge, skills and attitudes of nurses in implementing performance in care. Keywords: model prevention, nosocomial infections, nursing care, knowledge management, sectio Caesarea

Primary Prevention Is? A Global Perspective on How Organizations Engaging Men in Preventing Gender-Based Violence Conceptualize and Operationalize Their Work.

Science.gov (United States)

Storer, Heather L; Casey, Erin A; Carlson, Juliana; Edleson, Jeffrey L; Tolman, Richard M

2016-02-01

Engaging men in addressing violence against women (VAW) has become a strategy in the global prevention of gender-based violence. Concurrently, Western public health frameworks have been utilized to guide prevention agendas worldwide. Using qualitative methods, this study describes how global anti-violence organizations that partner with men conceptualize primary prevention in their work. Findings suggest that "primary prevention" is not a fixed term in the context of VAW and that front-line prevention work challenges rigidly delineated distinctions between levels of prevention. Much can be learned from global organizations' unique and contextualized approaches to the prevention of VAW. © The Author(s) 2015.

The joint effects of promotion and prevention focus on performance, exhaustion and sickness absence among managers and non-managers

NARCIS (Netherlands)

Petrou, Paraskevas; Van den Heuvel, Machteld; Schaufeli, Wilmar

2017-01-01

Purpose: The purpose of this paper is to examine the main and interaction effects of self-rated promotion and prevention regulatory focus on self-rated work performance, emotional exhaustion and sickness absence for managers and non-managers separately. The authors expected that promotion focus

Concurrent medical conditions among pregnant women - ignore at their peril: report from an antenatal anesthesia clinic.

Science.gov (United States)

Weiniger, Carolyn F; Einav, Sharon; Elchalal, Uriel; Ozerski, Vladislav; Shatalin, Daniel; Ioscovich, Alexander; Ginosar, Yehuda

2018-03-19

Care of pregnant women with concurrent medical conditions can be optimized by multidisciplinary antenatal management. In the current study we describe women with concurrent medical conditions who attended our antenatal anesthesia clinic over a 14-year period, 2002-2015 and, based on the findings, we suggest new policies, strategies and practices to improve antenatal care. In 2002, an antenatal anesthesia clinic was established in Hadassah Medical Center. Each consultation focused on the concurrent medical condition. A written anesthesia strategy according to the medical condition and its anesthesia considerations was discussed and given to the patient. Data regarding clinic visits were recorded. A total of 451 clinic women attended the antenatal anesthesia clinic. Maternal age was 31.7 ± 6.0 years (mean ± SD), with gestational age of pregnancy 33.0 ± 5.4 weeks at the clinic visit. Musculoskeletal conditions (23% of all the women seen) were the most frequent concurrent conditions, followed by anesthesia related concerns 20%, neurologic conditions 19%, and cardiac conditions 15%. Women were provided plans that were deliberated carefully rather than being concocted during labor. A wide range of concurrent medical conditions was seen in the antenatal anesthesia clinic, however fewer women attended the clinic than expected according to known population frequencies of concurrent medical conditions. Women with concurrent medical conditions should have labor and anesthesia plans considered during the nine months of pregnancy, prior to delivery, and hospitals should have a means of obtaining this information in a timely manner. Finally, there is a need to develop additional antenatal anesthesia clinics.

Caribbean (English-Speaking) Women in the United States: Cooking for Diabetes Prevention and Management.

Science.gov (United States)

Thomas, Nigel Mark

2018-01-22

This study surveyed 152 Caribbean-American women about their acculturation levels; their health behaviors; and their perceptions about a website portal for diabetes prevention and management. Participants followed a study link to documents created via SurveyMonkey. The study link included seven edited videos each fewer than 2 min; the videos included ingredients; preparation/cooking instructions; and plating tips for modifying traditional Caribbean meals for diabetes management and prevention. Overall engagement in six healthy living behaviors was moderate Mean = 2.07; Minimum = 1 (Never); Maximum = 3.0 (Always). Self-efficacy for cooking 'healthy' before exploring the website was a mean 3.52 between 40 and 60% confident (SD = 1.509) versus the after Mean of 4.59 closest to 80% confident (SD = 1.154); t = - 10.353, df = 147 (P cooking meals more consistent with diabetes prevention and management.

California Breast Cancer Prevention Initiatives: Setting a research agenda for prevention.

Science.gov (United States)

Sutton, P; Kavanaugh-Lynch, M H E; Plumb, M; Yen, I H; Sarantis, H; Thomsen, C L; Campleman, S; Galpern, E; Dickenson, C; Woodruff, T J

2015-07-01

The environment is an underutilized pathway to breast cancer prevention. Current research approaches and funding streams related to breast cancer and the environment are unequal to the task at hand. We undertook the California Breast Cancer Prevention Initiatives, a four-year comprehensive effort to set a research agenda related to breast cancer, the environment, disparities and prevention. We identified 20 topics for Concept Proposals reflecting a life-course approach and the complex etiology of breast cancer; considering the environment as chemical, physical and socially constructed exposures that are experienced concurrently: at home, in the community and at work; and addressing how we should be modifying the world around us to promote a less carcinogenic environment. Redirecting breast cancer research toward prevention-oriented discovery could significantly reduce the incidence and associated disparities of the disease among future generations. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Validation of the Saskatoon Falls Prevention Consortium's Falls Screening and Referral Algorithm

Science.gov (United States)

Lawson, Sara Nicole; Zaluski, Neal; Petrie, Amanda; Arnold, Cathy; Basran, Jenny

2013-01-01

ABSTRACT Purpose: To investigate the concurrent validity of the Saskatoon Falls Prevention Consortium's Falls Screening and Referral Algorithm (FSRA). Method: A total of 29 older adults (mean age 77.7 [SD 4.0] y) residing in an independent-living senior's complex who met inclusion criteria completed a demographic questionnaire and the components of the FSRA and Berg Balance Scale (BBS). The FSRA consists of the Elderly Fall Screening Test (EFST) and the Multi-factor Falls Questionnaire (MFQ); it is designed to categorize individuals into low, moderate, or high fall-risk categories to determine appropriate management pathways. A predictive model for probability of fall risk, based on previous research, was used to determine concurrent validity of the FSRI. Results: The FSRA placed 79% of participants into the low-risk category, whereas the predictive model found the probability of fall risk to range from 0.04 to 0.74, with a mean of 0.35 (SD 0.25). No statistically significant correlation was found between the FSRA and the predictive model for probability of fall risk (Spearman's ρ=0.35, p=0.06). Conclusion: The FSRA lacks concurrent validity relative to to a previously established model of fall risk and appears to over-categorize individuals into the low-risk group. Further research on the FSRA as an adequate tool to screen community-dwelling older adults for fall risk is recommended. PMID:24381379

Kinetic energy management in road traffic injury prevention: a call for action

Directory of Open Access Journals (Sweden)

Davoud Khorasani-Zavareh

2015-01-01

Full Text Available Abstract: By virtue of their variability, mass and speed have important roles in transferring energies during a crash incidence (kinetic energy. The sum of kinetic energy is important in determining an injury severity and that is equal to one half of the vehicle mass multiplied by the square of the vehicle speed. To meet the Vision Zero policy (a traffic safety policy prevention activities should be focused on vehicle speed management. Understanding the role of kinetic energy will help to develop measures to reduce the generation, distribution, and effects of this energy during a road traffic crash. Road traffic injury preventive activities necessitate Kinetic energy management to improve road user safety.

Concurrency & Asynchrony in Declarative Workflows

DEFF Research Database (Denmark)

Debois, Søren; Hildebrandt, Thomas; Slaats, Tijs

2015-01-01

of concurrency in DCR Graphs admits asynchronous execution of declarative workflows both conceptually and by reporting on a prototype implementation of a distributed declarative workflow engine. Both the theoretical development and the implementation is supported by an extended example; moreover, the theoretical....... In this paper, we pro- pose a notion of concurrency for declarative process models, formulated in the context of Dynamic Condition Response (DCR) graphs, and exploiting the so-called “true concurrency” semantics of Labelled Asynchronous Transition Systems. We demonstrate how this semantic underpinning...

An Automation-Assisted Empirical Study on Lock Usage for Concurrent Programs

OpenAIRE

Xin Rui; Qi Zhengwei; Huang Shiqiu; Xiang Chengcheng; Zheng Yudi; Wang Yin; Guan Haibing

2013-01-01

Nowadays concurrent programs are becoming more and more important with the development of hardware and network technologies. However it is not easy for programmers to write reliable concurrent programs. Concurrency characteristics such as thread interleaving make it difficult to debug or maintain concurrent programs. Although there are lots of research work on concurrency such as multi thread testing tools concurrent program verification and data race detection all of them leave open problems...

Ecological association between HIV and concurrency point ...

African Journals Online (AJOL)

Ecological association between HIV and concurrency point-prevalence in South Africa's ethnic groups. Chris Kenyon. Abstract. HIV prevalence between different ethnic groups within South Africa exhibits considerable variation. Numerous authors believe that elevated sexual partner concurrency rates are important in the ...

Prevention and management of work disability in Asia Pacific: challenges and opportunities.

Science.gov (United States)

Feuerstein, Michael

2011-03-01

The economic growth in Asia Pacific brings with it challenges and opportunities in many areas of work and health. As economies grow and work demands increase so do accidents, injures and work disability. Burns, chemical exposures, and construction related injuries are often catastrophic in severity and lead to work disability, major acute medical and subsequent rehabilitation efforts. In addition to these acute injuries, musculoskeletal and chronic illnesses are also sources of work disability. Industrial injuries and health problems are often explained and managed based on the classic unidimensional hazard prevention model. In contrast, work disability is a multi-factorial problem and requires more complex conceptualizations than an exposure outcome model. The economic impact of disability, limitations of the widely used impairment based disability determination method, lack of adherence to wide scale implementation of evidence based clinical approaches, the need for meaningful stakeholder involvement and the potential of a multivariable view of work disability, in all aspects of work disability prevention, management and policy are discussed in the context of Asia Pacific economic growth. With ideal alignment of diverse goals and incentives along with consideration of past efforts in disability prevention and management, new models, processes and policies can be created as commerce in these countries continues to grow.

The Caltech Concurrent Computation Program - Project description

Science.gov (United States)

Fox, G.; Otto, S.; Lyzenga, G.; Rogstad, D.

1985-01-01

The Caltech Concurrent Computation Program wwhich studies basic issues in computational science is described. The research builds on initial work where novel concurrent hardware, the necessary systems software to use it and twenty significant scientific implementations running on the initial 32, 64, and 128 node hypercube machines have been constructed. A major goal of the program will be to extend this work into new disciplines and more complex algorithms including general packages that decompose arbitrary problems in major application areas. New high-performance concurrent processors with up to 1024-nodes, over a gigabyte of memory and multigigaflop performance are being constructed. The implementations cover a wide range of problems in areas such as high energy and astrophysics, condensed matter, chemical reactions, plasma physics, applied mathematics, geophysics, simulation, CAD for VLSI, graphics and image processing. The products of the research program include the concurrent algorithms, hardware, systems software, and complete program implementations.

Concurrent radiotherapy and chemotherapy

International Nuclear Information System (INIS)

Fu, K.K.

1985-01-01

The principal objective of combining chemotherapy with radiotherapy (XRT) for the treatment of advanced head and neck cancer is to improve the therapeutic ratio through the enhancement of local control and reduction of distant metastases without excessively enhancing normal tissue effects. Improved tumour control can result from sole additivity of either therapy or direct interactions between drug and radiation leading to increased tumour cell kill. Chemotherapy may sensitize the cells to radiation, interfere with repair of sublethal or potentially lethal radiation damage, induce cell synchrony, and reduce tumour mass leading to reoxygenation and decreased fraction of resistant hypoxic cells. Radiation may improve drug accessibility to tumour cells and reduce tumour volume leading to increased cell proliferation and chemosensitivity. If the enhanced effects of combined therapy are purely additive, then the two modalities can be administered either sequentially or concurrently with the same results. However, if the enhanced effects result from the direct interaction between drug and radiation, it is necessary that the two modalities be administered concurrently and in close temporal proximity. This review summarizes the results of clinical studies in which chemotherapy was administered concurrently during the course of radiotherapy for patients with previously untreated advanced squamous cell carcinoma in the head and neck

Peer victimization during adolescence: concurrent and prospective impact on symptoms of depression and anxiety.

Science.gov (United States)

Stapinski, Lexine A; Araya, Ricardo; Heron, Jon; Montgomery, Alan A; Stallard, Paul

2015-01-01

Peer victimization is ubiquitous across schools and cultures, and has the potential for long-lasting effects on the well-being of victims. To date, research has focused on the consequences of peer victimization during childhood but neglected adolescence. Peer relationships and approval become increasingly important during adolescence; thus, peer victimization at this age may have a damaging psychological impact. Participants were 5030 adolescents aged 11-16 recruited from secondary schools in the UK. Self-report measures of victimization and symptoms of anxiety and depression were administered on three occasions over a 12-month period. Latent growth models examined concurrent and prospective victimization-related elevations in anxiety and depression symptoms above individual-specific growth trajectories. Peer victimization was associated with a concurrent elevation of 0.64 and 0.56 standard deviations in depression and anxiety scores, respectively. There was an independent delayed effect, with additional elevations in depression and anxiety (0.28 and 0.25 standard deviations) six months later. These concurrent and prospective associations were independent of expected symptom trajectories informed by individual risk factors. Adolescent peer victimization was associated with immediate and delayed elevations in anxiety and depression. Early intervention aimed at identifying and supporting victimized adolescents may prevent the development of these disorders.

Channels as Objects in Concurrent Object-Oriented Programming

Directory of Open Access Journals (Sweden)

Joana Campos

2011-10-01

Full Text Available There is often a sort of a protocol associated to each class, stating when and how certain methods should be called. Given that this protocol is, if at all, described in the documentation accompanying the class, current mainstream object-oriented languages cannot provide for the verification of client code adherence against the sought class behaviour. We have defined a class-based concurrent object-oriented language that formalises such protocols in the form of usage types. Usage types are attached to class definitions, allowing for the specification of (1 the available methods, (2 the tests clients must perform on the result of methods, and (3 the object status - linear or shared - all of which depend on the object's state. Our work extends the recent approach on modular session types by eliminating channel operations, and defining the method call as the single communication primitive in both sequential and concurrent settings. In contrast to previous works, we define a single category for objects, instead of distinct categories for linear and for shared objects, and let linear objects evolve into shared ones. We introduce a standard sync qualifier to prevent thread interference in certain operations on shared objects. We formalise the language syntax, the operational semantics, and a type system that enforces by static typing that methods are called only when available, and by a single client if so specified in the usage type. We illustrate the language via a complete example.

Concurrence Measurement for the Two-Qubit Optical and Atomic States

Directory of Open Access Journals (Sweden)

Lan Zhou

2015-06-01

Full Text Available Concurrence provides us an effective approach to quantify entanglement, which is quite important in quantum information processing applications. In the paper, we mainly review some direct concurrence measurement protocols of the two-qubit optical or atomic system. We first introduce the concept of concurrence for a two-qubit system. Second, we explain the approaches of the concurrence measurement in both a linear and a nonlinear optical system. Third, we introduce some protocols for measuring the concurrence of the atomic entanglement system.

Concurrent enterprise: a conceptual framework for enterprise supply-chain network activities

Science.gov (United States)

Addo-Tenkorang, Richard; Helo, Petri T.; Kantola, Jussi

2017-04-01

Supply-chain management (SCM) in manufacturing industries has evolved significantly over the years. Recently, a lot more relevant research has picked up on the development of integrated solutions. Thus, seeking a collaborative optimisation of geographical, just-in-time (JIT), quality (customer demand/satisfaction) and return-on-investment (profits), aspects of organisational management and planning through 'best practice' business-process management - concepts and application; employing system tools such as certain applications/aspects of enterprise resource planning (ERP) - SCM systems information technology (IT) enablers to enhance enterprise integrated product development/concurrent engineering principles. This article assumed three main organisation theory applications in positioning its assumptions. Thus, proposing a feasible industry-specific framework not currently included within the SCOR model's level four (4) implementation level, as well as other existing SCM integration reference models such as in the MIT process handbook's - Process Interchange Format (PIF), the TOVE project, etc. which could also be replicated in other SCs. However, the wider focus of this paper's contribution will be concentrated on a complimentary proposed framework to the SCC's SCOR reference model. Quantitative empirical closed-ended questionnaires in addition to the main data collected from a qualitative empirical real-life industrial-based pilot case study were used: To propose a conceptual concurrent enterprise framework for SCM network activities. This research adopts a design structure matrix simulation approach analysis to propose an optimal enterprise SCM-networked value-adding, customised master data-management platform/portal for efficient SCM network information exchange and an effective supply-chain (SC) network systems-design teams' structure. Furthermore, social network theory analysis will be employed in a triangulation approach with statistical correlation analysis

Prevention and Management of Refeeding Syndrome

Directory of Open Access Journals (Sweden)

Andika Indrarespati

2016-12-01

Full Text Available Refeeding Syndrome is a syndrome which occurs as a result of food administration in poorly nourished individuals. In this syndrome, there are wide range of biochemical alterations, clinical manifestations, and complications, starting from mild (asymptomatic to severe (death. This syndrome was initially proposed in 1950s; however, there is still no agreement for its clear definition, causing clinicians to be less aware and tend to overlook this condition. Clinical manifestations which usually appear include electrolyte imbalances (hypophosphatemia, hypokalemia, hyponatremia, hypomagnesemia and vitamin B1 deficiency. The main principle in management of refeeding syndrome is prevention, where clinicians need to identify this condition in the early stage in high risk individuals, supervision during refeeding, and administration of appropriate diet.

Preventive distribution and plans of iodine tablets stocks management

International Nuclear Information System (INIS)

2002-01-01

This official note includes two parts: one concerns the new preventive distribution of iodine tablets on the areas defined by the Particular Intervention Plans (P.P.I.) around nuclear facilities and the other one the setting up of iodine tablets stocks beyond the P.P.I. areas. In annexe is a guide for the elaboration of stocks management plans for steady iodine tablets. (N.C.)

Case-based Reasoning in Conflict Negotiation in Concurrent Engineering

Institute of Scientific and Technical Information of China (English)

无

1999-01-01

Case-based reasoning (CBR) is a kind of analogous reasoning that is widely used in artificial intelligence. Conflicts are pervasive in Concurrent Engineering design environment. Conflict negotiation is necessary when conflicts occur. It is difficult to resolve conflicts due to several reasons. An approach to resolving conflicts by case-based reasoning is proposed in this paper. The knowledge representation of conflict negotiation cases, the judgment of case similarity, the retrieval model of cases, the management of case bases, and the process of case-based conflict negotiation are studied. The implementation structure of the Case-based Conflict Solving System (CCSS) is also given.

Erlang Programming A Concurrent Approach to Software Development

CERN Document Server

Cesarini, Francesco

2009-01-01

This book offers you an in-depth explanation of Erlang, a programming language ideal for any situation where concurrency, fault-tolerance, and fast response is essential. You'll learn how to write complex concurrent programs in this language, regardless of your programming background or experience. Erlang Programming focuses on the language's syntax and semantics, and explains pattern matching, proper lists, recursion, debugging, networking, and concurrency, with exercises at the end of each chapter.

National Athletic Trainers' Association Position Statement: Conservative Management and Prevention of Ankle Sprains in Athletes

Science.gov (United States)

Kaminski, Thomas W.; Hertel, Jay; Amendola, Ned; Docherty, Carrie L.; Dolan, Michael G.; Hopkins, J. Ty; Nussbaum, Eric; Poppy, Wendy; Richie, Doug

2013-01-01

Objective: To present recommendations for athletic trainers and other allied health care professionals in the conservative management and prevention of ankle sprains in athletes. Background: Because ankle sprains are a common and often disabling injury in athletes, athletic trainers and other sports health care professionals must be able to implement the most current and evidence-supported treatment strategies to ensure safe and rapid return to play. Equally important is initiating preventive measures to mitigate both first-time sprains and the chance of reinjury. Therefore, considerations for appropriate preventive measures (including taping and bracing), initial assessment, both short- and long-term management strategies, return-to-play guidelines, and recommendations for syndesmotic ankle sprains and chronic ankle instability are presented. Recommendations: The recommendations included in this position statement are intended to provide athletic trainers and other sports health care professionals with guidelines and criteria to deliver the best health care possible for the prevention and management of ankle sprains. An endorsement as to best practice is made whenever evidence supporting the recommendation is available. PMID:23855363

Special issue review of pollution prevention management within the Department of Energy, final report

International Nuclear Information System (INIS)

1994-08-01

The Department of Energy's (DOE) national role and overall mission has been undergoing significant change. In the post-Cold War era, a new emphasis on cleaning up the wastes from the past has emerged. These changes provide both significant challenges as well as new opportunities for DOE. While the challenges may seem overwhelming as DOE realizes the magnitude of its environmental problems, its network of national laboratories and sites provide the resources to become a leader in environmental management through the development of new technologies and management practices. Because of the growing importance of pollution prevention in the United States and more specifically to DOE's environmental management strategy, the Office of Environmental Audit (EH-24) identified this as an area worthy of a Special Issue Review. A Special Issue Review is not an audit but rather an in-depth review of key environmental programs or activities which cut across organizational boundaries. The purpose of a Special Issue Review is to identify strengths and weaknesses of a program as well as significant crosscutting issues or challenges that are important to the future success of that program. The scope of the review included an assessment of pollution prevention program activities at Headquarters, selected operations offices, and selected sites offices and contractor organizations. All aspects of a pollution prevention program were considered including program strategy, infrastructure, management systems, and implementation practices. Also summarized are future pollution prevention challenges and recommendations

A cross-sectional study on self-management of pressure ulcer prevention in paraplegic patients.

Science.gov (United States)

de Laat, H E W; de Munter, A C; van der Burg, M J; Ulrich, D J O; Kloeters, O

2017-02-01

Little is known about health activation and self-management behavior in preventing pressure ulcers (PU) in paraplegic patients. Therefore this study aimed to describe the extent of health activation and self-management behavior in paraplegics to prevent PU's and associations between this behavior and patient characteristics. Furthermore, we aimed to find differences in health activation in paraplegics who never had a PU compared to paraplegics with a previous history of PU's or a new-onset PU's. A cross-sectional survey on health activation and self-management behavior was conducted among adult paraplegics recruited from two rehabilitation centers in the Netherlands. The Patient Activation Measure (PAM-score) was used to measure the extent of health activation. Patient statements on their level of self management behavior to prevent PU were evaluated. The mean PAM-score (0-100) was 54 (±8.1; n = 162) indicating a low level of health activation. Two indicators turned out to be statistically significant associated with health activation: level of education (OR = 2.2, p = 0.017) and degree of paraplegia (OR = 2.8, p = 0.036). Evaluation of health activation levels amongst paraplegics with or without a PU- history showed no significant difference. Analysis of patients statements demonstrated a large discrepancy between intended and actual behavior to prevent pressure ulcers. Level of education and level of paraplegia are significantly associated with health activation. A positive PU-history is not associated with future responsible behavior nor for compliant behavior in terms of health management. Copyright © 2016 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

Risk management as applied to collider dipole magnet development

International Nuclear Information System (INIS)

Patel, R.

1992-01-01

The risk management procedure described here represent sound engineering and management practice. By implementing these practices in the CDM program it has allowed us to maximize the resources for overall productivity. The risk management program is supported by all personnel working for the GDSS CDM program, which includes Engineering, Test, Quality Assurance, Production, Facility, Material and Management. Best of all, it is supported, encouraged, directed and monitored by program management. Using this structured process we are able to identify and resolve problems and issues before they have adverse impact to the program. This procedure serves as a long range Attention-Getter before preventable problems turn into crises. Risk management provides a broad range of potential risk assessment and allows us to utilize management resources and expertise for effective and timely solutions. This is a useful management tool to use in a concurrent engineering environment to reduce the barriers between Design, Test, Production, etc. It provides a creative climate and improves communication. Individuals receive feedback and support, not criticism

NFC based Equipment Qualification Management (NEQM) system preventing counterfeit and fraudulent item

Energy Technology Data Exchange (ETDEWEB)

Chang, C.K., E-mail: ckchang@kings.ac.kr [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of); Lee, K.J., E-mail: klee@khu.ac.kr [Kyung Hee Univ., Seoul (Korea, Republic of)

2014-07-01

Qualification of equipment essential to safety in nuclear power plants (NPPs) ensures its capability to perform designated safety functions on demand under postulated service conditions. However, a number of incidents identified by the NRC since 1980s catalysed the US nuclear industry to adopt standard precautions to guard against counterfeit items. The purpose of this paper is to suggest the NFC (Near Field Communication) based equipment qualification management system preventing counterfeit and fraudulent items. The NEQM (NFC based Equipment Qualification Management) system work with the support of legacy systems such as PMS (Procurement Management System) and FMS (Facility management System). (author)

NFC based Equipment Qualification Management (NEQM) system preventing counterfeit and fraudulent item

International Nuclear Information System (INIS)

Chang, C.K.; Lee, K.J.

2014-01-01

Qualification of equipment essential to safety in nuclear power plants (NPPs) ensures its capability to perform designated safety functions on demand under postulated service conditions. However, a number of incidents identified by the NRC since 1980s catalysed the US nuclear industry to adopt standard precautions to guard against counterfeit items. The purpose of this paper is to suggest the NFC (Near Field Communication) based equipment qualification management system preventing counterfeit and fraudulent items. The NEQM (NFC based Equipment Qualification Management) system work with the support of legacy systems such as PMS (Procurement Management System) and FMS (Facility management System). (author)

Diagnosis, prevention, and management of canine hip dysplasia: a review

Directory of Open Access Journals (Sweden)

Schachner ER

2015-05-01

Full Text Available Emma R Schachner, Mandi J Lopez Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA Abstract: Canine hip dysplasia (CHD is a polygenic and multifactorial developmental disorder characterized by coxofemoral (hip joint laxity, degeneration, and osteoarthritis (OA. Current diagnostic techniques are largely subjective measures of joint conformation performed at different stages of development. Recently, measures on three-dimensional images generated from computed tomography scans predicted the development of OA associated with CHD. Continued refinement of similar imaging methods may improve diagnostic imaging techniques to identify dogs predisposed to degenerative hip joint changes. By current consensus, joint changes consistent with CHD are influenced by genetic predisposition as well as environmental and biomechanical factors; however, despite decades of work, the relative contributions of each to the development and extent of CHD signs remain elusive. Similarly, despite considerable effort to decipher the genetic underpinnings of CHD for selective breeding programs, relevant genetic loci remain equivocal. As such, prevention of CHD within domestic canine populations is marginally successful. Conservative management is often employed to manage signs of CHD, with lifelong maintenance of body mass as one of the most promising methods. Surgical intervention is often employed to prevent joint changes or restore joint function, but there are no gold standards for either goal. To date, all CHD phenotypes are considered as a single entity in spite of recognized differences in expression and response to environmental conditions and treatment. Identification of distinct CHD phenotypes and targeting evidence-based conservative and invasive treatments for each may significantly advance prevention and management of a prevalent, debilitating condition in canine companions. Keywords: canine

Learning from Mistakes --- A Comprehensive Study on Real World Concurrency Bug Characteristics

International Nuclear Information System (INIS)

Shan Lu; Soyeon Park; Eunsoo Seo; Yuanyuan Zhou

2008-01-01

The reality of multi-core hardware has made concurrent programs pervasive. Unfortunately, writing correct concurrent programs is difficult. Addressing this challenge requires advances in multiple directions, including concurrency bug detection, concurrent program testing, concurrent programming model design, etc. Designing effective techniques in all these directions will significantly benefit from a deep understanding of real world concurrency bug characteristics. This paper provides the first (to the best of our knowledge) comprehensive real world concurrency bug characteristic study. Specifically, we have carefully examined concurrency bug patterns, manifestation, and fix strategies of 105 randomly selected real world concurrency bugs from 4 representative server and client opensource applications (MySQL, Apache, Mozilla and OpenOffice). Our study reveals several interesting findings and provides useful guidance for concurrency bug detection, testing, and concurrent programming language design. Some of our findings are as follows: (1) Around one third of the examined non-deadlock concurrency bugs are caused by violation to programmers order intentions, which may not be easily expressed via synchronization primitives like locks and transactional memories; (2) Around 34% of the examined non-deadlock concurrency bugs involve multiple variables, which are not well addressed by existing bug detection tools; (3) About 92% of the examined concurrency bugs can be reliably triggered by enforcing certain orders among no more than 4 memory accesses. This indicates that testing concurrent programs can target at exploring possible orders among every small groups of memory accesses, instead of among all memory accesses; (4) About 73% of the examined non-deadlock concurrency bugs were not fixed by simply adding or changing locks, and many of the fixes were not correct at the first try, indicating the difficulty of reasoning concurrent execution by programmers.

Concurrent Collections

OpenAIRE

Budimlić, Zoran; Burke, Michael; Cavé, Vincent; Knobe, Kathleen; Lowney, Geoff; Newton, Ryan; Palsberg, Jens; Peixotto, David; Sarkar, Vivek; Schlimbach, Frank; Taşırlar, Sağnak

2010-01-01

We introduce the Concurrent Collections (CnC) programming model. CnC supports flexible combinations of task and data parallelism while retaining determinism. CnC is implicitly parallel, with the user providing high-level operations along with semantic ordering constraints that together form a CnC graph. We formally describe the execution semantics of CnC and prove that the model guarantees deterministic computation. We evaluate the performance of CnC implementations on several applications an...

Creatine supplementation prevents acute strength loss induced by concurrent exercise.

Science.gov (United States)

de Salles Painelli, Vítor; Alves, Victor Tavares; Ugrinowitsch, Carlos; Benatti, Fabiana Braga; Artioli, Guilherme Giannini; Lancha, Antonio Herbert; Gualano, Bruno; Roschel, Hamilton

2014-08-01

To investigate the effect of creatine (CR) supplementation on the acute interference induced by aerobic exercise on subsequent maximum dynamic strength (1RM) and strength endurance (SE, total number of repetitions) performance. Thirty-two recreationally strength-trained men were submitted to a graded exercise test to determine maximal oxygen consumption (VO2max: 41.56 ± 5.24 ml kg(-1) min(-1)), anaerobic threshold velocity (ATv: 8.3 ± 1.18 km h(-1)), and baseline performance (control) on the 1RM and SE (4 × 80 % 1RM to failure) tests. After the control tests, participants were randomly assigned to either a CR (20 g day(-1) for 7 days followed by 5 g day(-1) throughout the study) or a placebo (PL-dextrose) group, and then completed 4 experimental sessions, consisting of a 5-km run on a treadmill either continuously (90 % ATv) or intermittently (1:1 min at vVO2max) followed by either a leg- or bench-press SE/1RM test. CR was able to maintain the leg-press SE performance after the intermittent aerobic exercise when compared with C (p > 0.05). On the other hand, the PL group showed a significant decrease in leg-press SE (p ≤ 0.05). CR supplementation significantly increased bench-press SE after both aerobic exercise modes, while the bench-press SE was not affected by either mode of aerobic exercise in the PL group. Although small increases in 1RM were observed after either continuous (bench press and leg press) or intermittent (bench press) aerobic exercise in the CR group, they were within the range of variability of the measurement. The PL group only maintained their 1RM. In conclusion, the acute interference effect on strength performance observed in concurrent exercise may be counteracted by CR supplementation.

A case for evaluating sensor network protocols concurrently

KAUST Repository

Gnawali, Omprakash; Guibas, Leonidas; Levis, Philip

2010-01-01

Researchers typically evaluate and compare protocols on the testbeds by running them one at a time. This methodology ignores the variation in link qualities and wireless environment across these experiments. These variations can introduce significant noise in the results. Evaluating two protocols concurrently, however, suffers from inter-protocol interactions. These interactions can perturb performance even under very light load, especially timing and timing sensitive protocols. We argue that the benefits of running protocols concurrently greatly outweigh the disadvantages. Protocols rarely run in isolation in real networks, and so considering such interactions is valuable. Although the wireless environment is still uncontrolled, concurrent evaluations make comparisons fair and more statistically sound. Through experiments on two testbeds, we make the case for evaluating and comparing low data-rate sensor network protocols by running them concurrently. Copyright 2010 ACM.

Context Aware Concurrent Execution Framework for Web Browser

DEFF Research Database (Denmark)

Saeed, Aamir; Erbad, Aiman Mahmood; Olsen, Rasmus Løvenstein

Computing hungry multimedia web applications need to efficiently utilize the device resources. HTML5 web workers is a non-sharing concurrency platform that enables multimedia web application to utilize the available multi-core hardware. HTML5 web workers are implemented by major browser vendors...... to facilitate concurrent execution in web clients and enhance the quality of ambitious web applications. The concurrent execution in web workers allows parallel processing using available cores at the expense of communication overhead and extra computation. The benefits of concurrent execution can be maximized...... by balancing load across workers/CPU cores. This work presents load-balancing algorithms between web workers using parameters such as scheduler throughput, computation priority and game entity locality. An award-winning web-based multimedia game (raptjs.com) is used to test the performance of the load balance...

Temporal Concurrent Constraint Programming

DEFF Research Database (Denmark)

Valencia, Frank Dan

Concurrent constraint programming (ccp) is a formalism for concurrency in which agents interact with one another by telling (adding) and asking (reading) information in a shared medium. Temporal ccp extends ccp by allowing agents to be constrained by time conditions. This dissertation studies...... temporal ccp by developing a process calculus called ntcc. The ntcc calculus generalizes the tcc model, the latter being a temporal ccp model for deterministic and synchronouss timed reactive systems. The calculus is built upon few basic ideas but it captures several aspects of timed systems. As tcc, ntcc...... structures, robotic devises, multi-agent systems and music applications. The calculus is provided with a denotational semantics that captures the reactive computations of processes in the presence of arbitrary environments. The denotation is proven to be fully-abstract for a substantial fragment...

Health promotion and disease prevention: a look at demand management programs.

Science.gov (United States)

Fronstin, P

1996-09-01

This Issue Brief describes employers' efforts to contain health expenditures through demand management programs. These programs are designed to reduce utilization by focusing on disease prevention and health promotion. Demand management includes work site health promotion, wellness programs, and access management. Work site health promotion is a comprehensive approach to improving health and includes awareness, health education, behavioral change, and organizational health initiatives. Wellness programs usually include stress management, smoking cessation, weight management, back care, health screenings, nutrition education, work place safety, prenatal and well baby care, CPR and first aid classes, and employee assistance programs (EAPs). These programs are often viewed positively by workers and can have long-term benefits for employers above and beyond health care cost containment. Demand management can benefit employers by increasing productivity, employee retention, and employee morale and by reducing turnover, absenteeism, future medical claims, and ultimately expenditures on health care. Even though a growing number of employers are offering wellness programs, only 37 percent of full-time workers employed in medium and large private establishments were eligible for wellness programs by 1993. However, a recent survey found that 88 percent of major employers have introduced some form of health promotion, disease prevention, or early intervention initiative to encourage healthy lifestyles among their salaried employees. Distinctions must be drawn between short- and long-term strategies. Demand management can be thought of as a short-term strategy when the focus of the program is on creating more appropriate and efficient health care utilization. Disease prevention is characterized by longer-term health improvement objectives. Whether the purpose is to reduce utilization in the short term or in the long term, the ultimate goal remains the same: to reduce health

Cutaneous Scar Prevention and Management; Overview of current therapies

Directory of Open Access Journals (Sweden)

Sultan Al-Shaqsi

2016-02-01

Full Text Available Cutaneous scarring is common after trauma, surgery and infection and occurs when normal skin tissue is replaced by fibroblastic tissue during the healing process. The pathophysiology of scar formation is not yet fully understood, although the degree of tension across the wound edges and the speed of cell growth are believed to play central roles. Prevention of scars is essential and can be achieved by attention to surgical techniques and the use of measures to reduce cell growth. Grading and classifying scars is important to determine available treatment strategies. This article presents an overview of the current therapies available for the prevention and treatment of scars. It is intended to be a practical guide for surgeons and other health professionals involved with and interested in scar management.

Nurses' knowledge of prevention and management of pressure ulcer at a health insurance hospital in Alexandria.

Science.gov (United States)

El Enein, Nagwa Younes Abou; Zaghloul, Ashraf Ahmad

2011-06-01

Nurses' knowledge of pressure ulcer prediction, prevention and management plays a very important role in the incidence and prevalence of pressure ulcers in health-care systems. The aim of the current study was to assess the nurse's knowledge about prevention and management of pressure ulcer at one of the largest health insurance hospitals in Alexandria. A descriptive cross-sectional study using an interview questionnaire format to assess the nurses' knowledge (n = 122) regarding prevention of pressure ulcers. The overall mean per cent score for nurses was below the minimum acceptable level. The mean per cent score for nurses was below 70% for nine measures of the 15 correct measures, which accounted for 60% of the measures of pressure ulcer prevention. Correct answers for non-useful measures for preventing pressure ulcers accounted for 66% of the non-useful measures on the questionnaire. It had been concluded that the nurses' knowledge regarding pressure ulcer prevention is below the acceptable levels. © 2011 Blackwell Publishing Asia Pty Ltd.

Reliability and Concurrent Validity of the International Personality ...

African Journals Online (AJOL)

Reliability and Concurrent Validity of the International Personality item Pool (IPIP) Big-five Factor Markers in Nigeria. ... Nigerian Journal of Psychiatry ... Aims: The aim of this study was to assess the internal consistency and concurrent validity ...

Consultation and concurrence: workshop proceedings, September 23-26, 1979, the Orcas meeting, Eastsound, Washington

International Nuclear Information System (INIS)

1980-01-01

Purpose of the workshop was to probe the concepts of consultation and concurrence and to address issues in establishing and maintaining an effective state-federal process in nuclear waste management. The workshop was a gathering of some 50 people from industry, the environmental movement, local government, executive and legislative branches of state government, US Congressional staffs, the US Department of Energy, Nuclear Regulatory Commission, ONWI, university social science departments, and other research institutions. The workshop consisted of general sessions at which ten papers covering various aspects of consultation and concurrence were presented and of working groups which further explored issues raised by the papers. This report presents a general summary of discussions, the text of a background paper prepared for the workshop, the presented papers, and individual comments by several participants

Recurrent Hip Fracture Prevention With Osteoporosis Management

Directory of Open Access Journals (Sweden)

A. Shahla

2007-02-01

Full Text Available Background:Osteoporosis is a major public health threat,and hip fracture is a serious consequence of osteoporosis.Apatient with an osteoporosis-related hip fracture has an increased risk for a second hip fracture.The effect of osteoporosis management on the risk of recurrent hip fracture was evaluated in this study.Methods:58 hip fracture patients older than 50yr and BMD < 2.5 were discharged from hospital with Ca-Vitamin D- Alendronate prescriptions, and followed up for 4 years to determine the rate of recurrent hip fractures. Rate of second hip fractures was compared with 58 hip fractures in the control group (without osteoporosis treatment which were also followed for 4 years. Results:72% of patients continued treatment for 2 years. There were no second hip fractures in the critical first 12 months in the treated group.Overall second hip fractures in osteoporosis treated and control groups were 3.4% and 8.6%(p<0.03, respectively.Conclusion:Management of hip fractures in the elderly should include bone mineral density determination and osteoporosis treatment to prevent further fractures.

An Implementation of the Object-Oriented Concurrent Programming Language SINA

NARCIS (Netherlands)

Triphathi, Anand; Berge, Eric; Aksit, Mehmet

SINA is an object-oriented language for distributed and concurrent programming. The primary focus of this paper is on the object-oriented concurrent programming mechanisms of SINA and their implementation. This paper presents the SINA constructs for concurrent programming and inter-object

Primary prevention of peri-implantitis: Managing peri-implant mucositis

OpenAIRE

Jepsen, Søren; Berglundh, Tord; Genco, Robert; Aass, Anne Merete; Demirel, Korkud; Derks, Jan; Figuero, Elena; Giovannoli, Jean Louis; Goldstein, Moshe; LAMBERT, France; Ortiz-Vigon, Alberto; Polyzois, Ioannis; Salvi, Giovanni; Schwarz, Frank; Serino, Giovanni

2015-01-01

Abstract AIMS: Over the past decades, the placement of dental implants has become a routine procedure in the oral rehabilitation of fully and partially edentulous patients. However, the number of patients/implants affected by peri-implant diseases is increasing. As there are--in contrast to periodontitis--at present no established and predictable concepts for the treatment of peri-implantitis, primary prevention is of key importance. The management of peri-implant mucositis is considere...

A Highly Concurrent Replicated Data Structure EAI Endorsed Transactions

Directory of Open Access Journals (Sweden)

Mumtaz Ahmad

2015-12-01

Full Text Available Well defined concurrent replicated data structure is very important to design collaborative editing system, particularly, certain properties like out-of-order execution of concurrent operations and data convergence. In this paper, we introduce novel linear data structure based on unique identifier scheme required for indexed communication. These identifiers are real numbers holding specific pattern of precision. Based on the uniqueness and the total order of these identifiers, here, we present two concurrency control techniques to achieve high degree of concurrency according to strong and lazy happened-before relations. Our data structure preserves data convergence, yields better performance and avoids overheads as compared to existing approaches.

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

Medline Plus

Full Text Available ... Combined Councils Patient Education Primary Care Provider Risk Management Veteran Resources Community Health Behavioral Health Environmental Health Health Communications Health Promotion Injury Prevention School ...

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

Medline Plus

Full Text Available ... Risk Management Veteran Resources Community Health Behavioral Health Environmental Health Health Communications Health Promotion Injury Prevention School Health Sustainability Visualizing Data Contacts Career Opportunities ...

Hypoglycaemia in anesthesiology practice: Diagnostic, preventive, and management strategies

Directory of Open Access Journals (Sweden)

Sanjay Kalra

2013-01-01

Full Text Available Diabetes mellitus has emerged as one of the fastest growing non communicable diseases worldwide. Management of diabetic patients during surgical and critically illness is of paramount challenge to anesthesiologist and intensivist. Among its major acute complications, hypoglycemia has been given lesser attention as compared to other major acute complications; diabetic ketoacidosis and hyperosmolar non ketotic coma. However, newer studies and literary evidence have established the serious concerns of morbidity and mortality, both long- and short-term, related to hypoglycemia. basis. Invariably, diabetic patients are encountered in our daily routine practice of anesthesia. During fasting status as well as the perioperative period, it is hypoglycemia that is of high concern to anesthesiologist. Management has to be based on clinical, pharmacological, social, and psychological basis, so as to completely prevent the complications arising from an acute episode of hypoglycemia. This review aims to highlight various aspects of hypoglycemia and its management both from endocrine and anesthesia perspective.

Concurrent emphysematous pyelonephritis and thigh necrotizing fasciitis after intramuscular administration of diclofenac

Directory of Open Access Journals (Sweden)

Fateme Shamekhi Amiri

2014-01-01

Full Text Available Necrotizing fasciitis (NF is a rapidly progressive, life-threatening soft tissue infec-tion. NF may result from any injury to the skin or from hematogenous spread. However, con-current emphysematous pyelonephritis and necrotizing fasciitis of the left thigh has not been reported. We report a case of emphysematous pyelonephritis and necrotizing fasciitis of the left thigh after intramuscular administration of diclofenac that improved with aggressive management including broad-spectrum antibiotics, nephrectomy and surgical intervention.

Prevention and management of accidental foreign body ingestion and aspiration in orthodontic practice

Directory of Open Access Journals (Sweden)

Umesan UK

2012-05-01

Full Text Available Uday Kumar Umesan,1 Kui Lay Chua,1 Priya Balakrishnan21National Dental Centre, 2Kg Kiarong, Bandar Seri Begawan, Brunei DarussalamAbstract: Among the myriad emergencies that could arise in the dental clinical setting there are a few that occur occasionally despite being entirely preventable. Ingestion or aspiration of dental materials, appliances, or instruments comprises this category. Regardless of incidence, foreign body ingestion or aspiration episodes are recognized as potential complications in the specialty of orthodontics. Despite their infrequent occurrence, the morbidity from a single incident and the amount of specialty medical care that may be needed to manage such incidents is too high to ignore. There is also the associated risk of malpractice litigation given the fact that these incidents are preventable. At present, no clear guidelines exist regarding prevention of this emergency in practice. This article attempts to review relevant literature and aims to formulate certain recommendations based on best available evidence to minimize the incidence of such events, while also suggesting guidelines toward making their management more effective. A flow chart outlining management options and strategies to aid the clinician in the event of such an emergency is also presented.Keywords: foreign bodies, ingestion, orthodontics, respiratory aspiration, orthodontic appliances

Leukostasis: Management to Prevent Crisis in Acute Leukemia
.

Science.gov (United States)

Blackburn, Lisa M; Brown, Shelly; Munyon, Aimee; Orovets, Michelle

2017-12-01

Hyperleukocytosis, a peripheral white blood cell count greater than 100,000/mm3,is most commonly seen in patients with newly diagnosed or relapsed acute lymphoblastic leukemia and acute myeloid leukemia. Leukostasis is a reduction in blood flow related to hyperviscosity. Hyperleukocytosis, causing leukostasis, is an oncologic emergency and requires an exacting assessment and rapid response with appropriate intervention to prevent morbidity and mortality in the first week after diagnosis. The objectives of this article are to equip oncology nurse to identify patients with hyperleukocytosis and to provide nursing interventions that will ensure safe, quality care. A case study is used to demonstrate key concepts that are critical in early assessment, identification, and treatment of patients with leukostasis.
. Oncology nurses well versed in the pathophysiology, clinical presentation, and management of leukostasis can make a significant contribution to the safe management of patients with cancer.

Improving quality in Medicaid: the use of care management processes for chronic illness and preventive care.

Science.gov (United States)

Rittenhouse, Diane R; Robinson, James C

2006-01-01

Care management processes (CMPs), tools to improve the efficiency and quality of primary care delivery, are particularly important for low-income patients facing substantial barriers to care. To measure the adoption of CMPs by medical groups, Independent Practice Associations, community clinics, and hospital-based clinics in California's Medicaid program and the factors associated with CMP adoption. Telephone survey of every provider organization with at least 6 primary care physicians and at least 1 Medi-Cal HMO contract, Spring 2003. One hundred twenty-three organizations participated, accounting for 64% of provider organizations serving Medicaid managed care in California. We surveyed 30 measures of CMP use for asthma and diabetes, and for child and adolescent preventive services. The mean number of CMPs used by each organization was 4.5 for asthma and 4.9 for diabetes (of a possible 8). The mean number of CMPs for preventive services was 4.0 for children and 3.5 for adolescents (of a possible 7). Organizations with more extensive involvement in Medi-Cal managed care used more CMPs for chronic illness and preventive service. Community clinics and hospital-based clinics used more CMPs for asthma and diabetes than did Independent Practice Associations (IPAs), and profitable organizations used more CMPs for child and adolescent preventive services than did entities facing severe financial constraints. The use of CMPs by Medicaid HMOs and the presence of external (financial and nonfinancial) incentives for clinical performance were strongly associated with use of care management by provider organizations. Physician and provider organizations heavily involved in California's Medicaid program are extensively engaged in preventive and chronic care management programs.

Concurrent credit portfolio losses.

Science.gov (United States)

Sicking, Joachim; Guhr, Thomas; Schäfer, Rudi

2018-01-01

We consider the problem of concurrent portfolio losses in two non-overlapping credit portfolios. In order to explore the full statistical dependence structure of such portfolio losses, we estimate their empirical pairwise copulas. Instead of a Gaussian dependence, we typically find a strong asymmetry in the copulas. Concurrent large portfolio losses are much more likely than small ones. Studying the dependences of these losses as a function of portfolio size, we moreover reveal that not only large portfolios of thousands of contracts, but also medium-sized and small ones with only a few dozens of contracts exhibit notable portfolio loss correlations. Anticipated idiosyncratic effects turn out to be negligible. These are troublesome insights not only for investors in structured fixed-income products, but particularly for the stability of the financial sector. JEL codes: C32, F34, G21, G32, H81.

A typology for campus-based alcohol prevention: moving toward environmental management strategies.

Science.gov (United States)

DeJong, William; Langford, Linda M

2002-03-01

This article outlines a typology of programs and policies for preventing and treating campus-based alcohol-related problems, reviews recent case studies showing the promise of campus-based environmental management strategies and reports findings from a national survey of U.S. colleges and universities about available resources for pursuing environmentally focused prevention. The typology is grounded in a social ecological framework, which recognizes that health-related behaviors are affected through multiple levels of influence: intrapersonal (individual) factors, interpersonal (group) processes, institutional factors, community factors and public policy. The survey on prevention resources and activities was mailed to senior administrators responsible for their school's institutional response to substance use problems. The study sample was an equal probability sample of 365 2- and 4-year U.S. campuses. The response rate was 76.9%. Recent case studies suggest the value of environmentally focused alcohol prevention approaches on campus, but more rigorous research is needed to establish their effectiveness. The administrators' survey showed that most U.S. colleges have not yet installed the basic infrastructure required for developing, implementing and evaluating environmental management strategies. The typology of campus-based prevention options can be used to categorize current efforts and to inform strategic planning of multilevel interventions. Additional colleges and universities should establish a permanent campus task force that reports directly to the president, participate actively in a campus-community coalition that seeks to change the availability of alcohol in the local community and join a state-level association that speaks out on state and federal policy issues.

New concurrent iterative methods with monotonic convergence

Energy Technology Data Exchange (ETDEWEB)

Yao, Qingchuan [Michigan State Univ., East Lansing, MI (United States)

1996-12-31

This paper proposes the new concurrent iterative methods without using any derivatives for finding all zeros of polynomials simultaneously. The new methods are of monotonic convergence for both simple and multiple real-zeros of polynomials and are quadratically convergent. The corresponding accelerated concurrent iterative methods are obtained too. The new methods are good candidates for the application in solving symmetric eigenproblems.

Concurrent sexual partners-A predictor of Chlamydia

DEFF Research Database (Denmark)

Jørgensen, Marianne Johansson; Olesen, Frede; Maindal, Helle Terkildsen

2013-01-01

, but the significance of this compared with other well-known predictors has only been briefly described. Aim: The aim is to examine if concurrent partners isan independent predictor for C. trachomatis infection in young Danes aged 15-29 years. Methods: Detailed sexual behavior data were collected via a web......:These preliminary results suggest that concurrent sexual partners is an important predictor for C.trachomatis infections among young Danes aged 15-29. A more concise conclusion will be presented at the Ph.D day......Background:Chlamydia trachomatis is the most common sexually transmitted bacterial infection among young Danes and the spread is highly dependent on the population’s sexual behavior. Previous studies have found concurrent partnerships to be a possible predictor for C. trachomatis...

Cross Functional Working and Concurrent Engineering – a UK Study

Directory of Open Access Journals (Sweden)

H. Williams

2000-01-01

Full Text Available This paper reports on the preliminary results of an investigative study into the implementation of concurrent engineering applied to new product development. Concurrent (or Simultaneous engineering is the term commonly given to creating new products using multi-disciplined teams of marketing, design, manufacturing and support functions together with supplier and customers. Such techniques have produced robust, low cost quality products in short concept to market times compared to traditional ones. The research investigated design management practice and performance in a number of organisations across a range of industrial sectors in the UK by means of a questionnaire survey. The results identify the current use of a variety of design practices and methodologies such as different organisational structures, the extent of cross-functional working, the use of design and phase reviews and the use of different technologies. They indicate that companies implementing CE are more successful in time to market performance than those who don’t implement CE. Factors most influencing the successful adoption of CE are design and phase reviews, and, to a lesser extent, the use of multifunctional teams and supplier partnerships.

Ciguatera Fish Poisoning: Treatment, Prevention and Management

Directory of Open Access Journals (Sweden)

Andrew Reich

2008-08-01

Full Text Available Ciguatera Fish Poisoning (CFP is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol, the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients.

Ciguatera fish poisoning: treatment, prevention and management.

Science.gov (United States)

Friedman, Melissa A; Fleming, Lora E; Fernandez, Mercedes; Bienfang, Paul; Schrank, Kathleen; Dickey, Robert; Bottein, Marie-Yasmine; Backer, Lorraine; Ayyar, Ram; Weisman, Richard; Watkins, Sharon; Granade, Ray; Reich, Andrew

2008-01-01

Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients.

Ciguatera Fish Poisoning: Treatment, Prevention and Management

Science.gov (United States)

Friedman, Melissa A.; Fleming, Lora E.; Fernandez, Mercedes; Bienfang, Paul; Schrank, Kathleen; Dickey, Robert; Bottein, Marie-Yasmine; Backer, Lorraine; Ayyar, Ram; Weisman, Richard; Watkins, Sharon; Granade, Ray; Reich, Andrew

2008-01-01

Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients. PMID:19005579

Concurrency-Induced Transitions in Epidemic Dynamics on Temporal Networks.

Science.gov (United States)

Onaga, Tomokatsu; Gleeson, James P; Masuda, Naoki

2017-09-08

Social contact networks underlying epidemic processes in humans and animals are highly dynamic. The spreading of infections on such temporal networks can differ dramatically from spreading on static networks. We theoretically investigate the effects of concurrency, the number of neighbors that a node has at a given time point, on the epidemic threshold in the stochastic susceptible-infected-susceptible dynamics on temporal network models. We show that network dynamics can suppress epidemics (i.e., yield a higher epidemic threshold) when the node's concurrency is low, but can also enhance epidemics when the concurrency is high. We analytically determine different phases of this concurrency-induced transition, and confirm our results with numerical simulations.

Concurrency-Induced Transitions in Epidemic Dynamics on Temporal Networks

Science.gov (United States)

Onaga, Tomokatsu; Gleeson, James P.; Masuda, Naoki

2017-09-01

Social contact networks underlying epidemic processes in humans and animals are highly dynamic. The spreading of infections on such temporal networks can differ dramatically from spreading on static networks. We theoretically investigate the effects of concurrency, the number of neighbors that a node has at a given time point, on the epidemic threshold in the stochastic susceptible-infected-susceptible dynamics on temporal network models. We show that network dynamics can suppress epidemics (i.e., yield a higher epidemic threshold) when the node's concurrency is low, but can also enhance epidemics when the concurrency is high. We analytically determine different phases of this concurrency-induced transition, and confirm our results with numerical simulations.

Management and prevention of chronic obstructive pulmonary disease exacerbations: a state of the art review

Directory of Open Access Journals (Sweden)

Wedzicha Jadwiga A

2009-08-01

Full Text Available Abstract Exacerbations of chronic obstructive pulmonary disease (COPD are important events in the natural history of this prevalent and devastating condition. This review provides a concise, state of the art summary on prevention and management of exacerbations. Considerable new data underpins evidence in support of many preventative interventions, pharmacological and non-pharmacological, that are now available. Challenges remain in developing new approaches, and delivering those that already exist to the right patient at the right time. Management of an exacerbation remains stepwise according to clinical severity, but there is now additional focus on addressing comorbidities and taking the opportunity at acute events to optimise preventative strategies for the future. Ultimately, exacerbations are heterogeneous events in a heterogeneous disease, and an individualised approach is paramount.

Association of HIV prevalence and concurrency of sexual ...

African Journals Online (AJOL)

Association of HIV prevalence and concurrency of sexual partnerships in South Africa's language groups: An ecological analysis. C Kenyon. Abstract. Background. There is considerable variation in HIV prevalence between different language groups in South Africa (SA). Sexual partner concurrency has been linked to the ...

Prevention of cisplatin nephrotoxicity

Directory of Open Access Journals (Sweden)

Hayati Fatemeh

2016-01-01

Full Text Available Cisplatin has a well-established role in the treatment of broad spectrum of malignancies; however its use is limited because of cisplatin-induced nephrotoxicity (CIN which can be progressive in more than 50% of cases. The most important risk factors for CIN include higher doses of cisplatin, previous cisplatin chemotherapy, underlying kidney damage and concurrent treatment with other potential nephrotoxin agents, such as aminoglycosides, nonsteroidal anti-inflammatory agents, or iodinated contrast media. Different strategies have been offered to diminish or prevent nephrotoxicity of cisplatin. The standard approach for prevention of CIN is the administration of lower doses of cisplatin in combination with full intravenous hydration prior and after cisplatin administration. Cisplatin-induced oxidative stress in the kidney may be prevented by natural antioxidant compounds. The results of this review show that many strategies for prevention of CIN exist, however, attention to the administration of these agent for CIN is necessary.

Effect of the Japanese preventive-care version of the Minimum Data Set--Home Care on the health-related behaviors of community-dwelling, frail older adults and skills of preventive-care managers: a quasi-experimental study conducted in Japan

DEFF Research Database (Denmark)

Igarashi, Ayumi; Ikegami, Naoki; Yamada, Yukari

2009-01-01

. The skills of the preventive-care managers were assessed by considering the number of and variations in the needs of the clients, as reflected in the care plans formulated by the managers. RESULTS: The clients' self-care levels were higher in the intervention group than in the control group (P ...AIM: To determine whether the Japanese preventive-care version of the Minimum Data Set-Home Care improves the health-related behaviors of older adults and the skills of preventive-care managers. METHODS: Municipal preventive-care managers were instructed on the use of the Japanese preventive...... Data Set--Home Care may improve the skills of preventive-care managers, and consequently, the health-related behaviors of frail older clients....

The Importance of Emotion Management Emerging for the Prevention of Resistance in the Change Process: A Perspective for Service Businesses

Directory of Open Access Journals (Sweden)

Meryem Akoğlan Kozak

2014-07-01

Full Text Available The aim of this study is to draw the attention to the importance of emotions preventing employees’ resistance to change during the change process. The most important obstacle in today’s enterprises is the resistance of the employees to changing applications. To prevent this resistance methods such as prediction, ensure participation, communication, education, reconciliation, force are usually used. However, considering the structure of tourism managements which is labor-intensive or human-oriented, besides these traditional methods to prevent resistance also must be used as a method of managing emotions. As a result of the evaluation about the subject over literature; emotion management is an awareness in the sector, but it isn’t used as a method of preventing resistance. Emotion management which is used for preventing resistance in change process is expected to make easier this process in tourism managements. For this purpose, employees constantly informing, supporting and clarity towards them, special interest to them, by pinpointing desires and needs, to perform the effort up and continuous learning to encourage such applications are recommended.

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

Medline Plus

Full Text Available ... Email Groups National Combined Councils Patient Education Primary Care Provider Risk Management Veteran Resources Community Health Behavioral Health Environmental Health Health Communications Health Promotion Injury Prevention School ...

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

Medline Plus

Full Text Available ... Combined Councils Patient Education Primary Care Provider Risk Management Veteran Resources Community Health Behavioral Health Environmental Health Health Communications Health Promotion Injury Prevention School Health Sustainability Visualizing ...

Disability management: the application of preventive measures, health promotion and case management in Italy.

Science.gov (United States)

La Torre, G; De Giusti, M; Mannocci, A; De Waure, C; Agostinelli, A; Schena, S; Capelli, G; Ricciardi, W; Boccia, A; Damiani, G; von Pinoci, M; Fanton, C; Federico, B

2009-03-01

Disability Management can be defined as a practice to improve workers' health and to reduce the impact and costs of disability. The aim of the study was to estimate the diffusion of DM in Italian companies. A survey was conducted using a questionnaire, the Worksite Disability Management Audit. The questionnaire was structured into five parts addressing the following domains: 1) characteristics of the company; 2) health promotion activities; 3) preventive measures; 4) case management; 5) disability management. We selected public and private companies and collected information by direct interview. Twenty companies entered the survey. Twelve Companies (60%) indicated that health promotion programs and sensibilisation campaigns are usually carried out. The presence of an individual who provided workplace safety indications and materials was stated by 19 companies (95%). Periodical medical examinations are carried out by 19 companies (95%); 16 (80%) have an evaluation process for ergonomics concerns. Risk assessment and analysis are performed by all companies and the security procedures and policies are updated at least once in a year in 40% of cases. Health status monitoring of injured workers is performed in eight (40%) of the companies, while Disability Management is present as a whole in only three companies. This survey highlights that Disability Management is not undertaken in most companies and that, where applied, there is still confusion and disorganization about ways to promote health and manage workers' illness and disability. Hence, there is still the need to promote an all-inclusive evaluation and management of workers' safety, illness and disabilities.

Primary prevention of peri-implantitis: managing peri-implant mucositis.

Science.gov (United States)

Jepsen, Søren; Berglundh, Tord; Genco, Robert; Aass, Anne Merete; Demirel, Korkud; Derks, Jan; Figuero, Elena; Giovannoli, Jean Louis; Goldstein, Moshe; Lambert, France; Ortiz-Vigon, Alberto; Polyzois, Ioannis; Salvi, Giovanni E; Schwarz, Frank; Serino, Giovanni; Tomasi, Cristiano; Zitzmann, Nicola U

2015-04-01

Over the past decades, the placement of dental implants has become a routine procedure in the oral rehabilitation of fully and partially edentulous patients. However, the number of patients/implants affected by peri-implant diseases is increasing. As there are--in contrast to periodontitis--at present no established and predictable concepts for the treatment of peri-implantitis, primary prevention is of key importance. The management of peri-implant mucositis is considered as a preventive measure for the onset of peri-implantitis. Therefore, the remit of this working group was to assess the prevalence of peri-implant diseases, as well as risks for peri-implant mucositis and to evaluate measures for the management of peri-implant mucositis. Discussions were informed by four systematic reviews on the current epidemiology of peri-implant diseases, on potential risks contributing to the development of peri-implant mucositis, and on the effect of patient and of professionally administered measures to manage peri-implant mucositis. This consensus report is based on the outcomes of these systematic reviews and on the expert opinion of the participants. Key findings included: (i) meta-analysis estimated a weighted mean prevalence for peri-implant mucositis of 43% (CI: 32-54%) and for peri-implantitis of 22% (CI: 14-30%); (ii) bleeding on probing is considered as key clinical measure to distinguish between peri-implant health and disease; (iii) lack of regular supportive therapy in patients with peri-implant mucositis was associated with increased risk for onset of peri-implantitis; (iv) whereas plaque accumulation has been established as aetiological factor, smoking was identified as modifiable patient-related and excess cement as local risk indicator for the development of peri-implant mucositis; (v) patient-administered mechanical plaque control (with manual or powered toothbrushes) has been shown to be an effective preventive measure; (vi) professional intervention

Sustainable MSD prevention: management for continuous improvement between prevention and production. Ergonomic intervention in two assembly line companies.

Science.gov (United States)

Caroly, S; Coutarel, F; Landry, A; Mary-Cheray, I

2010-07-01

To increase output and meet customers' needs, companies have turned to the development of production management systems: Kaizen, one piece flow, Kanban, etc. The aim of such systems is to accelerate decisions, react to environmental issues and manage various productions. In the main, this type of management system has led to the continuous improvement of production performance. Consequently, such production management systems can have unexpected negative effects on operators' health and safety. Conversely, regulation and control systems focusing on work-related risks have obliged firms to implement health and safety management systems such as OHSAS 18001. The purpose of this type of system, also based on continuous improvement, is to reduce risks, facilitate work-related activities and identify solutions in terms of equipment and tools. However, the prevention actions introduced through health and safety systems often result in other unexpected and unwanted effects on production. This paper shows how companies can improve the way they are run by taking into account both types of management system. Copyright 2010 Elsevier Ltd. All rights reserved.

Complementary Role of Herbal Medicine and Exercise in Cardiovascular Disease Prevention and Management: A Review of Evidence.

Science.gov (United States)

Veluswamy, Sundar Kumar; Babu, Abraham Samuel; Sundar, Lakshmi Manickavasagam

2017-01-01

Cardiovascular disease (CVD) is the leading cause of death worldwide. Herbal medicine and exercise interventions have individually been shown to be effective in the prevention and management of CVD. However, the complementary roles of herbal medicine and exercise interventions for CVD prevention and management have not been adequately reported. 1. Identify studies analysing complementary roles of herbal medicine and exercise intervention in CVD prevention and management, 2. Identify herbs and exercise strategies that have been reported to exhibit complementary roles in CVD prevention and management, and 3. Summarize evidence of complementary roles of herbal medicine and exercise interventions for CVD prevention and management. PubMed, CINAHL and Web of Science were searched with a customised search strategy in May 2015. Two reviewers screened the search results for inclusion using pre-specified criteria. Data were extracted from full text of selected abstracts in a predetermined template by two reviewers and verified by the third reviewer when needed. A total of 35 titles were identified for full texts review after screening 827 abstracts. Data were extracted from 23 titles, representing 12 human studies and six animal studies. This review identified effects of 14 different herbs and 10 exercise strategies on over 18 CVD risk factors and markers. Complementary roles of herbal medicine and exercise were reported from five studies. Evidence of complementary role of herbal medicine and exercise is emerging from animal studies. More robust clinical studies on proven risk factors are needed before they can be recommended for clinical practice. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

The Effectiveness of Cognitive-Behavioral Stress Management on Relapse Prevention in Substance Dependent Men

Directory of Open Access Journals (Sweden)

Negar Karimian

2012-02-01

Full Text Available Introduction: The purpose of this study is to investigate the effectiveness of cognitive-behavioral stress management on relapse prevention in men who are substance dependent. Method: In a experimental study, 30 individuals who settled in Esfahan therapeutic community center were accidently divided in to an experimental (15 subjects and a control (15 subjects group. The experimental group underwent ten 90 minutes sessions of cognitive-behavioral stress management and the control group didn't receive any particular treatment. All participants underwent urine tests at the beginning of the study, completion of treatment and three months following the completion of treatment. Data were analyzed using descriptive statistics and X2 test. Findings: results showed significant difference in relapse rates of two groups in the following stage. Conclusion: Cognitive-behavioral stress management is effective in relapse prevention in men who are substance dependent.

New trends in the prevention and management of community-acquired pneumonia.

Science.gov (United States)

Postma, D F; van Werkhoven, C H; Huijts, S M; Bolkenbaas, M; Oosterheert, J J; Bonten, M J M

2012-10-01

Community-acquired pneumonia (CAP) is an important cause of morbidity and mortality worldwide. This review summarises current trends and knowledge gaps in CAP management and prevention. Although Streptococcus pneumoniae is the most frequent cause of CAP, identification of the microbial cause of infection remains unsuccessful in most episodes, and little is known about the aetiology of CAP in immunocompromised patients. Urinary antigen testing has become standard care for diagnosing Legionella infection, and pneumococcal urinary antigen testing is now recommended in the Dutch guidelines to streamline antibiotic therapy in patients hospitalised with CAP. In primary care C-reactive protein determination is recommended to improve antibiotic prescription for lower respiratory tract infections. In patients hospitalised with CAP, three strategies are considered equally effective for choosing empirical antibiotic treatment. Yet, more (and better designed) studies are needed to determine the best strategy, as well as to determine optimal (which usually means the minimum) duration of antibiotic therapy and the role of adjuvant treatment with corticosteroids. The effectiveness of the 23-valent pneumococcal polysaccharide vaccine in preventing invasive pneumococcal disease and pneumococcal CAP remains debated, and whether the newer conjugate vaccines are more effective remains to be determined. Many of these questions are currently being addressed in large-scaled trials in the Netherlands, and their results may allow evidence-based decisions in CAP management and prevention.

Notes on Timed Concurrent Constraint Programming

DEFF Research Database (Denmark)

Nielsen, Mogens; Valencia, Frank D.

2004-01-01

and program reactive systems. This note provides a comprehensive introduction to the background for and central notions from the theory of tccp. Furthermore, it surveys recent results on a particular tccp calculus, ntcc, and it provides a classification of the expressive power of various tccp languages.......A constraint is a piece of (partial) information on the values of the variables of a system. Concurrent constraint programming (ccp) is a model of concurrency in which agents (also called processes) interact by telling and asking information (constraints) to and from a shared store (a constraint...

Gender asymmetry in concurrent partnerships and HIV prevalence

NARCIS (Netherlands)

Leung, Ka Yin; Powers, Kimberly A.; Kretzschmar, Mirjam

The structure of the sexual network of a population plays an essential role in the transmission of HIV. Concurrent partnerships, i.e. partnerships that overlap in time, are important in determining this network structure. Men and women may differ in their concurrent behavior, e.g. in the case of

Gender asymmetry in concurrent partnerships and HIV prevalence

NARCIS (Netherlands)

Leung, Ka Yin; Powers, Kimberly A.; Kretzschmar, Mirjam

2017-01-01

The structure of the sexual network of a population plays an essential role in the transmission of HIV. Concurrent partnerships, i.e. partnerships that overlap in time, are important in determining this network structure. Men and women may differ in their concurrent behavior, e.g. in the case of

Resource Management and Prevention of Moral Harassment: The Cases of Two Agricultural Cooperatives of Paraná

Directory of Open Access Journals (Sweden)

Aline Alves Storti

2017-05-01

Full Text Available The objective of this study was to identify and analyze how preventive work is done on issues related to moral harassment in two agricultural cooperatives in Paraná. The locus chosen for analysis was justified by the need for actions that curb harassment in organizations and by the peculiarity of the environment, in addition to the two cooperatives surveyed being large employers in their region. A qualitative case study approach was taken. Descriptive data was collected through document research and interviews with four managers of the two cooperatives. Findings revealed that both cooperatives analyzed have no records of moral harassment in the Regional Labor Court and use some prevention methods. In addition, statements by personnel management professionals presented some discrepancies with other professionals interviewed, which may be related to a lack of knowledge on the theme or to cultural aspects. The Green Cooperative presented more preventive methods to moral harassment than the Blue Cooperative, including a code of ethics, denunciations via e-mail, organization environment research, a denunciation box and harassment prevention training for future leaders. The Blue Cooperative uses formal channels of communication and employee dialogue, but nothing specifically directed towards situations of harassment, organization climate research, or a code of ethics. Areas of personnel management are suggested to invest more in communicating prevention actions with those involved, which encourages dialogue and the dissemination of knowledge on what harassment is and how to prevent it.

Coalgebra, concurrency and control

NARCIS (Netherlands)

J.J.M.M. Rutten (Jan)

1999-01-01

textabstractCoalgebra is used to generalize notions and techniques from concurrency theory, in order to apply them to problems concerning the supervisory control of discrete event systems. The main ingredients of this approach are the characterization of controllability in terms of (a variant of)

[Prediction, prevention and management of shoulder dystocia].

Science.gov (United States)

Csorba, Roland

2012-05-20

Shoulder dystocia is one of the most tragic, fatal and unexpected obstetrical events, which is mostly unpredictable and unpreventable. This clinical picture is defined as a delivery that requires additional obstetric maneuvers to release the shoulders after gentle downward traction has failed. Shoulder dystocia occurs when the fetal shoulder impacts on the maternal symphysis or sacral promontory. The incidence of shoulder dystocia is 0.2-0.6%. High perinatal mortality and morbidity is associated with the condition, even when it is managed appropriately. Obstetricians should be aware of the existing risk factors, but should always be alert to the possibility of shoulder dystocia in all labors. Maternal morbidity is also increased, particularly postpartum hemorrhage, rupture of the uterus, injury of the bladder, urethra and the bowels and fourth-degree perineal tears. Complications of the newborn include asphyxia, perinatal mortality, fracture of the clavicula and the humerus. Brachial plexus injuries are one of the most important fetal complications of shoulder dystocia, complicating 4-16% of such deliveries. The purpose of this article is to review the current evidence regarding the possible prediction, prevention and management of shoulder dystocia.

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

Medline Plus

Full Text Available ... Email Groups National Combined Councils Patient Education Primary Care Provider Risk Management Veteran Resources Community Health Behavioral Health Environmental Health Health Communications Health Promotion Injury Prevention School Health Sustainability Visualizing ...

Data-centric concurrency control on the java programming language

OpenAIRE

Parreira, Daniel Luis Landeiroto

2013-01-01

Dissertação para obtenção do Grau de Mestre em Engenharia Informática The multi-core paradigm has propelled shared-memory concurrent programming to an important role in software development. Its use is however limited by the constructs that provide a layer of abstraction for synchronizing access to shared resources. Reasoning with these constructs is not trivial due to their concurrent nature. Data-races and deadlocks occur in concurrent programs, encumbering the programmer and furth...

Concurrent chemoradiotherapy for advanced esophageal cancer

International Nuclear Information System (INIS)

Shimizu, Wakako; Ogino, Takashi; Ishikura, Satoshi; Kawashima, Mitsuhiko; Ikeda, Hiroshi

1997-01-01

To investigate factors influencing response and survival for patients with squamous cell cancer of the esophagus. Forty-nine patients with squamous cell cancer of the esophagus, classified by guidelines for the clinical and pathologic studies on carcinoma of the esophagus published by the Japanese Society for Esophageal Disease, were treated by concurrent chemoradiotherapy using chemotherapy consisting of cisplatin and 5-fluorouracil with definitive irradiation of 60 Gy concurrently. Endoscopic findings and biopsy were used for evaluating the response. Nurse charts recording patient's feeding status were adopted to estimate severity of dysphagia. Complete response (CR) rate was 69.4%, median survival time (MST) was 12.3 months, and median local failure-free survival time 7.3 months. Patients in early stage (= 32.4 months, 20.4 months, 20.4 months, 15.7 months, respectively). Patients in A3 stage were often suffered from severe dysphagia both before and after treatment (81.5%, 70.4%), respectively. Concurrent chemoradiotherapy was effective treatment for esophageal cancer. Degree of dysphagia was considered to be a good prognosticator of patients' survival. (author)

Can Chronic Ankle Instability be Prevented? Rethinking Management of Lateral Ankle Sprains.

Science.gov (United States)

Denegar, Craig R.; Miller, Sayers J., III

2002-01-01

Investigates whether chronic ankle instability can be prevented, discussing: the relationship between mechanical and functional instability; normal ankle mechanics, sequelae to lateral ankle sprains, and abnormal ankle mechanics; and tissue healing, joint dysfunction, and acute lateral ankle sprain management. The paper describes a treatment model…

39 CFR 273.7 - Concurrence of Attorney General.

Science.gov (United States)

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Concurrence of Attorney General. 273.7 Section 273... PROGRAM FRAUD CIVIL REMEDIES ACT § 273.7 Concurrence of Attorney General. (a) The Attorney General is... the Attorney General or his designee approves such action in a written statement which specifies: (1...

Radiotherapy with concurrent or sequential temozolomide in elderly patients with glioblastoma multiforme

International Nuclear Information System (INIS)

Hashem, Sameh A.; Salem, Ahmed; Al-Rashdan, Abdulla

2012-01-01

The objective of this article was to evaluate therapeutic outcomes of elderly patients with glioblastoma multiforme (GBM) treated by surgery followed by combined modality therapy and compare achievable outcomes to those of a younger age population. Seventy-eight adult patients with histologically confirmed grade IV astrocytoma were treated at King Hussein Cancer Center (Amman, Jordan) between September 2004 and December 2008. Records were retrospectively reviewed and included 55 males and 23 females between 19 and 78 years of age (median age 50 years). This case series included 20 patients aged 60 years or older. All patients underwent craniotomy followed radiotherapy and concurrent or sequential temozolomide. The follow-up ranged from 1 to 56 months (median 9.4 months). The median survival for the whole cohort was 13.8 months. The median survival for patients less than 60 years was 14.3 months and for patients 60 years or older was 12.3 months (P = 0.19). Among elderly patients, radical surgical resection (P = 0.002), concurrent delivery of chemoradiation (0.041) and radiotherapy dose ≥5400 cGy (P = 0.0001) conferred statistically significant improvements in overall survival. Management of GBM in elderly patients should include maximal surgical resection followed by radiotherapy and temozolomide whenever medically feasible. Outcomes comparable to those obtained in younger age groups can be expected. Our results indicate that concurrent chemoradiation is superior to sequential chemoradiation in these patients.

MLIP: A Concurrent Approach for Clipping Indexing

OpenAIRE

Majoju Ravinder; R.Vijay Prakash

2011-01-01

Multidimensional databases are beginning to be used in a wide range of applications. To meet this fast-growing demand, the R-tree family is being applied to support fast access to multidimensional data, for which the R+-tree exhibits outstanding search performance. In order to support efficient concurrent access in multi-user environments, concurrency control mechanisms for multidimensional indexing have been proposed. However, these mechanisms cannot be directly applied to the R+-tree becaus...

The preventing recurrent vascular events and neurological worsening through intensive organized case-management (PREVENTION trial protocol [clinicaltrials.gov identifier: NCT00931788

Directory of Open Access Journals (Sweden)

Tsuyuki Ross

2010-04-01

Full Text Available Abstract Background Survivors of transient ischemic attack (TIA or stroke are at high risk for recurrent vascular events and aggressive treatment of vascular risk factors can reduce this risk. However, vascular risk factors, especially hypertension and high cholesterol, are not managed optimally even in those patients seen in specialized clinics. This gap between the evidence for secondary prevention of stroke and the clinical reality leads to suboptimal patient outcomes. In this study, we will be testing a pharmacist case manager for delivery of stroke prevention services. We hypothesize this new structure will improve processes of care which in turn should lead to improved outcomes. Methods We will conduct a prospective, randomized, controlled open-label with blinded ascertainment of outcomes (PROBE trial. Treatment allocation will be concealed from the study personnel, and all outcomes will be collected in an independent and blinded manner by observers who have not been involved in the patient's clinical care or trial participation and who are masked to baseline measurements. Patients will be randomized to control or a pharmacist case manager treating vascular risk factors to guideline-recommended target levels. Eligible patients will include all adult patients seen at stroke prevention clinics in Edmonton, Alberta after an ischemic stroke or TIA who have uncontrolled hypertension (defined as systolic blood pressure (BP > 140 mm Hg or dyslipidemia (fasting LDL-cholesterol > 2.00 mmol/L and who are not cognitively impaired or institutionalized. The primary outcome will be the proportion of subjects who attain 'optimal BP and lipid control'(defined as systolic BP Conclusions Nearly one-quarter of those who survive a TIA or minor stroke suffer another vascular event within a year. If our intervention improves the provision of secondary prevention therapies in these patients, the clinical (and financial implications will be enormous.

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

Medline Plus

Full Text Available ... National Combined Councils Patient Education Primary Care Provider Risk Management Veteran Resources Community Health Behavioral Health Environmental Health Health Communications Health Promotion Injury Prevention School Health Sustainability Visualizing Data Contacts Career Opportunities ...

CONCURRENT VALIDITY OF THE STUDENT TEACHER PROFESSIONAL IDENTITY SCALE

Directory of Open Access Journals (Sweden)

Predrag Živković

2018-04-01

Full Text Available The main purpose of study was to examine concurrent validity of the Student Teachers Professional Identity Scale–STPIS (Fisherman and Abbot, 1998 that was for the first time used in Serbia. Indicators of concurrent validity was established by correlation with student teacher self-reported well-being, self-esteem, burnout stress and resilience. Based on the results we can conclude that the STPIS meets the criterion of concurrent validity. The implications of these results are important for researchers and decisions makers in teacher education

Public health program planning logic model for community engaged type 2 diabetes management and prevention.

Science.gov (United States)

West, Joseph F

2014-02-01

Diabetes remains a growing epidemic with widening health inequity gaps in disease management, self-management knowledge, access to care and outcomes. Yet there is a paucity of evaluation tools for community engaged interventions aimed at closing the gaps and improving health. The Guide to Community Preventive Services (the Community Guide) developed by the Task Force on Community Preventive Services (the Task Force) at the Centers for Disease Control and Prevention (CDC) recommends two healthcare system level interventions, case management interventions and disease management programs, to improve glycemic control. However, as a public health resource guide for diabetes interventions a model for community engagement is a glaringly absent component of the Community Guide recommendations. In large part there are few evidence-based interventions featuring community engagement as a practice and system-level focus of chronic disease and Type 2 diabetes management. The central argument presented in this paper is that the absence of these types of interventions is due to the lack of tools for modeling and evaluating such interventions, especially among disparate and poor populations. A conceptual model emphasizing action-oriented micro-level community engagement is needed to complement the Community Guide and serve as the basis for testing and evaluation of these kinds of interventions. A unique logic model advancing the Community Guide diabetes recommendations toward measureable and sustainable community engagement for improved Type 2 diabetes outcomes is presented. Copyright © 2013 Elsevier Ltd. All rights reserved.

Epidemiology of concurrent headache and sleep problems in Denmark.

Science.gov (United States)

Lund, Nunu; Westergaard, Maria Lurenda; Barloese, Mads; Glümer, Charlotte; Jensen, Rigmor Højland

2014-09-01

There are no previous epidemiologic studies on concurrent headache and sleep problems (HSP). This cross-sectional study aimed to determine the prevalence of HSP in Denmark, broadly characterize those with HSP, and examine associations between HSP and socioeconomic/lifestyle factors. A total of 129,150 randomly selected individuals were invited to participate in the Danish National Health Survey 2010. Respondents were asked about headache, sleep problems, depression and anxiety in the last two weeks, health-related lifestyle and quality of life (SF-12). Socioeconomic data were retrieved from national registers. Prevalence proportions were adjusted for stratified sampling and non-response. Regression analyses examined associations between HSP and socioeconomic/lifestyle factors. Of 68,518 respondents, 16.3% reported only headache, 21.1% only sleep problems, and 18.1% HSP with 2.6% being severely affected. Prevalence was higher among women and the middle-aged. Severe HSP was associated with low socioeconomic position, non-Western ethnicity, unhealthy lifestyle, high stress and anxiety/depression. Those with HSP had substantially reduced quality of life; more so than those having only headache or only sleep problems. HSP is a highly prevalent condition. Lifestyle modification, stress reduction, and screening for concurrent depression and anxiety may play important roles in management. The high prevalence of HSP suggests a common pathophysiological mechanism. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Toward Highly Efficient Nanostructured Solar Cells Using Concurrent Electrical and Optical Design

KAUST Repository

Wang, Hsin-Ping

2017-07-11

Recent technological advances in conventional planar and microstructured solar cell architectures have significantly boosted the efficiencies of these devices near the corresponding theoretical values. Nanomaterials and nanostructures have promising potential to push the theoretical limits of solar cell efficiency even higher using the intrinsic advantages associated with these materials, including efficient photon management, rapid charge transfer, and short charge collection distances. However, at present the efficiency of nanostructured solar cells remains lower than that of conventional solar devices due to the accompanying losses associated with the employment of nanomaterials. The concurrent design of both optical and electrical components will presumably be an imperative route toward breaking the present-day limit of nanostructured solar cells. This review summarizes the losses in traditional solar cells, and then discusses recent advances in applications of nanotechnology to solar devices from both optical and electrical perspectives. Finally, a rule for nanostructured solar cells by concurrently engineering the optical and electrical design is devised. Following these guidelines should allow for exceeding the theoretical limit of solar cell efficiency soon.

A Concurrent Distributed System for Aircraft Tactical Decision Generation

Science.gov (United States)

McManus, John W.

1990-01-01

A research program investigating the use of artificial intelligence (AI) techniques to aid in the development of a Tactical Decision Generator (TDG) for Within Visual Range (WVR) air combat engagements is discussed. The application of AI programming and problem solving methods in the development and implementation of a concurrent version of the Computerized Logic For Air-to-Air Warfare Simulations (CLAWS) program, a second generation TDG, is presented. Concurrent computing environments and programming approaches are discussed and the design and performance of a prototype concurrent TDG system are presented.

Resistance Exercise to Prevent and Manage Sarcopenia and Dynapenia.

Science.gov (United States)

Law, Timothy D; Clark, Leatha A; Clark, Brian C

For well over twenty centuries the muscle wasting (sarcopenia) and weakness (dynapenia) that occurs with old age has been a predominant concern of mankind. Exercise has long been suggested as a treatment to combat sarcopenia and dynapenia, as it exerts effects on both the nervous and muscular systems that are critical to positive physiological and functional adaptations (e.g., enhanced muscle strength). For more than two decades scientists have recognized the profound role that progressive resistance exercise training can have on increasing muscle strength, muscle size and functional capacity in older adults. In this review article we discuss how resistance exercise training can be used in the management and prevention of sarcopenia and dynapenia. We first provide an overview of the evidence for this notion and highlight certain critical factors- namely exercise intensity, volume and progression- that are key to optimizing the resistance exercise prescription. We then highlight how many, if not most, of the commonly prescribed exercise programs for seniors are not the 'best practices', and subsequently present easy-to-read guidelines for a well-rounded resistance exercise training program designed for the management and prevention of sarcopenia and dynapenia, including example training programs for the beginner through the advanced senior resistance exerciser. These guidelines have been written for the academician as well as the student and health care provider across a variety of disciplines, including those in the long term care industry, such as wellness instructors or activity directors.

Interventions for preventing and managing of skin lesions after radiation.

Directory of Open Access Journals (Sweden)

Eleni Bafe

2017-12-01

Full Text Available Introduction: Radiotherapy has a pivotal role in the fight against cancer. However 85% of patients, who undergo radiotherapy, will face moderate to severe skin reactions, for the treatment of which various local products, available in the market, are used. Aim: The aim of this systematic literature review was to investigate the prevention and treatment of these skin lesions induced by radiation. Methods: For this purpose 34 articles were collected concerning materials, approved by the FDA, for the prevention and treatment of skin damage due to radiation, preclinical factors tested in animal models, factors involved in the prevention and treatment of moist desquamation and unauthorized agents or with little information about them. Results: According to the study results, the moisturizing and hydrophilic creams, herbal preparations, gels based on hyaluronic acid, and Vitamin E, heparinoid creams and formulations based on oils appear to have a positive effect in preventing dermatitis as well as in providing symptom relief. Patches are suitable for the case of moist desquamation. Vasculotide, agent EUK-207, agent RTA 408, agent ALDH2 and the agent Celecoxib are still in the preclinical stage but may become future therapeutic targets. Conclusion: Skin reactions due to radiation remain a significant problem for patients undergoing radical treatment. However, thanks to the multitude of formulations available in the market and several clinical trials it is possible that early prevention and treatment for actinic dermatitis could be achieved. In conclusion, it is crucial that health professionals are aware of the formulations indicated and contraindicated in case of skin reactions induced by radiation and adjust the treatment for the prevention and management of skin reactions in patients receiving radiation therapy.

Correctness of concurrent processes

NARCIS (Netherlands)

E.R. Olderog (Ernst-Rüdiger)

1989-01-01

textabstractA new notion of correctness for concurrent processes is introduced and investigated. It is a relationship P sat S between process terms P built up from operators of CCS [Mi 80], CSP [Ho 85] and COSY [LTS 79] and logical formulas S specifying sets of finite communication sequences as in

Stroke Prevention: Managing Modifiable Risk Factors

Directory of Open Access Journals (Sweden)

Silvia Di Legge

2012-01-01

Full Text Available Prevention plays a crucial role in counteracting morbidity and mortality related to ischemic stroke. It has been estimated that 50% of stroke are preventable through control of modifiable risk factors and lifestyle changes. Antihypertensive treatment is recommended for both prevention of recurrent stroke and other vascular events. The use of antiplatelets and statins has been shown to reduce the risk of recurrent stroke and other vascular events. Angiotensin-converting enzyme inhibitors (ACEIs and angiotensin II receptor blockers (ARBs are indicated in stroke prevention because they also promote vascular health. Effective secondary-prevention strategies for selected patients include carotid revascularization for high-grade carotid stenosis and vitamin K antagonist treatment for atrial fibrillation. The results of recent clinical trials investigating new anticoagulants (factor Xa inhibitors and direct thrombin inhibitors clearly indicate alternative strategies in stroke prevention for patients with atrial fibrillation. This paper describes the current landscape and developments in stroke prevention with special reference to medical treatment in secondary prevention of ischemic stroke.

Multiple and concurrent sexual partnerships among men who have sex with men in Viet Nam: results from a National Internet-based Cross-sectional Survey.

Science.gov (United States)

García, M C; Duong, Q L; Meyer, S B; Ward, P R

2016-03-01

Men who have sex with men (MSM) are one of the largest HIV risk groups in Viet Nam and have been understudied. Sexual concurrency and multiple sex partnerships may contribute to high HIV incidence among MSM in Viet Nam. Limited information is available on concurrency and multiple sexual partnerships among MSM in Viet Nam or on the extent to which this population engages in concurrent and multiple unprotected anal intercourse. Data are from a self-administered Internet-based survey of Vietnamese MSM aged 18 years or older, having sex with male partner(s) in the last 12 months and recruited from social networking MSM-specific websites in Viet Nam. Multiple partnerships and concurrency were measured using the UNAIDS-recommended sexual partner matrix, a key component in the questionnaire. Concurrent and multiple sexual partnerships were analyzed at the individual level. Logistic regression analyses were conducted to assess the demographic characteristics and behaviors associated with multiple sexual partnerships. A total of 1695 MSM reported on multiple sexual partnerships; 69.5% indicated multiple sexual partnerships in the last 6 months. A total of 257 MSM reported on concurrent sexual partnerships, with 51.0% reporting penetrative sex with concurrent partners in the last 6 months. Respondents were more likely to engage in multiple sexual partnerships if they were no longer a student, consumed alcohol before and/or during sex, used the Internet to meet casual sex partners and had never participated in a behavioral HIV intervention. Multiple sexual partnerships in the previous 6 months were common among MSM surveyed, as was sexual concurrency. High levels of multiple and concurrent sexual partnerships may be catalyzing the transmission of HIV among MSM in Viet Nam. Given the high prevalence of this high-risk sexual behavior, our findings underscore the urgent need for targeted prevention efforts, focusing on the reduction of multiple and concurrent sexual partners

Diabetes: Good Diabetes Management and Regular Foot Care Help Prevent Severe Foot Sores

Science.gov (United States)

Amputation and diabetes: How to protect your feet Good diabetes management and regular foot care help prevent severe foot sores that ... and may require amputation. By Mayo Clinic Staff Diabetes complications can include nerve damage and poor blood ...

Data refinement for true concurrency

Directory of Open Access Journals (Sweden)

Brijesh Dongol

2013-05-01

Full Text Available The majority of modern systems exhibit sophisticated concurrent behaviour, where several system components modify and observe the system state with fine-grained atomicity. Many systems (e.g., multi-core processors, real-time controllers also exhibit truly concurrent behaviour, where multiple events can occur simultaneously. This paper presents data refinement defined in terms of an interval-based framework, which includes high-level operators that capture non-deterministic expression evaluation. By modifying the type of an interval, our theory may be specialised to cover data refinement of both discrete and continuous systems. We present an interval-based encoding of forward simulation, then prove that our forward simulation rule is sound with respect to our data refinement definition. A number of rules for decomposing forward simulation proofs over both sequential and parallel composition are developed.

Authentic And Concurrent Evaluation-refining

DEFF Research Database (Denmark)

Eriksson, Carina Ihlström; Åkesson, Maria; Kautz, Karlheinz

2011-01-01

This paper addresses the need for more detailed accounts for evaluation in design science research literature. By revisiting a design project regarding the future e-newspaper we give detailed descriptions of its authentic and concurrent evaluation approach by illustrating the what, why and how...... of all evaluation activities throughout the whole project. The project produced seven different design artifacts that were evaluated. The utility and theoretical outcomes of the evaluation activities clearly influenced design decisions regarding newspaper design, user value and business model design...... as well as decisions on strategic levels. We emphasize a holistic and concurrent approach to evaluation compared to the general design science research thinking and argue that reflecting on how to seek authenticity is important. By authenticity we refer to the notion of how closely an evaluation captures...

Concurrent variable-interval variable-ratio schedules in a dynamic choice environment.

Science.gov (United States)

Bell, Matthew C; Baum, William M

2017-11-01

Most studies of operant choice have focused on presenting subjects with a fixed pair of schedules across many experimental sessions. Using these methods, studies of concurrent variable- interval variable-ratio schedules helped to evaluate theories of choice. More recently, a growing literature has focused on dynamic choice behavior. Those dynamic choice studies have analyzed behavior on a number of different time scales using concurrent variable-interval schedules. Following the dynamic choice approach, the present experiment examined performance on concurrent variable-interval variable-ratio schedules in a rapidly changing environment. Our objectives were to compare performance on concurrent variable-interval variable-ratio schedules with extant data on concurrent variable-interval variable-interval schedules using a dynamic choice procedure and to extend earlier work on concurrent variable-interval variable-ratio schedules. We analyzed performances at different time scales, finding strong similarities between concurrent variable-interval variable-interval and concurrent variable-interval variable- ratio performance within dynamic choice procedures. Time-based measures revealed almost identical performance in the two procedures compared with response-based measures, supporting the view that choice is best understood as time allocation. Performance at the smaller time scale of visits accorded with the tendency seen in earlier research toward developing a pattern of strong preference for and long visits to the richer alternative paired with brief "samples" at the leaner alternative ("fix and sample"). © 2017 Society for the Experimental Analysis of Behavior.

Continuous Activity Monitoring During Concurrent Chemoradiotherapy

International Nuclear Information System (INIS)

Ohri, Nitin; Kabarriti, Rafi; Bodner, William R.; Mehta, Keyur J.; Shankar, Viswanathan; Halmos, Balazs; Haigentz, Missak; Rapkin, Bruce; Guha, Chandan; Kalnicki, Shalom; Garg, Madhur

2017-01-01

Purpose: To perform a prospective trial testing the feasibility and utility of acquiring activity data as a measure of health status during concurrent chemoradiotherapy. Methods and Materials: Ambulatory patients who were planned for treatment with concurrent chemoradiotherapy with curative intent for cancers of the head and neck, lung, or gastrointestinal tract were provided with activity monitors before treatment initiation. Patients were asked to wear the devices continuously throughout the radiation therapy course. Step count data were downloaded weekly during radiation therapy and 2 and 4 weeks after radiation therapy completion. The primary objective was to demonstrate feasibility, defined as collection of step counts for 80% of the days during study subjects' radiation therapy courses. Secondary objectives included establishing step count as a dynamic predictor of unplanned hospitalization risk. Results: Thirty-eight enrolled patients were treated with concurrent chemoradiotherapy. Primary diagnoses included head and neck cancer (n=11), lung cancer (n=13), and a variety of gastrointestinal cancers (n=14). Step data were collected for 1524 of 1613 days (94%) during patients' radiation therapy courses. Fourteen patients were hospitalized during radiation therapy or within 4 weeks of radiation therapy completion. Cox regression modeling demonstrated a significant association between recent step counts (3-day average) and hospitalization risk, with a 38% reduction in the risk of hospitalization for every 1000 steps taken each day (hazard ratio 0.62, 95% confidence interval 0.46-0.83, P=.002). Inferior quality of life scores and impaired performance status were not associated with increased hospitalization risk. Conclusion: Continuous activity monitoring during concurrent chemoradiotherapy is feasible and well-tolerated. Step counts may serve as powerful, objective, and dynamic indicators of hospitalization risk.

Service-Oriented Synthesis of Distributed and Concurrent Protocol Specifications

Directory of Open Access Journals (Sweden)

Jehad Al Dallal

2008-01-01

Full Text Available Several methods have been proposed for synthesizing computer communication protocol specifications from service specifications. Some protocol synthesis methods based on the finite state machine (FSM model assume that primitives in the service specifications cannot be executed simultaneously. Others either handle only controlled primitive concurrency or have tight restrictions on the applicable FSM topologies. As a result, these synthesis methods are not applicable to an interesting variety of inherently concurrent applications, such as the Internet and mobile communication systems. This paper proposes a concurrent-based protocol synthesis method that eliminates the restrictions imposed by the earlier methods. The proposed method uses a synthesis method to obtain a sequential protocol specification (P-SPEC from a given service specification (S-SPEC. The resulting P-SPEC is then remodeled to consider the concurrency behavior specified in the S-SPEC, while guaranteeing that P-SPEC provides the specified service.

Prototyping of concurrent control systems implemented in FPGA devices

CERN Document Server

Wiśniewski, Remigiusz

2017-01-01

This book focuses on prototyping aspects of concurrent control systems and their further implementation and partial reconfiguration in programmable devices. Further, it lays out a full prototyping flow for concurrent control systems. Based on a given primary specification, a system is described with an interpreted Petri net, which naturally reflects the concurrent and sequential relationships of the design. The book shows that, apart from the traditional option of static configuration of the entire system, the latest programmable devices (especially FPGAs) offer far more sophistication. Partial reconfiguration allows selected parts of the system to be replaced without having to reprogram the entire structure of the device. Approaches to dynamic and static partial reconfiguration of concurrent control systems are presented and described in detail.< The theoretical work is illustrated by examples drawn from various applications, with a milling machine and a traffic-light controller highlighted as representat...

Functional Programming for Java Developers Tools for Better Concurrency, Abstraction, and Agility

CERN Document Server

Wampler, Dean

2011-01-01

Software development today is embracing functional programming (FP), whether it's for writing concurrent programs or for managing Big Data. Where does that leave Java developers? This concise book offers a pragmatic, approachable introduction to FP for Java developers or anyone who uses an object-oriented language. Dean Wampler, Java expert and author of Programming Scala (O'Reilly), shows you how to apply FP principles such as immutability, avoidance of side-effects, and higher-order functions to your Java code. Each chapter provides exercises to help you practice what you've learned. Once

Disability prevention and management in leprosy: A field experience

Directory of Open Access Journals (Sweden)

Ganapati R

2003-11-01

Full Text Available Bombay Leprosy Project has conducted operational research into cost effective ways of using therapeutic management for prevention of disabilities (POD. The goal of achieving this are broadly divided as 1 prevention of impairments and disabilities [POID] and 2 prevention of worsening of disabilities [POWD]. About 33-56% of newly registered leprosy patients already have clinically detectable nerve function impairment [NFI], often no longer amenable to MDT. An analysis of 892 leprosy cases treated with WHO-MDT stresses the need to focus attention on leprosy patients having > 5 skin lesions and multiple nerve thickening. Assessment of 454 disabled leprosy patients after 4 years indicated that the compliance for the services offered was good and it helped to improve the disability status in more than 50% of patients. In terms of effectiveness of the services, it was found to be effective in preventing worsening of deformities in hands and healing of trophic ulcers in feet. The methodology adopted has also helped us to develop an operational research model about the necessity to systematize the assistance and support to be given if the services can be routed through a public health facility. Because of the large numbers of leprosy patients with disability living in this region and the limited resources available, the services have to be targeted towards those who are most in need. The major advantage of such community based program is an attempt to eliminate the social stigma in the patients′ families and the education of the community.

Concurrent sourcing as a mechanism for safeguarding specific investments from opportunism

DEFF Research Database (Denmark)

Mols, Niels Peter

This paper identifies when concurrent sourcing is an effective safeguard. Concurrent sourcing shortens the period that a buyer needs in order to internalize production and thus, it shortens the period in which an external supplier is able to hold-up a buyer. Concurrent sourcing also allows...... for short run expansion of production and reduces costs of lost customers. However, when complementarities and diseconomies of scale make concurrent sourcing an efficient choice for a buyer, the same complementarities and diseconomies of scale also weaken the threat that the internal production unit may...

Engineering Bereitschaft as an enabler for Concurrent Engineering

DEFF Research Database (Denmark)

Christiansen, Kåre; Vesterager, Johan

1999-01-01

Industrial companies observe a general trend towards more customised products and shorter product life cycles. Furthermore, the market demands shorter lead-time and high-quality products at a competitive price. Concurrent Engineering address these challenges. Product modelling is a key aspect...... of the Concurrent Engineering literature. One problem with the product modelling literature is that it tends to assume that product development is revolutionary. Very often product development is evolutionary and it means that product modelling should have a major emphasis on reuse. In this paper it is suggested...... that industrial companies should develop an engineering development Bereitschaft (preparatory engineering knowledge) as an approach to Concurrent Engineering and product modelling. To develop such an engineering development Bereitschaft, a company must develop company generic product models.This paper...

Risk assessment and management to prevent preterm birth.

Science.gov (United States)

Koullali, B; Oudijk, M A; Nijman, T A J; Mol, B W J; Pajkrt, E

2016-04-01

Preterm birth is the most important cause of neonatal mortality and morbidity worldwide. In this review, we review potential risk factors associated with preterm birth and the subsequent management to prevent preterm birth in low and high risk women with a singleton or multiple pregnancy. A history of preterm birth is considered the most important risk factor for preterm birth in subsequent pregnancy. General risk factors with a much lower impact include ethnicity, low socio-economic status, maternal weight, smoking, and periodontal status. Pregnancy-related characteristics, including bacterial vaginosis and asymptomatic bacteriuria, appear to be of limited value in the prediction of preterm birth. By contrast, a mid-pregnancy cervical length measurement is independently associated with preterm birth and could be used to identify women at risk of a premature delivery. A fetal fibronectin test may be of additional value in the prediction of preterm birth. The most effective methods to prevent preterm birth depend on the obstetric history, which makes the identification of women at risk of preterm birth an important task for clinical care providers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Barista: A Framework for Concurrent Speech Processing by USC-SAIL

OpenAIRE

Can, Doğan; Gibson, James; Vaz, Colin; Georgiou, Panayiotis G.; Narayanan, Shrikanth S.

2014-01-01

We present Barista, an open-source framework for concurrent speech processing based on the Kaldi speech recognition toolkit and the libcppa actor library. With Barista, we aim to provide an easy-to-use, extensible framework for constructing highly customizable concurrent (and/or distributed) networks for a variety of speech processing tasks. Each Barista network specifies a flow of data between simple actors, concurrent entities communicating by message passing, modeled after Kaldi tools. Lev...

Concurrent sourcing and external supplier opportunism

DEFF Research Database (Denmark)

Mols, Niels Peter

costs of opportunism are determined as a product of four factors. The four factors are: likelihood of discovering supplier opportunism, buyer’s internalized quantity as reaction to supplier opportunism, asset specificity of external supplier’s investments, and multiplicator effects. Each......When a firm simultaneously makes and buys the same components then the firm uses concurrent sourcing. This paper presents an agency model for explaining how and when concurrent sourcing reduces the likelihood of external supplier opportunism. In the proposed model, the external supplier’s expected...... of these factors are explained and discussed in the paper. The paper ends by offering a number of theoretical and managerial implications....

IOM calls for transformation of attitudes toward pain and its prevention and management.

Science.gov (United States)

2012-01-01

The Institute of Medicine (IOM), the most influential health policy body in the United States, has published an extensive report calling for a cultural transformation of attitudes toward pain and its prevention and management. This report summarizes the IOM publication.

Policy environment for prevention, control and management of cardiovascular diseases in primary health care in Kenya.

Science.gov (United States)

Asiki, Gershim; Shao, Shuai; Wainana, Carol; Khayeka-Wandabwa, Christopher; Haregu, Tilahun N; Juma, Pamela A; Mohammed, Shukri; Wambui, David; Gong, Enying; Yan, Lijing L; Kyobutungi, Catherine

2018-05-09

In Kenya, cardiovascular diseases (CVDs) accounted for more than 10% of total deaths and 4% of total Disability-Adjusted Life Years (DALYs) in 2015 with a steady increase over the past decade. The main objective of this paper was to review the existing policies and their content in relation to prevention, control and management of CVDs at primary health care (PHC) level in Kenya. A targeted document search in Google engine using keywords "Kenya national policy on cardiovascular diseases" and "Kenya national policy on non-communicable diseases (NCDs)" was conducted in addition to key informant interviews with Kenyan policy makers. Relevant regional and international policy documents were also included. The contents of documents identified were reviewed to assess how well they aligned with global health policies on CVD prevention, control and management. Thematic content analysis of the key informant interviews was also conducted to supplement the document reviews. A total of 17 documents were reviewed and three key informants interviewed. Besides the Tobacco Control Act (2007), all policy documents for CVD prevention, control and management were developed after 2013. The national policies were preceded by global initiatives and guidelines and were similar in content with the global policies. The Kenya health policy (2014-2030), The Kenya Health Sector Strategic and Investment Plan (2014-2018) and the Kenya National Strategy for the Prevention and Control of Non-communicable diseases (2015-2020) had strategies on NCDs including CVDs. Other policy documents for behavioral risk factors (The Tobacco Control Act 2007, Alcoholic Drinks Control (Licensing) Regulations (2010)) were available. The National Nutrition Action Plan (2012-2017) was available as a draft. Although Kenya has a tiered health care system comprising primary healthcare, integration of CVD prevention and control at PHC level was not explicitly mentioned in the policy documents. This review revealed

Computational simulation of concurrent engineering for aerospace propulsion systems

Science.gov (United States)

Chamis, C. C.; Singhal, S. N.

1992-01-01

Results are summarized of an investigation to assess the infrastructure available and the technology readiness in order to develop computational simulation methods/software for concurrent engineering. These results demonstrate that development of computational simulations methods for concurrent engineering is timely. Extensive infrastructure, in terms of multi-discipline simulation, component-specific simulation, system simulators, fabrication process simulation, and simulation of uncertainties - fundamental in developing such methods, is available. An approach is recommended which can be used to develop computational simulation methods for concurrent engineering for propulsion systems and systems in general. Benefits and facets needing early attention in the development are outlined.

Computational simulation for concurrent engineering of aerospace propulsion systems

Science.gov (United States)

Chamis, C. C.; Singhal, S. N.

1993-01-01

Results are summarized for an investigation to assess the infrastructure available and the technology readiness in order to develop computational simulation methods/software for concurrent engineering. These results demonstrate that development of computational simulation methods for concurrent engineering is timely. Extensive infrastructure, in terms of multi-discipline simulation, component-specific simulation, system simulators, fabrication process simulation, and simulation of uncertainties--fundamental to develop such methods, is available. An approach is recommended which can be used to develop computational simulation methods for concurrent engineering of propulsion systems and systems in general. Benefits and issues needing early attention in the development are outlined.

The Role of Pest Control Advisers in Preventative Management of Grapevine Trunk Diseases.

Science.gov (United States)

Hillis, Vicken; Lubell, Mark; Kaplan, Jonathan; Doll, David; Baumgartner, Kendra

2016-04-01

Vineyards with trunk diseases (Botryosphaeria dieback, Esca, Eutypa dieback, and Phomopsis dieback) can have negative returns in the long run. Minimizing economic impacts depends on effective management, but adopting a preventative practice after infection occurs may not improve yields. Pest control advisers may reduce grower uncertainty about the efficacy of and need for prevention, which often entails future and unobservable benefits. Here, we surveyed advisers in California to examine their influence over grower decision-making, in the context of trunk diseases, which significantly limit grape production and for which curative practices are unavailable. Our online survey revealed adviser awareness of high disease incidence, and reduced yields and vineyard lifespan. Advisers rated both preventative and postinfection practices positively. Despite higher cost estimates given to postinfection practices, advisers did not recommend preventative practices at higher rates. High recommendation rates were instead correlated with high disease incidence for both preventative and postinfection practices. Recommendation rates declined with increasing cost for preventative, but not for postinfection, practices. Our findings suggest that even when advisers acknowledge the risks of trunk diseases, they may not recommend preventative practices before infection occurs. This underscores the importance of clear outreach, emphasizing both the need for prevention and its long-term cost efficacy.

The construction of an idealised urban masculinity among men with concurrent sexual partners in a South African township

Directory of Open Access Journals (Sweden)

Anna Mia Ekström

2010-07-01

Full Text Available Background : The perspectives of heterosexual males who have large sexual networks comprising concurrent sexual partners and who engage in high-risk sexual behaviours are scarcely documented. Yet these perspectives are crucial to understanding the high HIV prevalence in South Africa where domestic violence, sexual assault and rape are alarmingly high, suggesting problematic gender dynamics. Objective : To explore the construction of masculinities and men's perceptions of women and their sexual relationships, among men with large sexual networks and concurrent partners. Design : This qualitative study was conducted in conjunction with a larger quantitative survey among men at high risk of HIV, using respondent-driven sampling to recruit participants, where long referral chains allowed us to reach far into social networks. Twenty in-depth, open-ended interviews with South African men who had multiple and concurrent sexual partners were conducted. A latent content analysis was used to explore the characteristics and dynamics of social and sexual relationships. Results : We found dominant masculine ideals characterised by overt economic power and multiple sexual partners. Reasons for large concurrent sexual networks were the perception that women were too empowered, could not be trusted, and lack of control over women. Existing masculine norms encourage concurrent sexual networks, ignoring the high risk of HIV transmission. Biological explanations and determinism further reinforced strong and negative perceptions of women and female sexuality, which helped polarise men's interpretation of gender constructions. Conclusions : Our results highlight the need to address sexuality and gender dynamics among men in growing, informal urban areas where HIV prevalence is strikingly high. Traditional structures that could work as focal entry points should be explored for effective HIV prevention aimed at normative change among hard-to-reach men in high

Preventive home care of frail older people: a review of recent case management studies.

Science.gov (United States)

Hallberg, Ingalill Rahm; Kristensson, Jimmie

2004-09-01

Preventive actions targeting community-dwelling frail older people will be increasingly important with the growing number of very old and thereby also frail older people. This study aimed to explore and summarize the empirical literature on recent studies of case/care management interventions for community-dwelling frail older people and especially with regard to the content of the interventions and the nurse's role and outcome of it. Very few of the interventions took either a preventive or a rehabilitative approach using psycho-educative interventions focusing, for instance, on self-care activities, risk prevention, health complaints management or how to preserve or strengthen social activities, community involvement and functional ability. Moreover, it was striking that very few included a family-oriented approach also including support and education for informal caregivers. Thus it seems that the content of case/care management needs to be expanded and more influenced by a salutogenic health care perspective. Targeting frail older people seemed to benefit from a standardized two-stage strategy for inclusion and for planning the interventions. A comprehensive geriatric assessment seemed useful as a base. Nurses, preferably trained in gerontological practice, have a key role in case/care management for frail older people. This approach calls for developing the content of case/care management so that it involves a more salutogenic, rehabilitative and family-oriented approach. To this end it may be useful for nurses to strengthen their psychosocial skills or develop close collaboration with social workers. The outcome measures examined in this study represented one of three perspectives: the consumer's perspective, the perspective of health care consumption or the recipient's health and functional ability. Perhaps effects would be expected in all three areas and thus these should be included in evaluative studies in addition to measures for family and/or informal

Pediatric heat-related illness: recommendations for prevention and management [digest].

Science.gov (United States)

Dunn, Roberta J; Kim, Tommy Y; Chaudhari, Pradip

2017-08-22

Infants, children, and adolescents are at increased risk for heat-related illness due to their inability to remove themselves from dangerous environments. Evidence shows that morbidity and mortality from heat illness is related to the length of time core temperature is elevated, so rapid reduction and accurate serial measurements are crucial to prevention of organ system damage and death. The primary methods of patient cooling are conduction (ice-water immersion, cold packs) and convection (moisture and moving air). The choice of method used may depend on availability of equipment, but there is evidence that can guide optimal use of resources. This issue presents evidence-based recommendations and best practices in heat-illness resuscitation, including managing children who are obese, have special needs or take medications, and advocacy for prevention strategies. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

Concurrent Mesh Repair of a Morgagni and Umbilical Hernia during a Laparoscopic Sleeve Gastrectomy in a Morbidly Obese Individual

Directory of Open Access Journals (Sweden)

N.R Kosai

2016-10-01

Full Text Available Morgagni Hernia is a rare form of diaphragmatic hernia. It is mainly asymptomatic and often identified incidentally during surgery. Tension-free synthetic mesh repair is the preferred treatment modality. However, the use of synthetic mesh concurrently during a clean-contaminated surgery such as sleeve gastrectomy remains controversial due to the remote possibility of mesh infection. A middle-aged female 2 with BMI of 47 Kg/m was admitted electively for laparoscopic sleeve gastrectomy with concurrent umbilical hernia repair. Intra-operatively, a left Morgagni Hernia containing omentum and a segment of transverse colon was noted. She underwent a laparoscopic sleeve gastrectomy and simultaneous laparoscopic tension-free composite mesh repair of both Morgagni and umbilical hernia. Outpatient review three months later revealed excess weight loss of almost 30% with no recurrence of either hernia. In conclusion, the advantages of concurrent hernia repair during bariatric surgery outweigh the risk of mesh infection and should be performed to prevent future risk of visceral herniation and strangulation. Laparoscopic mesh repair of a Morgagni Hernia and umbilical hernia in the setting of an electively planned sleeve gastrectomy is feasible, effective and safe in the hands of a trained laparoscopic surgeon.

Barista: A Framework for Concurrent Speech Processing by USC-SAIL.

Science.gov (United States)

Can, Doğan; Gibson, James; Vaz, Colin; Georgiou, Panayiotis G; Narayanan, Shrikanth S

2014-05-01

We present Barista, an open-source framework for concurrent speech processing based on the Kaldi speech recognition toolkit and the libcppa actor library. With Barista, we aim to provide an easy-to-use, extensible framework for constructing highly customizable concurrent (and/or distributed) networks for a variety of speech processing tasks. Each Barista network specifies a flow of data between simple actors, concurrent entities communicating by message passing, modeled after Kaldi tools. Leveraging the fast and reliable concurrency and distribution mechanisms provided by libcppa, Barista lets demanding speech processing tasks, such as real-time speech recognizers and complex training workflows, to be scheduled and executed on parallel (and/or distributed) hardware. Barista is released under the Apache License v2.0.

Dynamic Frames Based Verification Method for Concurrent Java Programs

NARCIS (Netherlands)

Mostowski, Wojciech

2016-01-01

In this paper we discuss a verification method for concurrent Java programs based on the concept of dynamic frames. We build on our earlier work that proposes a new, symbolic permission system for concurrent reasoning and we provide the following new contributions. First, we describe our approach

Concurrent eruptions at Etna, Stromboli, and Vulcano: casualty or causality?

Directory of Open Access Journals (Sweden)

R. Funiciello

2008-06-01

Full Text Available Anecdotes of concurrent eruptions at Etna, Stromboli, and Vulcano (Southern Italy have persisted for more than 2000 years and volcanologists in recent and past times have hypothesized a causal link among these volcanoes. Here this hypothesis is tested. To introduce the problem and provide examples of the type of expected volcanic phenomena, narratives of the most notable examples of concurrent eruptions are provided. Then the frequency of eruptions at each individual volcano is analysed for about the last 300 years and the expected probability of concurrent eruptions is calculated to compare it to the observed probability. Results show that the occurrence of concurrent eruptions is often more frequent than a random probability, particularly for the Stromboli-Vulcano pair. These results are integrated with a statistical analysis of the earthquake catalogue to find evidence of linked seismicity in the Etnean and Aeolian areas. Results suggest a moderate incidence of non-random concurrent eruptions, but available data are temporally limited and do not allow an unequivocal identification of plausible triggers; our results, however, are the first attempt to quantify a more-than-2000-years-old curious observation and constitute a starting point for more sophisticated analyses of new data in the future. We look forward to our prediction of a moderate incidence of concurrent eruptions being confirmed or refuted with the passage of time and occurrence of new events.

Aspiration pneumonia. Pathophysiological aspects, prevention and management. A review.

Science.gov (United States)

Petroianni, A; Ceccarelli, D; Conti, V; Terzano, C

2006-12-01

Aspiration pneumonias occur more frequently than reported and, in many cases, the disease is not recognised. In hospitalised and institutionalised patients with predisposing diseases prompt diagnosis of this complication and correct preventive measures can drastically reduce the worsening of clinical conditions and the deaths due to aspiration pneumonia. Normal airway structure, effective defence mechanisms, and preventive measures are decisive in reducing aspiration episodes. An increased aspiration risk for food, fluids, medications, or secretions may lead to the development of pneumonia. Pneumonia is the most common respiratory complication in all stroke deaths and in mechanical ventilation patients. In addition, the increased incidence of aspiration pneumonia with aging may be a consequence of impairment of swallowing and the cough reflex. Dysphagia, compromised consciousness, invasive procedures, anaesthesia, insufficient oral care, sleep disorders, and vomiting are all risk factors. Aspiration pneumonia includes different characteristic syndromes based on the amount (massive, acute, chronic) and physical character of the aspirated material (acid, infected, lipoid), needing a different therapeutic approach. Chronic patients education and correct health care practices are the keys for preventing the events of aspiration. In patients at risk a clinical and instrumental assessment of dysphagia should be evaluated. Management includes the removal of etiologic factors (drugs, tubes, mobilisation, oral hygiene), supportive care, and in bacterial pneumonias a specific antibiotic therapy for community-acquired or nosocomial events.

Continuous Activity Monitoring During Concurrent Chemoradiotherapy

Energy Technology Data Exchange (ETDEWEB)

Ohri, Nitin, E-mail: ohri.nitin@gmail.com [Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York (United States); Kabarriti, Rafi; Bodner, William R.; Mehta, Keyur J. [Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York (United States); Shankar, Viswanathan [Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (United States); Halmos, Balazs; Haigentz, Missak [Department of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York (United States); Rapkin, Bruce [Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York (United States); Guha, Chandan; Kalnicki, Shalom; Garg, Madhur [Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York (United States)

2017-04-01

Purpose: To perform a prospective trial testing the feasibility and utility of acquiring activity data as a measure of health status during concurrent chemoradiotherapy. Methods and Materials: Ambulatory patients who were planned for treatment with concurrent chemoradiotherapy with curative intent for cancers of the head and neck, lung, or gastrointestinal tract were provided with activity monitors before treatment initiation. Patients were asked to wear the devices continuously throughout the radiation therapy course. Step count data were downloaded weekly during radiation therapy and 2 and 4 weeks after radiation therapy completion. The primary objective was to demonstrate feasibility, defined as collection of step counts for 80% of the days during study subjects' radiation therapy courses. Secondary objectives included establishing step count as a dynamic predictor of unplanned hospitalization risk. Results: Thirty-eight enrolled patients were treated with concurrent chemoradiotherapy. Primary diagnoses included head and neck cancer (n=11), lung cancer (n=13), and a variety of gastrointestinal cancers (n=14). Step data were collected for 1524 of 1613 days (94%) during patients' radiation therapy courses. Fourteen patients were hospitalized during radiation therapy or within 4 weeks of radiation therapy completion. Cox regression modeling demonstrated a significant association between recent step counts (3-day average) and hospitalization risk, with a 38% reduction in the risk of hospitalization for every 1000 steps taken each day (hazard ratio 0.62, 95% confidence interval 0.46-0.83, P=.002). Inferior quality of life scores and impaired performance status were not associated with increased hospitalization risk. Conclusion: Continuous activity monitoring during concurrent chemoradiotherapy is feasible and well-tolerated. Step counts may serve as powerful, objective, and dynamic indicators of hospitalization risk.

True Concurrency can be Traced

DEFF Research Database (Denmark)

Engberg, Uffe Henrik

1990-01-01

In this paper sets of labelled partial orders are employed as fundamental mathematical entities for modelling nondeterministic and concurrent processes thereby obtaining so-called noninterleaving semantics. Based on closures of sets of labelled partial orders, a simple algebraic language with ref...

Relationships between models of concurrency

DEFF Research Database (Denmark)

Nielsen, Mogens; Sassone, Vladimiro; Winskel, Glynn

1994-01-01

Models for concurrency can be classified with respect to the three relevant parameters: behaviour/system, interleaving/noninterleaving, linear/branching time. When modelling a process, a choice concerning such parameters corresponds to choosing the level of abstraction of the resulting semantics....

Timing is everything: international variations in historical sexual partnership concurrency and HIV prevalence.

Directory of Open Access Journals (Sweden)

Martina Morris

Full Text Available BACKGROUND: Higher prevalence of concurrent partnerships is one hypothesis for the severity of the HIV epidemic in the countries of Southern Africa. But measures of the prevalence of concurrency alone do not adequately capture the impact concurrency will have on transmission dynamics. The importance of overlap duration and coital exposure are examined here. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a comparison of data from three studies of sexual behavior carried out in the early 1990s in Uganda, Thailand and the US. Using cumulative concurrency measures, the three countries appeared somewhat similar. Over 50% of both Thai and Ugandan men reported a concurrency within the last three partnerships and over 20% reported a concurrency in the last year, the corresponding rates among US men were nearly 20% for Blacks and Hispanics, and about 10% for other racial/ethnic groups. Concurrency measures that were more sensitive to overlap duration, however, showed large differences. The point prevalence of concurrency on the day of interview was over 10% among Ugandan men compared to 1% for Thai men. Ugandan concurrencies were much longer duration - a median of about two years - than either the Thai (1 day or US concurrencies (4-9 months across all groups, and involved 5-10 times more coital risk exposure with the less frequent partner. In the US, Blacks and Hispanics reported higher prevalence, longer duration and greater coital exposure than Whites, but were lower than Ugandans on nearly every measure. Together, the differences in the prevalence, duration and coital exposure of concurrent partnerships observed align with the HIV prevalence differentials seen in these populations at the time the data were collected. CONCLUSIONS/SIGNIFICANCE: There were substantial variations in the patterns of concurrent partnerships within and between populations. More long-term overlapping partnerships, with regular coital exposure, were found in populations with

Evidence based guidelines for the prevention, identification, and management of occupational asthma.

Science.gov (United States)

Nicholson, P J; Cullinan, P; Taylor, A J Newman; Burge, P S; Boyle, C

2005-05-01

Occupational asthma is the most frequently reported work related respiratory disease in many countries. This work was commissioned by the British Occupational Health Research Foundation to assist the Health and Safety Executive in achieving its target of reducing the incidence of occupational asthma in Great Britain by 30% by 2010. The guidelines aim to improve the prevention, identification, and management of occupational asthma by providing evidence based recommendations on which future practice can be based. The literature was searched systematically using Medline and Embase for articles published in all languages up to the end of June 2004. Evidence based statements and recommendations were graded according to the Royal College of General Practitioner's star system and the revised Scottish Intercollegiate Guidelines Network grading system. A total of 474 original studies were selected for appraisal from over 2500 abstracts. The systematic review produced 52 graded evidence statements and 22 recommendations based on 223 studies. Evidence based guidelines have become benchmarks for practice in healthcare and the process used to prepare them is well established. This evidence review and its recommendations focus on interventions and outcomes to provide a robust approach to the prevention, identification, and management of occupational asthma, based on and using the best available medical evidence. The most important action to prevent cases of occupational asthma is to reduce exposure at source. Thereafter surveillance should be performed for the early identification of symptoms, including occupational rhinitis, with additional functional and immunological tests where appropriate. Effective management of workers suspected to have occupational asthma involves the identification and investigation of symptoms suggestive of asthma immediately they occur. Those workers who are confirmed to have occupational asthma should be advised to avoid further exposure completely

Concurrent object-oriented programming: The MP-Eiffel approach

OpenAIRE

Silva, Miguel Augusto Mendes Oliveira e

2004-01-01

This article evaluates several possible approaches for integrating concurrency into object-oriented programming languages, presenting afterwards, a new language named MP-Eiffel. MP-Eiffel was designed attempting to include all the essential properties of both concurrent and object-oriented programming with simplicity and safety. A special care was taken to achieve the orthogonality of all the language mechanisms, allowing their joint use without unsafe side-effects (such as inh...

Central nervous system leukemia in a patient with concurrent nasopharyngeal carcinoma and acute myeloid leukaemia: A case report.

Science.gov (United States)

Liu, Jun-Qing; Mai, Wen-Yuan; Wang, Si-Ben; Lou, Yin-Jun; Yan, Sen-Xiang; Jin, Jie; Xu, Wei-Lai

2017-12-01

Concurrent case of nasopharyngeal carcinoma (NPC) and acute myeloid leukemia (AML) has not been reported. Here, we report a case of NPC, who was concurrently suffered from AML one mother after the NPC diagnosis. The patient was a 45-year-old male who presented with a mass on his right side neck. The patient was diagnosed with Epstein-Barr virus negative type-2 non-keratinizing carcinoma with clivus involvement and unilateral metastasis to the cervical lymph node. He was treated with one cycle of cisplatin and 69.76 Gy of concurrent external-beam radiation. Three months after completion of chemo-radiotherapy, the patient was diagnosed as acute myeloid leukemia, which achieved complete remission after one course induction chemotherapy. Two months later, however, the patient was diagnosed as central nervous system leukemia. He ultimately died of relapsed leukemia. The overall survival of the patient was 10 months. The co-occurrence of NPC and AML is rare and prognosis is poor. Radiotherapy in NPC can disrupt the blood-brain barrier, which may contribute to the pathogenesis of central nervous system leukemia. Early alert and prevention of central nervous system leukemia following radiotherapy in NPC patient is recommended. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Mission Analysis for Using Preventive Radiological/Nuclear Detection Equipment for Consequence Management

Energy Technology Data Exchange (ETDEWEB)

Buddemeier, Brooke R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Wood-Zika, Annmarie R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Haynes, Daniel [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Klemic, Gladys A. [US Dept. of Homeland Security National Urban Security Technology Lab., Manhattan, NY (United States); Musolino, Stephen V. [Brookhaven National Lab. (BNL), Upton, NY (United States)

2017-09-01

The overall objective of this project is to research, evaluate, and test first responder preventive radiological/nuclear detection (PRND) equipment to provide state and local agencies with scientific guidance on how to effectively use this equipment for response after a radiological/nuclear release or detonation. While the equipment being tested in this effort has been specifically designed by technology manufacturers and purchased by responders for preventive detection and source interdiction operations, the fleet of PRND equipment can help fill critical needs for radiological instrumentation should a consequence management (CM) response take place, as it is currently the most widely available and fielded radiological instrumentation by state and local agencies. This effort will provide scientific guidance on the most effective way to utilize this class of equipment for consequence management missions. Gaining a better understanding of how PRND equipment can operate and perform for these missions will allow for recommendations on the tactical approach responders can use for consequence management operations. PRND equipment has been placed into service by federal, state, and local agencies throughout the nation. If the equipment capability and limitations are taken into account, this large inventory can be leveraged to support the emergency response in the aftermath of a radiological or nuclear event. With several hundred makes and models of PRND equipment, often with significantly different detection capabilities that do not align with their nominal PRND equipment type, development of a streamlined categorization scheme with respect to consequence management missions was the first step to identifying safe and effective uses of PRND equipment for radiological/nuclear incident response.

Salivary gland function after concurrent chemoradiotherapy

International Nuclear Information System (INIS)

Ikeda, Kenichiro; Shimane, Toshikazu; Uzuki, Aya; Sugimoto, Akane; Mori, Tomoaki; Akiyama, Rio; Gomibuchi, Hiroshi; Kobayashi, Sei; Sanbe, Takeyuki

2011-01-01

Concurrent chemoradiotherapy for cancer of head and neck is becoming more and more prevalent. In fact, it is considered to better maintain quality of life (QOL) of patients than operative treatment in terms of preserving the functions, organs, and structures, but recently I seems that it does not maintain the QOL of patients better than operative treatment because its complications after therapy disturb daily life. We previously conducted a questionnaire survey that investigated the complications experienced by patients who received concurrent chemoradiotherapy, and reported that xerostomia was markedly reduced QOL in these patients. In this study, we divided patients who were exposed to radiation in both major salivary glands into two groups: 20 patients who received a 36 Gy dose of radiation (36 Gy group) and 15 patients who underwent radiation therapy alone at a dose of 40 Gy (radiotherapy (RT) group). The gum test was conducted with the following results (mean volume of saliva): 11.2 ml in the 36 Gy group, 6.0 ml in the RT group. There was no significant difference between the 36 Gy group and RT group. Our findings suggest that there is no significant difference in the extent of salivary gland dysfunction even after chemotherapy is carried out concurrently with radiotherapy. (author)

Forward progress on GPU concurrency

NARCIS (Netherlands)

Donaldson, A.F.; Ketema, J.; Sorensen, T.; Wickerson, J.

2017-01-01

The tutorial at CONCUR will provide a practical overview of work undertaken over the last six years in the Multicore Programming Group at Imperial College London, and with collaborators internationally, related to understanding and reasoning about concurrency in software designed for acceleration on

A Model for Concurrent Objects

DEFF Research Database (Denmark)

Sørensen, Morten U.

1996-01-01

We present a model for concurrent objects where obejcts interact by taking part in common events that are closely matched to form call-response pairs, resulting in resulting in rendez-vous like communications. Objects are built from primitive objects by parallel composition, encapsulation...

Concurrent Speech Segregation Problems in Hearing Impaired Children

Directory of Open Access Journals (Sweden)

Hossein Talebi

2014-04-01

Full Text Available Objective: This study was a basic investigation of the ability of concurrent speech segregation in hearing impaired children. Concurrent segregation is one of the fundamental components of auditory scene analysis and plays an important role in speech perception. In the present study, we compared auditory late responses or ALRs between hearing impaired and normal children. Materials & Methods: Auditory late potentials in response to 12 double vowels were recorded in 10 children with moderate to severe sensory neural hearing loss and 10 normal children. Double vowels (pairs of synthetic vowels were presented concurrently and binaurally. Fundamental frequency (F0 of these vowels and the size of the difference in F0 between vowels was 100 Hz and 0.5 semitones respectively. Results: Comparing N1-P2 amplitude showed statistically significant difference in some stimuli between hearing impaired and normal children (P<0.05. This complex indexing the vowel change detection and reflecting central auditory speech representation without active client participation was decreased in hearing impaired children. Conclusion: This study showed problems in concurrent speech segregation in hearing impaired children evidenced by ALRs. This information indicated deficiencies in bottom-up processing of speech characteristics based on F0 and its differences in these children.

Concurrent Product & Supply Chain Creation

DEFF Research Database (Denmark)

Gubi, Ebbe

it is a structural premise. We also know that logistics costs generally are estimated 15-20% of total product costs. Accordingly, it stands to reason that a company can reduce costs, and thereby gain an edge on its competitors, by tailoring the supply chain in question to an individual product or product family; i.......e. by creating Focused Supply Chains. At the same time, customer satisfaction can be increased. As a second means to achieving a better fit between product and supply chain, the firm can deploy Design for Logistics, the discipline of considering the supply chain during product creation. The thesis sets out...... and supply chains should be created concurrently and integrated. The concept of Concurrent Product & Supply Chain Creation is introduced, and the two main components Focused Supply Chains and Design For Logistics are explained and exemplified by use of Bang & Olufsen....

Poverty and sexual concurrency: a case study of STI risk.

Science.gov (United States)

Tsui, Emma K; Leonard, Lori; Lenoir, Chavonne; Ellen, Jonathan M

2008-08-01

This paper is about sexual concurrency, or maintaining multiple sexual partnerships that overlap in time. Sexual concurrency is a concept that is used in the field of public health to explain the spread of sexually transmitted diseases. Sexual concurrency has also been proposed as a site of intervention to reduce sexually transmitted infection (STI) rates, particularly among those populations who carry the heaviest STI burden: adolescents and African Americans. In this paper, we use ethnographic data collected from a group of African American adolescents living in Baltimore to examine the socially produced configurations of risks and relationships that are obscured by the term sexual concurrency. The data we present show the limits of this concept, and suggest that structural reforms, including improvements to education, drug treatment, and work opportunities, are necessary to reduce racial disparities in STI rates.

Diabetes Prevention and Management among Minority Ethnic Groups in Nicaragua: Findings from Phase 2 of a Community-Based Participatory Research Study

Science.gov (United States)

Newlin Lew, Kelley; Mitchell, Emma McKim; Mclean, Yolanda

2016-01-01

Objectives: To (1) describe barriers to diabetes prevention and self-management, (2) explore how religious beliefs inform diabetes prevention and self-management and (3) describe community action strategies to address the problem of diabetes locally. Design: Qualitative, descriptive design. Setting: Three Moravian Churches located, respectively,…

[Early detection, prevention and management of renal failure in liver transplantation].

Science.gov (United States)

Castells, Lluís; Baliellas, Carme; Bilbao, Itxarone; Cantarell, Carme; Cruzado, Josep Maria; Esforzado, Núria; García-Valdecasas, Juan Carlos; Lladó, Laura; Rimola, Antoni; Serón, Daniel; Oppenheimer, Federico

2014-10-01

Renal failure is a frequent complication in liver transplant recipients and is associated with increased morbidity and mortality. A variety of risk factors for the development of renal failure in the pre- and post-transplantation periods have been described, as well as at the time of surgery. To reduce the negative impact of renal failure in this population, an active approach is required for the identification of those patients with risk factors, the implementation of preventive strategies, and the early detection of progressive deterioration of renal function. Based on published evidence and on clinical experience, this document presents a series of recommendations on monitoring RF in LT recipients, as well as on the prevention and management of acute and chronic renal failure after LT and referral of these patients to the nephrologist. In addition, this document also provides an update of the various immunosuppressive regimens tested in this population for the prevention and control of post-transplantation deterioration of renal function. Copyright © 2013 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

Contemporary considerations in concurrent endoscopic sinus surgery and rhinoplasty.

Science.gov (United States)

Steele, Toby O; Gill, Amarbir; Tollefson, Travis T

2018-06-11

Characterize indications, perioperative considerations, clinical outcomes and complications for concurrent endoscopic sinus surgery (ESS) and rhinoplasty. Chronic rhinosinusitis and septal deviation with or without inferior turbinate hypertrophy independently impair patient-reported quality of life. Guidelines implore surgeons to include endoscopy to accurately evaluate patient symptoms. Complication rates parallel those of either surgery (ESS and rhinoplasty) alone and are not increased when performed concurrently. Operative time is generally longer for joint surgeries. Patient satisfaction rates are high. Concurrent functional and/or cosmetic rhinoplasty and ESS is a safe endeavor to perform in a single operative setting and most outcomes data suggest excellent patient outcomes. Additional studies that include patient-reported outcome measures are needed.

Human Factors in Fire Safety Management and Prevention

Directory of Open Access Journals (Sweden)

M.A. Othuman Mydin

2014-07-01

Full Text Available Fire protection is the study and practice of mitigating the unwanted effects of potentially destructive fires. It involves the study of the behavior, compartmentalization, and investigation of fire and its related emergencies, as well as the research and development, production, testing and application of mitigating systems. Problems still occurred despite of the adequate fire safety systems installed. For most people in high-risk buildings, not all accidents were caused by them. They were more likely to be the victims of a fire that occurred. Besides damaging their properties and belongings, some people were burned to death for not knowing what to do if fire happens in their place. This paper will present the human factors in fire safety management and prevention system.

Preliminary Proceedings 15th International Workshop on Expressiveness in Concurrency

DEFF Research Database (Denmark)

The EXPRESS workshops aim at bringing together researchers interested in the relations between various formal systems, particularly in the field of Concurrency. More specifically, they focus on the comparison between programming concepts (such as concurrent, functional, imperative, logic and obje...

Regorafenib-associated hand–foot skin reaction: practical advice on diagnosis, prevention, and management

Science.gov (United States)

McLellan, B.; Ciardiello, F.; Lacouture, M. E.; Segaert, S.; Van Cutsem, E.

2015-01-01

Background Regorafenib is an orally available, small-molecule multikinase inhibitor with international marketing authorizations for use in colorectal cancer and gastrointestinal stromal tumors. In clinical trials, regorafenib showed a consistent and predictable adverse-event profile, with hand–foot skin reaction (HFSR) among the most clinically significant toxicities. This review summarizes the clinical characteristics of regorafenib-related HFSR and provides practical advice on HFSR management to enable health care professionals to recognize, pre-empt, and effectively manage the symptoms, thereby allowing patients to remain on active therapy for as long as possible. Design This review is based on a systematic literature search of the PubMed database (using synonyms of HFSR, regorafenib, and skin toxicities associated with targeted therapies or cytotoxic chemotherapy). However, as this search identified very few articles, the authors also use their clinical experience as oncologists and dermatologists managing patients with treatment-related HFSR to provide recommendations on recognition and management of HFSR in regorafenib-treated patients. Results Regorafenib-related HFSR is similar to that seen with other multikinase inhibitors (e.g. sorafenib, sunitinib, cabozantinib, axitinib, and pazopanib) but differs from the hand–foot syndrome seen with cytotoxic chemotherapies (e.g. fluoropyrimidines, anthracyclines, and taxanes). There have been no controlled trials of symptomatic management of regorafenib-related HFSR, and limited good-quality evidence from randomized clinical trials of effective interventions for HFSR associated with other targeted therapies. Recommendations on prevention and management of regorafenib-related HFSR in this review are therefore based on the expert opinion of the authors (dermatologists and oncologists with expertise in the management of treatment-related skin toxicities and oncologists involved in clinical trials of regorafenib) and

Regorafenib-associated hand-foot skin reaction: practical advice on diagnosis, prevention, and management.

Science.gov (United States)

McLellan, B; Ciardiello, F; Lacouture, M E; Segaert, S; Van Cutsem, E

2015-10-01

Regorafenib is an orally available, small-molecule multikinase inhibitor with international marketing authorizations for use in colorectal cancer and gastrointestinal stromal tumors. In clinical trials, regorafenib showed a consistent and predictable adverse-event profile, with hand-foot skin reaction (HFSR) among the most clinically significant toxicities. This review summarizes the clinical characteristics of regorafenib-related HFSR and provides practical advice on HFSR management to enable health care professionals to recognize, pre-empt, and effectively manage the symptoms, thereby allowing patients to remain on active therapy for as long as possible. This review is based on a systematic literature search of the PubMed database (using synonyms of HFSR, regorafenib, and skin toxicities associated with targeted therapies or cytotoxic chemotherapy). However, as this search identified very few articles, the authors also use their clinical experience as oncologists and dermatologists managing patients with treatment-related HFSR to provide recommendations on recognition and management of HFSR in regorafenib-treated patients. Regorafenib-related HFSR is similar to that seen with other multikinase inhibitors (e.g. sorafenib, sunitinib, cabozantinib, axitinib, and pazopanib) but differs from the hand-foot syndrome seen with cytotoxic chemotherapies (e.g. fluoropyrimidines, anthracyclines, and taxanes). There have been no controlled trials of symptomatic management of regorafenib-related HFSR, and limited good-quality evidence from randomized clinical trials of effective interventions for HFSR associated with other targeted therapies. Recommendations on prevention and management of regorafenib-related HFSR in this review are therefore based on the expert opinion of the authors (dermatologists and oncologists with expertise in the management of treatment-related skin toxicities and oncologists involved in clinical trials of regorafenib) and tried-and-tested empirical

Indicated Prevention of Fetal Alcohol Spectrum Disorders in South Africa: Effectiveness of Case Management

Directory of Open Access Journals (Sweden)

Marlene M. de Vries

2015-12-01

Full Text Available In the Western Cape Province of South Africa (ZA a subculture of binge drinking produces the highest global documented prevalence of fetal alcohol spectrum disorders (FASD. FASD prevention research activities in ZA use the Comprehensive Prevention approach from the United States Institute of Medicine. Case management (CM was delivered as a method of indicated prevention to empower heavy drinking pregnant women to achieve cessation or a reduction in drinking. CM activities incorporated life management, Motivational Interviewing (MI techniques and the Community Reinforcement Approach (CRA. Data were collected at baseline, 6, 12 and 18 months. Mean drinking decreases 6 months into CM; but overall alcohol consumption rose significantly over time to levels higher than baseline at 12 and 18 months. Alcohol consumption drops significantly from before pregnancy to the second and third trimesters. AUDIT scores indicate that problematic drinking decreases significantly even after the vulnerable fetus/baby was born. CM significantly increases client happiness, which correlates with reduced weekend drinking. CM was successful for women with high-risk drinking behaviour, and was effective in helping women stop drinking, or drink less, while pregnant, reducing the risk of FASD.

Indicated Prevention of Fetal Alcohol Spectrum Disorders in South Africa: Effectiveness of Case Management

Science.gov (United States)

de Vries, Marlene M.; Joubert, Belinda; Cloete, Marise; Roux, Sumien; Baca, Beth A.; Hasken, Julie M.; Barnard, Ronel; Buckley, David; Kalberg, Wendy O.; Snell, Cudore L.; Marais, Anna-Susan; Seedat, Soraya; Parry, Charles D. H.; May, Philip A.

2015-01-01

In the Western Cape Province of South Africa (ZA) a subculture of binge drinking produces the highest global documented prevalence of fetal alcohol spectrum disorders (FASD). FASD prevention research activities in ZA use the Comprehensive Prevention approach from the United States Institute of Medicine. Case management (CM) was delivered as a method of indicated prevention to empower heavy drinking pregnant women to achieve cessation or a reduction in drinking. CM activities incorporated life management, Motivational Interviewing (MI) techniques and the Community Reinforcement Approach (CRA). Data were collected at baseline, 6, 12 and 18 months. Mean drinking decreases 6 months into CM; but overall alcohol consumption rose significantly over time to levels higher than baseline at 12 and 18 months. Alcohol consumption drops significantly from before pregnancy to the second and third trimesters. AUDIT scores indicate that problematic drinking decreases significantly even after the vulnerable fetus/baby was born. CM significantly increases client happiness, which correlates with reduced weekend drinking. CM was successful for women with high-risk drinking behaviour, and was effective in helping women stop drinking, or drink less, while pregnant, reducing the risk of FASD. PMID:26703708

Risk factors for concurrent bacteremia in adult patients with dengue.

Science.gov (United States)

Thein, Tun-Linn; Ng, Ee-Ling; Yeang, Ming S; Leo, Yee-Sin; Lye, David C

2017-06-01

Bacteremia in dengue may occur with common exposure to pathogens in association with severe organ impairment or severe dengue, which may result in death. Cohort studies identifying risk factors for concurrent bacteremia among patients with dengue are rare. We conducted a retrospective case-control study of adult patients with dengue who were admitted to the Department of Infectious Diseases at Tan Tock Seng Hospital, Singapore from 2004 to 2008. For each case of dengue with concurrent bacteremia (within the first 72 hours of admission), we selected four controls without bacteremia, who were matched on year of infection and dengue confirmation method. Conditional logistic regression was performed to identify risk factors for concurrent bacteremia. Among 9,553 patients with dengue, 29 (0.3%) had bacteremia. Eighteen of these patients (62.1%) had concurrent bacteremia. The predominant bacteria were Staphylococcus aureus, one of which was a methicillin-resistant strain. Dengue shock syndrome occurred more frequently and hospital stay was longer among cases than among controls. Three cases did not survive, whereas none of the controls died. In multivariate analysis, being critically ill at hospital presentation was independently associated with 15 times the likelihood of a patient with dengue having concurrent bacteremia. Concurrent bacteremia in adult patients with dengue is uncommon but presents atypically and results in more deaths and longer hospital stay. Given the associated mortality, collection of blood cultures and empiric antibiotic therapy may be considered in patients who are critically ill. Copyright © 2015. Published by Elsevier B.V.

7 CFR 1610.6 - Concurrent Bank and RUS cost-of-money loans.

Science.gov (United States)

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Concurrent Bank and RUS cost-of-money loans. 1610.6..., DEPARTMENT OF AGRICULTURE LOAN POLICIES § 1610.6 Concurrent Bank and RUS cost-of-money loans. (a) The Bank makes loans, under section 408 of the Act, concurrently with RUS cost-of-money loans made under section...

An initial experience using concurrent paclitaxel and radiation in the treatment of head and neck malignancies

International Nuclear Information System (INIS)

Tishler, Roy B.; Busse, Paul M.; Norris, Charles M.; Rossi, Rene; Poulin, Mark; Thornhill, Lee; Costello, Rosemary; Peters, Edward S.; Colevas, A. Dimitrios; Posner, Marshall R.

1999-01-01

Background: Combined modality therapy plays a central role in the management of head and neck malignancies. This study examined the feasibility and preliminary results of treating a group of patients using concurrent bolus paclitaxel (Taxol TM ) and radiation therapy. Methods: Fourteen patients with a median age of 56 years (range 42-81) were treated. Paclitaxel was given every 3 weeks at a dose of 100 mg/m 2 concurrently with external beam radiation. The patients treated included those who had failed to achieve a complete response (CR) to induction chemotherapy with cisplatin, 5-fluorouracil, and leucovorin (PFL), or who had locally advanced disease not previously treated. Results: Median follow-up from the initiation of treatment is 40 months (range 23-48). The majority of patients (13/14) achieved clinical CRs at the primary site. The development of responses was characterized by a long time course. Three patients who were nonresponders (NRs) to induction PFL chemotherapy were treated. One was a clinical CR at the primary site, one did not achieve a CR, and the other had residual disease in the neck. Four patients have failed, one with local-regional disease, one with a marginal failure, one with distant metastases, and one was not rendered disease-free by the treatment. As expected, significant local toxicity was observed. Most patients were managed with the aid of a percutaneous endoscopic gastrostomy (PEG). Two patients experienced significant moist desquamation and required treatment breaks of greater than 1 week. Conclusion: Paclitaxel can be given on a 3-week schedule at 100 mg/m 2 concurrently with radiation. The preliminary results indicate good local responses and acceptable toxicity. This treatment approach merits further study in the treatment of head and neck malignancies, and should be considered as an option in other sites

Paclitaxel and concurrent radiation for gastric cancer

International Nuclear Information System (INIS)

Safran, Howard; Wanebo, Harry J.; Hesketh, Paul J.; Akerman, Paul; Ianitti, David; Cioffi, William; Di Petrillo, Thomas; Wolf, Brian; Koness, James; McAnaw, Robert; Moore, Todd; Chen, M.-H.; Radie-Keane, Kathy

2000-01-01

Purpose: To determine the activity and toxicity of paclitaxel and concurrent radiation for gastric cancer. Methods and Materials: Twenty-seven patients were studied. Twenty-five had proximal gastric cancers, two had distal cancers. Eight had esophageal extension, 6 had celiac adenopathy, and 7 had retroperitoneal adenopathy. Patients received paclitaxel, 50 mg/m 2 by 3-hour intravenous (IV) infusion, weekly, on days 1, 8, 15, 22, and 29. Radiation was administered concurrently to a total dose of 45.0 Gy, in 1.80 Gy fractions, for 25 treatments. Patients who were medically or surgically inoperable received a sixth week of paclitaxel with a radiation boost to 50.4 Gy. Results: Esophagitis and gastritis were the most important toxicities, Grade 3 in four patients (15%), and Grade 4 in three patients (11%). Five patients (19%) had Grade 3 nausea. The overall response rate was 56%, including three patients (11%) with a complete response. The 2-year progression-free and overall survival rates were 29% and 31%, respectively. Conclusion: Concurrent paclitaxel and radiation demonstrates substantial local-regional activity in gastric cancer. Future investigations combining paclitaxel and radiation with other local-regional and systemic treatments are warranted

A Concurrent Multiple Negotiation Protocol Based on Colored Petri Nets.

Science.gov (United States)

Niu, Lei; Ren, Fenghui; Zhang, Minjie; Bai, Quan

2017-11-01

Concurrent multiple negotiation (CMN) provides a mechanism for an agent to simultaneously conduct more than one negotiation. There may exist different interdependency relationships among these negotiations and these interdependency relationships can impact the outcomes of these negotiations. The outcomes of these concurrent negotiations contribute together for the agent to achieve an overall negotiation goal. Handling a CMN while considering interdependency relationships among multiple negotiations is a challenging research problem. This paper: 1) comprehensively highlights research problems of negotiations at concurrent negotiation level; 2) provides a graph-based CMN model with consideration of the interdependency relationships; and 3) proposes a colored Petri net-based negotiation protocol for conducting CMNs. With the proposed protocol, a CMN can be efficiently and concurrently processed and negotiation agreements can be efficiently achieved. Experimental results indicate the effectiveness and efficiency of the proposed protocol in terms of the negotiation success rate, the negotiation time and the negotiation outcome.

Mathematical techniques for analyzing concurrent and probabilistic systems

CERN Document Server

Rutten, J J M M; Panangaden, Prakash; Panangaden, Prakash; Breugel, Franck van

2004-01-01

The book consists of two sets of lecture notes devoted to slightly different methods of analysis of concurrent and probabilistic computational systems. The first set of lectures develops a calculus of streams (a generalization of the set of natural numbers) based on the coinduction principle coming from the theory of coalgebras. It is now well understood that the interplay between algebra (for describing structure) and coalgebra (for describing dynamics) is crucial for understanding concurrent systems. There is a striking analogy between streams and formula calculus reminiscent to those appearing in quantum calculus. These lecture notes will appeal to anyone working in concurrency theory but also to algebraists and logicians. The other set of lecture notes focuses on methods for automatically verifying probabilistic systems using techniques of model checking. The unique aspect of these lectures is the coverage of both theory and practice. The authors have been responsible for one of the most successful experi...

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

Medline Plus

Full Text Available ... Available! Check out the updated "Glucose Management in Type 2 Diabetes" Algorithm, a quick one-page downloadable and mobile ... Upcoming Live CME/CE Education June 21 st @ 2 pm EDT Breastfeeding and Depression Dr. Kathleen ... Mail Stops Office of Clinical and Preventive Services - 08N34 A&B Office of ...

Potential contaminants in the food chain: identification, prevention and issue management.

Science.gov (United States)

Scanlan, Francis P

2007-01-01

Contaminants are a vast subject area of food safety and quality. They are generally divided into chemical, microbiological and physical classes and are present in our food chain from raw materials to finished products. They are the subject of international and national legislation that has widened to cover more and more contaminant classes and food categories. In addition, consumers have become increasingly aware of and alarmed by their risks, whether rightly or not. What is the food industry doing to ensure the safety and quality of the products we feed our children? This is a valid question which this article attempts to address from an industrial viewpoint. Chemical food safety is considered a complex field where the risk perception of consumers is often the highest. The effects of chronic or acute exposure to chemical carcinogens may cause disease conditions long after exposure that can be permanently debilitating or even fatal. It is also a moving target, as knowledge about the toxicity and occurrence data of new chemical contaminants continues to be generated. Their identification, prevention and management are challenges to the food industry as a whole. A reminder of the known chemical hazards in the food chain will be presented with an emphasis on the use of early warning to identify potential new contaminants. Early warning is also a means of prevention, anticipating food safety concerns before they become issues to manage. Current best management practices including Hazard Analysis and Critical Control Points relating to the supply chain of baby foods and infant formulae will be developed. Finally, key lessons from a case study on recent contamination issues in baby food products will be presented.

Predicting and preventing the future: actively managing multiple sclerosis.

LENUS (Irish Health Repository)

Hutchinson, Michael

2012-02-01

Relapsing-remitting multiple sclerosis (MS) has a highly variable clinical course but a number of demographic, clinical and MRI features can guide the clinician in the assessment of disease activity and likely disability outcome. It is also clear that the inflammatory activity in the first five years of relapsing-remitting MS results in the neurodegenerative changes seen in secondary progressive MS 10-15 years later. While conventional first-line disease modifying therapy has an effect on relapses, about one third of patients have a suboptimal response to treatment. With the advent of highly active second-line therapies with their evident marked suppression of inflammation, the clinician now has the tools to manage the course of relapsing-remitting MS more effectively. The development of treatment optimisation recommendations based on the clinical response to first-line therapies can guide the neurologist in more active management of the early course of relapsing-remitting MS, with the aim of preventing both acute inflammatory axonal injury and the neurodegenerative process which leads to secondary progressive MS.

Guideline for the prevention, diagnosis and management of cryptococcal meningitis among HIV-infected persons: 2013 update

Directory of Open Access Journals (Sweden)

The Southern African HIV Clinicians Society

2013-06-01

Full Text Available Six years after the first Society guidelines were published, cryptococcal meningitis (CM remains an important cause of morbidity and mortality among HIV-infected adults in South Africa. Several important developments have spurred the  publication of updated guidelines to manage this common fungal opportunistic infection. Recommendations described here include: (1 screening and pre-emptive treatment; (2 laboratory diagnosis and monitoring; (3 management of a first episode of CM; (4 amphotericin B deoxycholate toxicity prevention, monitoring and management; (5 timing of antiretroviral therapy among patients with CM; (6 management of raised intracranial pressure; (7 management of relapse episodes of CM.

Reference Capabilities for Trait Based Reuse and Concurrency Control

OpenAIRE

Castegren, Elias; Wrigstad, Tobias

2016-01-01

The proliferation of shared mutable state in object-orientedprogramming complicates software development as two seeminglyunrelated operations may interact via an alias and produceunexpected results. In concurrent programming this manifestsitself as data-races. Concurrent object-oriented programming further suffers from thefact that code that warrants synchronisation cannot easily bedistinguished from code that does not. The burden is placed solelyon the programmer to reason about alias freedo...

Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises.

Science.gov (United States)

Kraaijenga, Sophie A C; van der Molen, Lisette; Jacobi, Irene; Hamming-Vrieze, Olga; Hilgers, Frans J M; van den Brekel, Michiel W M

2015-11-01

Concurrent chemoradiotherapy (CCRT) for advanced head and neck cancer (HNC) is associated with substantial early and late side effects, most notably regarding swallowing function, but also regarding voice quality and quality of life (QoL). Despite increased awareness/knowledge on acute dysphagia in HNC survivors, long-term (i.e., beyond 5 years) prospectively collected data on objective and subjective treatment-induced functional outcomes (and their impact on QoL) still are scarce. The objective of this study was the assessment of long-term CCRT-induced results on swallowing function and voice quality in advanced HNC patients. The study was conducted as a randomized controlled trial on preventive swallowing rehabilitation (2006-2008) in a tertiary comprehensive HNC center with twenty-two disease-free and evaluable HNC patients as participants. Multidimensional assessment of functional sequels was performed with videofluoroscopy, mouth opening measurements, Functional Oral Intake Scale, acoustic voice parameters, and (study specific, SWAL-QoL, and VHI) questionnaires. Outcome measures at 6 years post-treatment were compared with results at baseline and at 2 years post-treatment. At a mean follow-up of 6.1 years most initial tumor-, and treatment-related problems remained similarly low to those observed after 2 years follow-up, except increased xerostomia (68%) and increased (mild) pain (32%). Acoustic voice analysis showed less voicedness, increased fundamental frequency, and more vocal effort for the tumors located below the hyoid bone (n = 12), without recovery to baseline values. Patients' subjective vocal function (VHI score) was good. Functional swallowing and voice problems at 6 years post-treatment are minimal in this patient cohort, originating from preventive and continued post-treatment rehabilitation programs.

Environmental evaluation of municipal waste prevention

International Nuclear Information System (INIS)

Gentil, Emmanuel C.; Gallo, Daniele; Christensen, Thomas H.

2011-01-01

Highlights: → Influence of prevention on waste management systems, excluding avoided production, is relatively minor. → Influence of prevention on overall supply chain, including avoided production is very significant. → Higher relative benefits of prevention are observed in waste management systems relying mainly on landfills. - Abstract: Waste prevention has been addressed in the literature in terms of the social and behavioural aspects, but very little quantitative assessment exists of the environmental benefits. Our study evaluates the environmental consequences of waste prevention on waste management systems and on the wider society, using life-cycle thinking. The partial prevention of unsolicited mail, beverage packaging and food waste is tested for a 'High-tech' waste management system relying on high energy and material recovery and for a 'Low-tech' waste management system with less recycling and relying on landfilling. Prevention of 13% of the waste mass entering the waste management system generates a reduction of loads and savings in the waste management system for the different impacts categories; 45% net reduction for nutrient enrichment and 12% reduction for global warming potential. When expanding our system and including avoided production incurred by the prevention measures, large savings are observed (15-fold improvement for nutrient enrichment and 2-fold for global warming potential). Prevention of food waste has the highest environmental impact saving. Prevention generates relatively higher overall relative benefit for 'Low-tech' systems depending on landfilling. The paper provides clear evidence of the environmental benefits of waste prevention and has specific relevance in climate change mitigation.

Determinants of overweight with concurrent stunting among Ghanaian children.

Science.gov (United States)

Atsu, Benedicta K; Guure, Chris; Laar, Amos K

2017-07-27

Malnutrition (undernutrition and overnutrition) is a major public health problem in Ghana -affecting growth and development of individuals and the nation. Stunting and overweight are of particular interest, as recent national surveys show a rising trend of overnutrition and stubbornly high burden of stunting among Ghanaian children. There are currently no data on the simultaneous occurrence of overweight and stunting within individuals in Ghana. This paper presents the burden, the individual-level, and contextual determinants of overweight with concurrent stunting among Ghanaian children. This study analyzed data set of the fourth round of the Ghana Multiple Indicator Cluster Survey (MICS4). Bivariate analyses were used to describe selected characteristics of survey respondents and their children. Hierarchical modelling approach facilitated identification of significant distal, intermediate and proximal factors/determinants of concurrent stunting and overweight. Both crude and adjusted prevalence ratios via a multivariable Poison regression model with their corresponding 95% Confidence Intervals (CI) are reported. Variables with p ≤ 0.25 at the bivariate level were included in the multivariable analysis. An alpha value of 5% was used to indicate significance. Of 7550 cases (children) analyzed, the prevalence of stunting was 27.5%; underweight was 17.3%; and wasting was 7.7%. The prevalence of overweight and concurrent overweight and stunting were respectively 2.4% and 1.2%. Children who belonged to the fourth wealth quintile, were more likely to be overweight and concurrently stunted as against children belonging to the poorest quintile (aPR = 1.010; 95% CI, 1.003-1.017). Compared to religious (Christians/Muslim/Traditionalist) household heads, children whose household heads did not belong to any religion had 2 times the rates of the Overweight with concurrent stunting (PR = 2.024; 95% CI, 1.016-4.034). Children with mothers aged 20-34 and 35-49 had an

Concurrent engineering and product models in seafood companies

DEFF Research Database (Denmark)

Jonsdottir, Stella; Vesterager, Johan; Børresen, Torger

1998-01-01

Concurrent Engineering (CE) can provide an improved approach to product development for extending the lines of seafood products. Information technology (IT) support tools based on product models can provide an integrated and simultaneous approach for specifying new recipes. The seafood industry can...... benefit from the CE approach which can support product developers to provide concurrent specifications for raw materials, ingredients, packaging, and production methods. The approach involves the use of product models from which line extensions are more easily generated than by use of customary stepwise...

Preventing and managing challenging behaviour.

Science.gov (United States)

Hallett, Nutmeg

2018-02-21

Patients exhibiting challenging behaviour, which includes any non-verbal, verbal or physical behaviour, is a significant issue in healthcare settings. Preventing such behaviour and the harm it can cause is important for healthcare organisations and individuals, and involves following a public health model comprised of three tiers: primary, secondary and tertiary prevention. Primary prevention aims to reduce the risk of challenging behaviour occurring in the first instance; secondary prevention involves reducing the risk associated with imminent challenging behaviour and its potential escalation; and tertiary prevention focuses on minimising the physical and emotional harm caused by challenging behaviours, during and after an event. De-escalation should be the first-line response to challenging behaviour, and healthcare staff should use a range of techniques - maintaining safety, self-regulation, effective communication, and assessment and actions - to reduce the incidence of challenging behaviour. In some situations, physical interventions may be required to protect the safety of the individual, healthcare staff and other individuals involved, and healthcare staff should be aware of local policies and procedures for this. Following a serious incident, where there was potential or actual harm to patients and healthcare staff, healthcare organisations should use post-incident reviews to learn from the situation, while healthcare staff should be offered the opportunity for debriefing. Positive responses to challenging behaviour at an organisational and individual level can lead to improved work environments for healthcare staff and optimal patient care and outcomes. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

[Mind-body approach in the area of preventive medicine: focusing on relaxation and meditation for stress management].

Science.gov (United States)

Kang, Yunesik

2010-09-01

Emotional support and a stress management program should be simultaneously provided to clients as effective preventive services for healthy behavioral change. This study was conducted to review various relaxation and meditation intervention methods and their applicability for a preventive service program. The author of this paper tried to find various relaxation and meditation programs through a literature review and program searching and to introduce them. The 'Relaxation Response' and 'Mindfulness Based Stress Reduction (MBSR)' are the most the widely used meditative programs in mainstream medical systems. Abdominal breathing, Progressive Musclular Relaxation (PMR), Relaxative Imagery, Autogenic Training (AT) and Biofeedback are other well-known techniques for relaxation and stress management. I have developed and implemented some programs using these methods. Relaxation and meditation classes for cancer patients and a meditation based stress coping workshop are examples of this program. Relaxation and meditation seem to be good and effective methods for primary, secondary and tertiary preventive service programs. Program development and standardization and further study are needed for more and wider use of the mind-body approach in the preventive service area of medicine.

Concurrent paclitaxel and radiotherapy. Treatment feasibility studies

International Nuclear Information System (INIS)

Vogt, H.G.; Martin, T.; Kolotas, C.; Hey, S.; Schneider, L.; Templin, T.; Zamboglou, N.; Dornoff, W.; Kettner, H.

1997-01-01

Background: The anti-neoplastic effect of paclitaxel has been demonstrated in various clinical studies in different malignant diseases. Clinical studies have also demonstrated a greater efficacy for simultaneous radio-chemotherapy compared with radiotherapy alone when using radiosensitizing drugs. Based on these clinical and in-vitro data we initiated several pilot studies using paclitaxel as a radiosensitizing agent and we now present our initial experience in its use in a combined modality protocol, radiation and simultaneous chemotherapy with paclitaxel. Methods: I. Concurrent paclitaxel and radiation for locally advanced non-small-cell lung cancer (NSCLC): In a phase-I-study we applicated paclitaxel (45 to 65 mg/m 2 ) as a 3-hour infusion weekly for 3 to 7 weeks simultaneously with primary radiotherapy in shrinking field technique with 5x1.8 Gy/week up to 59.4 Gy. - II. Concurrent paclitaxel and radiation for breast cancer as neoadjuvant or palliative: 50 mg/m 2 paclitaxel as a 3-hour infusion weekly for 6 weeks simultaneous with neoadjuvant or palliative radiotherapy of the breast/chest wall with 5x1.8 Gy/week up to 54.0 Gy. - III./IV. Concurrent paclitaxel/carboplatin and combined radiation (EBRT+brachytherapy) for locally advanced inoperable cancer of the cervix: 50 mg/m 2 paclitaxel as a 3-hour infusion weekly for 5 weeks, 50 mg/m 2 carboplatin at day 1 to 5 in week 1 and 5 simultaneously with external beam radiotherapy of the pelvis with 5x1.8 Gy/week up to 54.0 Gy and endocavitary LDR-brachytherapy (4x5 Gy). - V. Concurrent paclitaxel and radiation for locally advanced inoperable cancer of the bladder: 50 mg/m 2 paclitaxel as a 3-hour infusion weekly for 5 weeks simultaneous with radiotherapy of the pelvis with 5x1.8 Gy/week up to 50.4 Gy. VI. Concurrent paclitaxel and radiation in locally advanced inoperable head and neck cancer: 50 mg/m 2 paclitaxel as a 3-hour infusion weekly for 7 to 8 weeks simultaneous with radiotherapy in shrinking field technique

Basic studies on computer aided concurrent engineering for hull structure design and piping design; Kakugi ittai wo koryoshita doji heikotekina sekkei no shien ni kansuru kisoteki kenkyu

Energy Technology Data Exchange (ETDEWEB)

Aoyama, K.; Sawada, K. [The University of Tokyo, Tokyo (Japan)

1996-12-31

Considering integrated hull and piping design in shipbuilding industry as a good example for concurrent engineering (CE), discussions were given on a computer aided method to perform integrated hull and piping design smoothly. When CE aiding by means of a computer is considered, it is important to discuss a method for information management not only for `utilization of product models`, but also for `maintaining consistency between items of product information` and `concurrent utilization and production of product information` in concurrent designs. For the CE aided information management, utilization and production of the product information is effective if restrictive relationship between items of product information, and design functions are made clear. Definitions were given on the restrictive relationship between items of product information and `restrictive relationship information` that has `decision/provisional decision`, `date and time`, `designer` and `design functions`. Furthermore, `comprehensive relationship between items of product information` that can be produced from the restrictive relationship information was defined as a `restrictive network`. Utilizing the restrictive relationship between items of product information for CE aiding is effective. 9 refs., 14 figs.

Basic studies on computer aided concurrent engineering for hull structure design and piping design; Kakugi ittai wo koryoshita doji heikotekina sekkei no shien ni kansuru kisoteki kenkyu

Energy Technology Data Exchange (ETDEWEB)

Aoyama, K; Sawada, K [The University of Tokyo, Tokyo (Japan)

1997-12-31

Considering integrated hull and piping design in shipbuilding industry as a good example for concurrent engineering (CE), discussions were given on a computer aided method to perform integrated hull and piping design smoothly. When CE aiding by means of a computer is considered, it is important to discuss a method for information management not only for `utilization of product models`, but also for `maintaining consistency between items of product information` and `concurrent utilization and production of product information` in concurrent designs. For the CE aided information management, utilization and production of the product information is effective if restrictive relationship between items of product information, and design functions are made clear. Definitions were given on the restrictive relationship between items of product information and `restrictive relationship information` that has `decision/provisional decision`, `date and time`, `designer` and `design functions`. Furthermore, `comprehensive relationship between items of product information` that can be produced from the restrictive relationship information was defined as a `restrictive network`. Utilizing the restrictive relationship between items of product information for CE aiding is effective. 9 refs., 14 figs.

37 CFR 2.99 - Application to register as concurrent user.

Science.gov (United States)

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Application to register as concurrent user. 2.99 Section 2.99 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK... Proceedings § 2.99 Application to register as concurrent user. (a) An application for registration as a lawful...

Radiation Therapy in the Management of Head-and-Neck Cancer of Unknown Primary Origin: How Does the Addition of Concurrent Chemotherapy Affect the Therapeutic Ratio?

International Nuclear Information System (INIS)

Chen, Allen M.; Farwell, D. Gregory; Lau, Derick H.; Li Baoqing; Luu, Quang; Donald, Paul J.

2011-01-01

Purpose: To determine how the addition of cisplatin-based concurrent chemotherapy to radiation therapy influences outcomes among a cohort of patients treated for head-and-neck cancer of unknown primary origin. Methods and Materials: The medical records of 60 consecutive patients treated by radiation therapy for squamous cell carcinoma of the head and neck presenting as cervical lymph node metastasis of occult primary origin were reviewed. Thirty-two patients (53%) were treated by concurrent chemoradiation, and 28 patients (47%) were treated by radiation therapy alone. Forty-five patients (75%) received radiation therapy after surgical resection, and 15 patients (25%) received primary radiation therapy. Thirty-five patients (58%) were treated by intensity-modulated radiotherapy. Results: The 2-year estimates of overall survival, local-regional control, and progression-free survival were 89%, 89%, and 79%, respectively, among patients treated by chemoradiation, compared to 90%, 92%, and 83%, respectively, among patients treated by radiation therapy alone (p > 0.05, for all). Exploratory analysis failed to identify any subset of patients who benefited from the addition of concurrent chemotherapy to radiation therapy. The use of concurrent chemotherapy was associated with a significantly increased incidence of Grade 3+ acute and late toxicity (p < 0.001, for both). Conclusions: Concurrent chemoradiation is associated with significant toxicity without a clear advantage to overall survival, local-regional control, and progression-free survival in the treatment of head-and-neck cancer of unknown primary origin. Although selection bias cannot be ignored, prospective data are needed to further address this question.

NFC based Inspection and Qualification Management (NIQM) System Preventing Counterfeit and Fraudulent Item

International Nuclear Information System (INIS)

Chang, Choong Koo; Kim, Young Joo

2013-01-01

Design, manufacturing, fabrication, transportation and installation of the devices and equipment for nuclear power plants shall be conducted under the thorough quality assurance program for the nuclear safety. However, from late in the 1980s, NRC began to issue a number of communications alerting licenses to issues involving counterfeit and fraudulent items. A number of incidents identified by the NRC in the 1980s and 1990s catalyzed the US nuclear industry to adopt standard precautions to guard against counterfeit items. The purpose of this paper is to develop the NFC (Near Field Communication) based Inspection and Qualification Management(NIQM) system preventing counterfeit and fraudulent items. NFC is one of the latest wireless communication technologies. As a short-range wireless connectivity technology, NFC offers safe-yet simple and intuitive-communication between electronic devices. As described above, NFC technology can be applied to the inspection and qualification management system very effectively to prevent counterfeit and fraudulent items. In addition, NIQM system can use existing data and information through the interface with legacy system

NFC based Inspection and Qualification Management (NIQM) System Preventing Counterfeit and Fraudulent Item

Energy Technology Data Exchange (ETDEWEB)

Chang, Choong Koo; Kim, Young Joo [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

2013-10-15

Design, manufacturing, fabrication, transportation and installation of the devices and equipment for nuclear power plants shall be conducted under the thorough quality assurance program for the nuclear safety. However, from late in the 1980s, NRC began to issue a number of communications alerting licenses to issues involving counterfeit and fraudulent items. A number of incidents identified by the NRC in the 1980s and 1990s catalyzed the US nuclear industry to adopt standard precautions to guard against counterfeit items. The purpose of this paper is to develop the NFC (Near Field Communication) based Inspection and Qualification Management(NIQM) system preventing counterfeit and fraudulent items. NFC is one of the latest wireless communication technologies. As a short-range wireless connectivity technology, NFC offers safe-yet simple and intuitive-communication between electronic devices. As described above, NFC technology can be applied to the inspection and qualification management system very effectively to prevent counterfeit and fraudulent items. In addition, NIQM system can use existing data and information through the interface with legacy system.

Development of a Patient Charting System to Teach Family Practice Residents Disease Management and Preventive Care

National Research Council Canada - National Science Library

Dickerman, Joel

1997-01-01

.... Designing notes which 'prompt' residents to gather patient information vital to optimal care can teach residents the concepts of longitudinal care, particularly chronic disease management and preventive care...

A system of safety management practices and worker engagement for reducing and preventing accidents: an empirical and theoretical investigation.

Science.gov (United States)

Wachter, Jan K; Yorio, Patrick L

2014-07-01

The overall research objective was to theoretically and empirically develop the ideas around a system of safety management practices (ten practices were elaborated), to test their relationship with objective safety statistics (such as accident rates), and to explore how these practices work to achieve positive safety results (accident prevention) through worker engagement. Data were collected using safety manager, supervisor and employee surveys designed to assess and link safety management system practices, employee perceptions resulting from existing practices, and safety performance outcomes. Results indicate the following: there is a significant negative relationship between the presence of ten individual safety management practices, as well as the composite of these practices, with accident rates; there is a significant negative relationship between the level of safety-focused worker emotional and cognitive engagement with accident rates; safety management systems and worker engagement levels can be used individually to predict accident rates; safety management systems can be used to predict worker engagement levels; and worker engagement levels act as mediators between the safety management system and safety performance outcomes (such as accident rates). Even though the presence of safety management system practices is linked with incident reduction and may represent a necessary first-step in accident prevention, safety performance may also depend on mediation by safety-focused cognitive and emotional engagement by workers. Thus, when organizations invest in a safety management system approach to reducing/preventing accidents and improving safety performance, they should also be concerned about winning over the minds and hearts of their workers through human performance-based safety management systems designed to promote and enhance worker engagement. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Preventative disease management and grower decision making: A case study of California wine-grape growers

Science.gov (United States)

We examined the adoption and timing of preventative grapevine trunk disease-management practices among agricultural decision-makers (growers) in California. These diseases (Botryosphaeria dieback, Esca, Eutypa dieback, Phomopsis dieback) significantly diminish vineyard productivity and longevity. Gi...

Routine culture-based screening versus risk-based management for the prevention of early-onset group B streptococcus disease in the neonate: a systematic review.

Science.gov (United States)

Kurz, Ella; Davis, Deborah

2015-04-17

Early-onset group B streptococcus disease, recognized as the most common cause of early onset neonatal sepsis in developed countries, is transmitted vertically from the group B streptococcus carrier mother to the neonate in the peripartum. Accordingly, early-onset group B streptococcus disease is prevented by halting the transmission of the microorganism from the mother to the infant. Two main methods, routine culture-based screening and risk-based management, may be used in the identification of mothers requiring intrapartum antibiotic prophylaxis in labor. While there are advantages and disadvantages to each, there is limited high level evidence available as to which method is superior. To identify the effectiveness of risk-based management versus routine culture-based screening in the prevention of early-onset group B streptococcus disease in the neonate. This review considered studies which treated pregnant women with intrapartum antibiotic prophylaxis following risk- and culture-based protocols for the prevention of early-onset group B streptococcus disease in the neonate. Types of intervention: This review considered studies that evaluated risk-based management against routine culture-based screening for the prevention of early-onset group B streptococcus disease in the neonate. Types of studies: This review looked for highest evidence available which in this case consisted of one quasi experimental study and eight comparative cohort studies with historical or concurrent control groups. Types of outcomes: Incidence of early-onset group B streptococcus disease in neonates as measured by positive group B streptococcus culture from an otherwise sterile site. Secondary outcomes include neonatal death due to group B streptococcus sepsis and percentage of women who received intrapartum antibiotic prophylaxis. A multi-step search strategy was used to find studies which were limited to the English language and published between January 2000 and June 2013. The quality

Pathophysiological and parasitological studies on a concurrent infection of Ostertagia ostertagi and Cooperia oncophora in calves.

Science.gov (United States)

Parkins, J J; Taylor, L M; Holmes, P H; Bairden, K; Salman, S K; Armour, J

1990-03-01

Calves which had received daily concurrent infections of 2000 Ostertagia ostertagi and 10,000 Cooperia oncophora infective larvae over a 42-day period displayed a range of clinical signs typical of acute parasitic gastroenteritis including inappetence, weight loss, hypoalbuminaemia and diarrhoea. There were consistent and significant depressions in both digestive efficiency and nitrogen retention. Radioisotopic studies revealed marked disturbances in protein metabolism which were associated with high losses of plasma proteins into the gastrointestinal tract. On post mortem examination larval establishment of O ostertagi was seen to be high. The adverse changes were prevented by the prior administration of a morantel bolus.

PyCSP - controlled concurrency

DEFF Research Database (Denmark)

Vinter, Brian; Friborg, Rune Møllegaard; Bjørndalen, John Markus

2010-01-01

Producing readable and correct programs while at the same time taking advantage of multi-core architectures is a challenge. PyCSP is an implementation of Communicating Sequential Processes algebra (CSP) for the Python programming language, that take advantage of CSP's formal and verifiable approach...... to controlling concurrency and the readability of Python source code. We describe PyCSP, demonstrate it through examples and demonstrate how PyCSP compares to Pthreads in a master-worker benchmark....

PyCSP - controlled concurrency

DEFF Research Database (Denmark)

Friborg, Rune Møllegaard; Vinter, Brian; Bjørndalen, John Markus

Producing readable and correct programs while at the same time taking advantage of multi-core architectures is a challenge. PyCSP is an implementation of Communicating Sequential Processes algebra (CSP) for the Python programming language, taking advantage of CSP’s formal and verifiable approach...... to controlling concurrency and the readability of Python source code. We describe PyCSP, demonstrate it through examples and demonstrate how PyCSP compares to Pthreads using a benchmark....

Separative power of an optimised concurrent gas centrifuge

Energy Technology Data Exchange (ETDEWEB)

Bogovalov, Sergey; Boman, Vladimir [National Research Nuclear University (MEPHI), Moscow (Russian Federation)

2016-06-15

The problem of separation of isotopes in a concurrent gas centrifuge is solved analytically for an arbitrary binary mixture of isotopes. The separative power of the optimised concurrent gas centrifuges for the uranium isotopes equals to δU = 12.7 (V/700 m/s)2(300 K/T)(L/1 m) kg·SWU/yr, where L and V are the length and linear velocity of the rotor of the gas centrifuge and T is the temperature. This equation agrees well with the empirically determined separative power of optimised counter-current gas centrifuges.

Double Trouble: Concurrent Sigmoid Volvulus and Gastric Volvulus in Alzheimer’s Disease.

Directory of Open Access Journals (Sweden)

Ngo Choon Woon

2017-10-01

Full Text Available Background: Volvulus is the rotation of a hollow viscus either on its mesentery or upwards against its own body. Multiple gastrointestinal volvuli occurring in a single individual is extremely rare. Several reports have suggested sequential dilatation of the proximal sigmoid as the triggering factor for the development of the gastric volvulus. This is only the 4th case of concurrent sigmoid and gastric volvulus to be reported in the world and the first in Asia, making it a rare and unique learning opportunity for surgeons of all ages with varying levels of experience. Case Report: We discuss an acute presentation of concurrent sigmoid and gastric volvulus in an elderly individual with underlying Alzheimer’s disease. Despite initial endoscopic treatment, he eventually succumbed as a result of septic shock with multi-organ failure secondary to bowel ischemia. Discussion and Conclusion: The increased morbidity and mortality risk associated with the dual pathology warrants high index of suspicion and prompt management. Clinical symptoms and radiological imaging are often sufficient to reach a diagnosis. Decision to treat the patient conservatively, endoscopically or surgically would depend on the manner of presentation. The relative vascularity of all affected organs should be taken into consideration when prioritizing the order of organs to undergo de-torsion and decompression.

How change management can prevent the failure of information systems implementation among Malaysian government hospitals?

Science.gov (United States)

ChePa, Noraziah; Jasin, Noorhayati Md; Bakar, Nur Azzah Abu

2017-10-01

Fail to prevent or control challenges of Information System (IS) implementation have led to the failure of its implementation. Successful implementation of IS has been a challenging task to any organization including government hospitals. Government has invested a big amount of money on information system (IS) projects to improve service delivery in healthcare. However, several of them failed to be implemented successfully due to several factors. This article proposes a prevention model which incorporated Change Management (CM) concepts to avoid the failure of IS implementation, hence ensuring the success of it. Challenges of IS implementation in government hospitals have been discovered. Extensive literature review and deep interview approaches were employed to discover these challenges. A prevention model has been designed to cater the challenges. The model caters three main phases of implementation; pre-implementation, during implementation, and post-implementation by adopting CM practices of Lewin's, Kotter's and Prosci's CM model. Six elements of CM comprising thirteen sub-elements adopted from the three CM models have been used to handle CFFs of Human and Support issues; guiding team, resistance avoidance, IS adoption, enforcement, monitoring, and IS sustainability. Successful practice of the proposed mapping is expected to prevent CFFs to occur, hence ensuring a successful implementation of IS in the hospitals. The proposed model has been presented and successfully evaluated by the domain experts from the selected hospitals. The proposed model is believed to be beneficial for top management, IT practitioners and medical practitioners in preventing IS implementation failure among government hospitals towards ensuring the success implementation.

Concurrency at work with Go

CERN Document Server

CERN. Geneva

2017-01-01

High Energy and Nuclear Physics (HENP) libraries are now required to be increasingly multi-thread-safe, if not multi-thread-friendly and multi-threaded. This is usually done using the new constructs and library components offered by the C++11 and C++14 standards. These components are however quite low-level (threads, mutexes, locks, ...) and hard to use and compose, or easy to misuse. However, Go -- a somewhat new language -- provides a set of better building blocks for tackling concurrency: goroutines and channels. This language is now used by the cloud industry at large; docker/moby, rkt, Kubernetes, OpenShift, etc... are obvious flagships for Go. It is also used in other interesting places like SpaceX's telemetry monitoring system and in the New York Times', YouTube's or Disney's content delivery infrastructures. In this talk, we will describe the building blocks of Go and see how they are combined to easily create concurrent programs that grow with grace, are fast to compile and deploy, but also easy to...

Case management helps prevent criminal justice recidivism for people with serious mental illness.

Science.gov (United States)

Leutwyler, Heather; Hubbard, Erin; Zahnd, Elaine

2017-09-11

Purpose The purpose of this paper is to discuss how case management can decrease recidivism for people with serious mental illness (SMI) because people with SMI are at high risk for incarceration and recidivism. Design/methodology/approach Examples of successful case management models for formerly incarcerated individuals with SMI found through a secondary analysis of qualitative data and an analysis of the literature are presented. Findings Currently, no international, national, or statewide guidelines exist to ensure that formerly incarcerated individuals with SMI receive case management upon community reentry despite evidence that such services can prevent further criminal justice involvement. Recommendations include establishment of and evaluation of best practices for case management. In addition, the authors recommend additional funding for case management with the goal of greatly increasing the number of individuals with SMI leaving the criminal justice system in their ability to access adequate case management. Originality/value Providing effective case management tailored to the needs of formerly incarcerated people with SMI improves their quality of life and reduces their involvement in the criminal justice system with clear positive outcomes for public safety and public health.

Performing concurrent operations in academic vascular neurosurgery does not affect patient outcomes.

Science.gov (United States)

Zygourakis, Corinna C; Lee, Janelle; Barba, Julio; Lobo, Errol; Lawton, Michael T

2017-11-01

OBJECTIVE Concurrent surgeries, also known as "running two rooms" or simultaneous/overlapping operations, have recently come under intense scrutiny. The goal of this study was to evaluate the operative time and outcomes of concurrent versus nonconcurrent vascular neurosurgical procedures. METHODS The authors retrospectively reviewed 1219 procedures performed by 1 vascular neurosurgeon from 2012 to 2015 at the University of California, San Francisco. Data were collected on patient age, sex, severity of illness, risk of mortality, American Society of Anesthesiologists (ASA) status, procedure type, admission type, insurance, transfer source, procedure time, presence of resident or fellow in operating room (OR), number of co-surgeons, estimated blood loss (EBL), concurrent vs nonconcurrent case, severe sepsis, acute respiratory failure, postoperative stroke causing neurological deficit, unplanned return to OR, 30-day mortality, and 30-day unplanned readmission. For aneurysm clipping cases, data were also obtained on intraoperative aneurysm rupture and postoperative residual aneurysm. Chi-square and t-tests were performed to compare concurrent versus nonconcurrent cases, and then mixed-effects models were created to adjust for different procedure types, patient demographics, and clinical indicators between the 2 groups. RESULTS There was a significant difference in procedure type for concurrent (n = 828) versus nonconcurrent (n = 391) cases. Concurrent cases were more likely to be routine/elective admissions (53% vs 35%, p returns to the OR (3.3% vs 6.9%; all p return to the OR and 30-day mortality were significantly lower in concurrent cases (odds ratio 0.55, 95% confidence interval 0.31-0.98, p = 0.0431, and odds ratio 0.81, p fashion. After adjusting for patient demographics, procedure type, and clinical indicators, concurrent cases had longer procedure times, but equivalent patient outcomes, as compared with nonconcurrent vascular neurosurgical procedures.

Takotsubo Cardiomyopathy in Intensive Care Unit: Prevention, Diagnosis and Management

Directory of Open Access Journals (Sweden)

Hannah Masoud

2016-01-01

Full Text Available Accurate diagnosis of Takotsubo Cardiomyopathy has substantial prognostic implications in an intensive care unit, given its increased mortality risk and association with life-threatening complications. This report seeks to discuss diagnostic modalities that can be useful in accurately differentiating Takotsubo Cardiomyopathy from Acute Coronary Syndrome, and also briefly discuss prevention and management of this cardiomyopathy in an intensive care unit. For critically ill Takotsubo patients, intensive clinicians can consider establishment of diagnosis by specific electrocardiograph changes, distinctive marked release of cardiac enzymes, characteristic echocardiograph findings, as well as invasive coronary angiography or noninvasive cardiac magnetic imaging.

The roles of community pharmacists in cardiovascular disease prevention and management

Directory of Open Access Journals (Sweden)

George J

2011-05-01

Full Text Available There is ample evidence in the international literature forpharmacist involvement in the prevention and managementof cardiovascular disease (CVD conditions in primary care.Systematic reviews and meta-analyses have confirmed thesignificant clinical benefits of pharmacist interventions for arange of CVD conditions and risk factors. Evidence generatedin research studies of Australian community pharmacistinvolvement in CVD prevention and management issummarised in this article.Commonwealth funding through the Community PharmacyAgreements has facilitated research to establish the feasibilityand effectiveness of new models of primary care involvingcommunity pharmacists. Australian community pharmacistshave been shown to effect positive clinical, humanistic andeconomic outcomes in patients with CVD conditions.Improvements in blood pressure, lipid levels, medicationadherence and CVD risk have been demonstrated usingdifferent study designs. Satisfaction for GPs, pharmacists andconsumers has also been reported. Perceived ‘turf’encroachment, expertise of the pharmacist, space, time andremuneration are challenges to the implementation of diseasemanagement services involving community pharmacists.

Declarative interpretations of session-based concurrency

DEFF Research Database (Denmark)

Cano, Mauricio; Rueda, Camilo; López-Acosta, Hugo-Andrés

2015-01-01

Session-based concurrency is a type-based approach to the analysis of communication-intensive systems. Correct behavior in these systems may be specified in an operational or declarative style: the former defines how interactions are structured; the latter defines governing conditions...

Exploiting communication concurrency on high performance computing systems

Energy Technology Data Exchange (ETDEWEB)

Chaimov, Nicholas [Univ. of Oregon, Eugene, OR (United States); Ibrahim, Khaled Z. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Williams, Samuel [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Iancu, Costin [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2015-01-01

Although logically available, applications may not exploit enough instantaneous communication concurrency to maximize hardware utilization on HPC systems. This is exacerbated in hybrid programming models such as SPMD+OpenMP. We present the design of a "multi-threaded" runtime able to transparently increase the instantaneous network concurrency and to provide near saturation bandwidth, independent of the application configuration and dynamic behavior. The runtime forwards communication requests from application level tasks to multiple communication servers. Our techniques alleviate the need for spatial and temporal application level message concurrency optimizations. Experimental results show improved message throughput and bandwidth by as much as 150% for 4KB bytes messages on InfiniBand and by as much as 120% for 4KB byte messages on Cray Aries. For more complex operations such as all-to-all collectives, we observe as much as 30% speedup. This translates into 23% speedup on 12,288 cores for a NAS FT implemented using FFTW. We also observe as much as 76% speedup on 1,500 cores for an already optimized UPC+OpenMP geometric multigrid application using hybrid parallelism.

Transactions on Petri Nets and Other Models of Concurrency V

DEFF Research Database (Denmark)

submission track of ToPNoC. The 12 papers cover a diverse range of topics including model checking and system verification, synthesis, foundational work on specific classes of Petri nets, and innovative applications of Petri nets and other models of concurrency. Thus, this volume gives a good view of ongoing...... concurrent systems and Petri nets research...

Rationale and methods of the European Study on Cardiovascular Risk Prevention and Management in Daily Practice (EURIKA

Directory of Open Access Journals (Sweden)

Jiménez Francisco

2010-06-01

Full Text Available Abstract Background The EURIKA study aims to assess the status of primary prevention of cardiovascular disease (CVD across Europe. Specifically, it will determine the degree of control of cardiovascular risk factors in current clinical practice in relation to the European guidelines on cardiovascular prevention. It will also assess physicians' knowledge and attitudes about CVD prevention as well as the barriers impeding effective risk factor management in clinical practice. Methods/Design Cross-sectional study conducted simultaneously in 12 countries across Europe. The study has two components: firstly at the physician level, assessing eight hundred and nine primary care and specialist physicians with a daily practice in CVD prevention. A physician specific questionnaire captures information regarding physician demographics, practice settings, cardiovascular prevention beliefs and management. Secondly at the patient level, including 7641 patients aged 50 years or older, free of clinical CVD and with at least one classical risk factor, enrolled by the participating physicians. A patient-specific questionnaire captures information from clinical records and patient interview regarding sociodemographic data, CVD risk factors, and current medications. Finally, each patient provides a fasting blood sample, which is sent to a central laboratory for measuring serum lipids, apolipoproteins, hemoglobin-A1c, and inflammatory biomarkers. Discussion Primary prevention of CVD is an extremely important clinical issue, with preventable circulatory diseases remaining the leading cause of major disease burden. The EURIKA study will provide key information to assess effectiveness of and attitudes toward primary prevention of CVD in Europe. A transnational study creates opportunities for benchmarking good clinical practice across countries and improving outcomes. (ClinicalTrials.gov number, NCT00882336.

Patterns of and motivations for concurrent use of video games and substances.

Science.gov (United States)

Ream, Geoffrey L; Elliott, Luther C; Dunlap, Eloise

2011-10-01

"Behavioral addictions" share biological mechanisms with substance dependence, and "drug interactions" have been observed between certain substances and self-reinforcing behaviors. This study examines correlates of patterns of and motivations for playing video games while using or feeling the effects of a substance (concurrent use). Data were drawn from a nationally-representative survey of adult Americans who "regularly" or "occasionally" played video games and had played for at least one hour in the past seven days (n = 3,380). Only recent concurrent users' data were included in analyses (n = 1,196). Independent variables included demographics, substance use frequency and problems, game genre of concurrent use (identified by looking titles up in an industry database), and general game playing variables including problem video game play (PVP), consumer involvement, enjoyment, duration, and frequency of play. Exploratory factor analysis identified the following dimensions underlying patterns of and motivations for concurrent use: pass time or regulate negative emotion, enhance an already enjoyable or positive experience, and use of video games and substances to remediate each other's undesirable effects. Multivariate regression analyses indicated PVP and hours/day of video game play were associated with most patterns/motivations, as were caffeine, tobacco, alcohol, marijuana, and painkiller use problems. This suggests that concurrent use with some regular situational pattern or effect-seeking motivation is part of the addictive process underlying both PVP and substance dependence. Various demographic, game playing, game genre of concurrent use, and substance use variables were associated with specific motivations/patterns, indicating that all are important in understanding concurrent use.

Concurrent infectious mononucleosis and community-associated methicillin-resistant Staphylococcus aureus bacteremia.

Science.gov (United States)

Wang, Li Jun; Du, Xiao Qin; Nyirimigabo, Eric; Shou, Song Tao

2014-04-01

It is rare to see a concurrent infection with infectious mononucleosis and community-associated methicillin-resistant Staphylococcus aureus in Tianjin, China. Until now, there is still no any single recorded case of concurrent infectious mononucleosis and community-associated methicillin-resistant Staphylococcus aureus bacteremia.

The prevention, detection and management of cancer treatment-induced cardiotoxicity: a meta-review

International Nuclear Information System (INIS)

Conway, Aaron; McCarthy, Alexandra L; Lawrence, Petra; Clark, Robyn A

2015-01-01

The benefits associated with some cancer treatments do not come without risk. A serious side effect of some common cancer treatments is cardiotoxicity. Increased recognition of the public health implications of cancer treatment-induced cardiotoxicity has resulted in a proliferation of systematic reviews in this field to guide practice. Quality appraisal of these reviews is likely to limit the influence of biased conclusions from systematic reviews that have used poor methodology related to clinical decision-making. The aim of this meta-review is to appraise and synthesise evidence from only high quality systematic reviews focused on the prevention, detection or management of cancer treatment-induced cardiotoxicity. Using Cochrane methodology, we searched databases, citations and hand-searched bibliographies. Two reviewers independently appraised reviews and extracted findings. A total of 18 high quality systematic reviews were subsequently analysed, 67 % (n = 12) of these comprised meta-analyses. One systematic review concluded that there is insufficient evidence regarding the utility of cardiac biomarkers for the detection of cardiotoxicity. The following strategies might reduce the risk of cardiotoxicity: 1) The concomitant administration of dexrazoxane with anthracylines; 2) The avoidance of anthracyclines where possible; 3) The continuous administration of anthracyclines (>6 h) rather than bolus dosing; and 4) The administration of anthracycline derivatives such as epirubicin or liposomal-encapsulated doxorubicin instead of doxorubicin. In terms of management, one review focused on medical interventions for treating anthracycline-induced cardiotoxicity during or after treatment of childhood cancer. Neither intervention (enalapril and phosphocreatine) was associated with statistically significant improvement in ejection fraction or mortality. This review highlights the lack of high level evidence to guide clinical decision-making with respect to the detection

Time concurrency/phase-time synchronization in digital communications networks

Science.gov (United States)

Kihara, Masami; Imaoka, Atsushi

1990-01-01

Digital communications networks have the intrinsic capability of time synchronization which makes it possible for networks to supply time signals to some applications and services. A practical estimation method for the time concurrency on terrestrial networks is presented. By using this method, time concurrency capability of the Nippon Telegraph and Telephone Corporation (NTT) digital communications network is estimated to be better than 300 ns rms at an advanced level, and 20 ns rms at final level.

The Challenges of Career and Technical Education Concurrent Enrollment: An Administrative Perspective

Science.gov (United States)

Haag, Patricia W.

2015-01-01

Career and technical education concurrent enrollment may pose unique challenges in programming and enrollment for program administrators, and this chapter describes the experiences and challenges of a CTE concurrent enrollment administrator.

Risk assessment and cost-benefit techniques as management tools for oil spill prevention

International Nuclear Information System (INIS)

Diller, S.

1998-01-01

In the last 15 years, and especially after remarkable large technological accidents like Bhopal, San Juanico, Tacoa, Piper Alpha, Exxon Valdez, Sea Empress, etc, the risk assessment tools have become a must for design engineers and also have been growing popular since more reliable oil spill accident analysis data has been gathered in the last ten years. On the other hand the large investments that have been necessary to execute in order to adequate and improve old facilities, equipment, etc., and the total loss control enhancements in new projects, have created some concern on how safe is safe and how much money is it necessary to spend in order to be sufficiently preventative without getting into financial trouble and being technologically sound according to the growing global concern about environmental issues. Concepts are presented in risk prevention and oil spill risk assessment, and examples are developed in order to understand the link between different oil spill risk prevention options and the management finance decision making process. (author)

Concurrent Design of Embedded Control Software

NARCIS (Netherlands)

Groothuis, M.A.; Frijns, Raymond; Voeten, Jeroen; Broenink, Johannes F.; Margaria, T.; Padberg, J.; Taentzer, G.; Levendovszky, T.; Lengyel, L.; Karsai, G.; Hardebolle, C.

2009-01-01

Embedded software design for mechatronic systems is becoming an increasingly time-consuming and error-prone task. In order to cope with the heterogeneity and complexity, a systematic model-driven design approach is needed, where several parts of the system can be designed concurrently. There is

[How can we prevent alveolar echinococcosis? Ecosystem and risk management viewpoints].

Science.gov (United States)

Konno, Keita; Oku, Yuzaburo; Kamiya, Masao; Doi, Rikuo; Tamashiro, Hidehiko

2002-01-01

This article focuses on understanding epidemiological features of alveolar echinococcosis and discussing its prevention and control, especially from a viewpoint of the ecosystem and risk management. Publications on alveolar echinococcosis throughout the world were systematically reviewed with special reference to ecology, epidemiology and countermeasures. Alveolar echinococcosis, caused by accidental infection with larva of the parasite Echinococcus multilocularis is fatal to humans unless diagnosed at an early stage. No effective control measures have been identified so far because it is difficult to fully understand the ecology of the parasite and its intermediate and definitive hosts. It is also not easy to determine the precise infection route to humans mainly because of the long latent period. In Hokkaido, infection rates among red foxes have recently risen even in low endemic districts. Not only stray and domestic dogs but also some pigs in Hokkaido have been found to be infected. While the number of reported human cases is still small, around 10 cases per year, local residents seem to be threatened with the risk of infection. We predict that the incidence of alveolar echinococcosis among humans in Japan will increase in the near future if no effective preventive measures are conducted. In addition, Echinococcus multilocularis infection has the potential to affect the economy of Hokkaido because of its impact on the agricultural and tourist industries. Well-designed epidemiological surveys are therefore urgently required, in the context of ecosystem and risk management prior to large outbreaks. International collaboration is also desired.

Patterns of and Motivations for Concurrent Use of Video Games and Substances

Directory of Open Access Journals (Sweden)

Geoffrey L. Ream

2011-10-01

Full Text Available “Behavioral addictions” share biological mechanisms with substance dependence, and “drug interactions” have been observed between certain substances and self-reinforcing behaviors. This study examines correlates of patterns of and motivations for playing video games while using or feeling the effects of a substance (concurrent use. Data were drawn from a nationally-representative survey of adult Americans who “regularly” or “occasionally” played video games and had played for at least one hour in the past seven days (n = 3,380. Only recent concurrent users’ data were included in analyses (n = 1,196. Independent variables included demographics, substance use frequency and problems, game genre of concurrent use (identified by looking titles up in an industry database, and general game playing variables including problem video game play (PVP, consumer involvement, enjoyment, duration, and frequency of play. Exploratory factor analysis identified the following dimensions underlying patterns of and motivations for concurrent use: pass time or regulate negative emotion, enhance an already enjoyable or positive experience, and use of video games and substances to remediate each other’s undesirable effects. Multivariate regression analyses indicated PVP and hours/day of video game play were associated with most patterns/motivations, as were caffeine, tobacco, alcohol, marijuana, and painkiller use problems. This suggests that concurrent use with some regular situational pattern or effect-seeking motivation is part of the addictive process underlying both PVP and substance dependence. Various demographic, game playing, game genre of concurrent use, and substance use variables were associated with specific motivations/patterns, indicating that all are important in understanding concurrent use.

A Model of Computation for Bit-Level Concurrent Computing and Programming: APEC

Science.gov (United States)

Ajiro, Takashi; Tsuchida, Kensei

A concurrent model of computation and a language based on the model for bit-level operation are useful for developing asynchronous and concurrent programs compositionally, which frequently use bit-level operations. Some examples are programs for video games, hardware emulation (including virtual machines), and signal processing. However, few models and languages are optimized and oriented to bit-level concurrent computation. We previously developed a visual programming language called A-BITS for bit-level concurrent programming. The language is based on a dataflow-like model that computes using processes that provide serial bit-level operations and FIFO buffers connected to them. It can express bit-level computation naturally and develop compositionally. We then devised a concurrent computation model called APEC (Asynchronous Program Elements Connection) for bit-level concurrent computation. This model enables precise and formal expression of the process of computation, and a notion of primitive program elements for controlling and operating can be expressed synthetically. Specifically, the model is based on a notion of uniform primitive processes, called primitives, that have three terminals and four ordered rules at most, as well as on bidirectional communication using vehicles called carriers. A new notion is that a carrier moving between two terminals can briefly express some kinds of computation such as synchronization and bidirectional communication. The model's properties make it most applicable to bit-level computation compositionally, since the uniform computation elements are enough to develop components that have practical functionality. Through future application of the model, our research may enable further research on a base model of fine-grain parallel computer architecture, since the model is suitable for expressing massive concurrency by a network of primitives.

Tribal-federal collaboration in resource management

Science.gov (United States)

Ellen M. Donoghue; Sara A. Thompson; John C. Bliss

2010-01-01

The increase in collaborative projects involving American Indian tribes and natural resource management agencies in the United States reflects two emergent trends: 1) the use of collaborative approaches between agencies and groups in managing natural resources; and 2) the concurrent increased recognition of American Indian rights, institutionalization of consultation...

Concurrent sexual partnerships among men who have sex with men in Shenzhen, China.

Science.gov (United States)

Ha, Toan H; Liu, Hongjie; Liu, Hui; Cai, Yumao; Feng, Tiejian

2010-08-01

The HIV epidemic spreads among men who have sex with men (MSM) in China. The objective of this study was to examine and compare HIV/AIDS knowledge and sexual risk for HIV between MSM who engaged in concurrent sexual partnerships and MSM who did not. A cross-sectional study using respondent driven sampling was conducted among 351 MSM in Shenzhen, China. About half (49%) of respondents reported having concurrent sexual partnerships during the past 6 months. Among MSM with concurrent sexual partnerships, 62% had only male partners and 38% had both male and female partners. The proportion of inconsistent condom use was 42% among MSM with concurrent partners and 30% among MSM without. These 2 groups reported a similar level of self-perceived risk for HIV. Compared to MSM without concurrent sexual partners, those with such partners were more likely to work in entertainment venues and had a lower level of HIV/AIDS knowledge. The large number of MSM engaging in concurrent sexual partnerships and the high prevalence of bisexuality could accelerate the spread of HIV to the general population unless effective HIV interventions for MSM are implemented in China.

Preventing food allergy

DEFF Research Database (Denmark)

de Silva, Debra; Panesar, Sukhmeet S; Thusu, Sundeep

2013-01-01

The European Academy of Allergy and Clinical Immunology is developing guidelines about how to prevent and manage food allergy. As part of the guidelines development process, a systematic review is planned to examine published research about the prevention of food allergy. This systematic review...... is one of seven inter-linked evidence syntheses that are being undertaken in order to provide a state-of-the-art synopsis of the current evidence base in relation to epidemiology, prevention, diagnosis and clinical management, and impact on quality of life, which will be used to inform clinical...... recommendations. The aim of this systematic review will be to assess the effectiveness of approaches for the primary prevention of food allergy....

On run-time exploitation of concurrency

NARCIS (Netherlands)

Holzenspies, P.K.F.

2010-01-01

The `free' speed-up stemming from ever increasing processor speed is over. Performance increase in computer systems can now only be achieved through parallelism. One of the biggest challenges in computer science is how to map applications onto parallel computers. Concurrency, seen as the set of

29 CFR 502.17 - Concurrent actions.

Science.gov (United States)

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Concurrent actions. 502.17 Section 502.17 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR REGULATIONS ENFORCEMENT OF CONTRACTUAL OBLIGATIONS FOR TEMPORARY ALIEN AGRICULTURAL WORKERS ADMITTED UNDER SECTION 218 OF THE IMMIGRATION...

29 CFR 501.17 - Concurrent actions.

Science.gov (United States)

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Concurrent actions. 501.17 Section 501.17 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR REGULATIONS ENFORCEMENT OF CONTRACTUAL OBLIGATIONS FOR TEMPORARY ALIEN AGRICULTURAL WORKERS ADMITTED UNDER SECTION 218 OF THE IMMIGRATION...

Patients survey after concurrent chemoradiotherapy

International Nuclear Information System (INIS)

Shimane, Toshikazku; Egawa, Syunya; Mori, Tomoaki; Ono, Tomohiro; Monden, Tetsuya; Kobayashi, Sei; Sanbe, Takeyuki; Suzaki, Harumi

2010-01-01

Concurrent chemoradiotherapy for cancer of head and neck is becoming more popular as the treatment of choice. It is considered to maintain the quality of life (QOL) of patients better than operative treatments in terms of preserving the functions, organs, and figure, but recently we cannot necessarily say that it maintains the QOL of patients better than operative treatments because its complications after therapy disturb daily life. We report the results of a questionnaire survey about complications after therapy, problems during therapy, improvements, and satisfaction level directed at patients with cancer of the head and neck who received Concurrent chemoradiotherapy for the purpose of ascertaining if patients can actually maintain their QOL after therapy. As a result, the most controversial problem was mouth dryness, but the symptom improved as the follow-up duration got longer. As for the satisfaction level, 'very-satisfied' and 'almost-satisfied' were more than 90%, so we concluded that the QOL of patients is maintained after therapy, while there are still improvements to be made. We also concluded that we should continue to make improvement and try to improve the QOL of patients during and after therapy. (author)

How Formal Dynamic Verification Tools Facilitate Novel Concurrency Visualizations

Science.gov (United States)

Aananthakrishnan, Sriram; Delisi, Michael; Vakkalanka, Sarvani; Vo, Anh; Gopalakrishnan, Ganesh; Kirby, Robert M.; Thakur, Rajeev

With the exploding scale of concurrency, presenting valuable pieces of information collected by formal verification tools intuitively and graphically can greatly enhance concurrent system debugging. Traditional MPI program debuggers present trace views of MPI program executions. Such views are redundant, often containing equivalent traces that permute independent MPI calls. In our ISP formal dynamic verifier for MPI programs, we present a collection of alternate views made possible by the use of formal dynamic verification. Some of ISP’s views help pinpoint errors, some facilitate discerning errors by eliminating redundancy, while others help understand the program better by displaying concurrent even orderings that must be respected by all MPI implementations, in the form of completes-before graphs. In this paper, we describe ISP’s graphical user interface (GUI) capabilities in all these areas which are currently supported by a portable Java based GUI, a Microsoft Visual Studio GUI, and an Eclipse based GUI whose development is in progress.

Factors associated with pathways toward concurrent sex work and injection drug use among female sex workers who inject drugs in northern Mexico.

Science.gov (United States)

Morris, Meghan D; Lemus, Hector; Wagner, Karla D; Martinez, Gustavo; Lozada, Remedios; Gómez, Rangel María Gudelia; Strathdee, Steffanie A

2013-01-01

To identify factors associated with time to initiation of (i) sex work prior to injecting drugs initiation; (ii) injection drug use prior to sex work initiation; and (iii) concurrent sex work and injection drug use (i.e. initiated at the same age) among female sex workers who currently inject drugs (FSW-IDU). Parametric survival analysis of baseline data for time to initiation event. Tijuana and Ciudad Juarez situated on the Mexico-US border. A total of 557 FSW-IDUs aged ≥18 years. Interview-administered surveys assessing context of sex work and injection drug use initiation. Nearly half (n = 258) initiated sex work prior to beginning to inject, a third (n = 163) initiated injection first and a quarter (n = 136) initiated both sex work and injection drug use concurrently. Low education and living in Ciudad Juarez accelerated time to sex work initiation. Being from a southern Mexican state and initiating drug use with inhalants delayed the time to first injection drug use. Having an intimate partner encourage entry into sex work and first injecting drugs to deal with depression accelerated time to initiating sex work and injection concurrently. Early physical abuse accelerated time to initiating sex work and injection, and substantially accelerated time to initiation of both behaviors concurrently. Among female sex workers who currently inject drugs in two Mexican-US border cities, nearly half appear to initiate sex work prior to beginning to inject, nearly one-third initiate injection drug use before beginning sex work and one-quarter initiate both behaviors concurrently. Predictors of these three trajectories differ, and this provides possible modifiable targets for prevention. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Preventive conservation and management: contribution to a new integrated model, based on the case study of National Archive Torre do Tombo, Portugal

Directory of Open Access Journals (Sweden)

Luís Filipe Raposo Pereira

2016-01-01

Full Text Available The development of a management model, in the preventive conservation area in the National Archive Torre do Tombo, included the identification of the specificities related to assessment and risk management methodology in Archives area/field and the definition of concepts and processes connected to management in that context. The present paper will focus on those contributions, particularly in the changes resulting by a new perspective in terms of management, based in the methodology defined by the AS/NZS 4360 standard. It also represents the end of the characterization of a process with two sequential phases, corresponding to the periods 2006-2007 and 2009-2013, which intention was to reinforce management assumptions in the preventive conservation field.

AEGIS: a wildfire prevention and management information system

Science.gov (United States)

Kalabokidis, Kostas; Ager, Alan; Finney, Mark; Athanasis, Nikos; Palaiologou, Palaiologos; Vasilakos, Christos

2016-03-01

We describe a Web-GIS wildfire prevention and management platform (AEGIS) developed as an integrated and easy-to-use decision support tool to manage wildland fire hazards in Greece (http://aegis.aegean.gr). The AEGIS platform assists with early fire warning, fire planning, fire control and coordination of firefighting forces by providing online access to information that is essential for wildfire management. The system uses a number of spatial and non-spatial data sources to support key system functionalities. Land use/land cover maps were produced by combining field inventory data with high-resolution multispectral satellite images (RapidEye). These data support wildfire simulation tools that allow the users to examine potential fire behavior and hazard with the Minimum Travel Time fire spread algorithm. End-users provide a minimum number of inputs such as fire duration, ignition point and weather information to conduct a fire simulation. AEGIS offers three types of simulations, i.e., single-fire propagation, point-scale calculation of potential fire behavior, and burn probability analysis, similar to the FlamMap fire behavior modeling software. Artificial neural networks (ANNs) were utilized for wildfire ignition risk assessment based on various parameters, training methods, activation functions, pre-processing methods and network structures. The combination of ANNs and expected burned area maps are used to generate integrated output map of fire hazard prediction. The system also incorporates weather information obtained from remote automatic weather stations and weather forecast maps. The system and associated computation algorithms leverage parallel processing techniques (i.e., High Performance Computing and Cloud Computing) that ensure computational power required for real-time application. All AEGIS functionalities are accessible to authorized end-users through a web-based graphical user interface. An innovative smartphone application, AEGIS App, also

Is "disease management" the answer to our problems? No! Population health management and (disease) prevention require "management of overall well-being".

Science.gov (United States)

Cramm, Jane Murray; Nieboer, Anna Petra

2016-09-21

managing their own well-being and adequately addressing their needs in a broader sense. So, is disease management the answer to our problems in the time of aging populations and increased prevalence of unhealthy lifestyles, chronic illnesses, and comorbidity? No! Effective (disease) prevention, disease management, patient-centered care, and high-quality chronic care and/or population health management calls for management of overall well-being.

23 CFR 635.114 - Award of contract and concurrence in award.

Science.gov (United States)

2010-04-01

... TRAFFIC OPERATIONS CONSTRUCTION AND MAINTENANCE Contract Procedures § 635.114 Award of contract and concurrence in award. (a) Federal-aid contracts shall be awarded only on the basis of the lowest responsive... 23 Highways 1 2010-04-01 2010-04-01 false Award of contract and concurrence in award. 635.114...

Clinical practice guidelines for prevention, diagnosis and management of early and delayed-onset ocular injuries due to mustard gas exposure

Directory of Open Access Journals (Sweden)

Zhale Rajavi

2017-01-01

Conclusion: Considering the lack of CPGs for the prevention, diagnosis, and management of mustard gas-induced keratitis, these recommendations would be useful to prevent the serious ocular complications of mustard gas and standardize eye care services to the affected individuals.

Physical activity and metabolic disease among people with affective disorders: Prevention, management and implementation.

Science.gov (United States)

Vancampfort, Davy; Stubbs, Brendon

2017-12-15

One in ten and one in three of people with affective disorders experience diabetes and metabolic syndrome respectively. Physical activity (PA) and sedentary behaviour (SB) are key risk factors that can ameliorate the risk of metabolic disease among this population. However, PA is often seen as luxury and/or a secondary component within the management of people with affective disorders. The current article provides a non-systematic best-evidence synthesis of the available literature, detailing a number of suggestions for the implementation of PA into clinical practice. Whilst the evidence is unequivocal for the efficacy of PA to prevent and manage metabolic disease in the general population, it is in its infancy in this patient group. Nonetheless, action must be taken now to ensure that PA and reducing SB are given a priority to prevent and manage metabolic diseases and improve wider health outcomes. PA should be treated as a vital sign and all people with affective disorders asked about their activity levels and if appropriate advised to increase this. There is a need for investment in qualified exercise specialists in clinical practice such as physiotherapists to undertake and oversee PA in practice. Behavioural strategies such as the self-determined theory should be employed to encourage adherence. Funding is required to develop the evidence base and elucidate the optimal intervention characteristics. PA interventions should form an integral part of the multidisciplinary management of people with affective disorders and our article outlines the evidence and strategies to implement this in practice. Copyright © 2016 Elsevier B.V. All rights reserved.

Integrated System-Level Optimization for Concurrent Engineering With Parametric Subsystem Modeling

Science.gov (United States)

Schuman, Todd; DeWeck, Oliver L.; Sobieski, Jaroslaw

2005-01-01

The introduction of concurrent design practices to the aerospace industry has greatly increased the productivity of engineers and teams during design sessions as demonstrated by JPL's Team X. Simultaneously, advances in computing power have given rise to a host of potent numerical optimization methods capable of solving complex multidisciplinary optimization problems containing hundreds of variables, constraints, and governing equations. Unfortunately, such methods are tedious to set up and require significant amounts of time and processor power to execute, thus making them unsuitable for rapid concurrent engineering use. This paper proposes a framework for Integration of System-Level Optimization with Concurrent Engineering (ISLOCE). It uses parametric neural-network approximations of the subsystem models. These approximations are then linked to a system-level optimizer that is capable of reaching a solution quickly due to the reduced complexity of the approximations. The integration structure is described in detail and applied to the multiobjective design of a simplified Space Shuttle external fuel tank model. Further, a comparison is made between the new framework and traditional concurrent engineering (without system optimization) through an experimental trial with two groups of engineers. Each method is evaluated in terms of optimizer accuracy, time to solution, and ease of use. The results suggest that system-level optimization, running as a background process during integrated concurrent engineering sessions, is potentially advantageous as long as it is judiciously implemented.

[Medication error management climate and perception for system use according to construction of medication error prevention system].

Science.gov (United States)

Kim, Myoung Soo

2012-08-01

The purpose of this cross-sectional study was to examine current status of IT-based medication error prevention system construction and the relationships among system construction, medication error management climate and perception for system use. The participants were 124 patient safety chief managers working for 124 hospitals with over 300 beds in Korea. The characteristics of the participants, construction status and perception of systems (electric pharmacopoeia, electric drug dosage calculation system, computer-based patient safety reporting and bar-code system) and medication error management climate were measured in this study. The data were collected between June and August 2011. Descriptive statistics, partial Pearson correlation and MANCOVA were used for data analysis. Electric pharmacopoeia were constructed in 67.7% of participating hospitals, computer-based patient safety reporting systems were constructed in 50.8%, electric drug dosage calculation systems were in use in 32.3%. Bar-code systems showed up the lowest construction rate at 16.1% of Korean hospitals. Higher rates of construction of IT-based medication error prevention systems resulted in greater safety and a more positive error management climate prevailed. The supportive strategies for improving perception for use of IT-based systems would add to system construction, and positive error management climate would be more easily promoted.

The first Iranian recommendations on prevention, evaluation and management of high blood pressure

Directory of Open Access Journals (Sweden)

Feridoun Noohi

2012-10-01

Full Text Available This paper presents the complete report of the first Iranian Recommendations on Prevention, Evaluation and Management of High Blood Pressure. The purpose is to provide an evidence-based approach to the prevention, management and control of hypertension (HTN by adapting the most internationally known and used guidelines to the local health care status with consideration of the currently available data and based on the locally conducted researches on HTN as well as social and health care requirements. A working group of national and international experts participated in discussions and collaborated in decision-making, writing and reviewing the whole report. Multiple subcommittees worked together to review the recent national and international literature on HTN in different areas. We used the evaluation tool that is called “AGREE” and considered a score of > 60% as a high score. We adapted the Canadian Hypertension Education Program (CHEP, the United Kingdom’s National Institute for Health and Clinical Excellence (NICE and the US-based joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7. The key topics that are highlighted in this report include: The importance of ambulatory and self-measurement of blood pressure, evaluation of cardiovascular risk in HTN patients, the role of lifestyle modification in the prevention of HTN and its control with more emphasis on salt intake reduction and weight control, introducing pharmacotherapy suitable for uncomplicated HTN or specific situations and the available drugs in Iran, highlighting the importance of angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers and calcium channel blockers as the first line therapy in many situations, the non-use of beta blockers as the first time treatment except in specific conditions, treating HTN in women, children, obese and elderly patients, the patient compliance to improve HTN control, practical

Educational program for the prevention and management of school violence

Directory of Open Access Journals (Sweden)

Viriam Leiva Díaz

2013-04-01

Full Text Available This article presents the main results of the implementation of an educational program for the preventionand management of violence in public schools by teachers of first and second cycle, the program was taught bythe School of Nursing at the University of Costa Rica, with a total of 40 hours from January to February 2011. Weused various teaching strategies based on the educational needs of this group of teachers, which were shown in aprevious study and application of a needs assessment. Attended by 33 teachers, 32 women and one man. Of theparticipants, 30 completed the program. The main results are as follows: participants were able to acquire, buildor improve their knowledge about the prevention and treatment of school violence, and also learned varioustechniques and strategies for prevention and control of violence in schools. It is concluded that success inachieving the goals set for each of the sessions is directly related to the fact that the entire educational programstuck to the educational needs expressed by the participating population and its characteristics as teachers, usingprinciples of andragogy, which allowed understanding learning as a knowledge sharing among stakeholders

Relationships between Wasting and Stunting and Their Concurrent Occurrence in Ghanaian Preschool Children

Directory of Open Access Journals (Sweden)

Mahama Saaka

2016-01-01

Full Text Available Objective. The main aim of the study was to assess the magnitude of concurrent wasting and stunting among Ghanaian preschool children. Secondly, we investigated the relationship between wasting and stunting as well as factors associated with these conditions. Methods. This paper is based on reanalysis of anthropometric and other relevant data which was collected in the 2014 Ghana Demographic and Health Survey. The data set consisted of 2,720 preschool children aged 0–59 months. We conducted three-step moderated hierarchical multiple regression analyses to determine independent predictors and moderators of height-for-age Z-score. Results. Nationally, the prevalence of concurrent wasting and stunting among children aged 0–59 months was low at 1.4% but it varied geographically with the Upper East Region having the highest prevalence of 3.2% (95% CI: 1.7–5.8. Children who had low weight-for-height Z-scores were at a higher risk of linear growth retardation (stunting especially among children aged less than three years. A 1-unit increase in weight-for-height Z-score (WHZ was associated with 0.07 standard units’ increase in height-for-age Z-score (HAZ [β = 0.071 (95% CI: 0.03, 0.15]. Conclusions. The study results suggest that weight-for-height relates to linear growth but this relationship is moderated by age of child. Stunting and wasting share some common risk factors. Therefore, measures to prevent wasting may positively influence linear growth.

Adjuvant external beam radiation therapy with concurrent chemotherapy in the management of gallbladder carcinoma

International Nuclear Information System (INIS)

Kresl, John J.; Schild, Steven E.; Henning, George T.; Gunderson, Leonard L.; Donohue, John; Pitot, Henry; Haddock, Michael G.; Nagorney, David

2002-01-01

Purpose: This study was performed to evaluate the outcome of patients with gallbladder cancer who received postoperative concurrent chemotherapy and radiation therapy. Methods and Materials: Curative resection followed by adjuvant combined modality therapy with external beam radiation therapy (EBRT) and chemotherapy was attempted in 21 consecutive gallbladder carcinoma (GBC) patients at the Mayo Clinic from 1985 through 1997. All patients received concurrent 5-fluorouracil during EBRT. EBRT fields encompassed the tumor bed and regional lymph nodes (median dose of 54 Gy in 1.8-2.0-Gy fractions). One patient received 15 Gy intraoperatively after EBRT. A retrospective analysis was performed for the end points of local control, distant failure, and overall survival. Results: After maximal resection, 12 patients had no residual disease on pathologic evaluation, 5 had microscopic residual disease, and 4 had gross residual disease. One patient had Stage I disease, and 20 had Stage III-IV disease. With median follow-up of 5 years (range: 2.6-11.5 years), 5-year survival for the entire cohort was 33%. The 5-year survival rate of patients with Stage I-III disease was 65% vs. 0% for those with Stage IV disease (p 54 Gy (microscopic residual, 3 patients; gross residual, 1 patient; negative but narrow margins, 2 patients) vs. 65% for the 15 who received a lower dose (3, gross residual; 2, microresidual; 10, negative margins). Conclusion: Patients with completely resected (negative margins) GBC followed by adjuvant EBRT plus 5-fluorouracil chemotherapy had a relatively favorable prognosis, with a 5-year survival rate of 64%. These results seem to be superior to historical surgical controls from the Mayo Clinic and other institutions, which report 5-year survival rates of approximately 33% with complete resection alone. Both tumor stage and extent of resection seemed to influence survival and local control. More aggressive measures using current cancer therapies and integration

Nurses' perception of knowledge, attitudes and reported practice towards patients with eating disorders: A concurrent mixed-methods study.

Science.gov (United States)

Seah, Xin Yi; Tham, Xiang Cong; Kamaruzaman, Netty Ryanie; Yobas, Piyanee Klainin

2018-02-01

Eating disorders are complex disorders requiring specialised care, thus knowledge and attitudes are crucial for management. This study aims to examine nurses' knowledge, attitudes, reported practice, and perceptions towards patients with eating disorders in Singapore. A concurrent mixed-methods study was carried out in Southeast Asia's only psychiatric unit with eating disorders programme. Twenty nurses were recruited using census sampling. Quantitative data were analysed with descriptive and inferential statistics, while qualitative data were analysed with content and thematic analysis. Certain personal factors were associated with nurses' levels of perceived knowledge. Different attitudes towards managing these patients were identified during interview sessions. Copyright © 2017 Elsevier Inc. All rights reserved.

Calf health from birth to weaning. II. Management of diarrhoea in pre-weaned calves

Directory of Open Access Journals (Sweden)

Lorenz Ingrid

2011-09-01

Full Text Available Abstract Calfhood diseases have a major impact on the economic viability of cattle operations. The second of this three part review series considers the management of diarrhoeic diseases in pre-weaned calves. In neonatal calf diarrhoea, oral rehydration therapy is the single most important therapeutic measure to be carried out by the farmer and is usually successful if instigated immediately after diarrhoea has developed. Continued feeding of milk or milk replacer to diarrhoeic calves is important, to prevent malnourishment and weight loss in affected calves. Indiscriminative antibiotic treatment of uncomplicated diarrhoea is discouraged, whereas systemically ill calves can benefit from systemic antibiotic treatment for the prevention of septicaemia or concurrent diseases. Ancillary treatments and specific preventive measures are discussed. Eimeriosis has a high economic impact on the farming industries due to direct cost of treatment and calf losses, but especially due to decreased performance of clinically as well as sub-clinically affected animals. Emphasis lies on prophylactic or metaphylactic treatment, since the degree of damage to the intestinal mucosa once diarrhoea has developed, makes therapeutic intervention unrewarding.

An Introduction to Parallelism, Concurrency and Acceleration (1/2)

CERN Multimedia

CERN. Geneva

2016-01-01

Concurrency and parallelism are firm elements of any modern computing infrastructure, made even more prominent by the emergence of accelerators. These lectures offer an introduction to these important concepts. We will begin with a brief refresher of recent hardware offerings to modern-day programmers. We will then open the main discussion with an overview of the laws and practical aspects of scalability. Key parallelism data structures, patterns and algorithms will be shown. The main threats to scalability and mitigation strategies will be discussed in the context of real-life optimization problems. Lecturer's short bio: Andrzej Nowak has 10 years of experience in computing technologies, primarily from CERN openlab and Intel. At CERN, he managed a research lab collaborating with Intel and was part of the openlab Chief Technology Office. Andrzej also worked closely and initiated projects with the private sector (e.g. HP and Google), as well as international research institutes, such as EPFL. Current...

Outcomes of Concurrent Operations: Results From the American College of Surgeons' National Surgical Quality Improvement Program.

Science.gov (United States)

Liu, Jason B; Berian, Julia R; Ban, Kristen A; Liu, Yaoming; Cohen, Mark E; Angelos, Peter; Matthews, Jeffrey B; Hoyt, David B; Hall, Bruce L; Ko, Clifford Y

2017-09-01

To determine whether concurrently performed operations are associated with an increased risk for adverse events. Concurrent operations occur when a surgeon is simultaneously responsible for critical portions of 2 or more operations. How this practice affects patient outcomes is unknown. Using American College of Surgeons' National Surgical Quality Improvement Program data from 2014 to 2015, operations were considered concurrent if they overlapped by ≥60 minutes or in their entirety. Propensity-score-matched cohorts were constructed to compare death or serious morbidity (DSM), unplanned reoperation, and unplanned readmission in concurrent versus non-concurrent operations. Multilevel hierarchical regression was used to account for the clustered nature of the data while controlling for procedure and case mix. There were 1430 (32.3%) surgeons from 390 (77.7%) hospitals who performed 12,010 (2.3%) concurrent operations. Plastic surgery (n = 393 [13.7%]), otolaryngology (n = 470 [11.2%]), and neurosurgery (n = 2067 [8.4%]) were specialties with the highest proportion of concurrent operations. Spine procedures were the most frequent concurrent procedures overall (n = 2059/12,010 [17.1%]). Unadjusted rates of DSM (9.0% vs 7.1%; P < 0.001), reoperation (3.6% vs 2.7%; P < 0.001), and readmission (6.9% vs 5.1%; P < 0.001) were greater in the concurrent operation cohort versus the non-concurrent. After propensity score matching and risk-adjustment, there was no significant association of concurrence with DSM (odds ratio [OR] 1.08; 95% confidence interval [CI] 0.96-1.21), reoperation (OR 1.16; 95% CI 0.96-1.40), or readmission (OR 1.14; 95% CI 0.99-1.29). In these analyses, concurrent operations were not detected to increase the risk for adverse outcomes. These results do not lessen the need for further studies, continuous self-regulation and proactive disclosure to patients.

Prevention and management of maternal obesity in pregnancy

Directory of Open Access Journals (Sweden)

E. Alexopoulou

2017-03-01

Full Text Available Nowadays obesity is one of the most important nutritional problems with features contemporary epidemic which concerns not only the developed but also the developing countries. Obesity during pregnancy associate with maternal and perinatal risks that make the management of obesity, before and during pregnancy imperative. The best and most effective treatment of obesity in pregnancy is prevention. A healthy diet and regular exercise of pregnant woman is crucial for the normal development of pregnancy. Moreover every obese pregnant woman should be informed about the importance of calorie - intake regulation and weight reduction both before and after pregnancy. Additional therapeutic options are bariatric surgical procedures that a woman can have before pregnancy and anticoagulation therapy during pregnancy. This article attempts brief review on the current scientific knowledge that exists about the role of nutrition and physical activity in controlling the weight of obese pregnant women and its beneficial contribution to the health of both the mother and the newborn.

Concurrent bevacizumab and temozolomide alter the patterns of failure in radiation treatment of glioblastoma multiforme

International Nuclear Information System (INIS)

Shields, Lisa BE; Kadner, Robert; Vitaz, Todd W; Spalding, Aaron C

2013-01-01

We investigated the pattern of failure in glioblastoma multiforma (GBM) patients treated with concurrent radiation, bevacizumab (BEV), and temozolomide (TMZ). Previous studies demonstrated a predominantly in-field pattern of failure for GBM patients not treated with concurrent BEV. We reviewed the treatment of 23 patients with GBM who received 30 fractions of simultaneous integrated boost IMRT. PTV60 received 2 Gy daily to the tumor bed or residual tumor while PTV54 received 1.8 Gy daily to the surrounding edema. Concurrent TMZ (75 mg/m 2 ) daily and BEV (10 mg/kg every 2 weeks) were given during radiation therapy. One month after RT completion, adjuvant TMZ (150 mg/m 2 × 5 days) and BEV were delivered monthly until progression or 12 months total. With a median follow-up of 12 months, the median disease-free and overall survival were not reached. Four patients discontinued therapy due to toxicity for the following reasons: bone marrow suppression (2), craniotomy wound infection (1), and pulmonary embolus (1). Five patients had grade 2 or 3 hypertension managed by oral medications. Of the 12 patients with tumor recurrence, 7 suffered distant failure with either subependymal (5/12; 41%) or deep white matter (2/12; 17%) spread detected on T2 FLAIR sequences. Five of 12 patients (41%) with a recurrence demonstrated evidence of GAD enhancement. The patterns of failure did not correlate with extent of resection or number of adjuvant cycles. Treatment of GBM patients with concurrent radiation, BEV, and TMZ was well tolerated in the current study. The majority of patients experienced an out-of-field pattern of failure with radiation, BEV, and TMZ which has not been previously reported. Further investigation is warranted to determine whether BEV alters the underlying tumor biology to improve survival. These data may indicate that the currently used clinical target volume thought to represent microscopic disease for radiation may not be appropriate in combination with TMZ

Preventive distribution and plans of iodine tablets stocks management; Distribution preventive et plans de gestion des stocks de comprimes d'iode

Energy Technology Data Exchange (ETDEWEB)

NONE

2002-07-01

This official note includes two parts: one concerns the new preventive distribution of iodine tablets on the areas defined by the Particular Intervention Plans (P.P.I.) around nuclear facilities and the other one the setting up of iodine tablets stocks beyond the P.P.I. areas. In annexe is a guide for the elaboration of stocks management plans for steady iodine tablets. (N.C.)

Systematic review of prevention and management strategies for the consequences of gender-based violence in refugee settings.

Science.gov (United States)

Asgary, Ramin; Emery, Eleanor; Wong, Marcia

2013-06-01

Uncertainties continue regarding effective strategies to prevent and address the consequences of gender-based violence (GBV) among refugees. The databases of PubMed, Cochrane Library, Scopus, PsycINFO, Web of Science, Anthropology Plus, EMBASE, DARE, Google Scholar, MSF Field Research, UNHCR and the regional and global indices of the WHO Global Health Library were searched twice within a 6-month period (April and September 2011) for English-language clinical, public health, basic and social science studies evaluating strategies to prevent and manage health sequelae of GBV among refugees before September 2011. Studies not primarily about prevention and treatment, and not describing population, health outcome and interventions, were excluded. The literature search for the prevention and management arms produced 1212 and 1106 results, respectively. After reviewing the titles and abstracts, 29 and 27 articles were selected for review in their entirety, none of which met the inclusion criteria. Multiple panels of expert recommendations and guidelines were not supported by primary data on actual displaced populations. There is a dire need for research that evaluates the efficacy and effectiveness of various responses to GBV to ultimately allow a transition from largely theoretical and expertise driven to a more evidence-based field. We recommend strategies to improve data collection and to overcome barriers in primary data driven research.

F-MARC: promoting the prevention and management of sudden cardiac arrest in football

OpenAIRE

Kramer, Efraim Benjamin; Dvorak, J; Schmied, C; Meyer, T

2015-01-01

Sudden cardiac death is the most common cause of unnatural death in football. To prevent and urgently manage sudden cardiac arrest on the football field-of-play, F-MARC (FIFA Medical and Research Centre) has been fully committed to a programme of research, education, standardisation and practical implementation. This strategy has detected football players at medical risk during mandatory precompetition medical assessments. Additionally, FIFA has (1) sponsored internationally accepted guidelin...

Mastering concurrency in Go

CERN Document Server

Kozyra, Nathan

2014-01-01

A practical approach covering everything you need to know to get up and running with Go, starting with the basics and imparting increasingly more detail as the examples and topics become more complicated. The book utilizes a casual, conversational style, rife with actual code and historical anecdotes for perspective, as well as usable and extensible example applications. This book is intended for systems developers and programmers with some experience in either Go and/or concurrent programming who wish to become fluent in building high-performance applications that scale by leveraging single-c

Domain Theory for Concurrency

DEFF Research Database (Denmark)

Nygaard, Mikkel

and associated comonads, it highlights the role of linearity in concurrent computation. Two choices of comonad yield two expressive metalanguages for higher-order processes, both arising from canonical constructions in the model. Their denotational semantics are fully abstract with respect to contextual...... equivalence. One language, called HOPLA for Higher-Order Process LAnguage, derives from an exponential of linear logic. It can be viewed as an extension of the simply-typed lambda calculus with CCS-like nondeterministic sum and prefix operations, in which types express the form of computation path of which...

Morse Theory and Concurrency

DEFF Research Database (Denmark)

Wisniewski, Rafal

2003-01-01

The work is intended to provide some insight about concurrency theory using ideas from geometry and algebraic topology. We define a topological space containing all traces of execution of the computer program and the information about how time flows. This is the main difference with standard...... topological reasoning in which there is no information about relation "in time" among points. The main task is to define equivalence of paths reflecting execution of a program. We use the notion of homotopy history equivalence relation. The model space considered in this work is a differentiable manifold...

A study of pedestrian compliance with traffic signals for exclusive and concurrent phasing.

Science.gov (United States)

Ivan, John N; McKernan, Kevin; Zhang, Yaohua; Ravishanker, Nalini; Mamun, Sha A

2017-01-01

This paper describes a comparison of pedestrian compliance at traffic signals with two types of pedestrian phasing: concurrent, where both pedestrians and vehicular traffic are directed to move in the same directions at the same time, and exclusive, where pedestrians are directed to move during their own dedicated phase while all vehicular traffic is stopped. Exclusive phasing is usually perceived to be safer, especially by senior and disabled advocacy groups, although these safety benefits depend upon pedestrians waiting for the walk signal. This paper investigates whether or not there are differences between pedestrian compliance at signals with exclusive pedestrian phasing and those with concurrent phasing and whether these differences continue to exist when compliance at exclusive phasing signals is evaluated as if they had concurrent phasing. Pedestrian behavior was observed at 42 signalized intersections in central Connecticut with both concurrent and exclusive pedestrian phasing. Binary regression models were estimated to predict pedestrian compliance as a function of the pedestrian phasing type and other intersection characteristics, such as vehicular and pedestrian volume, crossing distance and speed limit. We found that pedestrian compliance is significantly higher at intersections with concurrent pedestrian phasing than at those with exclusive pedestrian phasing, but this difference is not significant when compliance at exclusive phase intersections is evaluated as if it had concurrent phasing. This suggests that pedestrians treat exclusive phase intersections as though they have concurrent phasing, rendering the safety benefits of exclusive pedestrian phasing elusive. No differences were observed for senior or non-senior pedestrians. Published by Elsevier Ltd.

Adding Concurrency to Smart Contracts

OpenAIRE

Dickerson, Thomas; Gazzillo, Paul; Herlihy, Maurice; Koskinen, Eric

2017-01-01

Modern cryptocurrency systems, such as Ethereum, permit complex financial transactions through scripts called smart contracts. These smart contracts are executed many, many times, always without real concurrency. First, all smart contracts are serially executed by miners before appending them to the blockchain. Later, those contracts are serially re-executed by validators to verify that the smart contracts were executed correctly by miners. Serial execution limits system throughput and fails ...

Evaluation of concurrent peak responses

International Nuclear Information System (INIS)

Wang, P.C.; Curreri, J.; Reich, M.

1983-01-01

This report deals with the problem of combining two or more concurrent responses which are induced by dynamic loads acting on nuclear power plant structures. Specifically, the acceptability of using the square root of the sum of the squares (SRSS) value of peak values as the combined response is investigated. Emphasis is placed on the establishment of a simplified criterion that is convenient and relatively easy to use by design engineers

Cost-Effectiveness Analysis of Screening for and Managing Identified Hypertension for Cardiovascular Disease Prevention in Vietnam

NARCIS (Netherlands)

Nguyen, Thi-Phuong-Lan; Wright, E. Pamela; Thanh-Trung Nguyen,; Schuiling-Veninga, C. C. M.; Bijlsma, M. J.; Thi-Bach-Yen Nguyen,; Postma, M. J.

2016-01-01

Objective To inform development of guidelines for hypertension management in Vietnam, we evaluated the cost-effectiveness of different strategies on screening for hypertension in preventing cardiovascular disease (CVD). Methods A decision tree was combined with a Markov model to measure incremental

The role of episiotomy in prevention and management of shoulder dystocia: a systematic review.

Science.gov (United States)

Sagi-Dain, Lena; Sagi, Shlomi

2015-05-01

Shoulder dystocia is an obstetric emergency with potential catastrophic outcomes. To perform a systematic literature review examining the effectiveness of episiotomy in the prevention and management of shoulder dystocia during vaginal birth. Search was conducted by a research librarian in MEDLINE, Web of Science, Cochrane Library, and SCOPUS databases using the terms "episiotomy" and "shoulder dystocia," with no language or time restrictions. Two investigators independently selected original researches examining the effects of episiotomy on shoulder dystocia and its neonatal andmaternal outcomes. Relevant articles were accessed in full text, including manual search of the references. We contacted authors of studies with insufficient or unclear data. Because of clinical and methodological diversity of the studies, meta-analysis was not performed. Fourteen articles met the inclusion criteria, encompassing a total of 9769 shoulder dystocia cases. Only 1 study effectively evaluated the role of episiotomy in shoulder dystocia prevention, yielding a nonsignificant result. Three articles assessed neonatal consequences of shoulder dystocia, one of them linking episiotomy to higher risk of neonatal injury. Two of the 3 studies evaluating maternal outcomes showed that episiotomy is related to increased risk of advanced perineal tears. Overall quality of evidence was rated as very low. Our systematic review found no evidence supporting the use of episiotomy in the prevention and management of shoulder dystocia. This observation carries major clinical and legal implications for the obstetricians. Higher-quality studies are needed to evaluate this important issue.

Automatic Management of Parallel and Distributed System Resources

Science.gov (United States)

Yan, Jerry; Ngai, Tin Fook; Lundstrom, Stephen F.

1990-01-01

Viewgraphs on automatic management of parallel and distributed system resources are presented. Topics covered include: parallel applications; intelligent management of multiprocessing systems; performance evaluation of parallel architecture; dynamic concurrent programs; compiler-directed system approach; lattice gaseous cellular automata; and sparse matrix Cholesky factorization.

Analyzing and designing object-oriented missile simulations with concurrency

Science.gov (United States)

Randorf, Jeffrey Allen

2000-11-01

A software object model for the six degree-of-freedom missile modeling domain is presented. As a precursor, a domain analysis of the missile modeling domain was started, based on the Feature-Oriented Domain Analysis (FODA) technique described by the Software Engineering Institute (SEI). It was subsequently determined the FODA methodology is functionally equivalent to the Object Modeling Technique. The analysis used legacy software documentation and code from the ENDOSIM, KDEC, and TFrames 6-DOF modeling tools, including other technical literature. The SEI Object Connection Architecture (OCA) was the template for designing the object model. Three variants of the OCA were considered---a reference structure, a recursive structure, and a reference structure with augmentation for flight vehicle modeling. The reference OCA design option was chosen for maintaining simplicity while not compromising the expressive power of the OMT model. The missile architecture was then analyzed for potential areas of concurrent computing. It was shown how protected objects could be used for data passing between OCA object managers, allowing concurrent access without changing the OCA reference design intent or structure. The implementation language was the 1995 release of Ada. OCA software components were shown how to be expressed as Ada child packages. While acceleration of several low level and other high operations level are possible on proper hardware, there was a 33% degradation of 4th order Runge-Kutta integrator performance of two simultaneous ordinary differential equations using Ada tasking on a single processor machine. The Defense Department's High Level Architecture was introduced and explained in context with the OCA. It was shown the HLA and OCA were not mutually exclusive architectures, but complimentary. HLA was shown as an interoperability solution, with the OCA as an architectural vehicle for software reuse. Further directions for implementing a 6-DOF missile modeling

Clinical Characteristics of the Suicide Attempters Who Refused to Participate in a Suicide Prevention Case Management Program

OpenAIRE

Park, Soyoung; Choi, Kyoung Ho; Oh, Youngmin; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai; Lee, Kyoung-Uk

2015-01-01

Case management interventions for suicide attempters aimed at helping adjust their social life to prevent reattempts have high nonparticipation and dropout rates. We analyzed the clinical characteristics of the group who refused to participate in the suicide prevention program in Korea. A total of 489 patients with a suicide attempt who visited Uijeongbu St. Mary's Hospital, the Catholic University of Korea, from December 2009 to December 2013 were analyzed. All patients were divided into the...

The first Iranian recommendations on prevention, evaluation and management of high blood pressure.

Science.gov (United States)

Noohi, Feridoun; Sarrafzadegan, Nizal; Khosravi, Alireza; Andalib, Elham

2012-01-01

This paper presents the complete report of the first Iranian Recommendations on Prevention, Evaluation and Management of High Blood Pressure. The purpose is to provide an evidence-based approach to the prevention, management and control of hypertension (HTN) by adapting the most internationally known and used guidelines to the local health care status with consideration of the currently available data and based on the locally conducted researches on HTN as well as social and health care requirements. A working group of national and international experts participated in discussions and collaborated in decision-making, writing and reviewing the whole report. Multiple subcommittees worked together to review the recent national and international literature on HTN in different areas. We used the evaluation tool that is called "AGREE" and considered a score of > 60% as a high score. We adapted the Canadian Hypertension Education Program (CHEP), the United Kingdom's National Institute for Health and Clinical Excellence (NICE) and the US-based joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7). The key topics that are highlighted in this report include: The importance of ambulatory and self-measurement of blood pressure, evaluation of cardiovascular risk in HTN patients, the role of lifestyle modification in the prevention of HTN and its control with more emphasis on salt intake reduction and weight control, introducing pharmacotherapy suitable for uncomplicated HTN or specific situations and the available drugs in Iran, highlighting the importance of angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers and calcium channel blockers as the first line therapy in many situations, the non-use of beta blockers as the first time treatment except in specific conditions, treating HTN in women, children, obese and elderly patients, the patient compliance to improve HTN control, practical guidelines to improve

Prioritizing and optimizing sustainable measures for food waste prevention and management.

Science.gov (United States)

Cristóbal, Jorge; Castellani, Valentina; Manfredi, Simone; Sala, Serenella

2018-02-01

Food waste has gained prominence in the European political debate thanks to the recent Circular Economy package. Currently the waste hierarchy, introduced by the Waste Framework Directive, has been the rule followed to prioritize food waste prevention and management measures according to the environmental criteria. But when considering other criteria along with the environmental one, such as the economic, other tools are needed for the prioritization and optimization. This paper addresses the situation in which a decision-maker has to design a food waste prevention programme considering the limited economic resources in order to achieve the highest environmental impact prevention along the whole food life cycle. A methodology using Life Cycle Assessment and mathematical programing is proposed and its capabilities are shown through a case study. Results show that the order established in the waste hierarchy is generally followed. The proposed methodology revealed to be especially helpful in identifying "quick wins" - measures that should be always prioritized since they avoid a high environmental impact at a low cost. Besides, in order to aggregate the environmental scores related to a variety of impact categories, different weighting sets were proposed. In general, results show that the relevance of the weighting set in the prioritization of the measures appears to be limited. Finally, the correlation between reducing food waste generation and reducing environmental impact along the Food Supply Chain has been studied. Results highlight that when planning food waste prevention strategies, it is important to set the targets at the level of environmental impact instead of setting the targets at the level of avoided food waste generation (in mass). Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Oligopolistic concurrence and investment: application to electricity markets

International Nuclear Information System (INIS)

Meunier, G.

2008-12-01

This research aims at analysing investment strategies of firms which are in an oligopolistic situation. After a brief description of the physical characteristics of an electric system, the author describes the reforms and defines the problematic of an investment in electricity production within markets in imperfect concurrence. In a first part, the author analyses the heterogeneity (either exogenous or endogenous) and technology choices of oligopolistic firms. In case of an exogenous heterogeneity, he studies the impact of the number of firms on investment decisions. In the second part, the author examines the regulations introduced in industries in imperfect concurrence: electricity production by a public firm and interaction between emission allowance market and investment

Non-Blocking Concurrent Imperative Programming with Session Types

Directory of Open Access Journals (Sweden)

Miguel Silva

2017-01-01

Full Text Available Concurrent C0 is an imperative programming language in the C family with session-typed message-passing concurrency. The previously proposed semantics implements asynchronous (non-blocking output; we extend it here with non-blocking input. A key idea is to postpone message reception as much as possible by interpreting receive commands as a request for a message. We implemented our ideas as a translation from a blocking intermediate language to a non-blocking language. Finally, we evaluated our techniques with several benchmark programs and show the results obtained. While the abstract measure of span always decreases (or remains unchanged, only a few of the examples reap a practical benefit.

[Prevention and management of postresectional bronchopleural fistula].

Science.gov (United States)

Ishikawa, Shigemi

2008-07-01

Bronchopleural fistula (BPF) is still a life-threatening complication after pulmonary resection. Several factors were identified to contribute BPF. Meticulous surgical technique and the liberal use of prophylactic, pedicled flaps are important for prevention. Although these patients often present compromised and moribund, evaluation and management should proceed in a logical, stepwise fashion. In high-risk surgical patients, bronchoscopic procedures using different glues and sealants may serve as a temporary bridge until the patient's recovery or as a permanent resolution. However persistent conservative therapy may deteriorate patient's condition. Immediate creation of open window thoracotomy has been shown to be a significant predictor of wound closure afterwards. Pedicled muscle or omental flaps are useful to close bronchial stump and to fill the residual space in the thorax after pulmonary resection. Once fistula closed, the pleural space is filled with an antibiotic solution and then the open window thoracotomy closed in layers as Clagett procedure. The transternal transpericardial approach to recalcitrant postpneumonectomy BPF can be considered when patients have failed prior closure attempt. To conclude, survival and excellent result of BPF depends on early diagnosis, and aggressive surgical intervention.

Environmental evaluation of municipal waste prevention

DEFF Research Database (Denmark)

Gentil, Emmanuel; Gallo, Daniele; Christensen, Thomas Højlund

2011-01-01

society, using life-cycle thinking. The partial prevention of unsolicited mail, beverage packaging and food waste is tested for a “High-tech” waste management system relying on high energy and material recovery and for a “Low-tech” waste management system with less recycling and relying on landfilling......Waste prevention has been addressed in the literature in terms of the social and behavioural aspects, but very little quantitative assessment exists of the environmental benefits. Our study evaluates the environmental consequences of waste prevention on waste management systems and on the wider....... Prevention of 13% of the waste mass entering the waste management system generates a reduction of loads and savings in the waste management system for the different impacts categories; 45% net reduction for nutrient enrichment and 12% reduction for global warming potential. When expanding our system...

CONCURRENT CONTACT SENSITIZATION TO METALS IN DENTAL EXPOSURES

Directory of Open Access Journals (Sweden)

Maya Lyapina

2018-03-01

aluminium and tin - in the groups of dental professionals and in the group of dental patients. Conclusions: Our data indicate a high risk of concurrent contact sensitization to the studied relevant for dental practice metals. Since the role of occupational exposures can’t be excluded, adequate preventive measures and information should be provided. General population also need to be well informed and the European Union regulations to be properly applied.

Invited review : Determinants of farmers' adoption of management-based strategies for infectious disease prevention and control

NARCIS (Netherlands)

Ritter, Caroline; Jansen, Jolanda; Roche, Steven; Kelton, David F; Adams, Cindy L; Orsel, Karin; Erskine, Ron J; Benedictus, Geart; Lam, Theo J G M; Barkema, Herman W

2017-01-01

The prevention and control of endemic pathogens within and between farms often depends on the adoption of best management practices. However, farmers regularly do not adopt recommended measures or do not enroll in voluntary disease control programs. This indicates that a more comprehensive

A concurrent multiscale micromorphic molecular dynamics

International Nuclear Information System (INIS)

Li, Shaofan; Tong, Qi

2015-01-01

In this work, we have derived a multiscale micromorphic molecular dynamics (MMMD) from first principle to extend the (Andersen)-Parrinello-Rahman molecular dynamics to mesoscale and continuum scale. The multiscale micromorphic molecular dynamics is a con-current three-scale dynamics that couples a fine scale molecular dynamics, a mesoscale micromorphic dynamics, and a macroscale nonlocal particle dynamics together. By choosing proper statistical closure conditions, we have shown that the original Andersen-Parrinello-Rahman molecular dynamics is the homogeneous and equilibrium case of the proposed multiscale micromorphic molecular dynamics. In specific, we have shown that the Andersen-Parrinello-Rahman molecular dynamics can be rigorously formulated and justified from first principle, and its general inhomogeneous case, i.e., the three scale con-current multiscale micromorphic molecular dynamics can take into account of macroscale continuum mechanics boundary condition without the limitation of atomistic boundary condition or periodic boundary conditions. The discovered multiscale scale structure and the corresponding multiscale dynamics reveal a seamless transition from atomistic scale to continuum scale and the intrinsic coupling mechanism among them based on first principle formulation

Anesthesia information management system-based near real-time decision support to manage intraoperative hypotension and hypertension.

Science.gov (United States)

Nair, Bala G; Horibe, Mayumi; Newman, Shu-Fang; Wu, Wei-Ying; Peterson, Gene N; Schwid, Howard A

2014-01-01

Intraoperative hypotension and hypertension are associated with adverse clinical outcomes and morbidity. Clinical decision support mediated through an anesthesia information management system (AIMS) has been shown to improve quality of care. We hypothesized that an AIMS-based clinical decision support system could be used to improve management of intraoperative hypotension and hypertension. A near real-time AIMS-based decision support module, Smart Anesthesia Manager (SAM), was used to detect selected scenarios contributing to hypotension and hypertension. Specifically, hypotension (systolic blood pressure 1.25 minimum alveolar concentration [MAC]) of inhaled drug and hypertension (systolic blood pressure >160 mm Hg) with concurrent phenylephrine infusion were detected, and anesthesia providers were notified via "pop-up" computer screen messages. AIMS data were retrospectively analyzed to evaluate the effect of SAM notification messages on hypotensive and hypertensive episodes. For anesthetic cases 12 months before (N = 16913) and after (N = 17132) institution of SAM messages, the median duration of hypotensive episodes with concurrent high MAC decreased with notifications (Mann Whitney rank sum test, P = 0.031). However, the reduction in the median duration of hypertensive episodes with concurrent phenylephrine infusion was not significant (P = 0.47). The frequency of prolonged episodes that lasted >6 minutes (sampling period of SAM), represented in terms of the number of cases with episodes per 100 surgical cases (or percentage occurrence), declined with notifications for both hypotension with >1.25 MAC inhaled drug episodes (δ = -0.26% [confidence interval, -0.38% to -0.11%], P 1.25 MAC inhaled drug episodes. However, since phenylephrine infusion is manually documented in an AIMS, the impact of notification messages was less pronounced in reducing episodes of hypertension with concurrent phenylephrine infusion. Automated data capture and a higher frequency of

[Efficacy of MVP chemotherapy combined with concurrent radiotherapy for advanced non-small cell lung cancer].

Science.gov (United States)

Qiao, Tiankui; Zhou, Daoan; Chen, Wei; Wang, Xianglian

2004-12-20

To observe the effects of MVP chemotherapy combined with concurrent radiotherapy for stage IIIB-IV non-small cell lung cancer. Sixty-two patients with stage IIIB-IV non-small cell lung cancer were randomized into two groups, concurrent radiochemotherapy group and MVP che-motherapy group. All patients in two groups were treated with MVP regimen (mitomycin C 6 mg/m² on day 1, vindesine 2 mg/m² on days 1, 8, and cisplatin 80-100 mg/m²). Patients in concurrent radiochemotherapy group received concurrent radiotherapy (46-56 Gy in 5-6 weeks). All patients received 2-4 cycles of MVP chemotherapy. The response rate was 48.4% and 19.4% in concurrent radiochemotherapy group and MVP group respectively (P MVP group.. The results show that efficacy of MVP chemotherapy combined with concurrent radiotherapy is significantly higher than that of MVP chemotherapy alone for advanced non-small cell lung cancer.

Solid waste prevention and management at green festivals: A case study of the Andanças Festival, Portugal.

Science.gov (United States)

Martinho, Graça; Gomes, Ana; Ramos, Mário; Santos, Pedro; Gonçalves, Graça; Fonseca, Miguel; Pires, Ana

2018-01-01

Research on waste prevention and management at green festivals is scarce. The present study helps to fill this gap by analyzing waste prevention/reduction and management measures implemented at the Andanças festival, Portugal. Waste characterization campaigns and a questionnaire survey were conducted during the festival. The results show that the largest amount of waste generated was residual waste, followed by food and kitchen waste and packaging waste. The amount of waste generated per person per day at the festival was lower than that of other festivals for both the entire venue and the canteen. Concerning food and kitchen waste generated at the canteen, the amounts are in accordance with the findings of previous studies, but the amount of the edible fraction is comparatively low. Source separation rates are high, in line with other festivals that engage in food-waste source separation. Factors affecting the participation of attendees in waste prevention measures at the festival are the type of participant, their region of origin, the frequency of visits, and whether they are attending as a family. Efforts must be made to increase the awareness of attendees about waste prevention measures, to develop guidelines and methods to quantify the waste prevention measures, and to formulate policies aimed at increasing the application of the zero-waste principle at festivals. Copyright © 2017 Elsevier Ltd. All rights reserved.

European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases: report of the European Union Parliament Summit (29 March 2017).

Science.gov (United States)

Hellings, Peter W; Borrelli, David; Pietikainen, Sirpa; Agache, Ioana; Akdis, Cezmi; Bachert, Claus; Bewick, Michael; Botjes, Erna; Constantinidis, Jannis; Fokkens, Wytske; Haahtela, Tari; Hopkins, Claire; Illario, Maddalena; Joos, Guy; Lund, Valerie; Muraro, Antonella; Pugin, Benoit; Seys, Sven; Somekh, David; Stjärne, Pär; Valiulis, Arunas; Valovirta, Erkka; Bousquet, Jean

2017-01-01

On March 29, 2017, a European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases (CRD) was organized by the European Forum for Research and Education in Allergy and Airway Diseases. The event took place in the European Parliament of Brussels and was hosted by MEP David Borrelli and MEP Sirpa Pietikainen. The aim of the Summit was to correspond to the needs of the European Commission and of patients suffering from CRD to join forces in Europe for the prevention and self-management. Delegates of the European Rhinologic Society, European Respiratory Society, European Academy of Allergy and Clinical Immunology, European Academy of Paediatrics, and European Patients Organization EFA all lectured on their vision and action plan to join forces in achieving adequate prevention and self-management of CRD in the context of Precision Medicine. Recent data highlight the preventive capacity of education on optimal care pathways for CRD. Self-management and patient empowerment can be achieved by novel educational on-line materials and by novel mobile health tools enabling patients and doctors to monitor and optimally treat CRDs based on the level of control. This report summarizes the contributions of the representatives of different European academic stakeholders in the field of CRD.

How Do Developers Use APIs? A Case Study in Concurrency

DEFF Research Database (Denmark)

Blom, Stefan; Kiniry, Joseph; Huisman, Marieke

2013-01-01

and functionalities of the Java concurrency library java. util. concurrent. It discusses the Histogram tool that we developed for this purpose, i.e., to efficiently analyse a large collection of bytecode classes. The Histogram tool is used on a representative benchmark set, the Qualitas Corpus. The paper discusses...... the results of the analysis of this benchmark set in detail. This covers both an analysis of the important classes and methods used by the current releases of the benchmark collection, as well as an analysis of the time it took for the Java concurrency library to start being used in released software....... of static analysis and verification tools this information is highly important, because it indicates where and how to put the most efficient effort in annotating APIs, to make them usable for the static analysis and verification tools. This paper presents an analysis of the usage of the routines...

23 CFR 751.23 - Concurrent junkyard control and right-of-way projects.

Science.gov (United States)

2010-04-01

...-way projects. The State is encouraged to coordinate junkyard control and highway right-of-way projects. Expenses incurred in furtherance of concurrent projects shall be prorated between projects. ... 23 Highways 1 2010-04-01 2010-04-01 false Concurrent junkyard control and right-of-way projects...

Age dependent prognosis in concurrent chemo-radiation of locally advanced NSCLC

DEFF Research Database (Denmark)

Hansen, Olfred; Schytte, Tine; Nielsen, Morten

2015-01-01

. Material and methods. Altogether, 478 patients completed radical radiotherapy in doses of 60-66 Gy/30-33 fractions from 1995 to June 2012; 137 of the patients had concurrent chemotherapy. The data was analyzed in age groups ... specific survival the hazard ratio was related to the use of concurrent chemotherapy was 0.49 (95% CI 0.29; 0.82), 0.68 (95% CI 0.48; 0.98) and 1.01 (95% CI 0.67; 1.51) for the age groups ..., the results might be due to selection bias, thus reports from a cohort of consecutively treated patients are warranted. The current single institution study reports on the influence of age on survival of locally advanced NSCLC patients treated with radiotherapy combined with or without concurrent chemotherapy...

What's new with the flu? Reflections regarding the management and prevention of influenza from the 2nd New Zealand Influenza Symposium, November 2015.

Science.gov (United States)

Charania, Nadia A; Mansoor, Osman D; Murfitt, Diana; Turner, Nikki M

2016-09-09

Influenza is a common respiratory viral infection. Seasonal outbreaks of influenza cause substantial morbidity and mortality that burdens healthcare services every year. The influenza virus constantly evolves by antigenic drift and occasionally by antigenic shift, making this disease particularly challenging to manage and prevent. As influenza viruses cause seasonal outbreaks and also have the ability to cause pandemics leading to widespread social and economic losses, focused discussions on improving management and prevention efforts is warranted. The Immunisation Advisory Centre (IMAC) hosted the 2nd New Zealand Influenza Symposium (NZiS) in November 2015. International and national participants discussed current issues in influenza management and prevention. Experts in the field presented data from recent studies and discussed the ecology of influenza viruses, epidemiology of influenza, methods of prevention and minimisation, and experiences from the 2015 seasonal influenza immunisation campaign. The symposium concluded that although much progress in this field has been made, many areas for future research remain.

Swallowing rehabilitation before and during concurrent chemoradiotherapy for oropharyngeal cancer

International Nuclear Information System (INIS)

Tsuneyuki, Miki; Yonezawa, Kouichiro; Morimoto, Koichi; Tanimoto, Hitoshi; Saito, Miki; Otsuki, Naoki; Nibu, Ken-ichi

2011-01-01

Recently, oropharyngeal cancer is more frequently being managed with concurrent chemoradiotherapy (CCRT). As more patients receive CCRT, there is increasing attention on dysphagia. Since 2009, speech therapists in our hospital have performed swallowing rehabilitation for dysphagia associated with CCRT. We evaluated dysphagia after CCRT and examined the relationship between swallowing rehabilitation and swallowing disability. A total of 26 patients (22 males and 4 females) with a mean age of 63 years (range, 41 to 79), underwent CCRT between March 2008 and March 2010. Dysphagia after treatment was graded at the end of CCRT and discharge according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 and Fujishima dysphagia grade. Ten of the 26 patients underwent swallowing rehabilitation, exercise and education on muscle strengthening programs before and during CCRT. They tended not to have severe dysphagia, but there were no significant differences. (author)

Concurrent event-driven programming in occam-π for the Arduino

DEFF Research Database (Denmark)

Jacobsen, Christian Lyder; Jadud, Matthew C.; Kilic, Omer

2011-01-01

The success of the Arduino platform has made embedded programming widely accessible. The Arduino has seen many uses, for example in rapid prototyping, hobby projects, and in art installations. Arduino users are often not experienced embedded programmers however, and writing correct software...... for embedded devices can be challenging. This is especially true if the software needs to use interrupts in order to interface with attached devices. Insight and careful discipline are required to avoid introducing race hazards when using interrupt routines. Instead of programming the Arduino in C or C......++ as is the custom, we propose using occam-pi as a language as that can help the user manage the concurrency introduced when using interrupts and help in the creation of modular, well-designed programs. This paper will introduce the Arduino, the software that enables us to run occam-pi on it, and a case study...

Respiratory Tract Infections and the Role of Biologically Active Polysaccharides in Their Management and Prevention.

Science.gov (United States)

Jesenak, Milos; Urbancikova, Ingrid; Banovcin, Peter

2017-07-20

Respiratory tract infections (RTIs) are the most common form of infections in every age category. Recurrent respiratory tract infections (RRTIs), a specific form of RTIs, represent a typical and common problem associated with early childhood, causing high indirect and direct costs on the healthcare system. They are usually the consequence of immature immunity in children and high exposure to various respiratory pathogens. Their rational management should aim at excluding other severe chronic diseases associated with increased morbidity (e.g., primary immunodeficiency syndromes, cystic fibrosis, and ciliary dyskinesia) and at supporting maturity of the mucosal immune system. However, RRTIs can also be observed in adults (e.g., during exhausting and stressful periods, chronic inflammatory diseases, secondary immunodeficiencies, or in elite athletes) and require greater attention. Biologically active polysaccharides (e.g., β-glucans) are one of the most studied natural immunomodulators with a pluripotent mode of action and biological activity. According to many studies, they possess immunomodulatory, anti-inflammatory, and anti-infectious activities and therefore could be suggested as an effective part of treating and preventing RTIs. Based on published studies, the application of β-glucans was proven as a possible therapeutic and preventive approach in managing and preventing recurrent respiratory tract infections in children (especially β-glucans from Pleurotus ostreatus ), adults (mostly the studies with yeast-derived β-glucans), and in elite athletes (studies with β-glucans from Pleurotus ostreatus or yeast).

Product design for energy reduction in concurrent engineering: An Inverted Pyramid Approach

Science.gov (United States)

Alkadi, Nasr M.

Energy factors in product design in concurrent engineering (CE) are becoming an emerging dimension for several reasons; (a) the rising interest in "green design and manufacturing", (b) the national energy security concerns and the dramatic increase in energy prices, (c) the global competition in the marketplace and global climate change commitments including carbon tax and emission trading systems, and (d) the widespread recognition of the need for sustainable development. This research presents a methodology for the intervention of energy factors in concurrent engineering product development process to significantly reduce the manufacturing energy requirement. The work presented here is the first attempt at integrating the design for energy in concurrent engineering framework. It adds an important tool to the DFX toolbox for evaluation of the impact of design decisions on the product manufacturing energy requirement early during the design phase. The research hypothesis states that "Product Manufacturing Energy Requirement is a Function of Design Parameters". The hypothesis was tested by conducting experimental work in machining and heat treating that took place at the manufacturing lab of the Industrial and Management Systems Engineering Department (IMSE) at West Virginia University (WVU) and at a major U.S steel manufacturing plant, respectively. The objective of the machining experiment was to study the effect of changing specific product design parameters (Material type and diameter) and process design parameters (metal removal rate) on a gear head lathe input power requirement through performing defined sets of machining experiments. The objective of the heat treating experiment was to study the effect of varying product charging temperature on the fuel consumption of a walking beams reheat furnace. The experimental work in both directions have revealed important insights into energy utilization in machining and heat-treating processes and its variance based

The Hospital Management of Fatal Self-Poisoning in Industrialized Countries: An Opportunity for Suicide Prevention?

Science.gov (United States)

Kapur, Navneet; Turnbull, Pauline; Hawton, Keith; Simkin, Sue; Mackway-Jones, Kevin; Gunnell, David

2006-01-01

Suicide by self-poisoning is a prevalent cause of death worldwide. A substantial proportion of individuals who poison themselves come into contact with medical services before they die. Our focus in the current study was the medical management of drug self-poisoning in industrialized countries and its possible contribution to suicide prevention.…

Angelic semantics of fine-grained concurrency

OpenAIRE

Dan R. Ghica; Andrzej S. Murawski

2008-01-01

We introduce a game model for an Algol-like programming language with primitives for parallel composition and synchronization on semaphores. The semantics is based on a simplified version of Hyland–Ong-style games and it emphasizes the intuitive connection between the concurrent nature of games and that of computation. The model is fully abstract for may-equivalence.

Preventive Rad/Nuc Detection Equipment Categorization for Consequence Management

Energy Technology Data Exchange (ETDEWEB)

Buddemeier, B. R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Musolino, S. V. [Brookhaven National Lab. (BNL), Upton, NY (United States); Klemic, G. [US Dept. of Homeland Security National Security Technology Lab., New York, NY (United States)

2017-06-01

The overall objective of this project is to research, evaluate, and test first responder preventive radiological/nuclear detection equipment (PRND) to provide state and local agencies with guidance on how to best use this equipment for response after a radiological/nuclear release or detonation. While the equipment being tested in this effort has been specifically designed for detection and interdiction operations, the fleet of PRND equipment can help fill critical needs for radiological instrumentation should a consequence management response take place. This effort will provide scientific guidance on the best way to deploy and operate this class of equipment for consequence management missions. With the support of the US Department of Homeland Security’s (DHS) Domestic Nuclear Detection Office (DNDO), PRND equipment has been placed into service at federal, state, and local agencies throughout the nation. If the equipment capability and limitations are taken into account, this large inventory can be repurposed to support the emergency response in the aftermath of a radiological of nuclear event. This report evaluates PRND equipment to define key categories of equipment and the types of missions they can be used for. This is important because there are over 100 different types of PRND equipment, often with significantly different capabilities with respect to the consequence management mission. The current DNDO draft NIMS PRND equipment types were used as a foundation and expanded, when necessary, to address key characteristics important for the consequence mission. Table 1 provides a summary of the PRND instrument categories developed for this effort. Also included on the table are some common response mission detection equipment categories that will be used for capability comparisons.

A body sensor platform for concurrent applications

NARCIS (Netherlands)

Bui, T.V.; Verhoeven, R.; Lukkien, J.J.

2012-01-01

This paper presents a Body Sensor Platform supporting concurrent applications that share resources and data. Concerns are application isolation, data privacy and platform trustworthiness in view of dynamic loading of applications. A prototype has been built on commercial-off-the-shelf hardware. The

Management characteristics of successful public health programs: "Avahan" HIV prevention program in India.

Science.gov (United States)

Mabuchi, Shunsuke; Singh, Suneeta; Bishnu, Rituparna; Bennett, Sara

2013-01-01

This paper analyzes Avahan, an HIV prevention program in India, that achieved very rapid scale-up. The paper aims to (i) define the distinctive features of the management of Avahan, (ii) examine how the distinctive features relate to key constructs in management frameworks and (iii) investigate how the management approaches of Avahan contributed to the program's ability to scale-up rapidly while maintaining service quality. The Delphi method was used to identify the distinctive features of Avahan. Through three rounds of questions, 38 participants closely associated with Avahan were asked to identify and develop consensus on its distinctive features. These features were then mapped against the Baldrige Health Care Criteria for Performance Excellence to investigate how they related to important dimensions of management. A total of 17 distinctive features of Avahan were identified. These distinctive features emphasized the importance of data use and performance monitoring at all levels, especially combined with a flexible management style that facilitated local responsiveness to community, innovation and learning. The distinctive features comprehensively addressed the criteria for management excellence in the Baldridge framework. In the case of Avahan, the rigorous application of known management techniques to public health programs appears to have been an important factor in the successful scale-up of the program. Also, the Baldrige criteria seem applicable to health programs in low-income and middle-income countries; further applications would help test their robustness and utility in such contexts. Copyright © 2012 John Wiley & Sons, Ltd.

School- and Community-Based Youth Suicide Prevention Interventions: Hot Idea, Hot Air, or Sham?

Science.gov (United States)

Kutcher, Stan; Wei, Yifeng; Behzadi, Pegah

2017-06-01

Suicide in young people is a significant health concern, with numerous community- and school-based interventions promising to prevent suicide currently being applied across Canada. Before widespread application of any one of these, it is essential to determine its effectiveness and safety. We systematically reviewed the global literature on one of the most common community suicide prevention interventions in Canada and summarized data on 2 commonly applied school-based suicide prevention programmes. None of these has demonstrated effectiveness in preventing youth suicide or safety in application. Concurrently with their widespread distribution in Canada, the suicide rate in young women has increased-the first time in over 3 decades. Policy and regulatory implications of these findings are discussed.

Clinical comparative investigation using intensity-modulated radiotherapy combined with concurrent chemotherapy for the local advanced nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Zhao Yingchao; Dai Xiaofang; Wu Gang; Zhao Yanxia; Luo Ming

2009-01-01

Objective: To research the early effects and side-effects of the local advanced nasopharyngeal carcinoma patients using intensity-modulated radiotherapy (IMRT) combined with concurrent chemotherapy. Methods: From January 2005 to January 2007, 60 patients with nasopharyngeal carcinoma of stage m-IV b were received IMRT combined with concurrent chemotherapy in our center. Sixty patients were divided into paclitaxel concurrent group (32 patients) and cisplatin concurrent group (28 patients). The prescribing doses of the primary tumor were 68-72 Gy for each group. The patients of paclitaxel concurrent group received 5-7 times pacitaxel liposome chemotherapy of 30 mg · m -2 ·. The patients of cisplatin concurrent group received 5-7 times cisplatin chemotherapy of 30 mg · m -2 · week -1 . Results: As to the side-effects, the patients of the cisplatin concurrent group got earlier radiodermatitis and radiation-induced mucositis but also got significantly higher rate of radiodermatitis, radiation-induced mucositis, radiation-induced leucopenia and gastrointestinal toxicity, as well as the loss of weight. No significant difference was found on liver and renal functions between two groups.Four patients (12.5%) of the paclitaxel concurrent group were broken-off, which was much better than the cisplatin concurrent group. There was no significant difference on the specific length of break-off time, the 2-year overall survival rate and the 2-year diseaee-free survival rate between two groups. Conclusions: IMRT combined with concurrent chemotherapy of paclitaxel liposome for local advanced nasopharyngeal carcinoma results in less side-effects and better tolerance than IMRT combined with concurrent cisplatin chemotherapy. (authors)

Development and management of severe cutaneous side effects in head-and-neck cancer patients during concurrent radiotherapy and cetuximab

International Nuclear Information System (INIS)

Boelke, E.; Mueller-Homey, A.; Pape, H.; Giro, C.; Matuschek, C.; Gripp, S.; Budach, W.; Gerber, P.A.; Bruch-Gerharz, D.; Homey, B.; Lammering, G.; Peiper, M.; Hoffmann, T.K.

2008-01-01

Background: the concurrent administration of cetuximab to radiotherapy has recently been shown to improve the clinical outcome of head-and-neck cancer (HNC) patients. An aggravation of the radiation-induced skin toxicity was not described. Here, however, two cases with severe skin toxicity during the combined treatment are reported. Clinical observations: in a small group of five patients with locally advanced HNC treated with irradiation and concurrent cetuximab, two cases of unusually severe radiation dermatitis were observed. Both patients developed confluent moist desquamations confined to the irradiation field at a dose of 40 Gy (CTC - Common Toxicity Criteria, grade 3), which progressed into an ulcerative dermatitis (grade 4) at 58 Gy and 46 Gy, respectively. Histopathology showed a vacuolic degeneration of basal keratinocytes, subepidermal blister formation, and mixed perivascular and interstitial inflammatory infiltrates leading to a complete loss of the epidermis. These cutaneous side effects led to the discontinuation of radiotherapy. Topical corticosteroids and systemic antibiotic treatment resulted in wound healing, which allowed the continuation of radiotherapy. Conclusion: these findings indicate that cetuximab may have the potential to enhance the severity of radiation dermatitis in HNC patients. A systematic monitoring of cutaneous side effects during radiotherapy plus cetuximab is advised in order to reliably estimate the frequency of severe (grade 3/4) radiation dermatitis. (orig.)

Development and management of severe cutaneous side effects in head-and-neck cancer patients during concurrent radiotherapy and cetuximab

Energy Technology Data Exchange (ETDEWEB)

Boelke, E.; Mueller-Homey, A.; Pape, H.; Giro, C.; Matuschek, C.; Gripp, S.; Budach, W. [Dept. of Radiation Oncology, Univ. of Duesseldorf (Germany); Gerber, P.A.; Bruch-Gerharz, D.; Homey, B. [Dept. of Dermatology, Univ. of Duesseldorf (Germany); Lammering, G. [Dept. of Radiation Oncology (MAASTRO Clinic), Univ. Hospital Maastricht (Netherlands); Peiper, M. [Dept. of Surgery, Univ. of Duesseldorf (Germany); Hoffmann, T.K. [Dept. of Otorhinolarynogology, Univ. of Duesseldorf (Germany)

2008-02-15

Background: the concurrent administration of cetuximab to radiotherapy has recently been shown to improve the clinical outcome of head-and-neck cancer (HNC) patients. An aggravation of the radiation-induced skin toxicity was not described. Here, however, two cases with severe skin toxicity during the combined treatment are reported. Clinical observations: in a small group of five patients with locally advanced HNC treated with irradiation and concurrent cetuximab, two cases of unusually severe radiation dermatitis were observed. Both patients developed confluent moist desquamations confined to the irradiation field at a dose of 40 Gy (CTC - Common Toxicity Criteria, grade 3), which progressed into an ulcerative dermatitis (grade 4) at 58 Gy and 46 Gy, respectively. Histopathology showed a vacuolic degeneration of basal keratinocytes, subepidermal blister formation, and mixed perivascular and interstitial inflammatory infiltrates leading to a complete loss of the epidermis. These cutaneous side effects led to the discontinuation of radiotherapy. Topical corticosteroids and systemic antibiotic treatment resulted in wound healing, which allowed the continuation of radiotherapy. Conclusion: these findings indicate that cetuximab may have the potential to enhance the severity of radiation dermatitis in HNC patients. A systematic monitoring of cutaneous side effects during radiotherapy plus cetuximab is advised in order to reliably estimate the frequency of severe (grade 3/4) radiation dermatitis. (orig.)

Life-cycle modelling of waste management in Europe: tools, climate change and waste prevention

DEFF Research Database (Denmark)

Gentil, Emmanuel

. The outcome of the study indicates that, despite a common ‘minimum’ regulatory regime, the performance of waste management systems is very different among member states. The best performing member states are the nations which have promoted efficient material and energy recovery, leading to significant...... operated by each member state (structural indicators). Managing waste appropriately generates environmental benefits, leading to the comforting, and potentially misleading impression that waste generation is acceptable, as long as environmental value is gained from the recovery of materials and energy....... However, it is quite clear that, if waste is not produced in the first place, through waste prevention activities, waste management impacts and benefits cease to exist. Problem solved. The issue is that a ‘waste free’ or a ‘zero waste’ society is a purely abstract concept that has little value...

The prognostic value of concurrent phrenic nerve palsy in newborn babies with neonatal brachial plexus palsy.

Science.gov (United States)

Yoshida, Kiyoshi; Kawabata, Hidehiko

2015-06-01

To investigate the prognostic value of concurrent phrenic nerve palsy for predicting spontaneous motor recovery in neonatal brachial plexus palsy. We reviewed the records of 366 neonates with brachial plexus palsy. The clinical and follow-up data of patients with and without phrenic nerve palsy were compared. Of 366 newborn babies with neonatal brachial plexus palsy, 21 (6%) had concurrent phrenic nerve palsy. Sixteen of these neonates had upper-type palsy and 5 had total-type palsy. Poor spontaneous motor recovery was observed in 13 neonates with concurrent phrenic nerve palsy (62%) and in 129 without concurrent phrenic nerve palsy (39%). Among neonates born via vertex delivery, poor motor recovery was observed in 7 of 9 (78%) neonates with concurrent phrenic nerve palsy and 115 of 296 (39%) without concurrent phrenic nerve palsy. Concurrent phrenic nerve palsy in neonates with brachial plexus palsy has prognostic value in predicting poor spontaneous motor recovery of the brachial plexus, particularly after vertex delivery. Therapeutic IV. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Complications of minimally invasive cosmetic procedures: Prevention and management

Directory of Open Access Journals (Sweden)

Lauren L Levy

2012-01-01

Full Text Available Over the past decade, facial rejuvenation procedures to circumvent traditional surgery have become increasingly popular. Office-based, minimally invasive procedures can promote a youthful appearance with minimal downtime and low risk of complications. Injectable botulinum toxin (BoNT, soft-tissue fillers, and chemical peels are among the most popular non-invasive rejuvenation procedures, and each has unique applications for improving facial aesthetics. Despite the simplicity and reliability of office-based procedures, complications can occur even with an astute and experienced injector. The goal of any procedure is to perform it properly and safely; thus, early recognition of complications when they do occur is paramount in dictating prevention of long-term sequelae. The most common complications from BoNT and soft-tissue filler injection are bruising, erythema and pain. With chemical peels, it is not uncommon to have erythema, irritation and burning. Fortunately, these side effects are normally transient and have simple remedies. More serious complications include muscle paralysis from BoNT, granuloma formation from soft-tissue filler placement and scarring from chemical peels. Thankfully, these complications are rare and can be avoided with excellent procedure technique, knowledge of facial anatomy, proper patient selection, and appropriate pre- and post-skin care. This article reviews complications of office-based, minimally invasive procedures, with emphasis on prevention and management. Practitioners providing these treatments should be well versed in this subject matter in order to deliver the highest quality care.

Concurrency meets probability: theory and practice (abstract)

NARCIS (Netherlands)

Katoen, Joost P.

Treating random phenomena in concurrency theory has a long tradition. Petri nets [18, 10] and process algebras [14] have been extended with probabilities. The same applies to behavioural semantics such as strong and weak (bi)simulation [1], and testing pre-orders [5]. Beautiful connections between

The game changes: "Disaster Prevention and Management" after a quarter of a century

OpenAIRE

Alexander, D. E.

2016-01-01

Purpose – This paper has been written to mark the 25th anniversary of the founding of Disaster Prevention and Management. It reviews the modern-day challenges facing researchers, scholars and practitioners who work in the field of disaster risk reduction. Design/methodology/approach – The paper reviews key issues in disaster risk reduction, including the relationship between capital and labour and its influence on vulnerability, the role of human mobility and migration in disaster vulnerabili...

Ecological association between HIV and concurrency point-prevalence in South Africa's ethnic groups.

Science.gov (United States)

Kenyon, Chris

2013-11-01

HIV prevalence between different ethnic groups within South Africa exhibits considerable variation. Numerous authors believe that elevated sexual partner concurrency rates are important in the spread of HIV. Few studies have, however, investigated if differential concurrency rates could explain differential HIV spread within ethnic groups in South Africa. This ecological analysis, explores how much of the variation in HIV prevalence by ethnic group is explained by differential concurrency rates. Using a nationally representative survey (the South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey, 2005) the HIV prevalence in each of eight major ethnic groups was calculated. Linear regression analysis was used to assess the association between an ethnic group's HIV prevalence and the point-prevalence of concurrency. Results showed that HIV prevalence rates varied considerably between South Africa's ethnic groups. This applied to both different racial groups and to different ethnic groups within the black group. The point-prevalence of concurrency by ethnic group was strongly associated with HIV prevalence (R(2) = 0.83; p = 0.001). Tackling the key drivers of high HIV transmission in this population may benefit from more emphasis on partner reduction interventions.

A concurrent optimization model for supplier selection with fuzzy quality loss

International Nuclear Information System (INIS)

Rosyidi, C.; Murtisari, R.; Jauhari, W.

2017-01-01

The purpose of this research is to develop a concurrent supplier selection model to minimize the purchasing cost and fuzzy quality loss considering process capability and assembled product specification. Design/methodology/approach: This research integrates fuzzy quality loss in the model to concurrently solve the decision making in detailed design stage and manufacturing stage. Findings: The resulted model can be used to concurrently select the optimal supplier and determine the tolerance of the components. The model balances the purchasing cost and fuzzy quality loss. Originality/value: An assembled product consists of many components which must be purchased from the suppliers. Fuzzy quality loss is integrated in the supplier selection model to allow the vagueness in final assembly by grouping the assembly into several grades according to the resulted assembly tolerance.

A concurrent optimization model for supplier selection with fuzzy quality loss

Energy Technology Data Exchange (ETDEWEB)

Rosyidi, C.; Murtisari, R.; Jauhari, W.

2017-07-01

The purpose of this research is to develop a concurrent supplier selection model to minimize the purchasing cost and fuzzy quality loss considering process capability and assembled product specification. Design/methodology/approach: This research integrates fuzzy quality loss in the model to concurrently solve the decision making in detailed design stage and manufacturing stage. Findings: The resulted model can be used to concurrently select the optimal supplier and determine the tolerance of the components. The model balances the purchasing cost and fuzzy quality loss. Originality/value: An assembled product consists of many components which must be purchased from the suppliers. Fuzzy quality loss is integrated in the supplier selection model to allow the vagueness in final assembly by grouping the assembly into several grades according to the resulted assembly tolerance.

Nutritional management of breastfeeding infants for the prevention of common nutrient deficiencies and excesses

Directory of Open Access Journals (Sweden)

Jin Soo Moon

2011-07-01

Full Text Available Breastfeeding is the best source of nutrition for every infant, and exclusive breastfeeding for 6 months is usually optimal in the common clinical situation. However, inappropriate complementary feeding could lead to a nutrient-deficient status, such as iron deficiency anemia, vitamin D deficiency, and growth faltering. The recent epidemic outbreak of obesity in Korean children emphasizes the need for us to control children’s daily sedentary life style and their intakes of high caloric foods in order to prevent obesity. Recent assessment of breastfeeding in Korea has shown that the rate is between 63% and 89%; thus, up-to-dated evidence-based nutritional management of breastfeeding infants to prevent common nutrient deficiencies or excesses should be taught to all clinicians and health care providers.

Concurrent alcohol and tobacco use among a middle-aged and elderly population in Mumbai.

Science.gov (United States)

Gupta, Prakash C; Maulik, Pallab K; Pednekar, Mangesh S; Saxena, Shekhar

2005-01-01

The concurrent use of alcohol and tobacco and its deleterious effects have been reported in the western literature. However, studies on the relationship between concurrent alcohol and tobacco use in India are limited. This study outlines the association between concurrent alcohol and tobacco use among a middle-aged and elderly population in a western Indian cohort after controlling for various sociodemographic factors. A total of 35 102 men, 45 years of age and above were interviewed for concurrent alcohol and tobacco use. The sample was part of an earlier cohort drawn from the general population. The data were analysed after controlling for age, education, religion and mother-tongue. Among alcohol users, 51.1% smoked tobacco and 35.6% used smokeless tobacco. The relative risk of alcohol use was highest among those smoking cigarettes or beedis and among those using mishri with betel quid and tobacco. The risk of alcohol use increased with the frequency of tobacco use. The risk also increased with higher amounts of alcohol consumption, but peaked at around 100-150 ml of absolute alcohol use. The study highlights the association between concurrent alcohol and tobacco use among the Indian population. This has important public health implications since concurrent use of these is synergistic for increased risk of oropharyngeal cancers.

Concurrent Working Memory Load Can Facilitate Selective Attention: Evidence for Specialized Load

Science.gov (United States)

Park, Soojin; Kim, Min-Shik; Chun, Marvin M.

2007-01-01

Load theory predicts that concurrent working memory load impairs selective attention and increases distractor interference (N. Lavie, A. Hirst, J. W. de Fockert, & E. Viding, see record 2004-17825-003). Here, the authors present new evidence that the type of concurrent working memory load determines whether load impairs selective attention or not.…

Information Management in Creative Engineering Design and Capabilities of Database Transactions

DEFF Research Database (Denmark)

Jacobsen, Kim; Eastman, C. A.; Jeng, T. S.

1997-01-01

This paper examines the information management requirements and sets forth the general criteria for collaboration and concurrency control in creative engineering design. Our work attempts to recognize the full range of concurrency, collaboration and complex transactions structure now practiced...... in manual and semi-automated design and the range of capabilities needed as the demands for enhanced but flexible electronic information management unfolds.The objective of this paper is to identify new issues that may advance the use of databases to support creative engineering design. We start...... with a generalized description of the structure of design tasks and how information management in design is dealt with today. After this review, we identify extensions to current information management capabilities that have been realized and/or proposed to support/augment what designers can do now. Given...

Reducing Stress through Preventive Management.

Science.gov (United States)

Quick, James C.; Quick, Jonathan D.

1979-01-01

Two levels of prevention can be used to counter the key stressors of personnel at work; the first deals with organizational techniques and the second with individual techniques such as systematic desensitization, biofeedback, or aerobic exercise. (Author)

Concurrent Engineering in seafood product development

DEFF Research Database (Denmark)

Jonsdottir, Stella; Vesterager, Johan; Børresen, Torger

1998-01-01

benefit from the CE approach which can support product developers to provide concurrent specifications for raw materials, ingredients, packaging, and production methods. The approach involves the use of product models from which line extensions are more easily generated than by use of customary stepwise...... techniques. it is anticipated that other food industries also can benefit from the more simultaneous approach...

Iterative concurrent reconstruction algorithms for emission computed tomography

International Nuclear Information System (INIS)

Brown, J.K.; Hasegawa, B.H.; Lang, T.F.

1994-01-01

Direct reconstruction techniques, such as those based on filtered backprojection, are typically used for emission computed tomography (ECT), even though it has been argued that iterative reconstruction methods may produce better clinical images. The major disadvantage of iterative reconstruction algorithms, and a significant reason for their lack of clinical acceptance, is their computational burden. We outline a new class of ''concurrent'' iterative reconstruction techniques for ECT in which the reconstruction process is reorganized such that a significant fraction of the computational processing occurs concurrently with the acquisition of ECT projection data. These new algorithms use the 10-30 min required for acquisition of a typical SPECT scan to iteratively process the available projection data, significantly reducing the requirements for post-acquisition processing. These algorithms are tested on SPECT projection data from a Hoffman brain phantom acquired with a 2 x 10 5 counts in 64 views each having 64 projections. The SPECT images are reconstructed as 64 x 64 tomograms, starting with six angular views. Other angular views are added to the reconstruction process sequentially, in a manner that reflects their availability for a typical acquisition protocol. The results suggest that if T s of concurrent processing are used, the reconstruction processing time required after completion of the data acquisition can be reduced by at least 1/3 T s. (Author)

Concurrent Use of Cigarettes and Smokeless Tobacco in Minnesota

Directory of Open Access Journals (Sweden)

Raymond G. Boyle

2012-01-01

Full Text Available Cigarette smokers are being encouraged to use smokeless tobacco (SLT in locations where smoking is banned. We examined state-wide data from Minnesota to measure changes over time in the use of SLT and concurrent use of cigarettes and SLT. The Minnesota Adult Tobacco Survey was conducted four times between 1999 and 2010 and has provided state-wide estimates of cigarette smoking, SLT use and concurrent use of SLT by smokers. The prevalence of SLT was essentially unchanged through 2007, then increased significantly between 2007 and 2010 (3.1% versus 4.3%, P<0.05. Similarly, the prevalence of cigarette smokers who reported using SLT was stable then increased between 2007 and 2010 (4.4% versus 9.6%, P<0.05. The finding of higher SLT use by smokers could indicate that smokers in Minnesota are in an experimental phase of testing alternative products as they adjust to recent public policies restricting smoking in public places. The findings are suggestive that some Minnesota smokers are switching to concurrent use of cigarettes and SLT. Future surveillance reports will be necessary to confirm the results.

Concurrent control system for the JAERI tandem accelerator

International Nuclear Information System (INIS)

Hanashima, Susumu; Shozi, Tokio; Shiozaki, Yasuo; Saito, Motoi; Oogane, Yasuo; Sekiguchi, Satoshi.

1994-01-01

A new control system for the JAERI tandem accelerator is constructed. The system utilizes concurrent processing technology with multiprocessor. Transputers are used both for central processor and I/O front end processors. (author)

Prevention and management of shoulder pain in the hemiplegic patient.

Science.gov (United States)

Page, Tamara; Lockwood, Craig

The objective of this review was to summarise the best available research related to the prevention and management of shoulder pain in the hemiplegic patient. This review considered all studies that included hemiplegic patients post-cerebral vascular accident (CVA). Interventions of interest were any treatments or programs used to manage or prevent shoulder pain secondary to hemiplegia. The primary outcomes of interest were those related to pain. This review considered any randomised controlled trials (RCT) that evaluated the effectiveness of interventions that addressed shoulder pain in hemiplegic patients. In the absence of RCT, other research designs such as non-randomised controlled trials, time series and case series were also considered for inclusion in a narrative summary. The search sought to find both published and unpublished studies. Databases were searched up to February 2002 and included Medline, CINAHL, Current Contents, Cochrane Library, Expanded Academic Index, Electronic Collections Online, Turning Research Into Practice (TRIP), Dissertation Abstracts and Proceedings First. The reference lists of all studies identified were searched for additional studies. All studies were checked for methodological quality by two reviewers and data was extracted using a data extraction tool. Current research evaluating the effectiveness of treatment interventions on hemiplegic shoulder pain is very limited. The studies were very diverse in their nature of research. There has been no replication of studies, with the studies found using different populations, interventions or outcome measures. Not one study could be compared with another. Meta-analysis was unable to be performed not only because of inadequate reporting of results, but more often due to differences between the studies' participants and the range of interventions used. The diversity in interval post-CVA also makes it difficult to make any comparisons between studies. For this reason the review is in

Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises

NARCIS (Netherlands)

Kraaijenga, Sophie A. C.; van der Molen, Lisette; Jacobi, Irene; Hamming-Vrieze, Olga; Hilgers, Frans J. M.; van den Brekel, Michiel W. M.

2015-01-01

Concurrent chemoradiotherapy (CCRT) for advanced head and neck cancer (HNC) is associated with substantial early and late side effects, most notably regarding swallowing function, but also regarding voice quality and quality of life (QoL). Despite increased awareness/knowledge on acute dysphagia in

Aerospace Concurrent Engineering Design Teams: Current State, Next Steps and a Vision for the Future

Science.gov (United States)

Hihn, Jairus; Chattopadhyay, Debarati; Karpati, Gabriel; McGuire, Melissa; Borden, Chester; Panek, John; Warfield, Keith

2011-01-01

Over the past sixteen years, government aerospace agencies and aerospace industry have developed and evolved operational concurrent design teams to create novel spaceflight mission concepts and designs. These capabilities and teams, however, have evolved largely independently. In today's environment of increasingly complex missions with limited budgets it is becoming readily apparent that both implementing organizations and today's concurrent engineering teams will need to interact more often than they have in the past. This will require significant changes in the current state of practice. This paper documents the findings from a concurrent engineering workshop held in August 2010 to identify the key near term improvement areas for concurrent engineering capabilities and challenges to the long-term advancement of concurrent engineering practice. The paper concludes with a discussion of a proposed vision for the evolution of these teams over the next decade.

Severe accident management. Prevention and Mitigation

International Nuclear Information System (INIS)

1992-01-01

Effective planning for the management of severe accidents at nuclear power plants can produce both a reduction in the frequency of such accidents as well as the ability to mitigate their consequences if and when they should occur. This report provides an overview of accident management activities in OECD countries. It also presents the conclusions of a group of international experts regarding the development of accident management methods, the integration of accident management planning into reactor operations, and the benefits of accident management

Specifying and Verifying Concurrent Programs.

Science.gov (United States)

1985-02-01

for Verification and Specification of Concurrent Systems, held in La - Colle - Sur - Loup , France in October, 1984. Work Supported in part by the National...Proc. ACM Symposium on Princi- 0 ples of Programming Languages, Las Vegas, (January 1980), 251-261. [7] J. V. Guttag and J. J. Horning. An Introduction...names in ’V(S). However, the two formulas behave differently under a renaming mapping p. In particu- lar. p(Vv :A( LA )) equals Vv :p(A(v)), so the

Triangle inequalities in coherence measures and entanglement concurrence

Science.gov (United States)

Dai, Yue; You, Wenlong; Dong, Yuli; Zhang, Chengjie

2017-12-01

We provide detailed proofs of triangle inequalities in coherence measures and entanglement concurrence. If a rank-2 state ϱ can be expressed as a convex combination of two pure states, i.e., ϱ =p1| ψ1〉〈 ψ1|+ p2| ψ2〉〈 ψ2| , a triangle inequality can be established as |E (|Ψ1〉 )-E (|Ψ2〉 )|≤E (ϱ ) ≤E (|Ψ1〉 )+E (|Ψ2〉 ) , where | Ψ1〉= √{p1}|ψ1〉 and | Ψ2〉= √{p2}|ψ2〉 ; E can be considered either coherence measures or entanglement concurrence. This inequality displays mathematical beauty for its similarity to the triangle inequality in plane geometry. An illustrative example is given after the proof.

A familial concurrence of schizophrenia and Gaucher's disease

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Siomos Konstantinos E

2007-12-01

Full Text Available Abstract Background Gaucher's disease (GD is the most frequently encountered lysosomal storage disease. Here, we describe and discuss the observed concurrence of schizophrenia and Gaucher's disease in two siblings. Methods Presentation of a family with two siblings with Gaucher's disease. Results In a six-member family, the first son suffers from schizophrenia, while the third and fourth sons suffer from the Gaucher's disease (type 1 non-neuronopathic. The parents and the second son do not suffer from either illness. Conclusion The concurrence of schizophrenia and Gaucher's disease in the same family is an unusual phenomenon. The literature regarding this coincidence is limited, despite the fact that patients with Gaucher's disease have one or two mutated alleles, considered to be a risk factor leading to conditions such as Dementia, Parkinson's disease and schizophrenia.

Concurrent Disorders and Health Care Utilization Among Homeless and Vulnerably Housed Persons in Canada.

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Zhang, Linda; Norena, Monica; Gadermann, Anne; Hubley, Anita; Russell, Lara; Aubry, Tim; To, Matthew J; Farrell, Susan; Hwang, Stephen; Palepu, Anita

2018-03-01

Individuals who are homeless or vulnerably housed have a higher prevalence of concurrent disorders, defined as having a mental health diagnosis and problematic substance use, compared to the general housed population. The study objective was to investigate the effect of having concurrent disorders on health care utilization among homeless or vulnerably housed individuals, using longitudinal data from the Health and Housing in Transition Study. In 2009, 1190 homeless or vulnerably housed adults were recruited in Ottawa, Toronto, and Vancouver, Canada. Participants completed baseline interviews and four annual follow-up interviews, providing data on sociodemographics, housing history, mental health diagnoses, problematic drug use with the Drug Abuse Screening Test (DAST-10), problematic alcohol use with the Alcohol Use Disorders Identification Test (AUDIT), chronic health conditions, and utilization of the following health care services: emergency department (ED), hospitalization, and primary care. Concurrent disorders were defined as the participant having ever received a mental health diagnosis at baseline and having problematic substance use (i.e., DAST-10 ≥ 6 and/or AUDIT ≥ 20) at any time during the study period. Three generalized mixed effects logistic regression models were used to examine the independent association of having concurrent disorders and reporting ED use, hospitalization, or primary care visits in the past 12 months. Among our sample of adults who were homeless or vulnerably housed, 22.6% (n = 261) reported having concurrent disorders at baseline. Individuals with concurrent disorders had significantly higher odds of ED use (adjusted odds ratio [AOR] = 1.71; 95% confidence interval [CI], 1.4-2.11), hospitalization (AOR = 1.45; 95% CI, 1.16-1.81), and primary care visits (AOR = 1.34; 95% CI, 1.05-1.71) in the past 12 months over the four-year follow-up period, after adjusting for potential confounders. Concurrent disorders were associated with

NGOs as Bridging Organizations in Managing Nature Protection in Vietnam

NARCIS (Netherlands)

Nguyen, T.K.D.; Bush, S.R.; Mol, A.P.J.

2016-01-01

Comanagement in Vietnamese Special-Use Forests (SUFs) has been constrained by
an administrative mode of state control. Consequently, SUF Management Boards
have limited scope to engage local resource users in conservation and management. Concurrently, nongovernmental organizations (NGOs) have

Safety effects of exclusive and concurrent signal phasing for pedestrian crossing.

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Zhang, Yaohua; Mamun, Sha A; Ivan, John N; Ravishanker, Nalini; Haque, Khademul

2015-10-01

This paper describes the estimation of pedestrian crash count and vehicle interaction severity prediction models for a sample of signalized intersections in Connecticut with either concurrent or exclusive pedestrian phasing. With concurrent phasing, pedestrians cross at the same time as motor vehicle traffic in the same direction receives a green phase, while with exclusive phasing, pedestrians cross during their own phase when all motor vehicle traffic on all approaches is stopped. Pedestrians crossing at each intersection were observed and classified according to the severity of interactions with motor vehicles. Observation intersections were selected to represent both types of signal phasing while controlling for other physical characteristics. In the nonlinear mixed models for interaction severity, pedestrians crossing on the walk signal at an exclusive signal experienced lower interaction severity compared to those crossing on the green light with concurrent phasing; however, pedestrians crossing on a green light where an exclusive phase was available experienced higher interaction severity. Intersections with concurrent phasing have fewer total pedestrian crashes than those with exclusive phasing but more crashes at higher severity levels. It is recommended that exclusive pedestrian phasing only be used at locations where pedestrians are more likely to comply. Copyright © 2015. Published by Elsevier Ltd.