Galen, S.; Vinay, M.
TOPMERET represents a significant advance in the modelling fidelity of Balance of Plant systems (BOP). It is extremely flexible and can accommodate a variety of systems, including main steam, feedwater, turbine, condenser, offgas, large volumes, such as the containment, and water systems such as service water. It handles both normal and abnormal operating scenarios, including pipe break accidents. It was tested successfully on various simulators, and meets the fidelity required of BOP system models so as to successfully integrate with the high level of control automation of European designs. (Z.S.) 1 ref
Fabbro, Stephanie K; Zirwas, Matthew J
Systemic contact dermatitis (SCD), a cutaneous reaction that is a direct manifestation of systemic exposure to a known allergen in a sensitized individual, has been increasingly recognized as a cause of persistent cutaneous contact dermatitis that is refractory to conventional therapies. While SCD in response to drugs has been described well in the literature, SCD to allergens in common foodstuffs is a less well-articulated phenomenon. Several foods that are universally consumed throughout the world contain potent allergens including nickel, balsam of Peru, trace metals, urushiol, and sesquiterpene lactones as well as a host of others that may cause a distinctive clinical picture. In this review article, the authors review the typical presentation and prevalence of SCD to foods, pathophysiology, the most common offensive ingestible food allergens, several appropriate diets, and effectiveness of dietary avoidance for situations in which SCD is suspected.
Ishii, K.; Harada, H.; Yamamori, T.; Igarashi, K.; Arakida, T.
Digital instrumentation and control (I and C) systems using distributed control systems (DCS) are essential elements for nuclear power plants (NPPs) seeking higher reliability, availability and maintainability. Hitachi can boast its broad new build and refurbishment project experience in Japan and other markets since the 1970s. Throughout its continuous involvement in NPP design, fabrication, construction and maintenance over 30 years, Hitachi has increasingly integrated digital I and C system with its own DCS suite. This paper focuses on the fundamental characteristics of Hitachi's Balance of Plant (BOP) I and C systems structure for new build nuclear projects. (author)
... BOP test due to well-control problems such as lost circulation, formation fluid influx, or stuck drill pipe Record the reason for postponing the test in the driller's report and conduct the required BOP... tapered drill-string Install two or more sets of conventional or variable-bore pipe rams in the BOP stack...
This is a theoretical study of BOP crises in emerging markets in East Asia and LatinAmerica in the l990s. These BOP crises tend to be preceded by the current account deterioration, the real exchange rate appreciation, and inflationary pressures. The paper develops a model of BOP crises preceded by these macroeconomic phenomena. The model shows that an external shock (a decrease in the world nominal interest rate) leads to this type of BOP crises.
Full Text Available In the paper the dynamic analysis of a gantry crane used for transporting of BOP (BlowOut Preventer is presented. The crane is placed on a drilling platform. Sea waves cause motion of the platform and the load. Description of such systems can be used in the design process of control systems which allows us to compensate waving. Homogenous transformations and joint coordinates are used to describe behavior of the system. Equations of motion are derived using the Lagrange equations of the second order. In the paper the results of numerical calculations are presented as well.
Tsai Chi Kuo
Full Text Available Scholars who aim to solve problems with poverty and a lack of resources often focus on bottom of pyramid (BOP consumer groups. They propose that the traditional TOP (top of pyramid business strategies are not suitable for BOP populations, and that it is crucial to determine and satisfy BOP consumption demands. The purpose of this study is to find out which factors influence BOP consumption, and to explore BOP integrated products. The concepts of “national cultural traits” and sustainable product design are also used. The findings will help enterprises learn how to make profits in BOP markets (addressing economic goals, while helping the poor get out of poverty (addressing social goals. Two different areas concerning BOP consumers are used to illustrate the results.
Boer, J. de; Steen, M.G.D.; Posthumus, A.L.
Base-of-the-Pyramid (BoP) inclusive innovation projects aim to design, produce and market products and services for large and relatively poor market segments in developing countries, for example for people who have less than several dollars to spend per day. BoP projects have ‘normal’ goals,
Cho, Yoon Sang; Lee, Jae Gon; Han, Sung Heum [KHNP CRI, Daejeon (Korea, Republic of)
The BOP is one of the key factors for successful project implementation of NPP. In constructing the APR1400 NPP, the BOP procurement has been one of the biggest concerns. Due to the design changes and increased capacity of equipment in NPP, lots of BOPs should be ‘first supplied equipment’ [hereinafter, ‘FSE’]. The manufacture-ability, and the performances of FSEs have not been fully proved and tested, manufacturers and suppliers are requested to submit Reports for Equipment Qualification Evaluation in accordance with 10 CFR 50.49, IEEE 323. They need at least 1-2 years’ tests for Environment Qualification (EQ) and Seismic Qualification (SQ). This study is focused how to prepare the BOP purchase specifications in order to control the FSEs, especially in safety class equipment. With the optimization plan for BOP packages of this study, the FSEs’ occurrence can be reasonably controlled as low as possible. For successful NPP project, the concerns in procuring BOPs shall be fully analyzed beforehand. Now Korea is preparing new era of APR+, with closing the time of APR1400. The technical specification of APR+ BOPs can be developed and prepared successfully and very effectively according to this optimization plan. This will be a great contribution not only in constructing APR+ in time, but also in exporting APR+ overseas, all over the world in the future.
Nara, Satoru; Kamiya, Eisei
Fuji Electric Co., Ltd. has supplied many management systems to nuclear reactor institution. 'The nuclear countermeasures-against-calamities special-measures' was enforced. A nuclear entrepreneur has devised the measure about expansion prevention and restoration of a calamity while it endeavors after prevention of generating of a nuclear calamity. Our company have supplied the 'disaster prevention surveillance system' to the Japan Atomic Energy Research Institute Tokai Research Establishment aiming at strengthening of the monitoring function at the time (after the accident) of the accident used as one of the above-mentioned measures. A 'disaster prevention surveillance system' can share the information on the accident spot in an on-site command place, an activity headquarters, and support organizations, when the serious accident happens. This system is composed of various sensors (temperature, pressure and radiation), cameras, computers and network. (author)
Tsai Chi Kuo
Full Text Available The challenge for enterprises to enter the market in the bottom of the pyramid (BOP segment is to revise their supply chain design. This article compiles the cases that demonstrate how enterprises can successfully enter BOP markets. Factors are extracted and analyzed according to the stages of the value chain and the supply chain. Furthermore, the Importance—Performance Analysis (IPA is used to explore the gap and the opportunities for improvement. Also, the multinational enterprises (MNEs in Taiwan and local manufacturers in Indonesia are compared for their suitability to the different business strategies. Results of these analyses could serve as a gap analysis tool for decision-making and business strategies entering the BOP market.
Ravn, Jacob; Kroghstrup Nielsen, Martin; Lindgren, Peter
Through innovation of products, process and business models targeting the needs of 4 billion poor people living at "the base of pyramid" (BoP) (Prahalad & Hart 2002) in developing countries the private sector can actively support poverty alleviation and at the same time reach new untouched market...... countries seems to show up in the literature: The technological line - exemplified by the - exemplified by the Life Straw business model - a high tech "straw" consisting of 12 chemical filters to purify water - an example of technology driven innovation to meet the BoP demands for clean water (Kandachar...
Lazar, Stephen [Christopher S. Mancini, Tomball, TX (United States)
Events during 2010 have focused attention on increased ROV/BOP Intervention capabilities and standardization of BOP/ROV interfaces in the oil and gas offshore industry. Currently no enforced set standards for ROV intervention panels or manifold types for use on BOP Override systems are specified. The industry offers multiple configurations at present. This abstract will discuss the advantages and disadvantages of the various configurations in existence, trending toward suggested industry standards taking shape as requirements in the near term. Standards for the offshore industry or a set specification must be made to increase safety and functionality of BOP control systems. To date, ROV override capabilities have been added to existing engineered BOP systems. BOP designed closing times were not a critical consideration, only that the access was there to allow for ROV override. Increased ROV flow and pressure capabilities: no current minimum flow requirements for Emergency BOP Override pumps are established. Based on stack valving and configuration, a minimum, 7 gpm may be required to shift valving fully to allow BOP operator function. IADC/API minimum requirements may be proposed at 10 gpm at 3000psi. Based on shear pressures exceeding 3000psi, pressures of 5000psi should be considered. Current intervention skids/pump capabilities will be required if ROVs must achieve API 16D BOP minimum closing times. Remote or isolated accumulation for increased intervention capabilities offers possibilities when ANY ROV of opportunity can trigger a function (such as small inspection type ROVs). Increased volumes will be required. This is critical in functioning stack rams with an ROV of opportunity to achieve API 16D closing times. We now understand that higher flows and pressures are required along with standardization of stab types. Current recommendations: API 17H Hi-Flow manifolds should be added to essential ROV overrides. ROV skids will have a minimum requirement of 10gpm
... as specified under paragraphs (e) and (f) of this section. The pipe rams shall be of proper size to fit the drill pipe in use. (c) Working pressure. The working-pressure rating of any BOP shall exceed... of hydraulic operations if rig air is lost. (2) An automatic backup to the accumulator system. The...
Alejandro, R.; Udbinac, M.J.
The Vermont Yankee simulator has undergone significant changes in the 20 years since the original order was placed. After the move from the original Unix to MS Windows environment, and upgrade to the latest version of SimPort, now called MASTER, the platform was set for an overhaul and replacement of major plant system models. Over a period of a few months, the VY simulator team, in partnership with WSC engineers, replaced outdated legacy models of the main steam, condenser, condensate, circulating water, feedwater and feedwater heaters, and main turbine and auxiliaries. The timing was ideal, as the plant was undergoing a power up-rate, so the opportunity was taken to replace the legacy models with industry-leading, true on-line object oriented graphical models. Due to the efficiency of design and ease of use of the MASTER tools, VY staff performed the majority of the modeling work themselves with great success, with only occasional assistance from WSC, in a relatively short time-period, despite having to maintain all of their 'regular' simulator maintenance responsibilities. This paper will provide a more detailed view of the VY simulator, including how it is used and how it has benefited from the enhancements and upgrades implemented during the project. (author)
Turner, Alan L.; Loustau, Philippe; Thibodeau, Dan
Ultra-deep water BOP (Blowout Preventer) operation poses numerous challenges in obtaining accurate knowledge of current system integrity and component condition- a salient example is the difficulty of verifying closure of the pipe and shearing rams during and after well control events. Ascertaining the integrity of these functions is currently based on a manual volume measurement performed with a stop watch. Advances in sensor technology now permit more accurate methods of BOP condition monitoring. Fiber optic sensing technology and particularly fiber optic strain gauges have evolved to a point where we can derive a good representation of what is happening inside a BOP by installing sensors on the outside shell. Function signatures can be baselined to establish thresholds that indicate successful function activation. Based on this knowledge base, signal variation over time can then be utilized to assess degradation of these functions and subsequent failure to function. Monitoring the BOP from the outside has the advantage of gathering data through a system that can be interfaced with risk based integrity management software and/or a smart monitoring system that analyzes BOP control redundancies without the requirement of interfacing with OEM control systems. The paper will present the results of ongoing work on a fully instrumented 13-½" 10,000 psi pipe ram. Instrumentation includes commonly used pressure transducers, accelerometers, flow meters, and optical strain gauges. Correlation will be presented between flow, pressure, acceleration signatures and the fiber optic strain gauge's response as it relates to functional verification and component level degradation trending.
Irvine-Halliday, Dave; Doluweera, Ganesh; Platonova, Inna; Irvine-Halliday, Jenny
In this paper we discuss the real cost of fuel based lighting in the developing world and in comparison the incredible wealth creating prospects associated with safe, healthy and affordable solid state lighting (SSL), based on renewable energy (RE) and Micro Credit (MC). SSL technology and a number of SSL projects promoted by the Light Up The World Foundation (LUTW) are presented. A multi stake holder approach for the accelerated adoption of SSL in the developing world is proposed in order that those at the Base of the Pyramid (BOP) can get onto the first rung of the ladder of economic progress. The potential contributions of SSL to the Millennium Development Goals (MDGs) and the fundamental importance of MC are discussed in detail. The wholesale adoption of SSL by the BOP would be an added ‘incentive’ for the Top and Middle of the Pyramid to also adopt SSL wholesale. A Bottom Up plus a Top Down adoption of SSL can help combat climate change. LUTW promotes SSL systems for the benefit of the world’s poor, and its strategy is in line with the Jeffrey Sachs plan for the developed world to help the developing world pull itself up by its own bootstraps.
..., inside BOPs, and drill-string safety valves? 250.445 Section 250.445 Mineral Resources MINERALS... are the requirements for kelly valves, inside BOPs, and drill-string safety valves? You must use or... install an inside BOP for each size connection in the drill string; (f) A drill-string safety valve in the...
Full Text Available The paper presents the money laundering and terrorist financing prevention system in Croatia. The basic concepts are defined, the principles and fundamentals of international regulations analysed, and the regulatory system in Croatia covered by statute and money laundering prevention Regulations is presented, in conjunction with a description of the organisation, remit and international actions of the Money Laundering Prevention Office.The infiltration of dirty money is a crucial problem from national economies. The purchase of shares, of real estate, the establishment of dirty investment funds and the use of the banking system for the embedding of such resources is a danger to the credibility of a whole country, and in particular to the security of the financial and banking system. Croatia has adopted statutory measures aimed at the effective detection and prevention of suspicious financial transactions, in other words the prevention of money laundering.Launderers constantly find new ways, make use of new non-financial channels and expand their activities to real estate, artworks and insurance. Hence it is necessary to keep up with European approaches and recommendations, to strive for further improvement of the laws and the modernisation of the system, and to adopt new regulations harmonised with international standards, particularly with Directive 2005/60/EC.
Full Text Available Abstract Background Bifidobacteria belong to one of the predominant bacterial groups in the intestinal microbiota of infants and adults. Several beneficial effects on the health status of their human hosts have been demonstrated making bifidobacteria interesting candidates for probiotic applications. Adhesion of probiotics to the intestinal epithelium is discussed as a prerequisite for colonisation of and persistence in the gastrointestinal tract. Results In the present study, 15 different strains of bifidobacteria were tested for adhesion. B. bifidum was identified as the species showing highest adhesion to all tested intestinal epithelial cell (IEC lines. Adhesion of B. bifidum S17 to IECs was strongly reduced after treatment of bacteria with pronase. These results strongly indicate that a proteinaceous cell surface component mediates adhesion of B. bifidum S17 to IECs. In silico analysis of the currently accessible Bifidobacterium genomes identified bopA encoding a lipoprotein as a B. bifidum-specific gene previously shown to function as an adhesin of B. bifidum MIMBb75. The in silico results were confirmed by Southern Blot analysis. Furthermore, Northern Blot analysis demonstrated that bopA is expressed in all B. bifidum strains tested under conditions used to cultivate bacteria for adhesion assays. The BopA gene was successfully expressed in E. coli and purified by Ni-NTA affinity chromatography as a C-terminal His6-fusion. Purified BopA had an inhibitory effect on adhesion of B. bifidum S17 to IECs. Moreover, bopA was successfully expressed in B. bifidum S17 and B. longum/infantis E18. Strains overexpressing bopA showed enhanced adhesion to IECs, clearly demonstrating a role of BopA in adhesion of B. bifidum strains. Conclusions BopA was identified as a B. bifidum-specific protein involved in adhesion to IECs. Bifidobacterium strains expressing bopA show enhanced adhesion. Our results represent the first report on recombinant
Tangedahl, M.J.; Stone, C.R.
This paper reports that recent changes in the oil and gas industry and ongoing developments in horizontal and underbalanced drilling necessitated development of a better rotating head. A new device called the rotating blowout preventer (RBOP) was developed by Seal-Tech. It is designed to replace the conventional rotating control head on top of BOP stacks and allows drilling operations to continue even on live (underbalanced) wells. Its low wear characteristics and high working pressure (1,500 psi) allow drilling rig crews to drill safely in slightly underbalanced conditions or handle severe well control problems during the time required to actuate other BOPs in the stack. Drilling with a RBOP allows wellbores to be completely closed in tat the drill floor rather than open as with conventional BOPs
Errington, Frederick; Fujikura, Tatsuro; Gewertz, Deborah
Focusing primarily, but not exclusively, on urban and periurban Papua New Guinea (PNG), we discuss the significance of instant ramen noodles to those now known as the “bottom of the pyramid” (BOP). Although instant noodles are remarkable in that they are eaten by virtually everyone in the world, albeit in different amounts and for different reasons, they are marketed in PNG specifically as a “popularly positioned product” (PPP) for the BOP. Cheap, convenient, tasty, filling, and shelf stable, they are a modern addition to Sidney Mintz's classic “proletarian hunger killers” of sugar, tea, and coffee. But, we argue, instant noodles have a distinctive contemporary role: they do more than sustain the poor; they transform them into the aspiring consumers of the BOP. As such, instant noodles can be viewed as an antifriction device, greasing the skids of capitalism as it extends its reach.
Renata Giovinazzo Spers
Full Text Available The objective of this study is to outline a diagnosis of the BoP's population in Brazil, regarding their size and consumption characteristics. This is a relevant and current issue, considering that BoP needs to be understood as a large potential market with its own logic, also representing a large productive potential, which, if well developed, will bring very positive impacts to these communities. To achieve this, a theoretical survey was made. After, search was made based on secondary data about Brazilian BoP population participation and a mapping of their consumption profile, identifying main categories of goods consumed. This research generated meaningful results for society, companies and the Academy, hopefully consolidating a relevant line of research and management education.
BOP project is an important part of nuclear power plant to maintain the normal operation and maintenance of the plant. The level of the design management has the important influences on the quality of the whole project, Design management includes the choice of the design standards, design evaluation, document control, the management of the design interface, design modification management and the management of the design service. The paper will start from various design issues in the construction of the Fuqing BOP project, analyse the causes of the problems on the design schedule management, interface, evaluation and the modification management. And then the paper also provides suggestions for improvement about all of this. (author)
Jauregui Becker, Juan Manuel; Franco Garcia, Maria Maria; Groen, Arend J.
This paper frames the main components required to set-up Product Co-Creation Centers (PC3) within (rural or urban) BoP environments as a method to (1) identify creative and entrepreneur individuals; (2) aid the process of generating new ideas; (3) support the co-creation of products and services as
....11, Maintenance; and Sections 17.12 and 18.12, Quality Management, described in API RP 53... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What are the BOP maintenance and inspection requirements? 250.446 Section 250.446 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR...
Ibáñez, J; Carreño, A; García-Amorena, C; Caral, J; Gastón, F; Ferrer, E
Eighty-two patients operated on in our Department between 1989 and 1995 with an anterior cervical approach for soft and hard cervical disc herniations and cervical stenosis were included in this study. In 41 cases a heterologous intersomatic bovine graft (Surgibone) was used. Another 41 patients underwent surgery with a biocompatible osteoconductive polymer (BOP) as intervertebral graft. Both groups were retrospectively reviewed and compared with the objectives of evaluating the biodynamic behaviour of the grafts in the intersomatic space, the complications which appeared (specially those related to the grafts), the bone fusion rate achieved and the clinical outcome of the patients. The results of our study show that the BOP group presented a higher tendency to intersomatic space collapse 6 months after discectomy. There were no differences in the general surgical complications between both groups, but those related directly to the graft were significantly higher in the BOP group. The vast majority of the graft complications recorded had no clinical correlation. Without a strict radiological follow-up such complications would never have been discovered. Bone fusion in the BOP group was significantly slower and worse. Finally, the clinical outcome in both groups did not show any significant difference.
Jarvis, D. L.
Social workers, Cooperating with doctors, nurses, hospital social workers and educators in other helping systems, conducted a demonstration project described here, aimed at preventing illegitimate teenage pregnancy. (Author)
Kamp, L.M.; Ortt, J.R.; Harahap, B.
Companies that bring a new product to the market or enter a new market with an existing product, come across a number of barriers that prevent large?scale diffusion. In order to circumvent or remove these barriers, they can adopt alternative strategies. This paper looks into these barriers and
Full Text Available This study expands the definition of the poor group and attempts to delve into and make known the phenomenon of poverty in Taiwan and aims to explore the goals and possibilities of the BOP consumer market. Through a questionnaire survey and expert interviews, this research adopts the concept of sustainability to discuss the lifestyle and consumption characteristics of the BOP group and establishes a design strategic norm of the sustainable products. The findings show that the BOP group in Taiwan is new poverty or working poor and high quality and common prices are the main requirements; these should be introduced into the development model of sustainable design.
For increasing requirement of peoples for review of nuclear disaster countermeasure at a chance of the JCO critical accident, the Japanese Government newly established the 'Special Measure Act on Nuclear Disaster Countermeasure', which was enacted on July 16, 2000. The nuclear business relatives such as electric power company and so forth established the Business program on nuclear disaster prevention in nuclear business relatives' after their consultation with local communities at their construction, under their co-operation. Simultaneously, the electric power industry field decided to intend to provide some sufficient countermeasures to incidental formation of nuclear accident such as start of the Co-operative agreement on nuclear disaster prevention among the nuclear business relatives' and so forth. Here were described on nuclear safety and disaster prevention, nuclear disaster prevention systems at the electric power industry field, abstract on 'Business program on nuclear disaster prevention in nuclear business relatives', preparation of technical assistance system for nuclear disaster prevention, executive methods and subjects on nuclear disaster prevention at construction areas, recent business on nuclear disaster prevention at the Nuclear Technical Center, and subjects on establishment of nuclear disaster prevention system. (G.K.)
Sruti Mitra; Professor Tarun Kumar Singhal
Bottom of the wealth pyramid is about 80 percent of India’s population who suffer from extreme poverty and malnutrition . Spirulina and Chlorella are the most widely noted microalgae full of nutrition that can be consumed separately or in combination with food as a cheap food supplement to eradicate poverty and malnutrition among the BOP sector. An assessment to find the acceptability of this microalgae as food supplement is being focused in this research paper . The research study cou...
Full Text Available Information security is a challenging issue for all business organizations today amidst increasing cyber threats. While there are many alternative intrusion detection amp prevention systems available to choose from selecting the best solution to implement to detect amp prevent cyber-attacks is a difficult task. The best solution is of the one that gets the best reviews and suits the organizations needs amp budget. In this review paper we summarize various classes of intrusion detection and prevention systems compare features of alternative solutions and make recommendation for implementation of one as the best solution for business organization in Fiji.
Wang, Jun-Jie; He, Jiang-Tao; Lu, Yan; Liu, Li-Ya; Zhang, Xiao-Liang
Groundwater contamination prevention mapping is an important component of groundwater contamination geological survey and assessment work, which could provide the basis for making and implementing groundwater contamination prevention planning. A groundwater contamination prevention mapping system was constructed in view of the synthetic consideration on nature perspective derived from groundwater contamination sources and aquifer itself, social-economic perspective, policy perspective derived from outside. During the system construction process, analytic hierarchy process and relevant overlaying principles were used to couple groundwater contamination risk assessment, groundwater value as well as wellhead protection area zoning. Data processing and visualization of mapping results were achieved in the GIS environment. The research on groundwater contamination prevention mapping in Beijing Plain indicated that the final groundwater prevention map was in accordance with the actual conditions and well reflected the priorities of groundwater prevention, which could play a guidance role in designing and implementing further practical prevention and supervision measures. Besides, because of the dynamical properties of the system components, it was suggested to analyze the update frequency of the mapping.
Performing preventive maintenance activities for the computer is not optional. The computer is a sensitive and delicate device that needs adequate time and attention to make it work properly. In this paper, the concept and issues on how to prolong the life span of the system, that is, the way to make the system last long and ...
a given operational conditions and predicts the resulting stability margins for the new steady state, while avoiding time consuming time domain simulations. The method has been validated on the Western Danish power system model, containing 464 buses. The case study of aperiodic small signal angular....... The predicted effect of the suggested countermeasure application is in a good agreement with the results obtained by RMS dynamic simulation. Developed method enables adaptive preventive control for near real-time stability maintenance. The achieved results are opening promising perspective for power system’s......In the scope of this work, a method capable of fast identification of the proper countermeasure, that prevents emerging instability, has been developed. The focus is placed on the prevention of aperiodic small signal angular instability by means of manipulations applied to load nodes (nodes...
Full Text Available Poverty is a universal phenomenon which does not go well with the progressive 21st century and hence the worldwide efforts to overcome the problem. At the beginning of the 21st century (2002, the late professor C.K. Prahalad had propounded a path breaking theory of poverty alleviation called the bottom of the pyramid business theory, which is not only making MNCs investments (FDI in underdeveloped countries and promoting their growth and employment generation and increase in incomes and thereby consumption and expenditure but also producing goods and services needed by the poor households at the bottom of the economic and business pyramid. The paper is devoted to the consideration of the theory in the emerging market economy of India where poverty is a biggest problem and the situation is not found significant for the BOP business. Can there be a market solution to it?
Bingham County Career Education, Blackfoot, ID.
BOP, Inc., is a simulated mortgage and loan office serving students in the high schools of Bingham County, Idaho, through a mobile educational service program. The program's primary purpose is to provide work experiences for high school students who have office skills so that they can make decisions about working in an office. The teacher's manual…
Bingham County Career Education, Blackfoot, ID.
BOP, Inc. is a mobile educational service that places the student in a simulated mortgage and loan office to provide a realistic office learning environment. The student manual opens with a brief reference information section on: the purposes of an office simulation, an explanation of a mortgage loan office, an outline of normal business…
New cancer cases are expected to surge 57% worldwide in the next two decades. The greatest burden will be in low- and middle-income countries that are ill equipped to face this epidemic. Similarly, in the United States, low-income populations are at greater risk for cancer. As most cancers contain over 50 genetic alterations, and as these alterations define dysregulation of over 10 different critical cellular signaling pathways, a "silver bullet" treatment is not effective against most cancers. Instead, the latest World Cancer Report (2012) suggests a research shift toward developing prevention strategies for cancer. Accumulating evidence suggests that a diet high in plant-based foods is preventive of a variety of chronic diseases, including cancer. A plethora of bioactive compounds-such as polyphenols, glucosinolates and carotenoids in fruits, vegetables, grains, and legumes-are shown to suppress a variety of biological capabilities required for tumor growth. While much research has shown that plant bioactive compounds can suppress sustained proliferative signaling, angiogenesis, and metastasis, as well as promote cancer stem cell apoptosis, public health campaigns to increase fruit and vegetable consumption have, overall, been less effective than desired. Thus, there is a need for innovative strategies to support increased consumption of bioactive compounds for cancer prevention particularly in vulnerable populations. Many practices of the farm-to-fork continuum, including preharvest practices, postharvest storage, and processing and consumer practices, affect a food's bioactive compound content, composition, and chemopreventive bioactivity. Food system practices may be adjusted to reduce the toxic compound levels (e.g., glycoalkaloids in potatoes) and improve the bioactive compound profile, thus, elevate the cancer fighting properties of fruits, vegetables, and other food products. This review presents current scientific evidence outlining farm-to-fork effects
... Requirements § 125.181 Induction system ice prevention. A means for preventing the malfunctioning of each engine due to ice accumulation in the engine air induction system must be provided for each airplane. ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Induction system ice prevention. 125.181...
... Induction system ice prevention. A means for preventing the malfunctioning of each engine due to ice accumulation in the engine air induction system must be provided for each airplane. ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Induction system ice prevention. 121.283...
... District Manager may require testing every 7 days if conditions or BOP performance warrant. (b) BOP test... between control stations and pods. If a control station or pod is not functional, you must suspend further... at least every 30 days; (5) Function test annulars and rams every 7 days; (6) Pressure-test variable...
Chen, T.P. [Bechtel Corp, San Francisco, CA (United States)
M-C Power Corporation plans to introduce its molten carbonate fuel cell (MCFC) market entry unit in the year 2000 for distributed and on-site power generation. Extensive efforts have been made to analyze the cell stack manufacturing costs. The major objective of this study is to conduct a detailed analysis of BOP costs based on an initial design of the market entry unit.
Hollensen, Svend; Raman, Anthony
A disruptive innovation is a technology whose performance does not currently meet the requirements of the developed market. However, it does meet the requirements of a lower-end market, with customers that have lover performance requirements and are more sensitive to price. Indian Godrej followed...... these principles and developed a "simple" refrigerator, which is especially targeted for the Bottom-of Pyramid (BOP) market...
Youngblood, R.W.; Worrell, R.B.
A key step in formulating a regulatory basis for licensing complex and potentially hazardous facilities is identification of a collection of design elements that is necessary and sufficient to achieve the desired level of protection of the public, the workers, and the environment. Here, such a collection of design elements will be called a ''prevention set.'' At the design stage, identifying a prevention set helps to determine what elements to include in the final design. Separately, a prevention-set argument could be used to limit the scope of regulatory oversight to a subset of design elements. This step can be taken during initial review of a design, or later as part of an effort to justify relief from regulatory requirements that are burdensome but provide little risk reduction. This paper presents a systematic approach to the problem of optimally choosing a prevention set
Marìa Griselda Lassaga
Full Text Available More than 2 million people from the outskirts of the Buenos Aires Metropolitan Region live in neighborhoods with restricted access to education, credit, healthcare, and basic services (Goytia and Lanfranchi, 2009. With nearly 4 billion people now living in poverty world wide, this situation is not unique to Buenos Aires. The size of this “Base of the Pyramid” (BOP economic market makes it impossible to ignore in the 21st century (Prahalad and Hart, 2002. Unfortunately however, most private businesses have overlooked this population and thereby denied it the opportunity to participate in the global economy. This article describes how Fundación Pro Vivienda Social (FPVS seeks to rectify this situation by facilitating economic engagement with the BOP. This case study, based on the testimony and experiences of participants, details the effort to create financially sustainable business opportunities for both the BOP and private sector. Specifically, this study deals with FPVS‟s role as a facilitator between businesses and poor communities in doing business with the Base of the Pyramid, (BOP. Testimony from this real case study in addition to the experience of the researchers and current business literature was the chosen path. As a longitudinal study, the case looks at how perceptions and relationships change over time. Based on the Developing Business Network Model, this article looked at the co-creation of value for all the parties within a sustainable framework. Specifically, the FPVS case deals with the foundation‟s leverage function in developing mutually beneficial infrastructure solutions. Since 1995, FPVS has focused on housing improvements and infrastructure development. Through its projects, FPVS has demonstrated that working with low-income communities is not high-risk, but rather good business. The foundation believes that by organizing communities around mobilizing events related to standard of living improvements, it can create
Rodriguez Ivanna; Chocron Mauricio; Miceli Fiorella; Saucedo, Ramona
Steam quality determination (the ratio between steam mass flow rate and the sum of steam and liquid water mass flow rate) or its reciprocal named moisture carryover, is a magnitude of importance in fossil fired and nuclear power plants as well. This is due to that, the steam quality participates in the determination of the power transferred from the primary to the secondary circuit (ASME PTC, Gross Heat Input) and the performance of the secondary circuit, in the efficiency of the liquid separators located in the dome of the recirculating type steam generators and finally because the drops carryover implies mechanical wear in the turbine blades and transport of impurities as well. It is after the above mentioned reasons, that several standardized procedures exist (ASTM) and international institutions devoted to the properties of water and steam and applications in power plants release recommendations on the steam quality (IAPWS). Even though, the measurement is still a subject of new publications (Thomas et al., NPC10). In general, the determination methods make use of the addition of a tracer, stable alkaline element or isotope, which has to be later quantified by an analytical or radiochemical technique. It also means keeping the BOP under specified conditions during the test. Chemicals dosing of is not always accepted considering that ions used as tracers concentrate in the steam generator media and modify the water chemistry conditions. This is more pronounced in old devices with presence of fouling and sludge piles on the tube sheet. In the present work a technique based on the concentration of the ions currently existing in the cycle: Blowdown Water (BDW) and condensate (MSR-MSC) of the main steam used as heating fluid in the Moisture Separator Reheater (MSR). The latter ensures a total representative sample of the two phase stream, unlike sampling in the main steam sampling line. Those ion concentrations participate in the calculation of the steam quality. To
... Mental Health Record System (JUSTICE/BOP-007). (7) Inmate Safety and Accident Compensation Record System... Mental Health Records System, (Justice/BOP-007). (o) These exemptions apply only to the extent that... the health care of the inmates and the safety and security of the prisons and the public. (p) The...
Stetson, F.T.; Gallagher, D.W.; Le, P.T.; Ebert, M.W.
This report documents the results of an analysis of balance-of-plant (BOP) related reactor trips at commercial US nuclear power plants of a 5-year period, from January 1, 1984, through December 31, 1988. The study was performed for the Plant Systems Branch, Office of Nuclear Reactor Regulation, US Nuclear Regulatory Commission. The objectives of the study were: to improve the level of understanding of BOP-related challenges to safety systems by identifying and categorizing such events; to prepare a computerized data base of BOP-related reactor trip events and use the data base to identify trends and patterns in the population of these events; to investigate the risk implications of BOP events that challenge safety systems; and to provide recommendations on how to address BOP-related concerns in regulatory context. 18 refs., 2 figs., 27 tabs
Gutierrez, Jose; Pereira, Luis
A subsea processor may be located near the seabed of a drilling site and used to coordinate operations of underwater drilling components. The subsea processor may be enclosed in a single interchangeable unit that fits a receptor on an underwater drilling component, such as a blow-out preventer (BOP). The subsea processor may issue commands to control the BOP and receive measurements from sensors located throughout the BOP. A shared communications bus may interconnect the subsea processor and underwater components and the subsea processor and a surface or onshore network. The shared communications bus may be operated according to a time division multiple access (TDMA) scheme.
Hollensen, Svend; Raman, Anthony
A disruptive innovation is a technology whose performance does not currently meet the requirements of the developed market. However, it does meet the requirements of a lower-end market, with customers that have lover performance requirements and are more sensitive to price. Indian Godrej followed...... these principles and developed a "simple" refrigerator, which is especially targeted for the Bottom-of Pyramid (BOP) market......A disruptive innovation is a technology whose performance does not currently meet the requirements of the developed market. However, it does meet the requirements of a lower-end market, with customers that have lover performance requirements and are more sensitive to price. Indian Godrej followed...
phenomena involve dynamical systems coupled through interactions. So, a natural but important question which arises is 'what is the collective behaviour of a distributed system composed of several such coupled relaxation oscillators?' To model such large interactive systems one has to consider three principal features :.
hours, some point-of-sale system vendors install a remote desktop environment (RDE) product on the business’s point-of-sale system. Many hackers...who target point-of-sale systems begin by gathering a list 8 of common network ports associated with well-known remote desktop products . For...acquiring and analyzing the Windows Registry hives from the live machine, are particularly useful for analyzing compromised Windows based point-of
Scientific Reports (Nature) 4, 4308] on taming explosive growth in spatially extended systems. Specifically, we consider collections of relaxation oscillators, which are relevant to modelling phenomena ranging from ...
Dmitrova, Evgenia; Wittrock, Martin Lindholm; Jóhannsson, Hjörtur
are then determined, using a grid transformation coefficient (GTC) and a numerical, iterative solution to an equation system. The stability criteriacan then be assessed to evaluate the sufficiency of a suggested counter measure. The method is demonstrated on a synthetic 8-bus network and a 464-bus model...... of the Western Denm ark transmission grid. The method successfully demonstrates its ability to efficiently identify and evaluate counter measures for a large, practical system....
The appropriate goal of reducing the onset of mental disorder through modifying organic factors, stress, exploitation, coping skills, self-esteem and group support, will require cultural change. Group, organizational, and community norms can stand in the way of prevention efforts. In order to create a more supportive cultural environment for primary prevention, culture change principles must be adopted and a systematic change strategy must be employed. A four phase, Normative Systems model is proposed. The model has shown its utility over its 30 year history. A description of a Normative Systems application with migrant farm workers helps to illustrate Normative Systems project development.
Dodge, Kenneth A.; Berlin, Lisa J.; Epstein, Matthew; Spitz-Roth, Adele; O'Donnell, Karen; Kaufman, Martha; Amaya-Jackson, Lisa; Rosch, Joel; Christopoulos, Christina
This article describes the Durham Family Initiative (DFI), an innovative effort to bring together child welfare and juvenile justice systems to reach DFI's goal of reducing the child abuse rate in Durham, North Carolina, by 50% within the next 10 years. DFI will follow principles of a preventive system of care (PSoC), which focuses on nurturing…
The repair-bottleneck problem as a limiting factor for system reliability can be overcome. Design need only cover the steady state, wearout induced accumulations of failures being precluded by preventive replacements with subsequent recycling. As a result, a reliable system appears to be feasible on an economic basis, optimization in detail to be left to more precised cost-benefit studies. As a reference system the radio-frequency-generator cascade of a single-cell linear accelerator is considered. (DG)
Pelto, P.J.; Baker, E.G.; Holter, G.M.; Powers, T.B.
The liquefied natural gas (LNG) industry employs a variety of release prevention and control techniques to reduce the likelihood and the consequences of accidental LNG releases. A study of the effectiveness of these release prevention and control systems is being performed. Reference descriptions for the basic types of LNG facilities were developed. Then an overview study was performed to identify areas that merit subsequent and more detailed analyses. The specific objectives were to characterize the LNG facilities of interest and their release prevention and control systems, identify possible weak links and research needs, and provide an analytical framework for subsequent detailed analyses. The LNG facilities analyzed include a reference export terminal, marine vessel, import terminal, peakshaving facility, truck tanker, and satellite facility. A reference description for these facilities, a preliminary hazards analysis (PHA), and a list of representative release scenarios are included. The reference facility descriptions outline basic process flows, plant layouts, and safety features. The PHA identifies the important release prevention operations. Representative release scenarios provide a format for discussing potential initiating events, effects of the release prevention and control systems, information needs, and potential design changes. These scenarios range from relatively frequent but low consequence releases to unlikely but large releases and are the principal basis for the next stage of analysis.
Takahashi-Omoe, Hiromi; Omoe, Katsuhiko; Okabe, Nobuhiko
Japan is one of the few rabies-free countries. Although 3 imported cases of human rabies were seen in 1970 and 2006, no other cases have been reported for approximately 50 years. The elimination of rabies in Japan is attributed to not only its geographic isolation but also to effective prevention and control measures, such as registration and vaccination of domestic dogs, required quarantine of susceptible imported animals, and national plans of action based on scientific research. Countermeasures against rabies have been upgraded; an improved management system for domestic dogs under the amended Enforcement Regulations of the Rabies Prevention Law has been in effect since April 2007. The latest regulatory systems for preventing and controlling rabies provide an effective model for elimination of the disease worldwide.
Hogben, Matthew; Hood, Julia; Collins, Dayne; McFarlane, Mary
Systematic analysis of STD programme data contributes to a national portrait of sexually transmitted disease (STD) prevention activities, including research and evaluation specifically designed to optimise programme efficiency and impact. We analysed the narrative of the 2009 annual progress reports of the US Comprehensive STD Prevention Systems cooperative agreement for 58 STD programmes, concentrating on programme characteristics and partnerships. Programmes described 516 unique partnerships with a median of seven organisations cited per STD programme. Non-profit organisations (including service providers) were most frequently cited. Higher gonorrhoea morbidity was associated with reporting more partnerships; budget problems were associated with reporting fewer. Challenges to engaging in partnerships included budget constraints, staff turnover and low interest. Data provide a source of information for judging progress in programme collaboration and for informing a sustained programme-focused research and evaluation agenda.
Hoelscher, Deanna M; Ranjit, Nalini; Pérez, Adriana
To address the obesity epidemic, the public health community must develop surveillance systems that capture data at levels through which obesity prevention efforts are conducted. Current systems assess body mass index (BMI), diet, and physical activity behaviors at the individual level, but environmental and policy-related data are often lacking. The goal of this review is to describe US surveillance systems that evaluate obesity prevention efforts within the context of international trends in obesity monitoring, to identify potential data gaps, and to present recommendations to improve the evaluation of population-level initiatives. Our recommendations include adding environmental and policy measures to surveillance efforts with a focus on addressing underserved populations, harmonizing existing surveillance systems, including more sensitive measures of obesity outcomes, and developing a knowledgeable workforce. In addition, the widespread use of electronic health records and new technologies that allow self-quantification of behaviors offers opportunities for innovative surveillance methods.
Kang Seong Woo; Yim, Man Sung [KAIST, Daejeon (Korea, Republic of)
To the eyes of the general public, however, reducing the chance of such accident is not enough. A typical engineer views a risk as a combination of both consequences and likelihoods, whereas an ordinary person may only consider consequences. The implementations of better regulations, improved human operator actions, and installations of extra safety systems may reduce the chance of having uncontrolled accident practically to zero, yet the public still fears having nuclear reactors. One such barrier system is a portable suction-based radiation dispersion prevention system, called Integrated Portable Suction-Centrifugal Filtration System (IPS-CFS). To design such systems, detailed information about the radioactive source term at the release point to the environment must be available to draw design limits. The preliminary design limits of the IPS-CFS are presented in this paper. It may seem challenging to design a comprehensive radioactive dispersion system that can successfully prevent such extreme accident conditions, especially due to the releases from high pressure. However, as more technologies develop and more realistic source term analyses are performed, it may be possible to develop such a public relief technology. With the development of such technology that can effectively prevent the dispersion of the uncontrolled radioactive releases in case of another Fukushima-like accident, it will result in increased safety of the nuclear power plants for both the public and the workers and may contribute to the increase in the public acceptance of nuclear energy.
... Error processing SSI file About Heart Disease & Stroke Prevention Heart disease and stroke are an epidemic in ... secondhand smoke. Barriers to Effective Heart Disease & Stroke Prevention Many people with key risk factors for heart ...
Rodrigues, Paula L.F.; Rocha, Humberto A.R. [Universidade Estacio de Sa (UNESA), Rio de Janeiro, RJ (Brazil); Rodrigues, Antonio P. [Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN (Brazil)
In spite of the merits of the several hydrate prevention techniques used nowadays, such as: chemical product injection for inhibition and use of thick thermal insulate lines; hydrates per times happen and they are responsible for considerable production losses. Depressurization techniques can be used so much for prevention as in the remediation. Some hydrate removal techniques need a rig or vessel, resources not readily available and with high cost, reason that limits such techniques just for remediation and not for prevention. In the present work it is proposed and described an innovative depressurization system, remote and resident, for hydrate prevention and removal, applicable as for individual sub sea wells as for grouped wells by manifold. Based on low cost jet pumps, without movable parts and with a high reliability, this technique allows hydrate prevention or remediation in a fast and remote way, operated from the production unit. The power fluid line and fluid return line can be integrated in the same umbilical or annulus line structure, without significant increase in the construction costs and installation. It is not necessary to wait for expensive resource mobilization, sometimes not available quickly, such as: vessels or rigs. It still reduces the chemical product consumption and permits to depressurized stopped lines. Other additional advantage, depressurization procedure can be used in the well starting, removing fluid until riser emptying. (author)
Electronic Security Systems: Better Ways to Crime Prevention teaches the reader about the application of electronics for security purposes through the use of case histories, analogies, anecdotes, and other related materials. The book is divided into three parts. Part 1 covers the concepts behind security systems - its objectives, limitations, and components; the fundamentals of space detection; detection of intruder movement indoors and outdoors; surveillance; and alarm communication and control. Part 2 discusses equipments involved in security systems such as the different types of sensors,
Iwai, Hiroshi; Baba, Susumu; Omae, Mariko; Lee, Shinryu; Yamashita, Toshio; Ikehara, Susumu
There is no effective therapy for progressive hearing loss such as presbycusis, the causes of which remain poorly understood because of the difficulty of separating genetic and environmental contributions. In the present study, we show that the age-related dysfunctions of the systemic immune system in an animal model of accelerated presbycusis (SAMP1, senescence-accelerated mouse P1) can be corrected by allogeneic bone marrow transplantation (BMT). We also demonstrate that this presbycusis can be prevented; BMT protects the recipients from age-related hearing impairment and the degeneration of spiral ganglion cells (SGCs) as well as the dysfunctions of T lymphocytes, which have a close relation to immune senescence. No donor cells are infiltrated to the spiral ganglia, confirming that this experimental system using BMT is connected to the systemic immune system and does not contribute to transdifferentiation or fusion by donor hematopoietic stem cells (HSCs), or to the direct maintenance of ganglion cells by locally infiltrated donor immunocompetent cells. Therefore, another procedure which attempts to prevent the age-related dysfunctions of the recipient immune system is the inoculation of syngeneic splenocytes from young donors. These mice show no development of hearing loss, compared with the recipient mice with inoculation of saline or splenocytes from old donors. Our studies on the relationship between age-related systemic immune dysfunctions and neurodegeneration mechanisms open up new avenues of treatment for presbycusis, for which there is no effective therapy.
In Japan several services for providing information on heat-disorders and its prevention are available. For the information on patients of heat-disorders, National Institute for Environmental Studies (NIES) and Fire and Disaster Management Agency(FDMA) have systems for providing the information of the patients transported by ambulance cars from heat-disorders. NIES deals the data from major cities and FDMA deals the data of all Japan by prefecture. For the information on preventing heat-disorders, Japan Meteorological Agency (JMA) and NIES have systems for providing the weather information. JMA alarms when the daily maximum temperature reached or will reach to extremely high (> or = 35 degrees C) and NIES provides the WBGT(wet-bulb globe temperature) forecast for coming three days for all around Japan.
Kamel, Hani Fouad
Despite many efforts to structure the development and design processes of embedded systems, errors are discovered at the final stages of production and sometimes after the delivery of the products. The cost of such errors can be prohibitive.Different design techniques to detect such errors...... systems, a formal model for such systems is introduced. The main characteristics of embedded systems design and the interaction of these properties are described. A taxonomy for the structure of the software developed for such systems based on the amount of processes and processors involved is presented...... will be presented. Moreover, we will try to describe the causes of these errors and the countermeasures that can be taken to avoid them. The main theme is that prevention is better than cure.The presentation is structured in three parts. The first part deals with an introduction to the subject area of embedded...
and C. S. Yentsch. Light Absorption and Utilization by Colonies of the Congeneric Hermatypic Corals , Montastraea faveolata and Montastraea cavernosa...Coastal Benthic Optical Properties (CoBOP) of Coral Reef Environments: Small Scale Fluorescent Optical Signatures and Hyperspectral Remote...Sensing of Coral Reef Habitats Dr. Michael P. Lesser University of New Hampshire Department of Zoology and Center for Marine Biology Durham, NH 03824
Full Text Available In this study, it is aimed to detect mobbing issues in Atatürk University, Economics and Administrative Science Facultyand provide an information system model to prevent mobbing and reduce the risk. The study consists of two parts;i detect mobbing situation via questionnaire and ii design an information system based on the findings of the first part. The questionnaire was applied to research assistants in the faculty. Five factors were analyzed and it is concluded that research assistants have not been exposed to mobbing except the fact that they have mobbing perception about task assignment process. Results show that task operational difficulty, task time and task period are the common mobbing issues. In order to develop an information system to cope with these issues, assignment of exam proctor process is addressed. Exam time, instructor location, classroom location and exam duration are the considered as decision variables to developed linear programming (LP model. Coefficients of these variables and constraints about the LP model are specified in accordance with the findings. It is recommended that research assistants entrusting process should be conducted by using this method to prevent and reduce the risk of mobbing perception in the organization.
... Contact Aging & Health A to Z Find a Geriatrics Healthcare Professional Medications & Older Adults Making Your Wishes ... Prevention Hearing Loss Heart Attack High Blood Pressure Nutrition Osteoporosis Shingles Skin Cancer Related News Quitting Smoking, ...
Andersen, L V; Vestergaard, P; Deichgraeber, P
Warfarin for stroke prevention in patients with atrial fibrillation (AF) is well documented. However, it has not been examined in the prevention of systemic embolism.......Warfarin for stroke prevention in patients with atrial fibrillation (AF) is well documented. However, it has not been examined in the prevention of systemic embolism....
Coelho, Hugo; Torres, Alberto; Pacheco, Pedro; Moreira, Cristiano; Silva, Rute; Soares, José M.; Pinto, Dânia
The Movable Scaffolding System (MSS) is a heavy construction equipment used for casting situ of concrete bridge decks. In the past decades, MSSs have become increasingly complex and industrialized, enlarging its span ranges, incorporating auxiliary elevation machinery and increasing productivity. The tendency nowadays is for strong reutilization and the notion of MSS as a disposable or temporary structure is somehow reductive. The main structure of MSSs may be potentially exposed to fatigue, usually characterized by low number of cycles with significant stress amplitude. Fatigue may be prevented through adequate design; judicious selection of materials; demanding quality control and implementation of robust inspection and maintenance plans.
This Cold Run test is designed to demonstrate the functionality of systems necessary to move waste drums throughout the plant using approved procedures, and the compatibility of these systems to function as an integrated process. This test excludes all internal functions of the gloveboxes. In the interest of efficiency and support of the facility schedule, the initial revision of the test (rev 0) was limited to the following: Receipt and storage of eight overpacked drums, four LLW and four TRU; Receipt, routing, and staging of eleven empty drums to the process area where they will be used later in this test; Receipt, processing, and shipping of two verification drums (Route 9); Receipt, processing, and shipping of two verification drums (Route 1). The above listed operations were tested using the rev 0 test document, through Section 5.4.25. The document was later revised to include movement of all staged drums to and from the LLW and TRU process and RWM gloveboxes. This testing was performed using Sections 5.5 though 5.11 of the rev 1 test document. The primary focus of this test is to prove the functionality of automatic operations for all mechanical and control processes listed. When necessary, the test demonstrates manual mode operations as well. Though the gloveboxes are listed, only waste and empty drum movement to, from, and between the gloveboxes was tested.
This Cold Run test is designed to demonstrate the functionality of systems necessary to move waste drums throughout the plant using approved procedures, and the compatibility of these systems to function as an integrated process. This test excludes all internal functions of the gloveboxes. In the interest of efficiency and support of the facility schedule, the initial revision of the test (rev 0) was limited to the following: Receipt and storage of eight overpacked drums, four LLW and four TRU; Receipt, routing, and staging of eleven empty drums to the process area where they will be used later in this test; Receipt, processing, and shipping of two verification drums (Route 9); Receipt, processing, and shipping of two verification drums (Route 1). The above listed operations were tested using the rev 0 test document, through Section 5.4.25. The document was later revised to include movement of all staged drums to and from the LLW and TRU process and RWM gloveboxes. This testing was performed using Sections 5.5 though 5.11 of the rev 1 test document. The primary focus of this test is to prove the functionality of automatic operations for all mechanical and control processes listed. When necessary, the test demonstrates manual mode operations as well. Though the gloveboxes are listed, only waste and empty drum movement to, from, and between the gloveboxes was tested
Halken, S; Høst, A
, breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented extensively hydrolysed formula is recommended if exclusive breastfeeding is not possible for the first 4 months of life. There is no evidence for preventive dietary intervention neither during pregnancy nor lactation...... populations. These theories remain to be documented in proper, controlled and prospective studies. Breastfeeding and the late introduction of solid foods (>4 months) is associated with a reduced risk of food allergy, atopic dermatitis, and recurrent wheezing and asthma in early childhood. In all infants....... Preventive dietary restrictions after the age of 4-6 months are not scientifically documented....
Chen, Jian; Li, Peng; Song, Gangbing; Ren, Zhang
The design of a super-capacitor-powered shape-memory-alloy (SMA) actuated accumulator for blowout preventer (BOP) presented in this paper featured several advantages over conventional hydraulic accumulators including instant large current drive, quick system response and elimination of need for the pressure conduits. However, the mechanical design introduced two challenges, the nonlinear nature of SMA actuators and the varying voltage provided by a super capacitor, for control system design. A cerebellar model articulation controller (CMAC) feedforward plus PID controller was developed with the aim of compensation for these adverse effects. Experiments were conducted on a scaled down model and experimental results show that precision control can be achieved with the proposed configurations and algorithms.
Full Text Available Penelitian ini berjudul “Intrusion Detection Prevention System Local Area Network (LAN” yang bertujuan untuk memproteksi jaringan dari usaha- usaha penyusupan yang dilakukan oleh seorang intruder. Metode yang digunakan pada penelitian ini adalah menggunakan metode kerangka pikir sebagai acuan dari tahap- tahap penelitian yang penulis lakukan. IDS difungsikan sebagai pendeteksi adanya serangan sesuai rule yang ada kemudian pesan peringatan disimpan dalam database dan dikirim via sms kepada seorang network administrator, sedangkan Firewall digunakan sebagai packet filtering dengan cara menentukan security policy yang dinilai penting. Hasilnya adalah ketika IDS memberikanpesan peringatan ketika ada serangan, seorang network administrator dapat memblok adanya serangan tersebut dengan cara manual dengan firewall, ataupun firewall akan memblok sendiri serangan tersebut sesuai dengan security policy yang diterapkan oleh network adminisrator sebelumnya
Lynn, Sean R.; Bunker, Deborah; Hesbach, Thomas D., Jr.; Howerton, Everett B.; Hreinsson, G.; Mistr, E. Kirk; Palmer, Matthew E.; Rogers, Claiborne; Tischler, Dayna S.; Wrona, Daniel J.
Reduced quantities of ozone in the atmosphere allow greater levels of ultraviolet light (UV) radiation to reach the earth's surface. This is known to cause skin cancer and mutations. Chlorine liberated from Chlorofluorocarbons (CFC's) and natural sources initiate the destruction of stratospheric ozone through a free radical chain reaction. The project goals are to understand the processes which contribute to stratospheric ozone loss, examine ways to prevent ozone loss, and design a vehicle-based system to carry out the prevention scheme. The 1992/1993 design objectives were to accomplish the first two goals and define the requirements for an implementation vehicle to be designed in detail starting next year. Many different ozone intervention schemes have been proposed though few have been researched and none have been tested. A scheme proposed by R.J. Cicerone, Scott Elliot and R.P.Turco late in 1991 was selected because of its research support and economic feasibility. This scheme uses hydrocarbon injected into the Antarctic ozone hole to form stable compounds with free chlorine, thus reducing ozone depletion. Because most polar ozone depletion takes place during a 3-4 week period each year, the hydrocarbon must be injected during this time window. A study of the hydrocarbon injection requirements determined that 100 aircraft traveling Mach 2.4 at a maximum altitude of 66,000 ft. would provide the most economic approach to preventing ozone loss. Each aircraft would require an 8,000 nm. range and be able to carry 35,000 lbs. of propane. The propane would be stored in a three-tank high pressure system. Missions would be based from airport regions located in South America and Australia. To best provide the requirements of mission analysis, an aircraft with L/D(sub cruise) = 10.5, SFC = 0.65 (the faculty advisor suggested that this number is too low) and a 250,000 lb TOGW was selected as a baseline. Modularity and multi-role functionality were selected to be key
Sargusingh, Miriam; Callahan, Michael R.; Muirhead, Dean
The ability to recover and purify water through physiochemical processes is crucial for realizing long-term human space missions, including both planetary habitation and space travel. Because of their robust nature, rotary distillation systems have been actively pursued by NASA as one of the technologies for water recovery from wastewater primarily comprised of human urine. A specific area of interest is the prevention of the formation of solids that could clog fluid lines and damage rotating equipment. To mitigate the formation of solids, operational constraints are in place that limits such that the concentration of key precipitating ions in the wastewater brine are below the theoretical threshold. This control in effected by limiting the amount of water recovered such that the risk of reaching the precipitation threshold is within acceptable limits. The water recovery limit is based on an empirically derived worst case wastewater composition. During the batch process, water recovery is estimated by monitoring the throughput of the system. NASA Johnson Space Center is working on means of enhancing the process controls to increase water recovery. Options include more precise prediction of the precipitation threshold. To this end, JSC is developing a means of more accurately measuring the constituent of the brine and/or wastewater. Another means would be to more accurately monitor the throughput of the system. In spring of 2015, testing will be performed to test strategies for optimizing water recovery without increasing the risk of solids formation in the brine.
Calistri, Paolo; Conte, Annamaria; Natale, Fabrizio; Possenti, Luigi; Savini, Lara; Danzetta, Maria Luisa; Iannetti, Simona; Giovannini, Armando
The development of early warning systems is fundamental for preventing the spread of infectious diseases. Data collection, however, is a costly activity and it is not possible to implement early warning systems everywhere and for all possible events. Hence, tools helping to improve the focus of surveillance efforts are of paramount importance. Risk assessment methods and other provisional modelling techniques may permit to estimate the probability of introduction and spread of infectious diseases in different geographical areas. Similarly, efficient information systems must be in place to assist the veterinary services in case of epidemic emergencies in order to support the prompt application of control measures for the containment of the infection and the reduction of the magnitude of negative consequences. This review describes two recent approaches to the estimation of the probability of introduction and spread of infectious diseases based on the use of risk maps/ spatial modelling and Social Network Analysis (SNA) techniques. The review also describes a web application developed in Italy to help official veterinary services to trace animals in case of outbreaks of infectious diseases.
Robu, Andreea; Gauca, Bianca; Crisan-Vida, Mihaela; Stoicu-Tivadar, Lăcrămioara
A better monitoring of pregnant women, mainly during the third trimester of pregnancy and an easy communication between physician and patients are very important for the prevention and good health of baby and mother. The paper presents an integrated system as support for the Obstetrics - Gynaecology domain consisting in two modules: a mobile application, ObGynCare, dedicated to the pregnant women and a new component of the Obstetrics-Gynaecology Department Information System dedicated to the physicians for a better monitoring of the pregnant women. The mobile application informs the pregnant women about their status, permits them to introduce glycaemia and weight values and has as option pulse and blood pressure acquisition from a smart sensor and provides results in a graphic format. It also provides support for easy patient-doctor communication related to any health problems. ObGyn Care offers nutrition recommendations and gives the pregnant women the possibility to enter a social space of common interests using social networks (Facebook) to exchange useful and practical information. Data collected from patients and from sensor are stored on the cloud and the physician may access the information and analyse it. The extended module of the Obstetrics-Gynaecology Department Information System already developed supports the physicians to visualize weekly, monthly, or on a trimester, the patient data and to discuss with her through the chat module. The mobile application is in test by pregnant women and medical personnel.
Kalabokidis, Kostas; Ager, Alan; Finney, Mark; Athanasis, Nikos; Palaiologou, Palaiologos; Vasilakos, Christos
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
Moore, Murray E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Currie, Karissa Lyn [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Berg, Charlotte Katherine [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)
The air flowrate through a flexible HEPA grade filter (Part LANCS-BOP 6CPVC-1.5-2SPVC www.lancsindustries.com) was measured at 48 ALPM for a differential pressure drop of 1.0 psig (28 inWC, 7.0 kPa). These filters are rated by the manufacturer to have a flowrate of 3 ALPM at a differential pressure drop of 1 inWC (0.25 kPa). The Los Alamos National Laboratory Aerosol Engineering Facility used one of their test rigs (originally developed to measure the pressure drop in capsule HEPA filters) to measure the airflow through the LANCS bag filter.
Kim, Young-Ki; Cho, Yeong-Garp; Kwag, Byung-Ho
The HANARO is a 30 MW open pool type multi-purpose research reactor with forced light water coolant/moderator flows and heavy water annular reflector. The relatively small reactor core uses a low enriched fuel and is designed to maximize the power density, thus providing the required neutron flux for various research activities. It is mainly used for radioisotope production, nuclear material testing and neutron physics experiments. The initial criticality was achieved February 1995. Considering the importance of their functionality from the safety point of view, some components and equipment are categorized into a nuclear safety grade. There are three different inspection activities for the various reactor systems and components - a Surveillance Inspection(SI) for the safety grades and a Periodic Inspection (PI) for the non-safety grades and In-Service Inspection (ISI) for the ASME Sec.III components. All of the SIs are specified and required by the safety analysis report. The SI also differs from the PI in such a point that all kinds of activities for the SIs should be accompanied by an appropriate quality assurance, while for the PIs it is not necessarily mandatory. In addition, the inspection results for the SIs should go through an examination from regulatory body every two years and specific functions of the critical components or systems are demonstrated under the witness by the governmental inspector. The ISI is required and carried out as per international codes and standards as well as Korean atomic energy regulations. There are 54 SIs, 25 PIs and 4 ISIs for the HANARO. This paper concentrates on the managing strategy and its practices for the SIs and ISIs of the safety-related components, currently being done at HANARO. Most parts of the inspections fall into a group for the periodic performance testing and/or equipment calibration. Some mechanical inspections like a torque measurement are grouped into a preventive maintenance. Lastly the ASME Sec
Richard, Michelle D; Brahm, Nancy C
Published evidence on established and theoretical connections between immune system dysfunction and schizophrenia is reviewed, with a discussion of developments in the search for immunologically-targeted treatments. A growing body of evidence indicates that immunologic influences may play an important role in the etiology and course of schizophrenia. A literature search identified more than 100 articles pertaining to suspected immunologic influences on schizophrenia published over the past 15 years. Schizophrenia researchers have explored a wide range of potential immune system-related causal or contributory factors, including neurobiological and neuroanatomical disorders, genetic abnormalities, and environmental influences such as maternal perinatal infection. Efforts to establish an immunologic basis for schizophrenia and identify reliable immune markers continue to be hindered by sampling challenges and methodological problems. In aggregate, the available evidence indicates that at least some cases of schizophrenia have an immunologic component, suggesting that immune-focused prevention strategies (e.g., counseling of pregnant women to avoid immune stressors) and close monitoring of at-risk children are appropriate. While antipsychotics remain the standard treatments for schizophrenia, a variety of drugs with immunologic effects have been investigated as adjunctive therapies, with variable and sometimes conflicting results; these include the cyclooxygenase-2 inhibitor celecoxib, immune-modulating agents (e.g., azathioprine and various anticytokine agents such as atlizumab, anakinra, and tumor necrosis factor-α blockers), and an investigational anti-interferon-γ agent. The published evidence indicates that immune system dysfunction related to genetic, environmental, and neurobiological influences may play a role in the etiology of schizophrenia in a subset of patients.
Rau, C.A. Jr.; Becker, D.G.; Besuner, P.M.; Cipolla, R.C.; Egan, G.R.; Gupta, P.; Johnson, D.P.; Omry, U.; Tetelman, A.S.; Rettig, T.W.; Peters, D.C.
New methods have been developed and applied to better quantify and increase the reliability, safety, and availability of electric power plants. Present and potential problem areas have been identified both by development of an improved computerized data base of malfunctions in nuclear power plants and by detailed metallurgical and mechanical failure analyses of selected problems. Significant advances in the accuracy and speed of structural analyses have been made through development and application of the boundary integral equation and influence function methods of stress and fracture mechanics analyses. The currently specified flaw evaluation procedures of the ASME Boiler and Pressure Vessel Code have been computerized. Results obtained from these procedures for evaluation of specific in-service inspection indications have been compared with results obtained utilizing the improved analytical methods. Mathematical methods have also been developed to describe and analyze the statistical variations in materials properties and in component loading, and uncertainties in the flaw size that might be passed by quality assurance systems. These new methods have been combined to develop accurate failure rate predictions based upon probabilistic fracture mechanics. Improved failure prevention strategies have been formulated by combining probabilistic fracture mechanics and cost optimization techniques. The approach has been demonstrated by optimizing the nondestructive inspection level with regard to both reliability and cost. (Auth.)
Oliveira, Karla Regina Dias de; Liberal, Márcia Mello Costa de; Zucchi, Paola
To identify the financial resources and investments provided for preventive medicine programs by health insurance companies of all kinds. Data were collected from 30 large health insurance companies, with over 100 thousand individuals recorded, and registered at the Agência Nacional de Saúde Suplementar. It was possible to identify the percentage of participants of the programs in relation to the total number of beneficiaries of the health insurance companies, the prevention and promotion actions held in preventive medicine programs, the inclusion criteria for the programs, as well as the evaluation of human resources and organizational structure of the preventive medicine programs. Most of the respondents (46.7%) invested more than US$ 50,000.00 in preventive medicine program, while 26.7% invested more than US$ 500,000.00. The remaining, about 20%, invested less than US$ 50,000.00, and 3.3% did not report the value applied.
Lim, J.; Cho, K.; Lee, Y. S.; Jung, H. S.; Yoo, H. D.; Ryu, D.; Kwon, J.
Hydrological disaster relief expenditure accounts for as much as 70 percent of total expenditure of disasters occurring in Korea. Since the response to and recovery of disasters are normally based on previous experiences, there have been limitations when dealing with ever-increasing localized heavy rainfall with short range in the era of climate change. Therefore, it became necessary to establish a system that can respond to a disaster in advance through the analysis and prediction of hydrometeorological information. Because a wide range of big data is essential, it cannot be done by a single agency only. That is why the three hydrometeorology-related agencies cooperated to establish a pilot (trial) system at Soemjingang basin in 2013. The three governmental agencies include the National Emergency Management Agency (NEMA) in charge of disaster prevention and public safety, the National Geographic Information Institute (NGII under Ministry of Land, Infrastructure and Transport) in charge of geographical data, and the Korea Meteorological Administration (KMA) in charge of weather information. This pilot system was designed to be able to respond to disasters in advance through providing a damage prediction information for flash flood to public officers for safety part using high resolution precipitation prediction data provided by the KMA and high precision geographic data by NGII. To produce precipitation prediction data with high resolution, the KMA conducted downscaling from 25km×25km global model to 3km×3km local model and is running the local model twice a day. To maximize the utility of weather prediction information, the KMA is providing the prediction information for 7 days with 1 hour interval at Soemjingang basin to monitor and predict not only flood but also drought. As no prediction is complete without a description of its uncertainty, it is planned to continuously develop the skills to improve the uncertainty of the prediction on weather and its impact
Invasive plants continue to spread and impact rangelands in the western United States. Fortunately, many rangeland ecosystems still remain invasive weed-free.Cooperative prevention systems can safeguard these remaining areas. Local-level weed prevention areas (WPAs) prioritize prevention in the larg...
Loeb, Jeffrey A
While there are a plethora of medications that block seizures, these same drugs have little effect on preventing or curing epilepsy. This suggests that the molecular pathways for epileptogenesis are distinct from those that produce acute seizures and therefore will require the identification of novel truly 'antiepileptic' therapeutics. Identification and testing of potential antiepileptic drug targets first in animal models and then in humans is thus becoming an important next step in the battle against epilepsy. In focal forms of human epilepsy the battle, however, is complicated by the large and varied types of brain abnormalities capable of producing a state of chronic, recurrent seizures. Unfortunately, once the epileptic state develops, it often persists to produce a life-long seizure disorder that can only be suppressed by anticonvulsant medications, and cured only in some through surgical resection of the seizure focus. While deductive approaches to drug target identification use our current state of knowledge, based mostly on animal models of epileptogenesis, a growing reductionist approach often referred to as systems biology takes advantage of newer high-throughput technologies to profile large numbers and types of molecules simultaneously. Some of these approaches, such as functional genomics, proteomics, and metabolomics have been undertaken in both human and animal epileptic brain tissues and are beginning to hone in on new therapeutic targets. While these methods are highly sensitive, this same sensitivity also produces a high rate of false positives due to variables other than those of interest. The experimental design, therefore, needs to be tightly controlled to reduce these unintended results that can be misleading. Most importantly, epileptogenic targets need to be validated in animal models of epileptogenesis, so that, if successful, these new methods have the potential to identify unbiased, important new therapeutics. Copyright © 2011 Elsevier
Jeong, KwanSeong; Choi, ByungSeon; Moon, JeiKwon; Hyun, DongJun; Lee, JongHwan; Kim, IkJune; Kim, GeunHo; Seo, JaeSeok
Highlights: • This paper is meant to develop the training system to prevent accidents during decommissioning of nuclear facilities. • Requirements of the system were suggested. • Data management modules of the system were designed. • The system was developed on virtual reality environment. - Abstract: This paper is meant to develop the training system to prevent accidents during decommissioning of nuclear facilities. Requirements of the system were suggested. Data management modules of the system were designed. The system was developed on virtual reality environment. The performance test of the system was proved to be appropriate to decommissioning of nuclear facilities
Öztürk, Burcu Emine Tefon
Whooping cough also known as pertussis is a contagious acute upper respiratory disease primarily caused by Bordetella pertussis. It is known that this disease may be fatal especially in infants and recently, the number of pertussis cases has been increased. Despite the fact that there are numbers of acellular vaccines on the market, the current acellular vaccine compositions are inadequate for providing sustainable immunity and avoiding subclinical disease cases. Hence, exploring novel proteins with high immune protective capacities is essential to enhance the clinical efficacy of current vaccines. In this study, genes of selected immunogenic proteins via -omics studies, namely Putative outer protein D (BopD) and Leucin/Isoleucine/Valin Binding Protein (LivJ) were first cloned into pGEM-T Easy vector and transformed to into E. coli DH5α cells and then cloned into the expression vector pET-28a(+) and transformed into E. coli BL21 (DE3) cells to express the proteins.
Ruffolo, Mary C.; Evans, Mary E.; Lukens, Ellen P.
This paper presents the prevalence and incidence of children in need of social services due to child maltreatment, child poverty, parental incarceration, parental substance abuse problems, and homelessness. Examines early childhood family education and family support approaches in primary prevention designed to meet the needs of these children.…
Kostas Kalabokidis; Alan Ager; Mark Finney; Nikos Athanasis; Palaiologos Palaiologou; Christos Vasilakos
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...
Davis, R.; Fish, J.; Brown, C.
Sandia National Laboratories, New Mexico (Sandia/NM) has successfully developed and implemented a chargeback system to fund the implementation of Pollution Prevention activities. In the process of establishing this system, many valuable lessons have been learned. This paper describes how the chargeback system currently functions, the benefits and drawbacks of implementing such a system, and recommendations for implementing a chargeback system at other facilities. The initial goals in establishing a chargeback system were to create (1) funding for pollution prevention implementation, including specific pollution prevention projects; and (2) awareness on the part of the line organizations of the quantities and types of waste that they generate, thus providing them with a direct incentive to reduce that waste. The chargeback system inputs waste generation data and then filters and sorts the data to serve two purposes: (1) the operation of the chargeback system; and (2) the detailed waste generation reporting used for assessing processes and identifying pollution prevention opportunities
Zanazzi, José Luis; Gomes, Luiz Flávio Autran Monteiro; Dimitroff, Magdalena
This paper describes an application in group decision making, aimed at developing a procedure to help define priorities in preventive maintenance activities. The method applied is called DRV Processes (Decision with Reduction of Variability) and it combines both statistical techniques and multicriteria decision aid procedures. Among its advantages, we may highlight the possibility of reducing the noise affecting information in group decision making and of reaching a consensual decision. This ...
Loeb, Jeffrey A.
While there are a plethora of medications that block seizures, these same drugs have little effect on preventing or curing epilepsy. This suggests that the molecular pathways for epileptogenesis are distinct from those that produce acute seizures and therefore will require the identification of novel truly ‘antiepileptic’ therapeutics. Identification and testing of potential antiepileptic drug targets first in animal models and then in humans is thus becoming an important next step in the bat...
entire policy sector, spanning federal to local levels . A policy sector usually consists of a collection of many diverse governments, bureaucracies , courts...examine the variety of actors actually and potentially involved in addressing it; 2) street - level implementators are always important to implementation...34Implementing Pollution Prevention: Incentives and Irrationalities." J Air & Waste Management Association, 40, no. 9 (September 1990): 1227-1231. Lipsky , Michael
Reflective cracking in asphalt pavements presents a serious problem for highway agencies : worldwide. A new interlayer membrane system, DRM, which is a proprietary system consisting of : a sealant and an emulsion, was constructed by the Mississippi D...
From - To) 07/31/2017 Final 4/1/2016 - 5/31/2017 4. TITLE AND SUBTITLE Sa. CONTRACT NUMBER Understanding and Prevention of Transient Voltages and...and Prevention of Transient Voltages and Dielectric Breakdown in High Voltage Battery Systems Submitted to: Mr. Donald Hoffman donald.hoffman...the next hurdle was to begin to evaluate the suppression topologies ability to prevent transients. IV.a. TVS Diodes TVS diodes were evaluated from
Yazdani, Amin; Neumann, W Patrick; Imbeau, Daniel; Bigelow, Philip; Pagell, Mark; Wells, Richard
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.
Pérez-Gómez, Augusto; Mejía-Trujillo, Juliana; Brown, Eric C.; Eisenberg, Nicole
During the last 2 years, the Colombian government and the Nuevos Rumbos Corporation have been implementing an adapted version of the Communities That Care (CTC) prevention system, called Comunidades Que se Cuidan (CQC) in Spanish, for use in Colombia. This brief report presents the process of implementing CQC and identifies some of the main challenges and achievements of implementing the system in eight communities in Colombia. Preliminary results of a pilot study of CQC implementation in Colombia show that prevention system development, including a focus on measuring community risk and protection, can be established successfully in Latin American communities despite a lack of rigorously tested prevention programs and strategies. Moreover, mobilizing community coalitions toward science-based prevention, with a focus on examining local risk and protective factor data, can spur development and evaluation of prevention efforts in Latin America. PMID:28154437
Vartika Mehta; Deepak Punetha; Vishwanath Bijalwan
This paper report discusses a theft prevention system, which can prevent the theft and also can be track the object. This system is capable to tracking the vehicle as well as theft prevention. An R.F. module is use to exchange the information regarding vehicle and owner of the vehicle with police control room or SOS services. The vehicle can be track with the help of R.F. receiver. A DTMF based fuel lock has been attached in this system. A cell phone with SIM card has been attached with DTMF ...
Full Text Available Safety of radioactive waste repositories operation is associated with a multibarrier system designed and constructed to isolate and contain the waste from the biosphere. Each of radioactive waste repositories is equipped with system of barriers, which reduces the possibility of release of radionuclides from the storage site. Safety systems may differ from each other depending on the type of repository. They consist of the natural geological barrier provided by host rocks of the repository and its surroundings, and an engineered barrier system (EBS. The EBS may itself comprise a variety of sub-systems or components, such as waste forms, canisters, buffers, backfills, seals and plugs. The EBS plays a major role in providing the required disposal system performance. It is assumed that the metal canisters and system of barriers adequately isolate waste from the biosphere. The evaluation of the multibarrier system is carried out after detailed tests to determine its parameters, and after analysis including mathematical modeling of migration of contaminants. To provide an assurance of safety of radioactive waste repository multibarrier system, detailed long term safety assessments are developed. Usually they comprise modeling of EBS stability, corrosion rate and radionuclide migration in near field in geosphere and biosphere. The principal goal of radionuclide migration modeling is assessment of the radionuclides release paths and rate from the repository, radionuclides concentration in geosphere in time and human exposure to ionizing radiation
A primary goal of the Superconducting Super Collider Laboratory (SSCL) is to establish an exemplary safety program. Achieving this goal requires leadership, planning, coordination, and technical know-how. To ensure that safety is an inherent part of the design, the Environment, Safety and Health Office employs a systems engineering discipline and process known as System Safety. The goal of System Safety - hazard prevention - is accomplished by analyzing systems to identify hazards and to evaluate design and procedural options and countermeasures to prevent, eliminate, mitigate, or control hazards and risks. Establishment of safety and human factors design criteria at the outset of the project prevents unsafe designs and safety violations, reduces risks, and helps in avoiding costly design changes later. This process requires a considerable amount of coordination with a variety of technical disciplines and safety professionals to integrate methods of hazard prevention, mitigation, and risk reduction throughout the system life-cycle
Corman, F.; Kraijema, S.; Godjevac, M.; Lodewijks, G.
This article presents a case study determining the optimal preventive maintenance policy for a light rail rolling stock system in terms of reliability, availability, and maintenance costs. The maintenance policy defines one of the three predefined preventive maintenance actions at fixed time-based
José Luis Zanazzi
Full Text Available This paper describes an application in group decision making, aimed at developing a procedure to help define priorities in preventive maintenance activities. The method applied is called DRV Processes (Decision with Reduction of Variability and it combines both statistical techniques and multicriteria decision aid procedures. Among its advantages, we may highlight the possibility of reducing the noise affecting information in group decision making and of reaching a consensual decision. This approach generally improves the level of shared knowledge and helps to avoid conflict within the group. The application was carried out in a major pharmaceutical production plant. The experience showed an eighty per cent reduction in the original amount of process noise. Moreover, the paper describes evidence of improvement in interpersonal relationships.
Quinn, Audrey Catherine; Meek, Tim; Waldmann, Carl
Early warning scores, early warning systems and rapid response systems, were established in 1999. In the UK, a National Early Warning Score was launched in 2013 and is now used throughout the National Health Service. In 2007, a firm recommendation was made by the maternal confidential death enquiry that maternity units should incorporate a modified early obstetric warning score chart into clinical practice. Although there was enthusiastic uptake of this recommendation, local recording systems vary throughout the country and there is now a need to revisit revise and standardize an obstetric early warning system (ObsEWS). The intercollegiate Maternal Critical Care group of the Obstetric Anaesthetists' Association have produced an ObsEWS in line with the aggregate UK National Early Warning Score. Six physiological parameters are incorporated: respiratory rate, oxygen saturations, temperature, systolic blood pressure, diastolic blood pressure, and pulse rate. However, robust physiological thresholds for the measured parameters are currently lacking but required for a more sensitive and specific ObsEWS. A greater focus and study on the management of maternal morbidity (in addition to mortality data) and the development of better systems within and across the multidisciplinary team to detect early deterioration should improve management of serious illness in obstetrics. It is imperative that we undertake robust ObsEWS and data collection, including electronic systems with research and evidence-based recommendations to underpin this system. This should improve patient safety and result in more efficient, cost-effective management of sicker patients in our complex modern healthcare systems.
Liu, Xuejuan; Wang, Wenbin; Peng, Rui
This paper considers a production system that can produce multiple products alternately. Products go through the system in a sequence and a complete run of all products forms a production cycle. An integrated production, inventory and preventive maintenance model is constructed, which is characterized by the delay-time concept. Two different situations are studied based on whether the unqualified products and downtime caused by the failures of the system, set-up and preventive maintenance can be ignored or not. Three cases are considered for each situation, depending on the position of the preventive maintenance epochs: the first case, where preventive maintenance is carried out at the end of each production cycle; the second case, where preventive maintenance is carried out at each set-up time of the products; and the third case, where preventive maintenance is carried out at some set-up times only, since it may not always be optimal to carry out preventive maintenance at the end of the production cycle or at each set-up time. The modeling objectives are to find the optimal number of production cycles per year and the optimal position of preventive maintenance that will maximize the expected profit per unit time. Numerical examples, using real data, are presented to illustrate the model. - Highlights: • We propose an integrated economic production quantity and preventive maintenance model. • The situation that multiple products are produced on the same system alternately is studied. • Two situations are studied based on whether the downtime and the product quality can be ignored or not. • We use enumeration method and analytical method to select the optimal preventive maintenance policy, respectively. • We use the delay-time concept to model the preventive maintenance policy
Sasmoko; Widhoyoko, S. A.; Ariyanto, S.; Indrianti, Y.; Noerlina; Muqsith, A. M.; Alamsyah, M.
Corruption is an extraordinary crime, and then the prevention must also be extraordinary, simultaneously (national) in the form of early warning that involves all elements; government, industry, and society. To realize it the system needs to be built which in this study is called the Corruption Early Prevention (CEP) as a Decision Support System for President of the Republic of Indonesia. This study aims to examine 1) how is the construct of the Corruption Early Prevention as a Decision Support System for President of the Republic of Indonesia?, and 2) how is the design form of the system of Corruption Early Prevention as a Decision Support System for President of Republic of Indonesia? The research method is using Neuro-Research which is the collaboration of qualitative and quantitative research methods and the model development of Information Technology (IT). The research found that: 1) the construct of CEP is theoretically feasible, valid and reliable by content to be developed in the context of the prevention of corruption in Indonesia as an early prevention system that diagnoses Indonesia simultaneously and in real time, and 2) the concept of system design and business process of CEP is predicted to be realized in the IT-based program.
Weissenberger, S. (Editor)
A systems engineering approach is reported for the problem of reducing the number and severity of California's wildlife fires. Prevention methodologies are reviewed and cost benefit models are developed for making preignition decisions.
Leferink, Frank Bernardus Johannes
The present invention relates to an apparatus and/or a method for preventing radio-frequency (RF) interferences between rotating antennas. For example, the invention is particularly applicable to radar and communication systems on board naval ships.
Leferink, Frank Bernardus Johannes
The present invention relates to an apparatus and/or a method for preventing radio-frequency (RF) interferences between rotating antennas. For example, the invention is particularly applicable to radar and communication systems on board naval ships.
van Dijkhuizen, G.C.; van der Heijden, Matthijs C.
Traditionally, the optimal preventive maintenance interval for an unreliable production system has been determined by maximizing its limiting availability. Nowadays, it is widely recognized that this performance measure does not always provide relevant information for practical purposes. This is
most at risk are people who live in the inner cities and those who live in rural locations (Earnest, 1991; Friedman, 1994; Horner et al., 1994...BARRIERS TO HEALTH PROMOTION AND DISEASE PREVENTION WITHIN THE MILITARY HEALTHCARE SYSTEM 6. AUTHOR(S) CAPT MCLAUGHLIN GAYLA D 5. FUNDING NUMBERS 7...PROMOTION AND DISEASE PREVENTION WITHIN THE MILITARY HEALTHCARE SYSTEM Gayla D. McLaughlin APPROVED: Barbara M. Sylvia, Ph.D., R.R, Cftair ßW- l
Smeets, Ed; Kooman, Jeroen; van der Sande, Frank; Stobberingh, Ellen; Frederik, Peter; Claessens, Piet; Grave, Willem; Schot, Arend; Leunissen, Karel
Biofilm formations in dialysis systems may be relevant because they continuously release bacterial compounds and are resistant against disinfection. The aim of the study was to compare the development of biofilm between a water treatment system based on a single reverse osmosis unit producing purified dialysate water [bacterial count, 350 colony-forming unit (CFU)/L] (center A) and a water treatment system based on double reverse osmosis and electric deionization, which is continuously disinfected with ultraviolet light and treated with ozone once a week (bacterial count, 1 CFU/L) (center B). During a period of 12 weeks, biofilm formation was studied in the tubing segment between the water piping and the dialysis module, using four dialysis monitors in each center. On a weekly basis, tubing samples of 5 cm length (N = 96) were taken under aseptic conditions and investigated for microbiologic contamination [cystine lactose electrolyte-deficient (CLED) Agar], endotoxin levels [limulus amoeben lysate (LAL) gel test, cutoff value, 0.0125 EU/mL], and biofilm formation [electron scanning microscopy (SEM)]. In center A, tube cultures were positive (>100 CFU/mL) in 16% of samples at 22 degrees C and 37 degrees C, compared to 3% of samples of center B (P tubing samples of center A and negative in all of the samples of center B (P < 0.05). Biofilm was present in 91.7% of the samples of center A (Fig. 1), and only present in one sample (taken after 9 weeks) of center B (P < 0.05) (Fig. 2). In center A, biofilm formation was already observed after 1 week. In contrast to a standard water treatment system producing purified water, the use of a system producing highly purified water, which is also treated with regular disinfection procedures, leads to a significant reduction in biofilm formation, bacterial growth, and endotoxin levels in a highly vulnerable part of a water treatment system.
A. V. Mamaev
Full Text Available The problem of protection from deliberate leaks of information is one of the most difficult. Integrated systems of information protection against insider have a serious drawback. Using this disadvantage the offender receives the possibility of unauthorized theft of information from working machine.
Full Text Available Anti-runaway prevention of rolling stocks at a railway station is essential in railway safety management. The traditional track skates for anti-runaway prevention of rolling stocks have some disadvantages since they are operated and monitored completely manually. This paper describes an anti-runaway prevention system (ARPS based on intelligent track skates equipped with sensors and real-time monitoring and management system. This system, which has been updated from the traditional track skates, comprises four parts: intelligent track skates, a signal reader, a database station, and a monitoring system. This system can monitor the real-time situation of track skates without changing their workflow for anti-runaway prevention, and thus realize the integration of anti-runaway prevention information management. This system was successfully tested and practiced at Sunjia station in Harbin Railway Bureau in 2014, and the results confirmed that the system showed 100% accuracy in reflecting the usage status of the track skates. The system could meet practical demands, as it is highly reliable and supports long-distance communication.
Jiang, Chaozhe; Xu, Yibo; Wen, Chao; Chen, Dilin
Anti-runaway prevention of rolling stocks at a railway station is essential in railway safety management. The traditional track skates for anti-runaway prevention of rolling stocks have some disadvantages since they are operated and monitored completely manually. This paper describes an anti-runaway prevention system (ARPS) based on intelligent track skates equipped with sensors and real-time monitoring and management system. This system, which has been updated from the traditional track skates, comprises four parts: intelligent track skates, a signal reader, a database station, and a monitoring system. This system can monitor the real-time situation of track skates without changing their workflow for anti-runaway prevention, and thus realize the integration of anti-runaway prevention information management. This system was successfully tested and practiced at Sunjia station in Harbin Railway Bureau in 2014, and the results confirmed that the system showed 100% accuracy in reflecting the usage status of the track skates. The system could meet practical demands, as it is highly reliable and supports long-distance communication.
Hoffmire, Claire; Stephens, Brady; Morley, Sybil; Thompson, Caitlin; Kemp, Janet; Bossarte, Robert M
The US Department of Veterans Affairs' Suicide Prevention Applications Network (SPAN) is a national system for suicide event tracking and case management. The objective of this study was to assess data on suicide attempts among people using Veterans Health Administration (VHA) services. We assessed the degree of data overlap on suicide attempters reported in SPAN and the VHA's medical records from October 1, 2010, to September 30, 2014-overall, by year, and by region. Data on suicide attempters in the VHA's medical records consisted of diagnoses documented with E95 codes from the International Classification of Diseases, Ninth Revision . Of 50 518 VHA patients who attempted suicide during the 4-year study period, data on fewer than half (41%) were reported in both SPAN and the medical records; nearly 65% of patients whose suicide attempt was recorded in SPAN had no data on attempted suicide in the VHA's medical records. Evaluation of administrative data suggests that use of SPAN substantially increases the collection of data on suicide attempters as compared with the use of medical records alone, but neither SPAN nor the VHA's medical records identify all suicide attempters. Further research is needed to better understand the strengths and limitations of both systems and how to best combine information across systems.
Stylianos S. Mamais
Full Text Available Service commissions, which are claimed by Ad-Networks and Publishers, are susceptible to forgery as non-human operators are able to artificially create fictitious traffic on digital platforms for the purpose of committing financial fraud. This places a significant strain on Advertisers who have no effective means of differentiating fabricated Ad-Reports from those which correspond to real consumer activity. To address this problem, we contribute an advert reporting system which utilizes opportunistic networking and a blockchain-inspired construction in order to identify authentic Ad-Reports by determining whether they were composed by honest or dishonest users. What constitutes a user’s honesty for our system is the manner in which they access adverts on their mobile device. Dishonest users submit multiple reports over a short period of time while honest users behave as consumers who view adverts at a balanced pace while engaging in typical social activities such as purchasing goods online, moving through space and interacting with other users. We argue that it is hard for dishonest users to fake honest behaviour and we exploit the behavioural patterns of users in order to classify Ad-Reports as real or fabricated. By determining the honesty of the user who submitted a particular report, our system offers a more secure reward-claiming model which protects against fraud while still preserving the user’s anonymity.
Custer, M.S.; Leishman, N.L.; Walsh, M.L.; Nelson, J.D.; Davis, R.L.; Bueno, N.C.
Prioritizing waste generators is necessary to determine which are the best candidates for Pollution Prevention Opportunity Assessments (PPOAs). This paper describes the Sandia National Laboratories/New Mexico (SNL/NM) PPOA Ranking System. The system uses a multimedia approach that considers hazardous and radioactive waste disposal data, and hazardous chemical usage data (from which air emissions are extrapolated). Pollution prevention information is included, from the SNL Pollution Prevention Opportunities database that identifies waste streams that have readily apparent pollution prevention opportunities. The system also considers the relative costs of waste management and the chargeback fees paid for waste generation. From these data, organizations are ranked with an algorithm developed in Microsoft Access trademark on a personal computer. The concept could readily be transferred to other facilities needing to decide where to perform PPOAs
Takahashi, Mami; Hori, Mika; Mutoh, Michihiro; Wakabayashi, Keiji; Nakagama, Hitoshi
Pancreatic cancer is difficult to cure, so its prevention is very important. For this purpose, animal model studies are necessary to develop effective methods. Injection of N-nitrosobis(2-oxopropyl)amine (BOP) into Syrian golden hamsters is known to induce pancreatic ductal adenocarcinomas, the histology of which is similar to human tumors. Moreover, K-ras activation by point mutations and p16 inactivation by aberrant methylation of 5’ CpG islands or by homozygous deletions have been frequent...
Full Text Available This paper report discusses a theft prevention system, which can prevent the theft and also can be track the object. This system is capable to tracking the vehicle as well as theft prevention. An R.F. module is use to exchange the information regarding vehicle and owner of the vehicle with police control room or SOS services. The vehicle can be track with the help of R.F. receiver. A DTMF based fuel lock has been attached in this system. A cell phone with SIM card has been attached with DTMF IC. The fuel flow in the vehicle can be controlled by give a call to this cell phone. This system has been controlled by a microcontroller which can make the system cost effective, low power consumption, effective and reliable.
Cai, Baoping; Liu, Yonghong; Liu, Zengkai; Wang, Fei; Tian, Xiaojie; Zhang, Yanzhen
An extremely reliable remote control system for subsea blowout preventer stack is developed based on the off-the-shelf triple modular redundancy system. To meet a high reliability requirement, various redundancy techniques such as controller redundancy, bus redundancy and network redundancy are used to design the system hardware architecture. The control logic, human-machine interface graphical design and redundant databases are developed by using the off-the-shelf software. A series of experiments were performed in laboratory to test the subsea blowout preventer stack control system. The results showed that the tested subsea blowout preventer functions could be executed successfully. For the faults of programmable logic controllers, discrete input groups and analog input groups, the control system could give correct alarms in the human-machine interface. Copyright © 2011 ISA. Published by Elsevier Ltd. All rights reserved.
Broesby-Olsen, S; Vestergaard, H; Mortz, C G
BACKGROUND: Patients with systemic mastocytosis (SM) may suffer from mast cell (MC) mediator-related symptoms insufficiently controlled by conventional therapy. Omalizumab is an established treatment in other MC-driven diseases, but experiences in SM are limited. OBJECTIVE: To assess the efficacy...... and safety of omalizumab in SM. METHODS: In our patient cohort, we evaluated all SM patients treated with omalizumab. A physician global assessment of type and severity of symptoms was performed at baseline, at 3 and 6 months and at latest follow-up. Quality of life was assessed by visual analogue scale. S......-tryptase and KIT D816V allele burden were monitored. RESULTS: A total of 14 adult SM patients (10 ISM, 2 BMM, 1 SSM, and 1 ASM-AHN) received omalizumab with a median duration of 17 months (range: 1-73 months). One patient was excluded due to concomitant cytoreductive therapy. In the remaining 13 patients, we...
Bartolucci, G B; Santantonio, P; Casciani, M; Dagazzini, I
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.
... Prisons (Bureau) proposes to modify in part its system of records entitled ``Telephone Activity Record... Department of Justice. JUSTICE/BOP-011 SYSTEM NAME: Telephone Activity Record System. SECURITY CLASSIFICATION... DEPARTMENT OF JUSTICE [CPCLO Order No. 005-2011] Privacy Act of 1974; System of Records AGENCY...
Hamilton, Helen A; Peverill, M Samantha; Müller, Daniel B; Brattebø, Helge
Food waste (FW) generates large upstream and downstream emissions to the environment and unnecessarily consumes natural resources, potentially affecting future food security. The ecological impacts of FW can be addressed by the upstream strategies of FW prevention or by downstream strategies of FW recycling, including energy and nutrient recovery. While FW recycling is often prioritized in practice, the ecological implications of the two strategies remain poorly understood from a quantitative systems perspective. Here, we develop a multilayer systems framework and scenarios to quantify the implications of food waste strategies on national biomass, energy, and phosphorus (P) cycles, using Norway as a case study. We found that (i) avoidable food waste in Norway accounts for 17% of sold food; (ii) 10% of the avoidable food waste occurs at the consumption stage, while industry and retailers account for only 7%; (iii) the theoretical potential for systems-wide net process energy savings is 16% for FW prevention and 8% for FW recycling; (iv) the theoretical potential for systems-wide P savings is 21% for FW prevention and 9% for FW recycling; (v) while FW recycling results in exclusively domestic nutrient and energy savings, FW prevention leads to domestic and international savings due to large food imports; (vi) most effective is a combination of prevention and recycling, however, FW prevention reduces the potential for FW recycling and therefore needs to be prioritized to avoid potential overcapacities for FW recycling.
Hsu, T.C.; Jenkins, C.F.
This report is in response to the request to provide a recommendation for the prevention of possible microbiologically influenced corrosion (MIC) for the RHLWE (Replacement High-Level Waste Evaporator) flush water (FW) system. The recent occurrences of MIC at DWPF prompted HLWE to evaluate the possibility of MIC occurring in this 304L stainless steel RHLWE flush water system. Concern was heightened by the fact that the well water used and the other conditions at H-Tank Farm are similar to those at DWPF. However, only one known leak has occurred in the existing 304L evaporator flush water systems in either tank farm (in 1H system), and no MIC Corrosion has been confirmed in the tank farm area. The design of the RHLWE flush water system (completed long before the occurrence of MIC at DWPF) was modeled after the existing evaporator flush water systems and did not specifically include MIC prevention considerations. Therefore, MIC prevention was not specifically considered during the design phase of this flush water system. The system is presently being installed. After an extensive evaluation, a task team concluded that the best biocide to prevent the occurrence of MIC would be NaOH at fairly low concentration. Sodium hydroxide (NaOH) is optimal in this application, because of its effectiveness, low cost, and familiarity to the Operations personnel (see Appendix A). However, it is the opinion of the task group that application should be withheld until MIC corrosion is demonstrated in the system
Finnicum, D.J.; Jacob, M.C.; Schneider, R.E.; Weston, R.A.
The System 80 + design is ABB-CE's standardized evolutionary Advanced Light Water Reactor (ALWR) design. It incorporates design enhancements based on Probabilistic Risk Assessment (PRA) insights, guidance from the ALWR Utility Requirements Document (URD), and US NRC's Severe Accident Policy. Major severe accident prevention and mitigation design features of the System 80 + design are described. The results of the System 80 + PRA are presented and the insights gained from the PRA sensitivity analyses are discussed. ABB-CE considered defense-in-depth for accident prevention and mitigation early in the design process and used robust design features to ensure that the System 80 + design achieved a low core damage frequency, low containment conditional failure probability, and excellent deterministic containment performance under severe accident conditions and to ensure that the risk was properly allocated among design features and between prevention and mitigation. (author)
Wong, Leslie P
Infections are the second leading cause of death for patients with ESKD. Despite multiple efforts, nephrologists have been unable to prevent infections in dialysis facilities. The American Society of Nephrology and the Centers for Disease Control and Prevention have partnered to create Nephrologists Transforming Dialysis Safety to promote nephrologist leadership and engagement in efforts to "Target Zero" preventable dialysis infections. Because traditional approaches to infection control and prevention in dialysis facilities have had limited success, Nephrologists Transforming Dialysis Safety is reconceptualizing the problem in the context of the complexity of health care systems and organizational behavior. By identifying different parts of a problem and attempting to understand how these parts interact and produce a result, systems thinking has effectively tackled difficult problems in dynamic settings. The dialysis facility is composed of different physical and human elements that are interconnected and affect not only behavior but also, the existence of a culture of safety that promotes infection prevention. Because dialysis infections result from a complex system of interactions between caregivers, patients, dialysis organizations, and the environment, attempts to address infections by focusing on one element in isolation often fail. Creating a sense of urgency and commitment to eradicating dialysis infections requires leadership and motivational skills. These skills are not taught in the standard nephrology or medical director curriculum. Effective leadership by medical directors and engagement in infection prevention by nephrologists are required to create a culture of safety. It is imperative that nephrologists commit to leadership training and embrace their potential as change agents to prevent infections in dialysis facilities. This paper explores the systemic factors contributing to the ongoing dialysis infection crisis in the United States and the role
Zhou Xiaojun; Lu Zhiqiang; Xi Lifeng
Variability and small lot size is a common feature for many discrete manufacturing processes designed to meet a wide array of customer needs. Because of this, job shop schedule often has to be continuously updated in reaction to changes in production plan. Generally, the aim of preventive maintenance is to ensure production effectiveness and therefore the preventive maintenance models must have the ability to be adaptive to changes in job shop schedule. In this paper, a dynamic opportunistic preventive maintenance model is developed for a multi-component system with considering changes in job shop schedule. Whenever a job is completed, preventive maintenance opportunities arise for all the components in the system. An optimal maintenance practice is dynamically determined by maximizing the short-term cumulative opportunistic maintenance cost savings for the system. The numerical example shows that the scheme obtained by the proposed model can effectively address the preventive maintenance scheduling problem caused by the changes in job shop schedule and is more efficient than the ones based on two other commonly used preventive maintenance models.
Geary, Nora Ann; Dooyema, Carrie Ann; Reynolds, Meredith Ann
A quality rating and improvement system (QRIS) is a fundamental component of most states' early care and education infrastructures. States can use a QRIS to set standards that define high-quality care and award child care providers with a quality rating designation based on how well they meet these standards. The objective of this review was to describe the extent to which states' QRIS standards include obesity prevention content. We collected publicly available data on states' QRIS standards. We compared states' QRIS standards with 47 high-impact obesity prevention components in Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs, 3rd Edition, and 6 additional topics based on the Centers for Disease Control and Prevention's Spectrum of Opportunities for Obesity Prevention in the Early Care and Education Setting. Thirty-eight states operated a state-wide QRIS in early 2015. Of those, 27 states' QRIS included obesity prevention standards; 20 states had at least one QRIS standard that aligned with the high-impact obesity prevention components, and 21 states had at least one QRIS standard that aligned with at least one of the 6 additional topics. QRIS standards related to the physical activity high-impact obesity prevention components were the most common, followed by components for screen time, nutrition, and infant feeding. The high proportion of states operating a QRIS that included obesity prevention standards, combined with the widespread use of QRISs among states, suggests that a QRIS is a viable way to embed obesity prevention standards into state early care and education systems.
Wandersman, Abraham; Duffy, Jennifer; Flaspohler, Paul; Noonan, Rita; Lubell, Keri; Stillman, Lindsey; Blachman, Morris; Dunville, Richard; Saul, Janet
If we keep on doing what we have been doing, we are going to keep on getting what we have been getting. Concerns about the gap between science and practice are longstanding. There is a need for new approaches to supplement the existing approaches of research to practice models and the evolving community-centered models for bridging this gap. In this article, we present the Interactive Systems Framework for Dissemination and Implementation (ISF) that uses aspects of research to practice models and of community-centered models. The framework presents three systems: the Prevention Synthesis and Translation System (which distills information about innovations and translates it into user-friendly formats); the Prevention Support System (which provides training, technical assistance or other support to users in the field); and the Prevention Delivery System (which implements innovations in the world of practice). The framework is intended to be used by different types of stakeholders (e.g., funders, practitioners, researchers) who can use it to see prevention not only through the lens of their own needs and perspectives, but also as a way to better understand the needs of other stakeholders and systems. It provides a heuristic for understanding the needs, barriers, and resources of the different systems, as well as a structure for summarizing existing research and for illuminating priority areas for new research and action.
Fletcher, Andrew J W; Ruffell, Alison J; Young, Peter J
To discuss the development of the LoTrach system in light of current evidence around the prevention of ventilator-associated pneumonia (VAP) and its practical application in the intensive care setting. VAP causes substantial morbidity and mortality in ventilated patients in the Intensive Care Unit (ICU), increases length of stay in ICU and is extremely costly. Strategies are needed to reduce the risk of VAP. We examine the need for an endotracheal tube (ETT) specifically designed for the critically-ill patient, the development of the LoTrach system from conception to production, and the role of the various components of the system in preventing VAP. Early issues in implementing this revolutionary equipment into ICU are explored and three case studies highlight advantages of this system. The LoTrach system has been designed to facilitate the provision of a number of evidence-based interventions that have been shown to reduce VAP. Pulmonary aspiration is ubiquitous with conventional cuffs but prevented by the cuff of the LoTrach system when held at a constant and safe pressure against the tracheal wall with a cuff pressure controller. Other aspects incorporated in the ETT are aimed at clearing the secretions from the subglottic space, preventing tube occlusion and accidental extubation, and avoiding damage to the airway. In this way the LoTrach system employs a multifactorial approach to the prevention of VAP and the cost savings from LoTrach rather than a standard ETT will be considerable because of an average 3 day reduction in ICU length of stay related to this. It thus has the potential to be a very useful tool in the ICU setting in the prevention of VAP.
Belcastro, Christine M.
Loss of control (LOC) is one of the largest contributors to fatal aircraft accidents worldwide. LOC accidents are complex in that they can result from numerous causal and contributing factors acting alone or (more often) in combination. These LOC hazards include vehicle impairment conditions, external disturbances; vehicle upset conditions, and inappropriate crew actions or responses. Hence, there is no single intervention strategy to prevent these accidents. NASA previously defined a comprehensive research and technology development approach for reducing LOC accidents and an associated integrated system concept. Onboard technologies for improved situation awareness, guidance, and control for LOC prevention and recovery are needed as part of this approach. Such systems should include: LOC hazards effects detection and mitigation; upset detection, prevention and recovery; and mitigation of combined hazards. NASA is conducting research in each of these areas. This paper provides an overview of this research, including the near-term LOC focus and associated analysis, as well as preliminary flight system architecture.
Karatas, Bahtiyar Can; Jóhannsson, Hjörtur; Nielsen, Arne Hejde
. The software platform receives phasor measurement unit (PMU) data at a high repetition rate for full system observability. The PMU data serves as input for methods capable of analyzing the steady state torque balance for each individual generator and to determine available power reserves and possible remedial...... actions. The capabilities of the software platform were demonstrated by testing the methods on the Nordic32 test system and the results show that the methods can determine an active power re-dispatch and apply the countermeasures in realtime and prevent aperiodic rotor angle instability.......This paper presents an innovative approach to apply wide-area control actions in real-time and prevent emerging instability. A software platform has been further developed, which utilizes Real Time Digital Simulator (RTDS) technology to prevent scenarios leading to power system instability...
Wutzke, Sonia; Roberts, Nick; Willis, Cameron; Best, Allan; Wilson, Andrew; Trochim, William
Chronic diseases are a serious and urgent problem, requiring at-scale, multi-component, multi-stakeholder action and cooperation. Despite numerous national frameworks and agenda-setting documents to coordinate prevention efforts, Australia, like many countries internationally, is yet to substantively impact the burden from chronic disease. Improved evidence on effective strategies for the prevention of chronic disease is required. This research sought to articulate a priority set of important and feasible action domains to inform future discussion and debate regarding priority areas for chronic disease prevention policy and strategy. Using concept mapping, a mixed-methods approach to making use of the best available tacit knowledge of recognised, diverse and well-experienced actors, and national actions to improve the prevention of chronic disease in Australia were identified and then mapped. Participants (ranging from 58 to 78 in the various stages of the research) included a national sample of academics, policymakers and practitioners. Data collection involved the generation and sorting of statements by participants. A series of visual representations of the data were then developed. A total of 95 statements were distilled into 12 clusters for action, namely Inter-Sectoral Partnerships; Systems Perspective/Action; Governance; Roles and Responsibilities; Evidence, Feedback and Learning; Funding and Incentive; Creating Demand; Primary Prevention; Social Determinants and Equity; Healthy Environments; Food and Nutrition; and Regulation and Policy. Specific areas for more immediate national action included refocusing the health system to prevention over cure, raising the profile of public health with health decision-makers, funding policy- and practice-relevant research, improving communication about prevention, learning from both global best-practice and domestic successes and failures, increasing the focus on primary prevention, and developing a long-term prevention
Full Text Available This paper presents an overview of the technologies and the methodologies used in Network Intrusion Detection and Prevention Systems (NIDPS. Intrusion Detection and Prevention System (IDPS technologies are differentiated by types of events that IDPSs can recognize, by types of devices that IDPSs monitor and by activity. NIDPSs monitor and analyze the streams of network packets in order to detect security incidents. The main methodology used by NIDPSs is protocol analysis. Protocol analysis requires good knowledge of the theory of the main protocols, their definition, how each protocol works.
Anderson, Kathleen; Clavel, Alfred; Fricton, Regina; Hathaway, Kate; Kang, Wenjun; Jaeger, Bernadette; Maixner, William; Pesut, Daniel; Russell, Jon; Weisberg, Mark B.; Whitebird, Robin
Chronic pain conditions are the top reason patients seek care, the most common reason for disability and addiction, and the biggest driver of healthcare costs; their treatment costs more than cancer, heart disease, dementia, and diabetes care. The personal impact in terms of suffering, disability, depression, suicide, and other problems is incalculable. There has been much effort to prevent many medical and dental conditions, but little effort has been directed toward preventing chronic pain. To address this deficit, a massive open online course (MOOC) was developed for students and healthcare professionals. “Preventing Chronic Pain: A Human Systems Approach” was offered by the University of Minnesota through the online platform Coursera. The first offering of this free open course was in the spring of 2014 and had 23 650 participants; 53% were patients or consumers interested in pain. This article describes the course concepts in preventing chronic pain, the analytic data from course participants, and postcourse evaluation forms. PMID:26421231
Fricton, James; Anderson, Kathleen; Clavel, Alfred; Fricton, Regina; Hathaway, Kate; Kang, Wenjun; Jaeger, Bernadette; Maixner, William; Pesut, Daniel; Russell, Jon; Weisberg, Mark B; Whitebird, Robin
Chronic pain conditions are the top reason patients seek care, the most common reason for disability and addiction, and the biggest driver of healthcare costs; their treatment costs more than cancer, heart disease, dementia, and diabetes care. The personal impact in terms of suffering, disability, depression, suicide, and other problems is incalculable. There has been much effort to prevent many medical and dental conditions, but little effort has been directed toward preventing chronic pain. To address this deficit, a massive open online course (MOOC) was developed for students and healthcare professionals. "Preventing Chronic Pain: A Human Systems Approach" was offered by the University of Minnesota through the online platform Coursera. The first offering of this free open course was in the spring of 2014 and had 23 650 participants; 53% were patients or consumers interested in pain. This article describes the course concepts in preventing chronic pain, the analytic data from course participants, and postcourse evaluation forms.
Cheskin, L J; Frutchey, R; McDermott, A Y; Esposito, L; Lee, B Y; Kumanyika, S
Research on the types of interventions needed for population-level prevention of childhood obesity in complex societal systems can benefit from greater use of systems-science concepts and tools. We report outcomes of a funding programme promoting incorporation of systems-science approaches into studies of imminent policy or environmental changes potentially impacting childhood obesity. Seven funding cycles over 3 years yielded 172 initial submissions from 29 US states and 25 other countries were analyzed. Submissions focused primarily on aspects of school or child-care settings, parks and recreational settings, or access to healthy food; about half reflected attention to systems perspectives. Analysis of initial submissions as well as the 15 funded projects showed some success in motivating use of systems concepts and tools but suggested the need for a more focused effort to educate and prepare the childhood obesity prevention research community for this potentially crucial type of research. © 2016 World Obesity Federation.
Xanthopoulos, A.S.; Koulouriotis, D.E.; Botsaris, P.N.
Despite the fact that the fields of pull type production control policies and condition-based preventive maintenance have much in common contextually, they have evolved independently up to now. In this investigation, an attempt is made to bridge the gap between these two branches of knowledge by introducing the single-stage Kanban system with deterioration failures and condition-based preventive maintenance. The formalism of continuous time Markov chains is used to model the system and expressions for eight performance metrics are derived. Two important, from a managerial perspective, constrained optimization problems for the proposed model are defined where the objective is the simultaneous optimization of the Kanban policy, the preventive maintenance policy and the inspection schedule under conflicting performance criteria. Multiple instances of each optimization problem are solved by means of the augmented Lagrangian genetic algorithm. The results from the optimization trials coupled by the results from extensive numerical examples facilitate the thorough investigation of the system’s behaviour. - Highlights: • Kanban system with deterioration failures and preventive maintenance is introduced. • The system is modeled as a continuous time Markov chain. • Expressions for eight performance metrics are derived. • The behavior of the system is studied through numerical examples. • Optimization results for selected performance metrics are presented
Nahas, Nabil; Khatab, Abdelhakim; Ait-Kadi, Daoud; Nourelfath, Mustapha
This paper deals with preventive maintenance optimization problem for multi-state systems (MSS). This problem was initially addressed and solved by Levitin and Lisnianski [Optimization of imperfect preventive maintenance for multi-state systems. Reliab Eng Syst Saf 2000;67:193-203]. It consists on finding an optimal sequence of maintenance actions which minimizes maintenance cost while providing the desired system reliability level. This paper proposes an approach which improves the results obtained by genetic algorithm (GENITOR) in Levitin and Lisnianski [Optimization of imperfect preventive maintenance for multi-state systems. Reliab Eng Syst Saf 2000;67:193-203]. The considered MSS have a range of performance levels and their reliability is defined to be the ability to meet a given demand. This reliability is evaluated by using the universal generating function technique. An optimization method based on the extended great deluge algorithm is proposed. This method has the advantage over other methods to be simple and requires less effort for its implementation. The developed algorithm is compared to than in Levitin and Lisnianski [Optimization of imperfect preventive maintenance for multi-state systems. Reliab Eng Syst Saf 2000;67:193-203] by using a reference example and two newly generated examples. This comparison shows that the extended great deluge gives the best solutions (i.e. those with minimal costs) for 8 instances among 10
Kee, Ernest; Sun, Alice; Richards, Andrew; Grantom, Rick; Liming, James; Salter, James
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)
Sharma, Sudesh Raj; Page, Rachel; Matheson, Anna; Lambrick, Danielle; Faulkner, James; Mishra, Shiva Raj
Developing countries such as Nepal are experiencing a double burden of communicable and non-communicable diseases (NCDs) resulting in social and economic losses. In Nepal, more than half of the disease burden is due to NCDs. The major NCDs in Nepal are cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. Behavioural factors such as tobacco use, alcohol consumption, physical inactivity and unhealthy diet are driving the epidemic of NCDs, which are further influenced by social, economic and environmental determinants. The health system of Nepal has not been able to address the ever-increasing burden of NCDs. With the formulation of the Multisectoral Action Plan for Prevention and Control of NCDs 2014-2020, there has been some hope for tackling the NCDs and their social determinants in Nepal through a primary prevention approach. This paper discusses the systemic challenges and recommends two key actions for the prevention and control of NCDs in Nepal.
Belcastro, Christine M.
Validation of technologies developed for loss of control (LOC) prevention and recovery poses significant challenges. Aircraft LOC can result from a wide spectrum of hazards, often occurring in combination, which cannot be fully replicated during evaluation. Technologies developed for LOC prevention and recovery must therefore be effective under a wide variety of hazardous and uncertain conditions, and the validation framework must provide some measure of assurance that the new vehicle safety technologies do no harm (i.e., that they themselves do not introduce new safety risks). This paper summarizes a proposed validation framework for safety-critical systems, provides an overview of validation methods and tools developed by NASA to date within the Vehicle Systems Safety Project, and develops a preliminary set of test scenarios for the validation of technologies for LOC prevention and recovery
Conner, William; Nahrstedt, Klara; Gupta, Indranil
This paper presents a framework for preventing both selfishness and denial-of-service attacks in peer-to-peer media streaming systems. Our framework, called Oversight, achieves prevention of these undesirable activities by running a separate peer-to-peer download rate enforcement protocol along with the underlying peer-to-peer media streaming protocol. This separate Oversight protocol enforces download rate limitations on each participating peer. These limitations prevent selfish or malicious nodes from downloading an overwhelming amount of media stream data that could potentially exhaust the entire system. Since Oversight is based on a peer-to-peer architecture, it can accomplish this enforcement functionality in a scalable, efficient, and decentralized way that fits better with peer-to-peer media streaming systems compared to other solutions based on central server architectures. As peer-to-peer media streaming systems continue to grow in popularity, the threat of selfish and malicious peers participating in such large peer-to-peer networks will continue to grow as well. For example, since peer-to-peer media streaming systems allow users to send small request messages that result in the streaming of large media objects, these systems provide an opportunity for malicious users to exhaust resources in the system with little effort expended on their part. However, Oversight addresses these threats associated with selfish or malicious peers who cause such disruptions with excessive download requests. We evaluated our Oversight solution through simulations and our results show that applying Oversight to peer-to-peer media streaming systems can prevent both selfishness and denial-of-service attacks by effectively limiting the download rates of all nodes in the system.
Farve Daneshvar Fard
Full Text Available Introduction Pressure ulcers are tissue damages resulting from blood flow restriction, which occurs when the tissue is exposed to high pressure for a long period of time. These painful sores are common in patients and elderly, who spend extended periods of time in bed or wheelchair. In this study, a continuous pressure and temperature monitoring system was developed for pressure ulcer prevention. Materials and Methods The monitoring system consists of 64 pressure and 64 temperature sensors on a 40×50 cm2 sheet. Pressure and temperature data and the corresponding maps were displayed on a computer in real-time. Risk assessment could be performed by monitoring and recording absolute pressure and temperature values, as well as deviations over time. Furthermore, a posture detection procedure was proposed for sitting posture identification. Information about the patient’s movement history may help caregivers make informed decisions about the patient’s repositioning and ulcer prevention strategies. Results Steady temporal behaviour of the designed system and repeatability of the measurements were evaluated using several particular tests. The results illustrated that the system could be utilized for continuous monitoring of interface pressure and temperature for pressure ulcer prevention. Furthermore, the proposed method for detecting sitting posture was verified using a statistical analysis. Conclusion A continuous time pressure and temperature monitoring system was presented in this study. This system may be suited for pressure ulcer prevention given its feasibility for simultaneous monitoring of pressure and temperature and alarming options. Furthermore, a method for detecting different sitting postures was proposed and verified. Pressure ulcers in wheelchair-bound patients may be prevented using this sitting posture detection method.
Apostolopoulos, Yorghos; Lemke, Michael K; Barry, Adam E; Lich, Kristen Hassmiller
The drinking environment is a complex system consisting of a number of heterogeneous, evolving and interacting components, which exhibit circular causality and emergent properties. These characteristics reduce the efficacy of commonly used research approaches, which typically do not account for the underlying dynamic complexity of alcohol consumption and the interdependent nature of diverse factors influencing misuse over time. We use alcohol misuse among college students in the United States as an example for framing our argument for a complex systems paradigm. A complex systems paradigm, grounded in socio-ecological and complex systems theories and computational modeling and simulation, is introduced. Theoretical, conceptual, methodological and analytical underpinnings of this paradigm are described in the context of college drinking prevention research. The proposed complex systems paradigm can transcend limitations of traditional approaches, thereby fostering new directions in alcohol prevention research. By conceptualizing student alcohol misuse as a complex adaptive system, computational modeling and simulation methodologies and analytical techniques can be used. Moreover, use of participatory model-building approaches to generate simulation models can further increase stakeholder buy-in, understanding and policymaking. A complex systems paradigm for research into alcohol misuse can provide a holistic understanding of the underlying drinking environment and its long-term trajectory, which can elucidate high-leverage preventive interventions. © 2017 Society for the Study of Addiction.
She, Guo-lin; Ma, Yu-Cai; Wang, Fu-biao
To analyze the current situation of the comprehensive prevention and control system for imported falciparum malaria in Hanjiang District and evaluate its effect. According to the Management Scheme on Control of Imported Falciparum Malaria in Yangzhou City, the comprehensive prevention and control system for imported falciparum malaria was implemented, and the relevant malaria data were collected and analyzed statistically. The data included plasmodium blood test ratio of fever patients among exported labors and those returned, the ratio of laboratory-confirmed cases among all reported cases of falciparum malaria, the ratio of falciparum malaria patients who received the standard treatment within 24 hours after onset, etc from 2010 to 2012. After the implementation of the comprehensive prevention and control system, the confirmation ratio of falciparum malaria cases within 24 hours following first visit has reached 60.47%, the average time from first visit to confirmation has shortened to 1.8 d, and the average time from onset to confirmation has shortened to 3.7 d. The health education coverage ratio was 100%, the health knowledge awareness ratio was 95.56%, the ratio of patients seeking treatment on own initiative was 100%, the laboratory-confirmed ratio was 100%, and the ratio of standard treatment after malaria diagnosis was 100%. The comprehensive prevention and control system carried out by Hanjiang District has made remarkable achievements.
Ringel, Jeanne S; Moore, Melinda; Zambrano, John; Lurie, Nicole
To assess the extent to which the systems in place for prevention and control of routine annual influenza could provide the information and experience needed to manage a pandemic. The authors conducted a qualitative assessment based on key informant interviews and the review of relevant documents. Although there are a number of systems in place that would likely serve the United States well in a pandemic, much of the information and experience needed to manage a pandemic optimally is not available. Systems in place for routine annual influenza prevention and control are necessary but not sufficient for managing a pandemic, nor are they used to their full potential for pandemic preparedness. Pandemic preparedness can be strengthened by building more explicitly upon routine influenza activities and the public health system's response to the unique challenges that arise each influenza season (eg, vaccine supply issues, higher than normal rates of influenza-related deaths).
Full Text Available Fall prediction is a multifaceted problem that involves complex interactions between physiological, behavioral, and environmental factors. Existing fall detection and prediction systems mainly focus on physiological factors such as gait, vision, and cognition, and do not address the multifactorial nature of falls. In addition, these systems lack efficient user interfaces and feedback for preventing future falls. Recent advances in internet of things (IoT and mobile technologies offer ample opportunities for integrating contextual information about patient behavior and environment along with physiological health data for predicting falls. This article reviews the state-of-the-art in fall detection and prediction systems. It also describes the challenges, limitations, and future directions in the design and implementation of effective fall prediction and prevention systems.
Liu, Yanfei; Wang, Jieling; Jiang, Ke; He, Yanhui; Wu, Zhilin
In view of the fact that China’s border is very long and the border prevention and control measures are single, we designed a regional intrusion prevention and control system which based on target-tracking. The system consists of four parts: solar panel, radar, electro-optical equipment, unmanned aerial vehicle and intelligent tracking platform. The solar panel provides independent power for the entire system. The radar detects the target in real time and realizes the high precision positioning of suspicious targets, then through the linkage of electro-optical equipment, it can achieve full-time automatic precise tracking of targets. When the target appears within the range of detection, the drone will be launched to continue the tracking. The system is mainly to realize the full time, full coverage, whole process integration and active realtime control of the border area.
Full Text Available In order to prevent the onset of vascular dementia (VaD in aging individuals, it is critical to detect clinically relevant vascular and systemic pathophysiological changes to signal the onset of its preceding prodromal stages. Identifying behavioral and neurobiological markers that are highly sensitive to VaD classification vs. other dementias is likely to assist in developing novel preventive treatment strategies that could delay the onset of disruptive psychomotor symptoms, decrease hospitalizations, and increase the quality of life in clinically-high-risk aging individuals. In light of empirical diagnostic and clinical findings associated with VaD pathophysiology, the current investigation will suggest a few clinically-validated biomarker measures of prodromal VaD cognitive impairments that are correlated with vascular symptomology, and VaD endophenotypes in non-demented aging people. In prodromal VaD individuals, distinguishing VaD from other dementias (e.g., Alzheimer's disease could facilitate specific early preventive interventions that significantly delay more severe cognitive deterioration or indirectly suppress the onset of dementia with vascular etiology. Importantly, the authors conclude that primary prevention strategies should examine aging individuals by employing comprehensive geriatric assessment approach, taking into account their medical history, and longitudinally noting their vascular, systemic, cognitive, behavioral, and clinical functional status. Secondary prevention strategies may include monitoring chronic medication as well as promoting programs that facilitate social interaction and every-day activities.
Nakanishi, Miharu; Yamauchi, Takashi; Takeshima, Tadashi
In Japan, the Cabinet Office released the 'General Principles of Suicide Prevention Policy' in 2007 and suggested nine initiatives. In 2009, a national fund was launched to help prefectures (the administrative divisions of Japan) and local authorities implement five categories of suicide-prevention programs. This paper examines the impact of the national fund on the establishment of the systems for suicide prevention and the implementation of these initiatives among local authorities. The present study included 1385 local authorities (79.5%) from all 47 prefectures that responded to the cross-sectional questionnaire survey. Improved suicide-prevention systems and the implementation of nine initiatives in April 2013 were observed among 265 local authorities (19.1%) that implemented 'Training of community service providers' and 'Public awareness campaigns'; 178 local authorities (12.9%) that implemented 'Face-to-face counseling', 'Training of community service providers' and 'Public awareness campaigns'; and 324 local authorities (23.4%) that implemented 'Trauma-informed policies and practices'. There was no significant difference in suicide-prevention systems and the implementation of nine initiatives between 203 local authorities (14.7%) that implemented only 'Public awareness campaigns' and 231 local authorities (16.7%) that did not implement any suicide-prevention programs. The results of our study suggest that the national fund promoted the establishment of community systems for suicide prevention and helped implement initiatives among local authorities. The national suicide-prevention strategy in Japan should explore a standard package of programs to guide community suicide-prevention efforts with a sustained workforce among local authorities. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.
Bastman, J.; Lakervi, E. [Tampere Univ. of Tech. (Finland); Hirvonen, R.; Kuronen, P.; Hagman, E. [IVO Group (Finland)
The Finnish power system is a part of the Nordic power system (NORDEL), which includes Finland, Sweden, Norway and the eastern part of Denmark. In NORDEL the transmission distances are long, which implies that the power transmission capacities are determined by stability criteria . The methods to prevent and predict the voltage collapse during severe disturbances are studied using advances simulation program. Results are presented. (author) 10 figs., 1 tab.
Hsiang Huang, MD
Full Text Available Summary:. A new type of needle system combines 2 parts, an inner needle and an outer needle. The inner needle is used for filler injection and the outer needle acts as a guiding needle that can observe blood reflow when inserting into the vessel lumen during injection process. This new needle system can be used for all kinds of filler, providing real time monitoring for physician and preventing intravascular injection of any filler.
A Recommender System (RS) is a system that utilizes user and item information to predict the feeling of users towards unfamiliar items. Recommender Systems have become popular tools for online stores due to their usefulness in confidently recommending items to users. A popular algorithm for recommender system is Collaborative Filtering (CF). CF uses other users\\' profiles to predict whether a user is interested in a particular object. This system, however, is vulnerable to malicious users seeking to promote items by manipulating rating predictions with fake user profiles. Profiles with behaviors similar to "victim" users alter the prediction of a Recommender System. Manipulating rating predictions through injected profiles is referred to as a shilling attack. It is important to develop shilling attack prevention frameworks for to protect the trustworthiness of Recommender Systems. In this thesis, we will demonstrate a new methodology that utilizes social information to prevent malicious users from manipulating the prediction system. The key element in our new methodology rests upon the concept of trust among real users, an element we claim absent among malicious profiles. In order to use trust information for shilling attack prevention, we first develop a weighting system which makes the system rely more on trustworthy users when making predictions. We then use this trust information to cluster out untrustworthy users to improve rating robustness. The robustness of the new and classic systems is then evaluated with data from a public commercial consumer RS, Epinions.com. Several complexity reduction procedures are also introduced to make implementing the algorithms mentioned possible for a huge commercial database.
Introduction This paper presents a system dynamics computer simulation model to illustrate unintended consequences of apparently rational allocations to curative and preventive services. Methods A modeled population is subject to only two diseases. Disease A is a curable disease that can be shortened by curative care. Disease B is an instantly fatal but preventable disease. Curative care workers are financed by public spending and private fees to cure disease A. Non-personal, preventive services are delivered by public health workers supported solely by public spending to prevent disease B. Each type of worker tries to tilt the balance of government spending towards their interests. Their influence on the government is proportional to their accumulated revenue. Results The model demonstrates effects on lost disability-adjusted life years and costs over the course of several epidemics of each disease. Policy interventions are tested including: i) an outside donor rationally donates extra money to each type of disease precisely in proportion to the size of epidemics of each disease; ii) lobbying is eliminated; iii) fees for personal health services are eliminated; iv) the government continually rebalances the funding for prevention by ring-fencing it to protect it from lobbying. The model exhibits a “spend more get less” equilibrium in which higher revenue by the curative sector is used to influence government allocations away from prevention towards cure. Spending more on curing disease A leads paradoxically to a higher overall disease burden of unprevented cases of disease B. This paradoxical behavior of the model can be stopped by eliminating lobbying, eliminating fees for curative services, and ring-fencing public health funding. Conclusions We have created an artificial system as a laboratory to gain insights about the trade-offs between curative and preventive health allocations, and the effect of indicative policy interventions. The underlying dynamics of
Hong, Wen-Tang; Huang, Cheng-Nan; Tan, Hsueh-I; Chao, Yu [Institute of Nuclear Energy Research Atomic Energy Council, Taoyuan County 32546 (Taiwan, Province of China); Yen, Tzu-Hsiang [Green Technology Research Institute, CPC Corporation, Chia-Yi City 60036 (Taiwan, Province of China)
The balance of plant (BOP) of a Solid Oxide Fuel Cell (SOFC) system with a 2 kW stack and an electric efficiency of 40% is optimized using commercial GCTool software. The simulation results provide a detailed understanding of the optimal operating temperature, pressure and mass flow rate in all of the major BOP components, i.e., the gas distributor, the afterburner, the reformer and the heat exchanger. A series of experimental trials are performed to validate the simulation results. Overall, the results presented in this study not only indicate an appropriate set of operating conditions for the SOFC power system, but also suggest potential design improvements for several of the BOP components.
Araki, Masamitsu; Jibu, Noboru; Abe, Kazuhiro
The recent rate of operation of Japanese nuclear power stations attained the result exceeding 70 %, but in order to improve it further and maintain the high reliability, the preventive maintenance program of more elaborate and systematic must be planned and executed. However, in order to establish the plan for maintaining efficiently and with high accuracy the enormous machinery and equipment exceeding 60000 in a nuclear power station, the high advance by mechanization is indispensable. Therefore, Hitachi Ltd. has developed the total preventive maintenance system, and it has partially begun operation. This system has the function of the life diagnosis of machinery and equipment, in addition, it constructs the data base with the specifications of machinery and equipment, the history of checkup, the information on reliability in Japan and foreign countries and so on, and based on these information, the recommendation of checkup, the proposal of improving facilities and other items are to be summarized and offered to electric power companies. The preventive maintenance activities in Hitachi Ltd., the concept and the outline of the total preventive maintenance system are reported. (K.I.)
Crowley, Daniel M; Jones, Damon E; Greenberg, Mark T; Feinberg, Mark E; Spoth, Richard L
To prepare public systems to implement evidence-based prevention programs for adolescents, it is necessary to have accurate estimates of programs' resource consumption. When evidence-based programs are implemented through a specialized prevention delivery system, additional costs may be incurred during cultivation of the delivery infrastructure. Currently, there is limited research on the resource consumption of such delivery systems and programs. In this article, we describe the resource consumption of implementing the PROSPER (PROmoting School-Community-University Partnerships to Enhance Resilience) delivery system for a period of 5 years in one state, and how the financial and economic costs of its implementation affect local communities as well as the Cooperative Extension and University systems. We used a six-step framework for conducting cost analysis, using a Cost-Procedure-Process-Outcome Analysis model (Yates, Analyzing costs, procedures, processes, and outcomes in human services: An introduction, 1996; Yates, 2009). This method entails defining the delivery System; bounding cost parameters; identifying, quantifying, and valuing systemic resource Consumption, and conducting sensitivity analysis of the cost estimates. Our analyses estimated both the financial and economic costs of the PROSPER delivery system. Evaluation of PROSPER illustrated how costs vary over time depending on the primacy of certain activities (e.g., team development, facilitator training, program implementation). Additionally, this work describes how the PROSPER model cultivates a complex resource infrastructure and provides preliminary evidence of systemic efficiencies. This work highlights the need to study the costs of diffusion across time and broadens definitions of what is essential for successful implementation. In particular, cost analyses offer innovative methodologies for analyzing the resource needs of prevention systems. Copyright Â© 2012 Society for Adolescent Health and
Petersen, Poul Erik; Bourgeois, Denis; Bratthall, Douglas
programmes oriented towards disease prevention and health promotion. The WHO Oral Health Country/Area Profile Programme (CAPP) provides data on oral health from countries, as well as programme experiences and ideas targeted to oral health professionals, policy-makers, health planners, researchers...... systems are being developed within the framework of the WHO STEPwise approach to surveillance of noncommunicable, chronic disease, and data stored in the WHO Global InfoBase may allow advanced health systems research. Sound knowledge about progress made in prevention of oral and chronic disease......This article describes the essential components of oral health information systems for the analysis of trends in oral disease and the evaluation of oral health programmes at the country, regional and global levels. Standard methodology for the collection of epidemiological data on oral health has...
McQuiston, Thomas H; Cable, Steve; Cook, Linda; Drewery, Karen; Erwin, Glenn; Frederick, James; Lessin, Nancy; Ouellette, Dan; Scardella, John; Spaeth, Colin; Wright, Mike
After years of watching company health and safety programs fail to prevent major incidents, injuries, illness, and death in industrial workplaces, union health and safety staff and rank and file activists took up the challenge of creating a union-run alternative program. Named the Triangle of Prevention (TOP), the program successfully engages both local unions and management in incident and near-miss reporting and investigation, root cause analysis, recommending and tracking solutions, and learning and sharing lessons. In all phases, TOP uses a hierarchical, systems-of-safety-based approach to hazard identification, reporting, prevention and control while aiming to engage the union, its members, and all other employees of a worksite. This article explains the foundations and workings of this program, the role of an expansive worker-to-worker training regimen, and the ways in which the program has transformed workplaces.
Purchartová, K.; Baron, C.P.; Křen, V.
to prevent activation of hemoglobin (Hb) to highly reactive hypervalent heme protein species (ferrylHb and perferrylHb) was examined. Indeed, Hb cytotoxicity has been associated with the generation of protein radicals, which are formed when the ferric iron of Hb (Fe3+) is oxidised by H2O2 to (Fe4+) to form...... perferrylHb and ferrylHb, with the later also bearing a radical on its protein. The relationship between the structural properties of silybin and its derivatives and their ability to prevent oxidation of Hb was investigated in model system in the presence or the absence of lipids. The antioxidant activities...... of silybin, dehydrosilybin, 23-O-butanoyl and 23-O-palmitoyl silybin derivatives were correlated with their interaction with Hb species. Results are discussed in relation to the potential of dehydrosilybin, silybin and C4 and C16 derivates to prevent activation of Hb to hypevalent heme protein species....
Jacoby, Sara F; Kollar, Laura M Mercer; Ridgeway, Greg; Sumner, Steven A
Healthcare providers and law enforcement (LE) officers are among the most common first responders to injuring events. Despite frequent interface between the health system (HS) and LE sectors, the published evidence that supports their collaboration in injury surveillance, control and prevention has not been comprehensively reviewed. We conducted a scoping review of literature published from 1990 to 2016 that focused on local and regional HS and LE collaborations in injury surveillance, control and prevention. Our aim was to describe what is known and what remains unexplored about these cross-sector efforts. 128 articles were included in the final review. These were categorised by their focus on either surveillance activities or partnerships in injury control and prevention programmes. The majority of surveillance articles focused on road traffic injuries. Conversely, articles describing partnerships and programme evaluations primarily targeted the prevention of interpersonal violence. This review yielded two major findings: overall, the combination of HS and LE injury data added value to surveillance systems, especially as HS data augmented LE data; and HS and LE partnerships have been developed to improve injury control and prevention. However, there are few studies that have evaluated the impact and sustainability of these partnerships. The current evidence to support HS and LE collaboration in injury surveillance and control and prevention programmes is heterogeneous. Notable gaps suggest ample opportunity for further research and programme evaluation across all types of injury. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Crandall, Marie; Zarzaur, Ben; Tinkoff, Glen
Injury is the leading cause of death for all Americans aged 1 to 35 years, and injury-related costs exceed $100 billion per year in the United States. Trauma centers can be important resources for risk identification and prevention strategies. The authors review 3 important resources for injury prevention education and research: the National Trauma Data Bank, geographic information systems, and an overview of injury prevention education. The National Trauma Data Bank and the Trauma Quality Improvement Program are available through the Web site of the American College of Surgeons. Links to research examples using geographic information systems software and the National Trauma Data Bank are provided in the text. Finally, resources for surgical educators in the area of injury prevention are summarized and examples provided. Database research, geographic information systems, and injury prevention education are important tools in the field of injury prevention. This article provides an overview of current research and education strategies and resources. Copyright © 2013 Elsevier Inc. All rights reserved.
...: Species, Guinea Pig, Number Allowed, 276, Number Used, 83, LSU IACUC# 1061. ANIMAL PROJECT: The SPECIFIC MMS of this study are to demonstrate and explore mechanisms for preventing the effects of intense sound...
M. Pour, Shahrzad; Stidsen, Thomas Jacob Riis; Rasmussen, Kourosh Marjani
, the western part of Denmark. This case is particularly interesting, since the entire railway signalling system is currently being upgraded to the new European Railway Traffic Management System (ERTMS) standard. The new signals need continuous maintenance and in this article we plan the distribution of crew......A railway system is a large and complex infrastructure, which requires continuous maintenance in order to function correctly. Proper maintenance is critical but can also be costly. In this paper we consider the practical case of planning the preventive maintenance of railway signals in Jutland...
Qing, Yu; Shuai, Han; Qiang, Wang; Jing-Bo, Xue
To report the integrated progress of the hydatid disease information management system, and to provide the reference for further system improvements by analysis of results on simulation test feedback. The work of institutional code matching by collecting fundamental and integrated information of the system in epidemic areas of hydatid disease was carried out, and professional control agencies were selected to carry out the simulation test. The results of agencies code matching at stage indicated the average completion rate was 94.30% on administrative agencies, 69.94% on registered professional agencies and 56.40% on professional institutions matching related to hydatid disease prevention and control implements in seven provinces (autonomous regions) and Xinjiang Production and Construction Corps. Meanwhile, the response rate of open-ended proposals was 93.33% on fifteen feedbacks, and the statistics showed 21.43% believed the system was low fluency, 64.29% considered the system was inconvenience for data inputs and 42.86% considered it would be improved on system statistics functions, of which 27.78% were provincial users, 22.22% were the city users and 50.00% were the county users. The hydatid disease prevention information management system meets the fundamental needs of the majority agencies in hyperendemic areas of echinococcosis, it needs to develop the further test with more agencies joining after the work of the institutional code matching completion and the system service improvement in the next stage.
Corman, Francesco; Kraijema, Sander; Godjevac, Milinko; Lodewijks, Gabriel
This article presents a case study determining the optimal preventive maintenance policy for a light rail rolling stock system in terms of reliability, availability, and maintenance costs. The maintenance policy defines one of the three predefined preventive maintenance actions at fixed time-based intervals for each of the subsystems of the braking system. Based on work, maintenance, and failure data, we model the reliability degradation of the system and its subsystems under the current maintenance policy by a Weibull distribution. We then analytically determine the relation between reliability, availability, and maintenance costs. We validate the model against recorded reliability and availability and get further insights by a dedicated sensitivity analysis. The model is then used in a sequential optimization framework determining preventive maintenance intervals to improve on the key performance indicators. We show the potential of data-driven modelling to determine optimal maintenance policy: same system availability and reliability can be achieved with 30% maintenance cost reduction, by prolonging the intervals and re-grouping maintenance actions.
Hidekazu, Yoshikawa; Ming, Yang; Zhijian, Zhang
interface systems to support the collaboration work between workers at local workplace and the main control room. In this paper, the general issues are reviewed on how to configure the whole human interface system for helping proactive trouble prevention and risk evaluation on the basis of the presented......A new concept is first proposed of distributed human interface system to integrate both operation and maintenance of nuclear power plant. Then, a method of constructing human interface system is introduced by integrating the plant knowledge database system based on Multilevel Flow Model (MFM......) with the risk monitor to watch Defense-in Depth plant safety functions. The proposed concept is applied for a liquid metal fast reactor Monju and necessary R&D subjects are reviewed to realize human interface system for the maintenance work in Monju plant. Because of using high temperature liquid sodium...
Sansiritaweesook, Getsara; Muangsom, Niramon; Kanato, Manop; Ratanasiri, Amornrat
This study had a 2-group pre-post quasiexperimental design and was conducted in 2 selected areas of Ubon Ratchathani province, Thailand. The objective was to evaluate the extent to which the surveillance system that was developed helped in drowning prevention. The development process involved extensive participation from the community. System efficiency was evaluated, and the drowning rates were compared. The system demonstrated 82.8% system sensitivity and 87% positive-predictive value. There were 90.0% rescues with no injury during the study period. The relative risk of drowning injury suggests that the control area was at 5.6 times more at risk for drowning injury than the intervention area (95% CI = 1.58, 20.12). Local knowledge and participation from the community were found to be key issues in the success of the surveillance system, and such systems can be applied to other areas with similar problems. © 2013 APJPH.
Boĭtsov, S A; Kalinina, A M; Ipatov, P V
The paper deals with the justification and description of clinical and organizational approaches to preventing cardiovascular diseases (CVD) in the primary health care system (PHCS) under the present conditions of health care modernization in Russia. It formulates the basic directions of systematic measures in integration strategies for the prevention of noncommunicable diseases (mainly CVD) at a federal level, in which practical measures are presented to improve a system for the early detection of high-risk individuals and to carry out measures for risk factor correction in PHCS, i.e. to implement high-risk strategies, including clinical and organizational approaches to reconstituting the medical prevention infrastructure in PHCS. This is favored by the new normative documents adopted by the Ministry of Health of Russia on the follow-up and prophylactic medical examinations of the adult population. The paper substantiates the objective need for such examinations and characterizes the main clinical and organizational approaches promoted in medical examinations, which is aimed at introducing the current science-based and economically expedient methods in the real practice of PHCS for the early identifications of atherosclerosis-induced major CVDs and, what is particularly important, a risk for their development. Prophylactic counseling as a compulsory component is first being introduced in medical examination procedures. The key clinical and organizational principle of effective CVD prevention in public health is the implementation of the relationship and continuity of preventive measures, which becomes realistic with the adoption of new regulations of clinical examinations, prophylactic medical examinations, and follow-ups. The improvement of CVD prevention is associated not only with the introduction of organizational innovation changes, but also with the need to create a prevention ideology in physicians at all levels. It is emphasized that a comprehensive
Botwicz, Jakub; Buciak, Piotr; Sapiecha, Piotr
Intrusion Prevention Systems (IPSs) have become widely recognized as a powerful tool and an important element of IT security safeguards. The essential feature of network IPSs is searching through network packets and matching multiple strings, that are fingerprints of known attacks. String matching is highly resource consuming and also the most significant bottleneck of IPSs. In this article an extension of the classical Karp-Rabin algorithm and its implementation architectures were examined. The result is a software, which generates a source code of a string matching module in hardware description language, that could be easily used to create an Intrusion Prevention System implemented in reconfigurable hardware. The prepared module matches the complete set of Snort IPS signatures achieving throughput of over 2 Gbps on an Altera Stratix I1 evaluation board. The most significant advantage of the proposed architecture is that the update of the patterns database does not require reconfiguration of the circuitry.
Hoppe, George; Yoon, Suzy; Gopalan, Banu; Savage, Alexandria R.; Brown, Rebecca; Case, Kelsey; Vasanji, Amit; Chan, E. Ricky; Silver, Randi B.; Sears, Jonathan E.
Retinopathy of prematurity (ROP) causes 100,000 new cases of childhood blindness each year. ROP is initiated by oxygen supplementation necessary to prevent neonatal death. We used organ systems pharmacology to define the transcriptomes of mice that were cured of oxygen-induced retinopathy (OIR, ROP model) by hypoxia-inducible factor (HIF) stabilization via HIF prolyl hydroxylase inhibition using the isoquinolone Roxadustat or the 2-oxoglutarate analog dimethyloxalylglycine (DMOG). Although both molecules conferred a protective phenotype, gene expression analysis by RNA sequencing found that Roxadustat can prevent OIR by two pathways: direct retinal HIF stabilization and induction of aerobic glycolysis or indirect hepatic HIF-1 stabilization and increased serum angiokines. As predicted by pathway analysis, Roxadustat rescued the hepatic HIF-1 knockout mouse from retinal oxygen toxicity, whereas DMOG could not. The simplicity of systemic treatment that targets both the liver and the eye provides a rationale for protecting the severely premature infant from oxygen toxicity. PMID:27091985
Abidin, Norhaslinda Zainal; Zulkepli, Jafri Hj; Zaibidi, Nerda Zura
The rise in income and population growth have increased the demand for food and induced changes in food habits, food purchasing and consumption patterns in Malaysia. With this transition, one of the plausible causes of weight gain and obesity is the frequent consumption of outside food which is synonymous with bigger portion size. Therefore, the aim of this paper is to develop a system dynamics model to analyse the effect of reducing food portion size on weight and obesity prevention. This study combines the different strands of knowledge comprise of nutrition, physical activity and body metabolism. These elements are synthesized into a system dynamics model called SIMULObese. Findings from this study suggested that changes in eating behavior should not emphasize only on limiting the food portion size consumption. The efforts should also consider other eating events such as controlling the meal frequency and limiting intake of high-calorie food in developing guidelines to prevent obesity.
Ferrari, Marisa; Harrison, Barbara; Rawashdeh, Osamah; Hammond, Robert; Avery, Yvonne; Rawashdeh, Muawea; Sa'deh, Waseem; Maddens, Michael
The purpose of this pilot study was to test the feasibility of a wireless 5-sensor, motion detection system (5S-MDS) with hospitalized older adults. Interventions to prevent hospital-based falls in older adults are important to reduce morbidity, mortality, and health care costs. Wearable motion sensors, which track and wirelessly transmit body movements, may identify human movement patterns that immediately precede falls, thus allowing early prevention. Descriptive feasibility study in which 5 hospitalized older adults were recruited to wear the 5S-MDS for 4 hours. Measurement included assessment of participant acceptance, skin integrity, and sensor accuracy. All 5 participants (mean age, 90.2 years) agreed that sensors were acceptable and skin integrity was maintained. The sensor data accurately reflected the patient movements. The 5S-MDS was feasible for 4 hours' use with hospitalized older adults. It has potential as an early warning system for falls. Copyright © 2012 Mosby, Inc. All rights reserved.
The primary goals of this report are to discuss measures to prevent suicides on commuter and metro rail systems, and to outline : an approach for suicide prevention on rail systems. Based on existing literature and analysis of data obtained from the ...
Honma, Satoru; Wakamatsu, Hidetoshi; Ueda, Reiko
Some assessments have been applied to find possible factors that might lead to child abuse. PACAP is a new method proposed by Ueda and others as a pre-assessment of the concerning child abuse, which reduces its false-positive misclassification. The Internet PACAP is developed to reduce the laborious work of nurses and health care workers for the necessary processing and classifying the scores of the pre-assessment. The present system is expected to prevent the child abuse more effectively.
SAMMOURI, Wissam; COME, Etienne; OUKHELLOU, Latifa; AKNIN, Patrice; FONLLADOSA, Charles Eric
The increasing demand on railway transportation due to social, economic and demographic factors has triggered an evolution in preventive maintenance strategies towards more optimized and cost-effective processes. Within this context related to the increasing interest in predictive maintenance strategies, commercial trains are being equipped with both positioning and communication systems as well as onboard intelligent sensors monitoring various subsystems all over the train, thus providing...
Sacrificial coatings (e.g., galvanizing) Surface modification (e.g., weld overlays , electro-plating) Sealants (e.g., wet installed fasteners...operational environment should be avoided. Consider compatibility when using multiple materials. If dissimilar materials cannot be avoided, isolate those... Dissimilar Metals. MIL-HDBK-1568, Military Handbook: Materials and Processes for Corrosion Prevention and Control in Aerospace Weapons Systems (18 July
Van den Branden, G.; Koonen, E.
In 1961, the BR2 reactor became critical for the first time. Yet the multi-functional research reactor at SCK-CEN is not out of date, quite the contrary. Regular upgrades and innovations keep the reactor in step with the latest advancements in technology. In 2010, the control system of BR2, a vital part of the reactor, was replaced as a preventive measure.
ChePa, Noraziah; Jasin, Noorhayati Md; Bakar, Nur Azzah Abu
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.
Lu, Guanzhen; Yan, Qiang; Huang, Yutao; Zhong, Yan; Shi, Ping
Blood potassium levels were very important during perioperative management of patients undergoing abdominal surgery. According to various worldwide studies on the causes of hypokalemia and fast-track surgeries, prehospital hypokalemia was ignored. The aim of this study to construct a prevention and control system of hypokalemia through proper clinical pathways and investigate the effects in terms of fast postoperative recovery of patients undergoing open abdominal surgery. A total of 104 patients were randomized to an observation group or a control group. The prevention and control system of hypokalemia was constructed; it was composed of 3 major modules: blood potassium monitoring, etiologic intervention, and treatment of hypokalemia. In the observation group, blood was sampled at scheduled time points (the blood potassium monitoring module) and interventions involved the preadmission and pre- and postoperative periods (etiologic intervention module). In the control group, blood sampling was delayed until after admission (blood potassium monitoring module) and interventions were only performed during the pre- and postoperative periods (etiologic intervention module). In terms of blood potassium, indices regarding gastrointestinal motility and postoperative complications were compared. The severity of hypokalemia, postoperative defecation time, arrhythmia, fatigue syndrome, and urine retention differed statistically between the 2 groups (P control system of hypokalemia with the starting point being before admission was more effective and allows early prevention, detection, correction, surgery, and recovery of patients undergoing open abdominal surgeries and also could be used in other specialized nursing fields.
Daniel H. De La Iglesia
Full Text Available Context-aware monitoring systems designed for e-Health solutions and ambient assisted living (AAL play an important role in today’s personalized health-care services. The majority of these systems are intended for the monitoring of patients’ vital signs by means of bio-sensors. At present, there are very few systems that monitor environmental conditions and air quality in the homes of users. A home’s environmental conditions can have a significant influence on the state of the health of its residents. Monitoring the environment is the key to preventing possible diseases caused by conditions that do not favor health. This paper presents a context-aware system that monitors air quality to prevent a specific health problem at home. The aim of this system is to reduce the incidence of the Sudden Infant Death Syndrome, which is triggered mainly by environmental factors. In the conducted case study, the system monitored the state of the neonate and the quality of air while it was asleep. The designed proposal is characterized by its low cost and non-intrusive nature. The results are promising.
De La Iglesia, Daniel H; De Paz, Juan F; Villarrubia González, Gabriel; Barriuso, Alberto L; Bajo, Javier
Context-aware monitoring systems designed for e-Health solutions and ambient assisted living (AAL) play an important role in today's personalized health-care services. The majority of these systems are intended for the monitoring of patients' vital signs by means of bio-sensors. At present, there are very few systems that monitor environmental conditions and air quality in the homes of users. A home's environmental conditions can have a significant influence on the state of the health of its residents. Monitoring the environment is the key to preventing possible diseases caused by conditions that do not favor health. This paper presents a context-aware system that monitors air quality to prevent a specific health problem at home. The aim of this system is to reduce the incidence of the Sudden Infant Death Syndrome, which is triggered mainly by environmental factors. In the conducted case study, the system monitored the state of the neonate and the quality of air while it was asleep. The designed proposal is characterized by its low cost and non-intrusive nature. The results are promising.
Kwak, Sung Woo; Chang, Sung Soon; Yoo, Ho Sik
Fixed radiation portal monitors (RPMs) deployed at border, seaport, airport and key traffic checkpoints have played an important role in preventing the illicit trafficking and transport of nuclear and radioactive materials. However, the RPM is usually large and heavy and can't easily be moved to different locations. These reasons motivate us to develop a mobile radiation detection system. The objective of this paper is to report our experience on developing the mobile radiation detection system for search and detection of nuclear and radioactive materials during road transport. Field tests to characterize the developed detection system were performed at various speeds and distances between the radioactive isotope (RI) transporting car and the measurement car. Results of measurements and detection limits of our system are described in this paper. The mobile radiation detection system developed should contribute to defending public's health and safety and the environment against nuclear and radiological terrorism by detecting nuclear or radioactive material hidden illegally in a vehicle
Post, E J
This essay presents conclusive evidence of the impermissibility of Copenhagen's single system interpretation of the Schroedinger process. The latter needs to be viewed as a tool exclusively describing phase and orientation randomized ensembles and is not be used for isolated single systems. Asymptotic closeness of single system and ensemble behavior and the rare nature of true single system manifestations have prevented a definitive identification of this Copenhagen deficiency over the past three quarter century. Quantum uncertainty so becomes a basic trade mark of phase and orientation disordered ensembles. The ensuing void of usable single system tools opens a new inquiry for tools without statistical connotations. Three, in part already known, period integrals here identified as flux, charge and action counters emerge as diffeo-4 invariant tools fully compatible with the demands of the general theory of relativity. The discovery of the quantum Hall effect has been instrumental in forcing a distinction betw...
Full Text Available Abstract Many modalities of tobacco use prevention programming have been implemented including various policy regulations (tax increases, warning labels, limits on access, smoke-free policies, and restrictions on marketing, mass media programming, school-based classroom education, family involvement, and involvement of community agents (i.e., medical, social, political. The present manuscript provides a glance at these modalities to compare relative and combined impact of them on youth tobacco use. In a majority of trials, community-wide programming, which includes multiple modalities, has not been found to achieve impacts greater than single modality programming. Possibly, the most effective means of prevention involves a careful selection of program type combinations. Also, it is likely that a mechanism for coordinating maximally across program types (e.g., staging of programming is needed to encourage a synergistic impact. Studying tobacco use prevention as a complex system is considered as a means to maximize effects from combinations of prevention types. Future studies will need to more systematically consider the role of combined programming.
G. I. Nazarenko
Full Text Available Deep vein thrombosis and pulmonary embolism are an important medical and social problem, contributing to the structure of morbidity and mortality in the developed countries. Despite the availability of clinical guidelines for the prevention of venous thromboembolic complications there is a gap between scientific knowledge and clinical practice. Clinical decision support systems (CDSS are confirmed to be effective tool for the implementation of clinical guidelines in daily practice. CDSS should be based on national and international clinical guidelines; their effectiveness depends upon successful integration with other health information systems and care flow processes.
Schomburg, C.; Dotts, R. L.; Tillian, D. J.
The Space Shuttle Orbiter's silica tile Thermal Protection System (TPS) is beset by the moisture absorption problems inherently associated with low density, highly porous insulation systems. Attention is presently given to the comparative success of methods for the minimization and/or prevention of water ingestion by the TPS tiles, covering the development of water-repellent agents and their tile application techniques, flight test program results, and materials improvements. The use of external films for rewaterproofing of the TPS tiles after each mission have demonstrated marginal to unacceptable performance. By contrast, a tile interior waterproofing agent has shown promise.
Sacks, Gary; Swinburn, Boyd A; Lawrence, Mark A
As obesity prevention becomes an increasing health priority in many countries, including Australia and New Zealand, the challenge that governments are now facing is how to adopt a systematic policy approach to increase healthy eating and regular physical activity. This article sets out a structure for systematically identifying areas for obesity prevention policy action across the food system and full range of physical activity environments. Areas amenable to policy intervention can be systematically identified by considering policy opportunities for each level of governance (local, state, national, international and organisational) in each sector of the food system (primary production, food processing, distribution, marketing, retail, catering and food service) and each sector that influences physical activity environments (infrastructure and planning, education, employment, transport, sport and recreation). Analysis grids are used to illustrate, in a structured fashion, the broad array of areas amenable to legal and regulatory intervention across all levels of governance and all relevant sectors. In the Australian context, potential regulatory policy intervention areas are widespread throughout the food system, e.g., land-use zoning (primary production within local government), food safety (food processing within state government), food labelling (retail within national government). Policy areas for influencing physical activity are predominantly local and state government responsibilities including, for example, walking and cycling environments (infrastructure and planning sector) and physical activity education in schools (education sector). The analysis structure presented in this article provides a tool to systematically identify policy gaps, barriers and opportunities for obesity prevention, as part of the process of developing and implementing a comprehensive obesity prevention strategy. It also serves to highlight the need for a coordinated approach to
Sherzad K Rashid
Full Text Available AIMS: Portal hypertension characterized by generalized vasodilatation with endothelial dysfunction affecting nitric oxide (NO and endothelium-dependent hyperpolarization (EDH has been suggested to involve bacterial translocation and/or the angiotensin system. The possibility that ingestion of probiotics prevents endothelial dysfunction in rats following common bile duct ligation (CBDL was evaluated. METHODS: Rats received either control drinking water or the probiotic VSL#3 solution (50 billion bacteria.kg body wt⁻¹.day⁻¹ for 7 weeks. After 3 weeks, rats underwent surgery with either resection of the common bile duct or sham surgery. The reactivity of mesenteric artery rings was assessed in organ chambers, expression of proteins by immunofluorescence and Western blot analysis, oxidative stress using dihydroethidium, and plasma pro-inflammatory cytokine levels by flow cytometry. RESULTS: Both NO- and EDH-mediated relaxations to acetylcholine were reduced in the CBDL group compared to the sham group, and associated with a reduced expression of Cx37, Cx40, Cx43, IKCa and SKCa and an increased expression of endothelial NO synthase (eNOS. In aortic sections, increased expression of NADPH oxidase subunits, angiotensin converting enzyme, AT1 receptors and angiotensin II, and formation of ROS and peroxynitrite were observed. VSL#3 prevented the deleterious effect of CBDL on EDH-mediated relaxations, vascular expression of connexins, IKCa, SKCa and eNOS, oxidative stress, and the angiotensin system. VSL#3 prevented the CBDL-induced increased plasma TNF-α, IL-1α and MCP-1 levels. CONCLUSIONS: These findings indicate that VSL#3 ingestion prevents endothelial dysfunction in the mesenteric artery of CBDL rats, and this effect is associated with an improved vascular oxidative stress most likely by reducing bacterial translocation and the local angiotensin system.
Renata Giovinazzo Spers
Full Text Available Este trabalho apresenta as dimensões estratégicas c ríticas para atuar em mercados internacionais de Base-da-Pirâmide (BOP. As variáv eis estudadas são motivos para a internacionalização: preços, promoção, distribuição , produtos, inovação, ingresso em mercados e processos. Uma pesquisa descritiva, inve stigativa de vários casos foi desenvolvida com as empresas brasileiras Natura , O Boticário, AmBev, Embraco, Perdigão e Havaianas . Análises longitudinais e comparativas levaram à con clusão que o principal motivo para o ingresso nos mercados BOP internacionais são as mai ores vendas e receitas de longo prazo. Dimensões estratégicas críticas são gestão de marca s, mistura de produtos adequada, inovação do processo, relacionamentos com stakeholders e fortalecimento da cultura corporativa.
Nazir, Muhammad Ashraf
Periodontal diseases are prevalent both in developed and developing countries and affect about 20-50% of global population. High prevalence of periodontal disease in adolescents, adults, and older individuals makes it a public health concern. Several risk factors such as smoking, poor oral hygiene, diabetes, medication, age, hereditary, and stress are related to periodontal diseases. Robust evidence shows the association of periodontal diseases with systemic diseases such as cardiovascular disease, diabetes, and adverse pregnancy outcomes. Periodontal disease is likely to cause 19% increase in the risk of cardiovascular disease, and this increase in relative risk reaches to 44% among individuals aged 65 years and over. Type 2 diabetic individuals with severe form of periodontal disease have 3.2 times greater mortality risk compared with individuals with no or mild periodontitis. Periodontal therapy has been shown to improve glycemic control in type 2 diabetic subjects. Periodontitis is related to maternal infection, preterm birth, low birth weight, and preeclampsia. Oral disease prevention strategies should be incorporated in chronic systemic disease preventive initiatives to curtail the burden of disease in populations. The reduction in the incidence and prevalence of periodontal disease can reduce its associated systemic diseases and can also minimize their financial impact on the health-care systems. It is hoped that medical, dental practitioners, and other health-care professionals will get familiar with perio-systemic link and risk factors, and need to refer to the specialized dental or periodontal care. PMID:28539867
Nourelfath, Mustapha; Châtelet, Eric; Nahas, Nabil
This paper formulates a joint redundancy and imperfect preventive maintenance planning optimization model for series–parallel multi-state degraded systems. Non identical multi-state components can be used in parallel to improve the system availability by providing redundancy in subsystems. Multiple component choices are available in the market for each subsystem. The status of each component is considered to degrade with use. The objective is to determine jointly the maximal-availability series–parallel system structure and the appropriate preventive maintenance actions, subject to a budget constraint. System availability is defined as the ability to satisfy consumer demand that is represented as a piecewise cumulative load curve. A procedure is used, based on Markov processes and universal moment generating function, to evaluate the multi-state system availability and the cost function. A heuristic approach is also proposed to solve the formulated problem. This heuristic is based on a combination of space partitioning, genetic algorithms (GA) and tabu search (TS). After dividing the search space into a set of disjoint subsets, this approach uses GA to select the subspaces, and applies TS to each selected sub-space.
Nazir, Muhammad Ashraf
Periodontal diseases are prevalent both in developed and developing countries and affect about 20-50% of global population. High prevalence of periodontal disease in adolescents, adults, and older individuals makes it a public health concern. Several risk factors such as smoking, poor oral hygiene, diabetes, medication, age, hereditary, and stress are related to periodontal diseases. Robust evidence shows the association of periodontal diseases with systemic diseases such as cardiovascular disease, diabetes, and adverse pregnancy outcomes. Periodontal disease is likely to cause 19% increase in the risk of cardiovascular disease, and this increase in relative risk reaches to 44% among individuals aged 65 years and over. Type 2 diabetic individuals with severe form of periodontal disease have 3.2 times greater mortality risk compared with individuals with no or mild periodontitis. Periodontal therapy has been shown to improve glycemic control in type 2 diabetic subjects. Periodontitis is related to maternal infection, preterm birth, low birth weight, and preeclampsia. Oral disease prevention strategies should be incorporated in chronic systemic disease preventive initiatives to curtail the burden of disease in populations. The reduction in the incidence and prevalence of periodontal disease can reduce its associated systemic diseases and can also minimize their financial impact on the health-care systems. It is hoped that medical, dental practitioners, and other health-care professionals will get familiar with perio-systemic link and risk factors, and need to refer to the specialized dental or periodontal care.
Anund, Anna; Antonson, Hans; Ihlström, Jonas
There is a common understanding that driving under the influence of alcohol is associated with higher risk of being involved in crashes with injuries and possible fatalities as the outcome. Various countermeasures have therefore from time to time been taken by the authorities to prevent drunk driving. One of them has been the alcohol interlock. Up to now, interlocks have mainly been used by previously convicted drunk drivers and in the commercial road transport sector, but not in private cars. New technology has today reached a level where broader implementation might be possible. To our knowledge, however, little is known about different stakeholders' opinions of a broader implementation of such systems. In order to increase that knowledge, we conducted a focus group study to collect in-depth thoughts from different stakeholders on this topic. Eight focus groups representing a broad societal span were recruited and conducted for the purpose. The results show that most stakeholders thought that an integrated system for alcohol detection in vehicles might be beneficial in lowering the number of drunk driving crashes. They said that the system would probably mainly prevent driving by people who unintentionally and unknowingly drive under the influence of alcohol. The groups did, however, not regard the system as a final solution to the drunk driving problem, and believed that certain groups, such as criminals and alcoholics, would most likely find a way around the system. Concerns were raised about the risk of increased sleepy driving and driving just under the legal blood alcohol concentration (BAC) limit. The results also indicate that stakeholders preferred a system that provides information on the BAC up to the legal limit, but not for levels above the limit; for those, the system should simply prevent the car from starting. Acceptance of the system depended on the reliability of the system, on its ability to perform fast sampling, and on the analytical process
Full Text Available The paper presents a system for automatic prevention of raising of ashes from dedicated landfills based on a simple mathematical model which has modest entry requirements for meteorological data. Such an approach is efficient enough and enables fast information retrieval, i.e. zones with different concentrations of dust in the air, enabling quick start of counter measures to reduce emissions of ashes into the air. The system hardware consists of an automatic weather station, set of meters that determine moisture of ash, set of remotely managed sprinklers, computers, microprocessor and microcontroller based elements for the local acquisition and management of the executive elements and modules for wireless data transfer. An original software application for the system management has been developed. Within the application there is a module that allows entering of all data necessary to configure the system, as well as data about sensors and sprinklers. Based on the meteorological input data, measured moisture content of the ashes, and on the basis of determined functional dependencies, special software module operates sprinklers for soaking the surfaces from which the ashes is emitted into the air, in order to eliminate these emissions. The system, based on the developed mathematical model, predicts the propagation of ashes through the air, as well as dry and wet deposition, in real-time. The system automatically stores all the data relevant to the future analyses and reporting. The system is designed and implemented as modular and open. A custom developed graphical user interface serves as Man-Machine Interface (MMI. By using the TCP/IP connection it could be easily connected with the other information systems. [Projekat Ministarstva nauke Republike Srbije, br. TR-15005: Design and development of pilot system for preventing automatic raise of ashes from dedicated dumps
Mapp, Ila D; Davis, Leslie L; Krowchuk, Heidi
Researchers have found that patients exhibit physiological changes up to 8 hours prior to an arrest event. Deaths have been attributed to a lack of observation, lack of documentation of observations, inability of a caregiver to recognize early signs of deterioration, and lack of communication between healthcare providers. This integrative review examines early warning scoring systems and their effectiveness in predicting a patient's potential for deterioration and considers whether these scoring systems prevent unplanned intensive care unit admissions and/or death. Three databases (MEDLINE, CINAHL [Cumulative Index to Nursing and Allied Health Literature], and the Cochrane Collaboration) were searched to identify the instruments and clinical support systems available to assist healthcare personnel in recognizing early clinical deterioration. Key search words included modified early warning score, early warning score, early warning systems, deteriorating patient, patients at risk, shock index, track and trigger systems, and failure to rescue. Two prior literature reviews examined early warning scoring systems and their effects on patient outcomes; however, the most recent one reviewed only articles published before 2007. This review examined studies of early warning systems and the incorporation of clinical support published from 2007 to 2012. Nine studies fitting the search criteria were included in this review. Early warning scoring systems that interface with electronic medical records and are supplemented with decision aides (algorithms) and clinical support systems produce an effective screening system for early identification of deteriorating patients. This multifaceted approach decreases unplanned intensive care unit admissions and hospital mortality.
Full Text Available In order to determine the method of contact surface treatment and to define the rational surface roughness in the wheel/rail contact for the minimal growth rate of contact fatigue defects the program of experiments in operational conditions was developed. On the basis of the results and calculations the coefficients of regression equations, which describe dependencies of the wear rate on the parameters of the contact surface treatment in real operational conditions were obtained. Besides, the diagrams of dependencies of the friction coefficient on the roughness of railhead contact surface of the high rails with and without lubrication, when laid in curves of underground systems, were built. The experiments conducted in operational conditions of Kharkiv Metro revealed the influence of roughness of the railhead side surface of the high rails in curves on the contact fatigue defect development after preventive grinding and lubrication. According to the results of the experiments it was established that the rail preventive grinding with simultaneous lubrication led to slower contact fatigue defect development in rails of underground systems. The rational roughness of the railhead side surface of the high rails in curves after preventive grinding, which led to the minimal rate of defect development, was defined.
Otter, J A; Yezli, S; Perl, T M; Barbut, F; French, G L
Surface contamination in hospitals is involved in the transmission of pathogens in a proportion of healthcare-associated infections. Admission to a room previously occupied by a patient colonized or infected with certain nosocomial pathogens increases the risk of acquisition by subsequent occupants; thus, there is a need to improve terminal disinfection of these patient rooms. Conventional disinfection methods may be limited by reliance on the operator to ensure appropriate selection, formulation, distribution and contact time of the agent. These problems can be reduced by the use of 'no-touch' automated room disinfection (NTD) systems. To summarize published data related to NTD systems. Pubmed searches for relevant articles. A number of NTD systems have emerged, which remove or reduce reliance on the operator to ensure distribution, contact time and process repeatability, and aim to improve the level of disinfection and thus mitigate the increased risk from the prior room occupant. Available NTD systems include hydrogen peroxide (H(2)O(2)) vapour systems, aerosolized hydrogen peroxide (aHP) and ultraviolet radiation. These systems have important differences in their active agent, delivery mechanism, efficacy, process time and ease of use. Typically, there is a trade-off between time and effectiveness among NTD systems. The choice of NTD system should be influenced by the intended application, the evidence base for effectiveness, practicalities of implementation and cost constraints. NTD systems are gaining acceptance as a useful tool for infection prevention and control. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
Jain, Nitin; Stiller, Birgit; Khan, Imran; Elser, Dominique; Marquardt, Christoph; Leuchs, Gerd
With the emergence of an information society, the idea of protecting sensitive data is steadily gaining importance. Conventional encryption methods may not be sufficient to guarantee data protection in the future. Quantum key distribution (QKD) is an emerging technology that exploits fundamental physical properties to guarantee perfect security in theory. However, it is not easy to ensure in practice that the implementations of QKD systems are exactly in line with the theoretical specifications. Such theory-practice deviations can open loopholes and compromise security. Several such loopholes have been discovered and investigated in the last decade. These activities have motivated the proposal and implementation of appropriate countermeasures, thereby preventing future attacks and enhancing the practical security of QKD. This article introduces the so-called field of quantum hacking by summarising a variety of attacks and their prevention mechanisms.
Navarrete Campos, S.; Hernandez Vitoria, A.; Canellas Anoz, M.; Millan Cebrian, E.; Garcia Romero, A.
Computerized record-and-verify systems (RVS) are being used increasingly to improve the precision of radiotherapy treatments. With the introduction of new treatment devices, such as multileaf or asymmetric collimators and virtual wedges, the responsibility to ensure correct treatment has increased. The purpose of this paper is to present the method that we are following to prevent some potential radiotherapy errors and to point out some errors that can be easily detected using a RVS, through a check of the daily recorded treatment information. We conclude that a RVS prevents the occurrence of many errors, when the settings of the treatment machine do not match the intended parameters within some maximal authorized deviation, and allows to detect easily other potential errors related with a incorrect selection of the treatment patient data. A quality assurance program, including a check of all beam data and a weekly control of the manual and electronic chart, has helped reduce errors. (author)
Payne, Susan R T; Elliott, Delbert S
There is widespread agreement that many school shootings could be prevented if authorities were informed that a student was planning or preparing to carry out an attack. A universal problem is that young people are highly reluctant to report on their peers. This code of silence represents a major barrier to prevention efforts. In response to the Columbine shooting, the state of Colorado established the Safe2Tell® anonymous, 24/7 reporting system for receiving and forwarding threats of violence, bullying, and other concerns. This article describes how the program has grown to the point that it now receives more than 100 calls per month. A series of case examples illustrates its success in responding to threatening situations, including twenty-eight potential school attacks. Copyright © 2011 Wiley Periodicals, Inc., A Wiley Company.
Kocher, Walter M.
Pollution prevention (P2) opportunities and Greening the Government (GtG) activities, including the development of the Real-Time Environmental Monitoring System (RTEMS), are currently under development at the NASA Glenn Research Center. The RTEMS project entails the ongoing development of a monitoring system which includes sensors, instruments, computer hardware and software, plus a data telemetry system.Professor Kocher has been directing the RTEMS project for more than 3 years, and the implementation of the prototype system at GRC will be a major portion of his summer effort. This prototype will provide mulitmedia environmental monitoring and control capabilities, although water quality and air emissions will be the immediate issues addressed this summer. Applications beyond those currently identified for environmental purposes will also be explored.
Ford, Eric C.; Smith, Koren; Harris, Kendra; Terezakis, Stephanie [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland 21231 (United States)
Purpose: A series of examples are presented in which potential errors in the delivery of radiation therapy were prevented through use of incident learning. These examples underscore the value of reporting near miss incidents. Methods: Using a departmental incident learning system, eight incidents were noted over a two-year period in which fields were treated 'out-of-sequence,' that is, fields from a boost phase were treated, while the patient was still in the initial phase of treatment. As a result, an error-prevention policy was instituted in which radiation treatment fields are 'hidden' within the oncology information system (OIS) when they are not in current use. In this way, fields are only available to be treated in the intended sequence and, importantly, old fields cannot be activated at the linear accelerator control console. Results: No out-of-sequence treatments have been reported in more than two years since the policy change. Furthermore, at least three near-miss incidents were detected and corrected as a result of the policy change. In the first two, the policy operated as intended to directly prevent an error in field scheduling. In the third near-miss, the policy operated 'off target' to prevent a type of error scenario that it was not directly intended to prevent. In this incident, an incorrect digitally reconstructed radiograph (DRR) was scheduled in the OIS for a patient receiving lung cancer treatment. The incorrect DRR had an isocenter which was misplaced by approximately two centimeters. The error was a result of a field from an old plan being scheduled instead of the intended new plan. As a result of the policy described above, the DRR field could not be activated for treatment however and the error was discovered and corrected. Other quality control barriers in place would have been unlikely to have detected this error. Conclusions: In these examples, a policy was adopted based on incident learning, which
Ford, Eric C.; Smith, Koren; Harris, Kendra; Terezakis, Stephanie
Purpose: A series of examples are presented in which potential errors in the delivery of radiation therapy were prevented through use of incident learning. These examples underscore the value of reporting near miss incidents. Methods: Using a departmental incident learning system, eight incidents were noted over a two-year period in which fields were treated “out-of-sequence,” that is, fields from a boost phase were treated, while the patient was still in the initial phase of treatment. As a result, an error-prevention policy was instituted in which radiation treatment fields are “hidden” within the oncology information system (OIS) when they are not in current use. In this way, fields are only available to be treated in the intended sequence and, importantly, old fields cannot be activated at the linear accelerator control console. Results: No out-of-sequence treatments have been reported in more than two years since the policy change. Furthermore, at least three near-miss incidents were detected and corrected as a result of the policy change. In the first two, the policy operated as intended to directly prevent an error in field scheduling. In the third near-miss, the policy operated “off target” to prevent a type of error scenario that it was not directly intended to prevent. In this incident, an incorrect digitally reconstructed radiograph (DRR) was scheduled in the OIS for a patient receiving lung cancer treatment. The incorrect DRR had an isocenter which was misplaced by approximately two centimeters. The error was a result of a field from an old plan being scheduled instead of the intended new plan. As a result of the policy described above, the DRR field could not be activated for treatment however and the error was discovered and corrected. Other quality control barriers in place would have been unlikely to have detected this error. Conclusions: In these examples, a policy was adopted based on incident learning, which prevented several errors
Irma M. Puspitasari
Full Text Available The paper describes development activities of an e-health system for community health center (Puskesmas with integrated adverse drug events e-prescription module, consist of system design and development, human resource development, e-health system realization, laboratory and implementation test of e-health system. Some e-readiness evaluations were conducted, through a number of field visits and questionnaires. The results had been used in the e-health system design and development, installation of the internet access infrastructure, and implementation of the education and hands-on training for the medical and administrative staff of the healthcare units. After completing the e-health system design and development as well as system realization and laboratory tests stages, a series of field implementation and experiments have been successfully conducted at Puskesmas Babakansari in Bandung. A number of users feed back have been obtained and used for further improvements on both of the software and hardware modules. The e-health system with integrated e-prescription module has successfully developed and shown its expected functions in: patient registration, medical record, paperless prescription, producing the required reports and preventing possible adverse drug events.
Yaesoubi, Reza; Roberts, Stephen D
We consider a health care system consisting of two noncooperative parties: a health purchaser (payer) and a health provider, where the interaction between the two parties is governed by a payment contract. We determine the contracts that coordinate the health purchaser-health provider relationship; i.e. the contracts that maximize the population's welfare while allowing each entity to optimize its own objective function. We show that under certain conditions (1) when the number of customers for a preventive medical intervention is verifiable, there exists a gate-keeping contract and a set of concave piecewise linear contracts that coordinate the system, and (2) when the number of customers is not verifiable, there exists a contract of bounded linear form and a set of incentive-feasible concave piecewise linear contracts that coordinate the system. Copyright © 2011 Elsevier B.V. All rights reserved.
Full Text Available A properly configured firewall is a good starting point in securing a computer network. However, complex network environments that involve higher number of participants and endpoints require better security infrastructure. Intrusion Detection Systems (IDS, proposed as a solution to perimeter defense, have many open problems and it is clear that better solutions must be found. Due to many unsolved problems associated with IDS, Intrusion Prevention Systems (IPS are introduced. The main idea in IPS is to be proactive. This paper gives an insight of Cobrador Bouncer IPS implementation. System architecture is given and three different Bouncer IPS deployment modes are presented. The Bouncer IPS as a proactive honeypot is also discussed.
Swanepoel, Liam; van den Heever, Dawie; Dellimore, Kiran
Burn injury is a major public health issue in developing countries, with most injuries being largely associated with the use of kitchen stoves. This study details the development of a cost-effective gesture and voice recognition controlled (GVC) system to be used by individuals with disabilities to reduce the likelihood of burn injury and improve their quality of life. The device replaces conventional dial controls with voice and hand gesture recognition sensors and software which are designed to be easily implemented into a household kitchen. Preliminary evaluation of the GVC system's performance in gesture and voice recognition, gas leak detection and ignition control tests were conducted using a Bunsen burner as a stove top surrogate. The voice and gesture recognition tests yielded sensitivities of 88% and 100%, respectively. These results suggest that the GVC system may be a promising solution for burn injury prevention pending further work to improve its reliability and robustness.
Duffy, Jennifer L; Prince, Mary Severson; Johnson, Erin E; Alton, Forrest L; Flynn, Shannon; Faye, Amy Mattison; Padgett, Polly Edwards; Rollison, Chris; Becker, Dana; Hinzey, Angela L
Getting To Outcomes (GTO), an innovative framework for planning, implementing, evaluating, and sustaining interventions has been shown to be effective in helping community-based organizations (CBOs) introduce science-based approaches into their prevention work. However, the Interactive Systems Framework (ISF) suggests that adopting innovations like GTO requires a significant amount of capacity building through training and technical assistance (T/TA). In this study, 11 CBOs and three schools in South Carolina entered into a 3 year program of intense and proactive T/TA based on the ISF to learn how to apply an adaptation of GTO (Promoting Science-Based Approaches-Getting To Outcomes, PSBA-GTO) to their teen pregnancy prevention programs. Using semi-structured interviews, the partnering organizations were assessed at three points in time, pre-T/TA, 12 months, and post T/TA (30 months) for their performance of the steps of GTO in their work. The seven organizations which participated in T/TA until the end of the project received an average of 76 h of TA and 112 h of training per organization. Interview results showed increased performance of all 10 steps of PSBA-GTO by these organizations when conducting their teen pregnancy programs. These results suggest targeted and proactive T/TA can successfully bridge the gap between research and practice by using a three part delivery system, as prescribed in the ISF, which relies on an intermediary prevention support system to ensure accurate and effective translation of research to the everyday work of community-based practitioners.
Toscano, C M; Vijayaraghavan, M; Salazar-Bolaños, H M; Bolaños-Acuña, H M; Ruiz-González, A I; Barrantes-Solis, T; Fernández-Vargas, I; Panero, M S; de Oliveira, L H; Hyde, T B
Following World Health Organization recommendations set forth in the Global Framework for Immunization Monitoring and Surveillance, Costa Rica in 2009 became the first country to implement integrated vaccine-preventable disease (iVPD) surveillance, with support from the U.S. Centers for Disease Control and Prevention (CDC) and the Pan American Health Organization (PAHO). As surveillance for diseases prevented by new vaccines is integrated into existing surveillance systems, these systems could cost more than routine surveillance for VPDs targeted by the Expanded Program on Immunization. We estimate the costs associated with establishing and subsequently operating the iVPD surveillance system at a pilot site in Costa Rica. We retrospectively collected data on costs incurred by the institutions supporting iVPD surveillance during the preparatory (January 2007 through August 2009) and implementation (September 2009 through August 2010) phases of the iVPD surveillance project in Costa Rica. These data were used to estimate costs for personnel, meetings, infrastructure, office equipment and supplies, transportation, and laboratory facilities. Costs incurred by each of the collaborating institutions were also estimated. During the preparatory phase, the estimated total cost was 128,000 U.S. dollars (US$), including 64% for personnel costs. The preparatory phase was supported by CDC and PAHO. The estimated cost for 1 year of implementation was US$ 420,000, including 58% for personnel costs, 28% for laboratory costs, and 14% for meeting, infrastructure, office, and transportation costs combined. The national reference laboratory and the PAHO Costa Rica office incurred 64% of total costs, and other local institutions supporting iVPD surveillance incurred the remaining 36%. Countries planning to implement iVPD surveillance will require adequate investments in human resources, laboratories, data management, reporting, and investigation. Our findings will be valuable for
Full Text Available The emergence of internal control over specific segments of activities has been associated with management needs for evaluation of the consistency between the actual situation and development targets. Monitoring activities should enable detection and timely reaction to possible target-related deviations. While responding to complex market needs, companies are exposed to numerous internal and external influences, some of which may cause significant damage. Companies have realized that it is safer and cheaper to establish their own internal control systems in order to prevent such influences. The aim of this work is to show how the overall quality of control and The emergence of internal control over specific segments of activities has been associated with management needs for evaluation of the consistency between the actual situation and development targets. Monitoring activities should enable detection and timely reaction to possible target-related deviations. While responding to complex market needs, companies are exposed to numerous internal and external influences, some of which may cause significant damage. Companies have realized that it is safer and cheaper to establish their own internal control systems in order to prevent such influences. The aim of this work is to show how the overall quality of control and company performance is improved through implementation of preventive methods by internal controls, and to indicate that a developed system of internal control represents a protective barrier against various kinds of data manipulation and fraud inside the companies. Special attention was paid to fraud in financial statements since it can cause the most serious damage leading to instability of the economic-financial environment.
Watson, Tiffany L; Skinner, Christopher H; Skinner, Amy L; Cazzell, Samantha; Aspiranti, Kathleen B; Moore, Tara; Coleman, MariBeth
Evidence suggests that installing a classroom management system known as the Color Wheel reduced inappropriate behaviors and increased on-task behavior in second- and fourth-grade classrooms; however, no systematic studies of the Color Wheel had been disseminated targeting pre-school or kindergarten participants. To enhance our understanding of the Color Wheel System (CWS) as a prevention system, a multiple-baseline design was used to evaluate the effects of the Color Wheel on inappropriate vocalizations (IVs) in three general education kindergarten classrooms. Partial-interval time-sampling was used to record classwide IVs, which were operationally defined as any comment or vocal noise that was not solicited by the teacher. Time series graphs and effect size calculations suggest that the CWS caused immediate, large, and sustained decreases in IVs across the three classrooms. Teacher acceptability and interview data also supported the CWS. Implications related to prevention are discussed and directions for future research are provided. © The Author(s) 2016.
Martínez-Valderrama, Jaime; Ibáñez, Javier; Del Barrio, Gabriel; Sanjuán, Maria E; Alcalá, Francisco J; Martínez-Vicente, Silvio; Ruiz, Alberto; Puigdefábregas, Juan
Mitigation strategies are crucial for desertification given that once degradation starts, other solutions are extremely expensive or unworkable. Prevention is key to handle this problem and solutions should be based on spotting and deactivating the stressors of the system. Following this topic, the Spanish Plan of Action to Combat Desertification (SPACD) created the basis for implementing two innovative approaches to evaluate the threat of land degradation in the country. This paper presents tools for preventing desertification in the form of a geomatic approach to enable the periodic assessments of the status and trends of land condition. Also System Dynamics modelling has been used to integrate bio-physical and socio-economic aspects of desertification to explain and analyse degradation in the main hot spots detected in Spain. The 2dRUE procedure was implemented to map the land-condition status by comparing potential land productivity according to water availability, the limiting factor in arid lands, with plant-biomass data. This assessment showed that 20% of the territory is degraded and an additional 1% is actively degrading. System Dynamics modelling was applied to study the five desertification landscapes identified by the SPACD. The risk analysis, implemented on these models, concluded that 'Herbaceous crops affected by soil erosion' is the landscape most at risk, while the Plackett-Burman sensitivity analysis used to rank the factors highlighted the supremacy of climatic factors above socioeconomic drivers. Copyright © 2016 Elsevier B.V. All rights reserved.
This book focuses on the recent results of the research project funded by a Grant-in-Aid for Scientific Research (S) of the Japan Society for the Promotion of Science (No. 23226017) from FY 2011 to FY 2015 on an autonomous spilled oil and gas tracking buoy system and its applications to marine disaster prevention systems from a scientific point of view. This book spotlights research on marine disaster prevention systems related to incidents involving oil tankers and offshore platforms, approaching these problems from new scientific and technological perspectives. The most essential aspect of this book is the development of a deep-sea underwater robot for real-time monitoring of blowout behavior of oil and gas from the seabed and of a new type of autonomous surface vehicle for real-time tracking and monitoring of oil spill spread and drift on the sea surface using an oil sensor. The mission of these robots is to provide the simulation models for gas and oil blowouts or spilled oil drifting on the sea surface w...
Zhang, Xiao; Wang, Yadong; Yu, Miao; Huang, Jinzhao; Deng, Dongfeng; Xue, Huanzhou
Portal venous system thrombosis (PVST) is a common and potentially life-threatening complication of splenectomy for portal hypertension due to cirrhosis. A meta-analysis was conducted to study the necessity of pharmacologic prophylaxis of PVST after splenectomy and how to select the feasible treatment method. Articles were searched through the PubMed, EMBASE, Cochrane Library databases, and CNKI. Overall, 404 articles were initially identified, and 11 of them were eligible. Among these selected articles, 7 articles were associated with the necessity of anticoagulation for prevention of PVST, while 5 were about the drug selection. We first demonstrated that the incidence of PVST after splenectomy was significantly lower in patients who received the preventive measures than in those who did not (odds ratio [OR]: 0.22, 95% confidence interval [CI]: 0.13-0.39, P splenectomy and devascularization. Preventative use of anticoagulant drugs might decrease the incidence of PVST after splenectomy in patients with portal hypertension, new anticoagulant drugs such as low-molecular-weight heparin should be used, and early or combination use of anticoagulation drugs might lead to lower PVST incidence for patients.
McIntosh, Kent; Filter, Kevin J.; Bennett, Joanna L.; Ryan, Charlotte; Sugai, George
In this article, we provide an overview of School-wide Positive Behavior Support (SWPBS), an approach to building protective school cultures and preventing the development of problem behavior through instruction, environmental redesign, and attention to systems-level variables. We define the critical features of SWPBS within a prevention science…
Li Quan; Gao Tao; Wang Hongyan; Jiang Gang; Zhu Zhenghe
The calculated results of the temperature dependence of standard Gibbs free energy change ΔG 0 of the reactions of CO and H 2 with Pu, PuO, Pu 2 O 3 , PuO 2 , respectively, show that the CO-H 2 system enables a passive surface film to be formed on the compact and stable crystal surface of Pu 2 O 3 to prevent the metallic plutonium from further corrosion by the inward diffusive CO and H 2 gas. It is presumably like the protecting aluminum surface with its oxidized layer
Bennett, Brian J.; Hall, Kevin D.; Hu, Frank B.; McCartney, Anne L.; Roberto, Christina
Progress in nutritional science, genetics, computer science, and behavioral economics can be leveraged to address the challenge of noncommunicable disease. This report highlights the connection between nutrition and the complex science of preventing disease and discusses the promotion of optimal metabolic health, building on input from several complementary disciplines. The discussion focuses on (1) the basic science of optimal metabolic health, including data from gene–diet interactions, microbiome, and epidemiological research in nutrition, with the goal of defining better targets and interventions, and (2) how nutrition, from pharma to lifestyle, can build on systems science to address complex issues. PMID:26415028
Rahimi, Maral; Afshari, Alireza
In cold climates, the application of mechanical ventilation systems with heat recovery like are airto-air exchangers is used for reducing energy consumption for heating buildings by transferring heat exhausted air to supply air. However, increase efficiency of heat exchanger results in lower...... exhaust air temperatures and Ice formation on heat exchanger fins, which can cause problem and is not favourable. Therefore, prevention and control of ice formation on heat exchangers is necessary. The existing methods are divided into two different methods: active and passive ice control methods...
... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What are the choke manifold requirements? 250... Blowout Preventer (bop) System Requirements § 250.444 What are the choke manifold requirements? (a) Your BOP system must include a choke manifold that is suitable for the anticipated surface pressures...
Fasano, S; Margiotta, D P; Navarini, L; Pierro, L; Pantano, I; Riccardi, A; Afeltra, A; Valentini, G
Background Systemic lupus erythematosus is associated with an increased risk of cardiovascular disease. Low-dose aspirin, hydroxychloroquine and statins have been suggested to play a prophylactic role of cardiovascular events. This study is devoted to reviewing the literature on the topic and assessing the effects of these drugs in preventing a first cardiovascular event in a two-centre Italian series. Methods A PubMed search on cardiovascular prevention in systemic lupus erythematosus was performed. Moreover, systemic lupus erythematosus patients admitted to two centres from 2000-2015, who at admission had not experienced any cardiovascular event, were investigated. Aspirin, hydroxychloroquine and statin use, and the occurrence of any cardiovascular event, were recorded at each visit. Kaplan-Meier and Cox regression analyses were performed to evaluate the role of traditional, disease-related cardiovascular risk factors and of each of the three drugs in the occurrence of new cardiovascular events. Results The literature search produced conflicting results. Two hundred and ninety-one systemic lupus erythematosus patients were included in the study and followed for a median of eight years. During follow-up, 16 cardiovascular events occurred. At multivariate analysis, taking aspirin (hazard ratio: 0.24) and hydroxychloroquine for more than five years (hazard ratio: 0.27) reduced, while antiphospholipid antibody positivity (hazard ratio: 4.32) increased, the risk of a first cardiovascular event. No effect of statins emerged. Conclusion Our study confirms an additive role of aspirin and hydroxychloroquine in the primary prophylaxis of cardiovascular events in Italian patients with systemic lupus erythematosus. The lack of any detected effect in previous reports may depend on the design of studies and their short follow-up period.
Full Text Available Good quality water supplies and safe sanitation in urban areas are a big challenge for governments throughout the world. Providing adequate water quality is a basic requirement for our lives. The colony forming units of the bacterium Legionella pneumophila in potable water represent a big problem which cannot be overlooked for health protection reasons. We analysed several methods to program a virtual hot water tank with AI (artificial intelligence tools including neuro-fuzzy systems as a precaution against legionelosis. The main goal of this paper is to present research which simulates the temperature profile in the water tank. This research presents a tool for a water management system to simulate conditions which are able to prevent legionelosis outbreaks in a water system. The challenge is to create a virtual water tank simulator including the water environment which can simulate a situation which is common in building water distribution systems. The key feature of the presented system is its adaptation to any hot water tank. While respecting the basic parameters of hot water, a water supplier and building maintainer are required to ensure the predefined quality and water temperature at each sampling site and avoid the growth of Legionella. The presented system is one small contribution how to overcome a situation when legionelosis could find good conditions to spread and jeopardize human lives.
Sinčak, Peter; Ondo, Jaroslav; Kaposztasova, Daniela; Virčikova, Maria; Vranayova, Zuzana; Sabol, Jakub
Good quality water supplies and safe sanitation in urban areas are a big challenge for governments throughout the world. Providing adequate water quality is a basic requirement for our lives. The colony forming units of the bacterium Legionella pneumophila in potable water represent a big problem which cannot be overlooked for health protection reasons. We analysed several methods to program a virtual hot water tank with AI (artificial intelligence) tools including neuro-fuzzy systems as a precaution against legionelosis. The main goal of this paper is to present research which simulates the temperature profile in the water tank. This research presents a tool for a water management system to simulate conditions which are able to prevent legionelosis outbreaks in a water system. The challenge is to create a virtual water tank simulator including the water environment which can simulate a situation which is common in building water distribution systems. The key feature of the presented system is its adaptation to any hot water tank. While respecting the basic parameters of hot water, a water supplier and building maintainer are required to ensure the predefined quality and water temperature at each sampling site and avoid the growth of Legionella. The presented system is one small contribution how to overcome a situation when legionelosis could find good conditions to spread and jeopardize human lives.
Sinčak, Peter; Ondo, Jaroslav; Kaposztasova, Daniela; Virčikova, Maria; Vranayova, Zuzana; Sabol, Jakub
Good quality water supplies and safe sanitation in urban areas are a big challenge for governments throughout the world. Providing adequate water quality is a basic requirement for our lives. The colony forming units of the bacterium Legionella pneumophila in potable water represent a big problem which cannot be overlooked for health protection reasons. We analysed several methods to program a virtual hot water tank with AI (artificial intelligence) tools including neuro-fuzzy systems as a precaution against legionelosis. The main goal of this paper is to present research which simulates the temperature profile in the water tank. This research presents a tool for a water management system to simulate conditions which are able to prevent legionelosis outbreaks in a water system. The challenge is to create a virtual water tank simulator including the water environment which can simulate a situation which is common in building water distribution systems. The key feature of the presented system is its adaptation to any hot water tank. While respecting the basic parameters of hot water, a water supplier and building maintainer are required to ensure the predefined quality and water temperature at each sampling site and avoid the growth of Legionella. The presented system is one small contribution how to overcome a situation when legionelosis could find good conditions to spread and jeopardize human lives. PMID:25153475
Full Text Available The emergence and re-emergence of infectious diseases are now more than ever considered threats to public health systems. There have been over 20 outbreaks of Ebola in the past 40 years. Only recently, the World Health Organization has declared a public health emergency of international concern (PHEIC in West Africa, with a projected estimate of 1.2 million deaths expected in the next 6 months. Ebola virus is a highly virulent pathogen, often fatal in humans and non-human primates. Ebola is now a great priority for global health security and often becomes fatal if left untreated. This study employed a narrative review. Three major databases – MEDLINE, EMBASE, and Global Health – were searched using both ‘text-words’ and ‘thesaurus terms’. Evidence shows that low- and middle-income countries (LMICs are not coping well with the current challenges of Ebola, not only because they have poor and fragile systems but also because there are poor infectious disease surveillance and response systems in place. The identification of potential cases is problematic, particularly in the aspects of contact tracing, infection control, and prevention, prior to the diagnosis of the case. This review therefore aims to examine whether LMICs’ health systems would be able to control and manage Ebola in future and identifies two key elements of health systems strengthening that are needed to ensure the robustness of the health system to respond effectively.
Tabacchi, Garden; Bianco, Antonino; Alessi, Nicola; Filippi, Anna Rita; Napoli, Giuseppe; Jemni, Monèm; Censi, Laura; Breda, João; Schumann, Nathali Lehmann; Firenze, Alberto; Vitale, Francesco; Mammina, Caterina
Abstract The Adolescents Surveillance System for Obesity prevention (ASSO) Project aimed at developing standardized and web-based tools for collecting data on adolescents’ obesity and its potential determinants. This has been implemented and piloted in the local area of Palermo city, Italy. The aim of the present study is to provide an overview of the Project's design, implementation, and evaluation, highlighting all the aspects for a potential scale-up of the surveillance system on the whole national territory and abroad, as a sustainable and effective source of data. The overall structure and management, the ASSO-toolkit, the ASSO-NutFit software, and all developed and used procedures for recruiting, training, and data collecting/analyzing are addressed. An interim evaluation has been performed through a feasibility study; a final Project evaluation has been performed reporting the Strengths, Weaknesses, Opportunities, and Threats (SWOT) and the attributes that a surveillance system should have. This article provides a detailed overview of the Project and highlights that ASSO can be considered a valid, logical, coherent, efficient, and sustainable surveillance system that is consistent with countries’ needs and priorities. The system developed by the ASSO Project provides high-quality data and complies with several characteristics typical of a suitable surveillance system. It has a potential of being adopted within the National Health Service and other countries’ Health Services for monitoring adolescents’ obesity and its determinants, such as food intakes, behaviors, physical activity, and fitness profiles. PMID:27015195
Tabacchi, Garden; Bianco, Antonino; Alessi, Nicola; Filippi, Anna Rita; Napoli, Giuseppe; Jemni, Monèm; Censi, Laura; Breda, João; Schumann, Nathali Lehmann; Firenze, Alberto; Vitale, Francesco; Mammina, Caterina
The Adolescents Surveillance System for Obesity prevention (ASSO) Project aimed at developing standardized and web-based tools for collecting data on adolescents' obesity and its potential determinants. This has been implemented and piloted in the local area of Palermo city, Italy. The aim of the present study is to provide an overview of the Project's design, implementation, and evaluation, highlighting all the aspects for a potential scale-up of the surveillance system on the whole national territory and abroad, as a sustainable and effective source of data.The overall structure and management, the ASSO-toolkit, the ASSO-NutFit software, and all developed and used procedures for recruiting, training, and data collecting/analyzing are addressed. An interim evaluation has been performed through a feasibility study; a final Project evaluation has been performed reporting the Strengths, Weaknesses, Opportunities, and Threats (SWOT) and the attributes that a surveillance system should have.This article provides a detailed overview of the Project and highlights that ASSO can be considered a valid, logical, coherent, efficient, and sustainable surveillance system that is consistent with countries' needs and priorities.The system developed by the ASSO Project provides high-quality data and complies with several characteristics typical of a suitable surveillance system. It has a potential of being adopted within the National Health Service and other countries' Health Services for monitoring adolescents' obesity and its determinants, such as food intakes, behaviors, physical activity, and fitness profiles.
National Aeronautics and Space Administration — The main objective of the proposed work is to design and develop a multi-layer intelligent Loss-of-control Prevention System (LPS) for flight control applications....
Lien, Heng-Hui; Huang, Chi-Cheng; Liu, Jung-Sen; Shi, Min-Yean; Chen, Der-Fang; Wang, Nai-Yuan; Tai, Feng-Chuan; Huang, Ching-Shui
Experience collected from 5200 cases of laparoscopic cholecystectomy (LC) and 29 patients (6 ours, 23 referred) with major common bile duct (CBD) injury during LC in our institute between December 1990 and July 2004 was reported to demonstrate that the system approach we applied in performing LC prevents CBD injury and enhances surgical performance. Each case of CBD injury was meticulously analyzed to identify causative factors. We developed preventive strategies focusing on 4 dimensions: patient, environment, procedure, and operator. Surgical performance was then evaluated to demonstrate improvements. Incidence of CBD injury was calculated for early and latter halves of the series to compare 5 parameters of surgical performance: patient selection, operation time, indwelling drainage tube, surgeon, and conversion rate. Results of accident analysis demonstrated that CBD injury followed definite mechanisms; several warning signs appearing before and during injury were identified and classified. According to these results, we designed strategies to prevent injury, including: setting up patient-selection program, controlling surgical environment, developing error-proof procedures, and constructing training programs. Incidence of CBD injury in the whole series was 0.12% (6/5200), 0.27% in early half (6/2224), and zero (0/2967) in latter half. Attending doctors had significantly shorter operation times in latter period for both elective and emergent LC. Rate of using drainage tubes for elective surgery by attending doctors was significantly decreased in latter period. Operation time for elective surgery by residents was similar in both early and latter periods. However, residents in latter period had longer operation times (around 23 min long, Pperformance. Consistent use of systems approach promises continuing quality improvement. We believe our working model will help perform safer LC and also benefit other medical disciplines.
Miyano, Hiroshi; Sekimura, Naoto; Nakamura, Takao; Narumiya, Yoshiyuki
On March 11, 2011, severe accident occurred at multi units of nuclear power caused by natural disaster, which was the first of nuclear power in the world, and lead to nuclear disaster which contaminated a wide range of land and caused surrounding residents to evacuate for a long-term. Since Cyuetsu-oki earthquake and before this accident, Atomic Energy Society of Japan had activities to investigate 'safety of nuclear system' against earthquake beyond any expectation, identify research items and work out roadmap on future research activities. Correspondence against tsunami such as this accident was discussed but not included as proposal because of low tsunami hazards awareness. Based on this reflection and to prevent recurrence of nuclear disaster, reconsideration of nuclear safety from the standpoint of defense-in-depth against hazards beyond any expectation had been performed and proposed to establish roadmap for its realization. Basic principle of nuclear safety consisted of eleven principles so as to protect personnel and environment from harmful effects of radiation derived from nuclear facilities and their activities, which were categorized into three groups (responsibility and management system, personnel and environmental protection and prevention of accident initiation and effect mitigation). (T. Tanaka)
Huang, C.-C.; Yuan, John
This paper is to propose a two-stage preventive maintenance (PM) policy for the multi-state deterioration system under periodic inspection and with multiple candidate actions for PM. Such policy is mainly to schedule PM optimally and also on how to choose the action optimally for each PM. The scheduling includes two tasks: to determine after completing each PM when to make the decision and then at it to schedule the next PM optimally. We assume that: (1) such actions except replacement are imperfect, (2) the inspection and action times can be ignored, (3) the system can be modeled by a multi-state discrete time Markov chain whose transition probabilities will change and be updated only at the instant after completing each PM, and (4) the risks of such imperfect actions will be updated only at the instant after completing each PM. Finally, an example through simulation is presented to illustrate how such policy can be carried out.
Jaervinen, H.; Sipilae, P.; Parkkinen, R.; Kosunen, A.; Jokelainen, I.
High accuracy in radiotherapy is required for the good outcome of the treatments, which in turn implies the need to develop comprehensive Quality Systems for the operation of the clinic. The legal requirements as well as the recommendation by professional societies support this modern approach for improved accuracy, safety and accident prevention. The actions of a national radiation protection authority can play an important role in this development. In this paper, the actions of the authority in Finland (STUK) for the control of the implementation of the new requirements are reviewed. It is concluded that the role of the authorities should not be limited to simple control actions, but comprehensive practical support for the development of the Quality Systems should be provided. (author)
Osungbade, Kayode O.; Oladunjoye, Olubunmi O.
Objectives. Review of burden of congenital transmission of malaria, challenges of preventive measures, and implications for health system strengthening in sub-Saharan Africa. Methods. Literature from Pubmed (MEDLINE), Biomed central, Google Scholar, and Cochrane Database were reviewed. Results. The prevalence of congenital malaria in sub-Saharan Africa ranges from 0 to 23%. Diagnosis and existing preventive measures are constantly hindered by weak health systems and sociocultural issues. WHO ...
Full Text Available Background: Community-based initiatives show promise for preventing childhood obesity. They are characterized by community leaders and members working together to address complex local drivers of energy balance. Objectives: To present a protocol for a stepped wedge cluster randomized trial in ten communities in the Great South Coast Region of Victoria, Australia to test whether it is possible to: (1 strengthen community action for childhood obesity prevention, and (2 measure the impact of increased action on risk factors for childhood obesity. Methods: The WHO STOPS intervention involves a facilitated community engagement process that: creates an agreed systems map of childhood obesity causes for a community; identifies intervention opportunities through leveraging the dynamic aspects of the system; and, converts these understandings into community-built, systems-oriented action plans. Ten communities will be randomized (1:1 to intervention or control in year one and all communities will be included by year three. The primary outcome is childhood obesity prevalence among grade two (ages 7–8 y, grade four (9–10 y and grade six (11–12 y students measured using our established community-led monitoring system (69% school and 93% student participation rate in government and independent schools. An additional group of 13 external communities from other regions of Victoria with no specific interventions will provide an external comparison. These communities will also allow us to assess diffusion of the intervention to control communities during the first three years of the trial. Conclusion: This trial will test effectiveness, over a five-year period, of community-owned, -supported and -led strategies designed to address complex and dynamic causes of childhood obesity.
Allender, Steven; Millar, Lynne; Hovmand, Peter; Bell, Colin; Moodie, Marj; Carter, Rob; Swinburn, Boyd; Strugnell, Claudia; Lowe, Janette; de la Haye, Kayla; Orellana, Liliana; Morgan, Sue
Background : Community-based initiatives show promise for preventing childhood obesity. They are characterized by community leaders and members working together to address complex local drivers of energy balance. Objectives : To present a protocol for a stepped wedge cluster randomized trial in ten communities in the Great South Coast Region of Victoria, Australia to test whether it is possible to: (1) strengthen community action for childhood obesity prevention, and (2) measure the impact of increased action on risk factors for childhood obesity. Methods: The WHO STOPS intervention involves a facilitated community engagement process that: creates an agreed systems map of childhood obesity causes for a community; identifies intervention opportunities through leveraging the dynamic aspects of the system; and, converts these understandings into community-built, systems-oriented action plans. Ten communities will be randomized (1:1) to intervention or control in year one and all communities will be included by year three. The primary outcome is childhood obesity prevalence among grade two (ages 7-8 y), grade four (9-10 y) and grade six (11-12 y) students measured using our established community-led monitoring system (69% school and 93% student participation rate in government and independent schools). An additional group of 13 external communities from other regions of Victoria with no specific interventions will provide an external comparison. These communities will also allow us to assess diffusion of the intervention to control communities during the first three years of the trial. Conclusion : This trial will test effectiveness, over a five-year period, of community-owned, -supported and -led strategies designed to address complex and dynamic causes of childhood obesity.
Eisen, Lars; Eisen, Rebecca J
Emerging and resurging vector-borne diseases cause significant morbidity and mortality, especially in the developing world. We focus on how advances in mapping, Geographic Information System, and Decision Support System technologies, and progress in spatial and space-time modeling, can be harnessed to prevent and control these diseases. Major themes, which are addressed using examples from tick-borne Lyme borreliosis; flea-borne plague; and mosquito-borne dengue, malaria, and West Nile virus disease, include (a) selection of spatial and space-time modeling techniques, (b) importance of using high-quality and biologically or epidemiologically relevant data, (c) incorporation of new technologies into operational vector and disease control programs, (d) transfer of map-based information to stakeholders, and (e) adaptation of technology solutions for use in resource-poor environments. We see great potential for the use of new technologies and approaches to more effectively target limited surveillance, prevention, and control resources and to reduce vector-borne and other infectious diseases.
Mammas, Constantinos S; Geropoulos, Spyros; Markou, Georgia; Saatsakis, George; Lemonidou, Chryssa; Tentolouris, Nikolaos
Evaluation of feasibility and reliability of Mobile-Telemedicine Systems (M-TS) in the remote prevention of diabetes related complications. A feasibility-reliability evaluation based on a simulating experimentation by ten specialists (N=10) who examined a diabetic patient on the electronic space of a mobile experimental telemedicine system (MU-Exp.-TS). I. Remote prevention of diabetic foot and other diabetes related complications is feasible (acceptability: 89-100%). II. Remote ulcer classification and diabetic foot amputation risk estimation: Accuracy=89%. The proposed MU-TS based multidisciplinary approach and prevention of diabetes related complications is feasible while that of diabetic foot is both feasible and reliable.
Buden, D.; Angelo, J.A. Jr.; Lapin, S.
Nuclear systems are key to the success of many space missions as we have witness in the Apollo science packages, Viking Mars landers, and Pioneer and Voyager planetary exploration missions. There is always a concern that nuclear materials will re-enter the biosphere from a mission abort. In fact, this has happened for radioisotope and reactor power systems. Until now, the emphasize has been an incorporating on-board means to protect the biosphere. With possible increased use of nuclear power and propulsion systems in space, Project SIREN (Search, Intercept, Retrieve, Expulsion, Nuclear) has determined that external means can be used as a back up to current on-board systems to provide assured prevention of nuclear materials from re-entry once in space. The technology base to implement a SIREN vehicle has been assessed and a data base and mission analysis program prepared (called THOR) to evaluate various missions. The degree of hazard from existing nuclear power systems in space has been assessed and found to be significant
Conventional preventive maintenance (PM) policies generally hold same time interval for PM actions and are often applied with known failure modes. The same time interval will give unavoidably decreasing reliabilities at the PM actions for degradation system with imperfect PM effect and the known failure modes may be inaccurate in practice. Therefore, field managers would prefer policy with an acceptable reliability level to keep system often at a good state. A PM policy with the critical reliability level is presented to address the preference of field managers. Through assuming that system after a PM action starts a new failure process, a parameter so-called degradation ratio is introduced to represent the imperfect effect. The policy holds a law that there is same number of failures in the time intervals of various PM cycles, and same degradation ratio for the system reliability or benefit parameters such as the optimal time intervals and the hazard rates between the neighboring PM cycles. This law is valid to any of the failure modes that could be appropriately referred as a 'general isodegrading model', and the degradation ratio as a 'general isodegrading ratio'. In addition, life cycle availability and cost functions are derived for system with the policy. An analysis of the field data of a loading and unloading machine indicates that the reliability, availability and cost in life cycle might be well modeled by the present theory and approach
Shin, Hyun Kook; Nam, Sang Ku; Sohn, Se Do; Chang, Hoon Seon
The advanced digital reactor protection system (ADRPS) with diverse dual processors has been developed to prevent common-mode failure (CMF). The principle of diversity is applied to both hardware design and software design. For hardware diversity, two different types of CPUs are used for the bistable processor and local coincidence logic (LCL) processor. The Versa Module Eurocard-based single board computers are used for the CPU hardware platforms. The QNX operating system and the VxWorks operating system were selected for software diversity. Functional diversity is also applied to the input and output modules, and to the algorithm in the bistable processors and LCL processors. The characteristics of the newly developed digital protection system are described together with the preventive capability against CMF. Also, system reliability analysis is discussed. The evaluation results show that the ADRPS has a good preventive capability against the CMF and is a highly reliable reactor protection system
The aim of this paper is to review and discuss current methods of risk stratification for cardiovascular disease (CVD) prevention, emerging biomarkers, and imaging techniques, and their relative merits and limitations. This report is based on discussions that took place among experts in the area during a special CardioVascular Clinical Trialists workshop organized by the European Society of Cardiology Working Group on Cardiovascular Pharmacology and Drug Therapy in September 2009. Classical risk factors such as blood pressure and low-density lipoprotein cholesterol levels remain the cornerstone of risk estimation in primary prevention but their use as a guide to management is limited by several factors: (i) thresholds for drug treatment vary with the available evidence for cost-effectiveness and benefit-to-risk ratios; (ii) assessment may be imprecise; (iii) residual risk may remain, even with effective control of dyslipidemia and hypertension. Novel measures include C-reactive protein, lipoprotein-associated phospholipase A(2) , genetic markers, and markers of subclinical organ damage, for which there are varying levels of evidence. High-resolution ultrasound and magnetic resonance imaging to assess carotid atherosclerotic lesions have potential but require further validation, standardization, and proof of clinical usefulness in the general population. In conclusion, classical risk scoring systems are available and inexpensive but have a number of limitations. Novel risk markers and imaging techniques may have a place in drug development and clinical trial design. However, their additional value above and beyond classical risk factors has yet to be determined for risk-guided therapy in CVD prevention.
Full Text Available Modern port terminals are equipped with various localtransport systems, which have the main task to transport cargobetween local storehouses and transport resources (ships,trains, trucks in the fastest and most efficient way, and at thelowest possible cost. These local transport systems consist offully automated transport units (AGV- automatic guided vehiclewhich are controlled by the computer system. The portcomputer system controls the fully automated transport units inthe way to avoid possible deadlocks and collisions betweenthem. However, beside the fully automated local transportunits, there are human operated transport units (fork-lifttrucks, cranes etc. which cross the path oftheAGVfrom timeto time. The collision of human operated transp011 unit andA GV is possible due to human inattention. To solve this problem,it is necesswy to design a supe1vismy control system thatcoordinates and controls both human driven transport unit andA G V In other words, the human-machine interactions need tobe supen·ised. The supen•ising system can be realized in the waythat the port terminal is divided into zones. Vehicle movementsare supen•ised by a video system which detects the moving ofparticular l'ehicles as a discrete event. Based on detected events,dangerous moving of certain vehicles is blocked by the supe1visi11gsystem. The paper considers the design of collision preventionsupen•isor by using discrete event dynamic themy. The portterminal is modeled by using ordi1za1y Petri nets. The design ofcollision prevention supe1visor is cmTied out by using the P-inl'ariantmethod. The verification of the supervisor is done bycomputer simulation.
Lopez-Valdes, Francisco J; Forman, Jason L; Ash, Joseph H; Kent, Richard; Alba, Juan J; Segui-Gomez, Maria
Head injuries are the most common severe injuries sustained by pediatric occupants in road traffic crashes. Preventing children from adopting positions that can result in an increased injury risk due to unfavorable interactions with the restraints is fundamental. The objective of this paper was to assess the effect of a head support system (SS) on the lateral position of the head, the vertical position of the sternum and the shoulder belt fit. Thirty pediatric rear-seat passengers were exposed to two 75-minute trials. Volunteers were restrained by a three-point belt and, if needed, used the appropriate child restraint system for their anthropometry (high-back booster, low-back booster, no booster). A case crossover study was designed in which the volunteers used the head support system (SS) during one of the trials, acting as their own controls (No SS) in the other. Compared to the control group, the head support reduced significantly the 90(th) percentile value of the absolute value of the relative lateral motion of the head, regardless of the restraint used. The system also reduced the maximum downward position of the sternal notch within the low-back booster group. As for the belt fit, the use of the head support improved significantly the position of the shoulder belt on the occupant in the low-back booster and in the no booster groups.
Weerakkody, Sean [Carnegie Mellon Univ., Pittsburgh, PA (United States); Liu, Xiaofei [Carnegie Mellon Univ., Pittsburgh, PA (United States); Sinopoli, Bruno [Carnegie Mellon Univ., Pittsburgh, PA (United States)
We consider the design and analysis of robust distributed control systems (DCSs) to ensure the detection of integrity attacks. DCSs are often managed by independent agents and are implemented using a diverse set of sensors and controllers. However, the heterogeneous nature of DCSs along with their scale leave such systems vulnerable to adversarial behavior. To mitigate this reality, we provide tools that allow operators to prevent zero dynamics attacks when as many as p agents and sensors are corrupted. Such a design ensures attack detectability in deterministic systems while removing the threat of a class of stealthy attacks in stochastic systems. To achieve this goal, we use graph theory to obtain necessary and sufficient conditions for the presence of zero dynamics attacks in terms of the structural interactions between agents and sensors. We then formulate and solve optimization problems which minimize communication networks while also ensuring a resource limited adversary cannot perform a zero dynamics attacks. Polynomial time algorithms for design and analysis are provided.
Fedyai, S. G.; Prochonchukov, Alexander A.; Zhizhina, Nina A.; Metelnikov, Michael A.
We report results of clinical application of the new computer-laser system. The system includes hardware and software means, which are applied for new efficient methods of prevention and treatment of main dental diseases. The hardware includes a laser physiotherapeutic device (LPD) `Optodan' and a fiberoptic laser delivery system with special endodontic rigging. The semiconductor AG-AL-AG laser diode with wavelengths in the spectral range of 850 - 950 nm (produced by Scientific-Industrial Concern `Reflector') is used as a basic unit. The LPD `Optodan' and methods of treatment are covered by Russian patent No 2014107 and certified by the Russian Ministry of Health. The automated computer system allows us to examine patients quickly and to input differential diagnosis, to determine indications (and contraindications), parameters and regimen of laser therapy, to control treatment efficacy (for carious -- through clinical indexes of enamel solubles, velocity of demineralization and other tests; for periodontal diseases trough complex of the periodontal indexes with automated registry and calculation). We present last results of application of the new technique and methods in treatment of dental diseases in Russian clinics.
Siva Sundhara Raja DHANUSHKODI
Full Text Available Aim: Diabetic retinopathy (DR and glaucoma are two most common retinal disorders that are major causes of blindness in diabetic patients. DR caused in retinal images due to the damage in retinal blood vessels, which leads to the formation of hemorrhages spread over the entire region of retina. Glaucoma is caused due to hypertension in diabetic patients. Both DR and glaucoma affects the vision loss in diabetic patients. Hence, a computer aided development of diagnosis system for Diabetic retinopathy and Glaucoma screening is proposed in this paper to prevent vision loss. Method: The diagnosis system of DR consists of two stages namely detection and segmentation of fovea and hemorrhages. The diagnosis system of glaucoma screening consists of three stages namely blood vessel segmentation, Extraction of optic disc (OD and optic cup (OC region and determination of rim area between OD and OC. Results: The specificity and accuracy for hemorrhages detection is found to be 98.47% and 98.09% respectively. The accuracy for OD detection is found to be 99.3%. This outperforms state-of-the-art methods. Conclusion: In this paper, the diagnosis system is developed to classify the DR and glaucoma screening in to mild, moderate and severe respectively.
Pal, Dilipkumar; Banerjee, Subham; Ghosh, Ashoke Kumar
Diet plays a vital role in the management of cancer because they are the source of important physiologically functional components. Scientific observations support the idea that dietary supplement can prevent breast cancer recurrences. Strong correlations are established between the high intake of saturated fat and the incidence of different types of cancer. It is found that chronic alcohol consumption is associated with increased risk of cancers of oral cavity, pharynx, esophagus, and larynx. Again, some evidences are also found regarding phosphorous, glutamate level in the body, and incidence of cancer. Different physiologically functional components are found in the dietary materials. Fibers, the major dietary components, have long been recognized for the unique properties in the treatment of cancer, which are related to its antineoplastic functions. Antioxidant rich diet has been added to the list of cancer-preventing dietary components. Also, recently published research has shown that natural carotenoids in the diet leads to a normalization of body epithelial cells and protects against the risk of stomach and esophagus cancer, and improves the immune system's response. Again, fruit juices, processed vegetable juices, orange peel, green tea, vitamins, flavonoids, and trace materials have cancer inhibitory properties. Clearly, there has been increasing recognition of chemoprotective functions. Now, it can be recognized for another kind of functionality for the improvement of the health of mankind.
Astner Sabrina T
Full Text Available Abstract Several experimental strategies of radiation-induced central nervous system toxicity prevention have recently resulted in encouraging data. The present review summarizes the background for this research and the treatment results. It extends to the perspectives of tissue regeneration strategies, based for example on stem and progenitor cells. Preliminary data suggest a scenario with individually tailored strategies where patients with certain types of comorbidity, resulting in impaired regeneration reserve capacity, might be considered for toxicity prevention, while others might be "salvaged" by delayed interventions that circumvent the problem of normal tissue specificity. Given the complexity of radiation-induced changes, single target interventions might not suffice. Future interventions might vary with patient age, elapsed time from radiotherapy and toxicity type. Potential components include several drugs that interact with neurodegeneration, cell transplantation (into the CNS itself, the blood stream, or both and creation of reparative signals and a permissive microenvironment, e.g., for cell homing. Without manipulation of the stem cell niche either by cell transfection or addition of appropriate chemokines and growth factors and by providing normal perfusion of the affected region, durable success of such cell-based approaches is hard to imagine.
Bodmann, Kerstin; Reinhard, Constanze; Mödler, Michael; Tinson, Kevin; Johnson, Mark
Errors are a part of life. With human errors accounting for approximately 50% of quality incidents and related problems within the pharmaceutical industry, the need to improve human performance in manufacturing operations is obvious. The purpose of this article is to describe error-proofing ways of structuring and writing knowledge documents, procedures, batch records, as well as practices for structuring, conducting, and documenting training to assure competence. These practices are recommended for adoption to shift the current 'training for compliance' paradigm to a 'training for competence' paradigm. It will also be demonstrated that a training for competence focus achieves GMP compliance. Results at Lonza have been encouraging, with human error-related quality deviations and non-conformities reduced by more than 40% across 13 sites globally within the first two years of the implementation of its Error Prevention System.
Petersen, Poul Erik; Bourgeois, Denis; Bratthall, Douglas
This article describes the essential components of oral health information systems for the analysis of trends in oral disease and the evaluation of oral health programmes at the country, regional and global levels. Standard methodology for the collection of epidemiological data on oral health has...... been designed by WHO and used by countries worldwide for the surveillance of oral disease and health. Global, regional and national oral health databanks have highlighted the changing patterns of oral disease which primarily reflect changing risk profiles and the implementation of oral health...... programmes oriented towards disease prevention and health promotion. The WHO Oral Health Country/Area Profile Programme (CAPP) provides data on oral health from countries, as well as programme experiences and ideas targeted to oral health professionals, policy-makers, health planners, researchers...
Hanna D. Zolotova
Full Text Available The subjects of the system of prevention of children’s addictive behavior include leading, accompanying, and mediated subjects. The macrolevel subjects are gromadas (units of local government and their leadership, institutions of higher learning that prepare social pedagogues, institutes of post-diploma education, the Center of Social Services for Families, Children, and Youth, and social service non-governmental organizations. The mesolevel subjects are institutions of learning and out-of-school and specialized institutions. The microlevel subjects are social pedagogues, form masters, curators, instructors, social workers, and children volunteers. The leading subject of social-pedagogical influence is the social pedagogue, who must act as a conscientious carrier of the idea of renouncing addictions.
Mendes, R W B; Pueyo, V; Béguin, P; Duarte, F J C M
This research was conducted in the Brazilian granite mining sector. After epidemiological studies, it was established that professional pneumoconiosis is related to the inhalation of dust. Therefore, the Brazilian mining health and safety regulatory standard made it compulsory to provide humidification throughout the extraction and mineral treatment processes. To develop the concept of systemic appropriation of the technological innovations that aim to protect the worker's health. Until now, appropriation has usually been presented in its individual dimensions. In this article, the focus is placed on the collective and organizational aspects of this appropriation. Two methodological approaches were used: interviews with the different individuals involved in order to report the history of the implementation of technical devices which meet the humidification norm; and ergonomic analysis of the work of the operators who used these devices. The appropriation of the technical devices occurred at two distinct levels: 1) Individual, related to the direct contact of the operator with the instrument; 2) Systemic, as the effects of the innovation propagated through the system affecting interdependent tasks, adaptation of the work organization and new production strategies. The implementation of prevention norms require innovations which are necessarily accompanied by transformations in the companies' techniques, work and management.
Wiltz, Jennifer L; Blanck, Heidi M; Lee, Brian; Kocot, S Lawrence; Seeff, Laura; McGuire, Lisa C; Collins, Janet
Electronic information technology standards facilitate high-quality, uniform collection of data for improved delivery and measurement of health care services. Electronic information standards also aid information exchange between secure systems that link health care and public health for better coordination of patient care and better-informed population health improvement activities. We developed international data standards for healthy weight that provide common definitions for electronic information technology. The standards capture healthy weight data on the "ABCDs" of a visit to a health care provider that addresses initial obesity prevention and care: assessment, behaviors, continuity, identify resources, and set goals. The process of creating healthy weight standards consisted of identifying needs and priorities, developing and harmonizing standards, testing the exchange of data messages, and demonstrating use-cases. Healthy weight products include 2 message standards, 5 use-cases, 31 LOINC (Logical Observation Identifiers Names and Codes) question codes, 7 healthy weight value sets, 15 public-private engagements with health information technology implementers, and 2 technical guides. A logic model and action steps outline activities toward better data capture, interoperable systems, and information use. Sharing experiences and leveraging this work in the context of broader priorities can inform the development of electronic information standards for similar core conditions and guide strategic activities in electronic systems.
This paper investigates and considers the actual state of hospital infection. The 80% or more of surgical wound infection is self-infection, for which the factor is the microorganisms that exist in a surgical wound at the completion of an operation. Airborne infection is generally due to staphylococcus aureus. There rarely is a bacteria carrier, and the germ is dispersed from him in some instances. Staphylococcus epidermis sticks to prosthesis, propagates and causes wound infection in rare occasions. Clostridium perfringens and escherichia coli also sometimes cause self-infection from wound. An ordinary plenum ventilation system is less effective for the prevention of wound infection. A remarkable example for reduction in infection is the employment of an ultra clean air system in joint replacement operations, showing reduction in joint septicemic infection from 1.5 to 0.3%. A vertical air flow system may be effectively employed in an operation room for the purpose of improving the air stream. No interrelation exists between the total number of indoor bacteria and infection without staphylococcus aureus. A person infected by methicillin-resistant staphylococcus has to be isolated into a unit. 13 refs., 1 fig., 1 tab.
Rogério Brandão Wichi
Full Text Available The aging process is associated with alterations in the cardiovascular and autonomic nervous systems. Autonomic changes related to aging involve parasympathetic and sympathetic alterations leading to a higher incidence of cardiovascular disease morbidity and mortality. Several studies have suggested that physical exercise is effective in preventing deleterious changes. Chronic exercise in geriatrics seems to be associated with improvement in the cardiovascular system and seems to promote a healthy lifestyle. In this review, we address the major effects of aging on the autonomic nervous system in the context of cardiovascular control. We examine the use of chronic exercise to prevent cardiovascular changes during the aging process.
Wichi, Rogério Brandão; De Angelis, Kátia; Jones, Lia; Irigoyen, Maria Claudia
The aging process is associated with alterations in the cardiovascular and autonomic nervous systems. Autonomic changes related to aging involve parasympathetic and sympathetic alterations leading to a higher incidence of cardiovascular disease morbidity and mortality. Several studies have suggested that physical exercise is effective in preventing deleterious changes. Chronic exercise in geriatrics seems to be associated with improvement in the cardiovascular system and seems to promote a healthy lifestyle. In this review, we address the major effects of aging on the autonomic nervous system in the context of cardiovascular control. We examine the use of chronic exercise to prevent cardiovascular changes during the aging process. PMID:19330253
This paper presents viewgraphs on the development of the Weather Accident Prevention (WxAP) System architecture and Concept of Operation (CONOPS) activities. The topics include: 1) Background Information on System Architecture/CONOPS Activity; 2) Activity Work in Progress; and 3) Anticipated By-Products.
Tara N. Furstenau
Full Text Available Inbreeding in hermaphroditic plants can occur through two different mechanisms: biparental inbreeding, when a plant mates with a related individual, or self-fertilization, when a plant mates with itself. To avoid inbreeding, many hermaphroditic plants have evolved self-incompatibility (SI systems which prevent or limit self-fertilization. One particular SI system—homomorphic SI—can also reduce biparental inbreeding. Homomorphic SI is found in many angiosperm species, and it is often assumed that the additional benefit of reduced biparental inbreeding may be a factor in the success of this SI system. To test this assumption, we developed a spatially-explicit, individual-based simulation of plant populations that displayed three different types of homomorphic SI. We measured the total level of inbreeding avoidance by comparing each population to a self-compatible population (NSI, and we measured biparental inbreeding avoidance by comparing to a population of self-incompatible plants that were free to mate with any other individual (PSI. Because biparental inbreeding is more common when offspring dispersal is limited, we examined the levels of biparental inbreeding over a range of dispersal distances. We also tested whether the introduction of inbreeding depression affected the level of biparental inbreeding avoidance. We found that there was a statistically significant decrease in autozygosity in each of the homomorphic SI populations compared to the PSI population and, as expected, this was more pronounced when seed and pollen dispersal was limited. However, levels of homozygosity and inbreeding depression were not reduced. At low dispersal, homomorphic SI populations also suffered reduced female fecundity and had smaller census population sizes. Overall, our simulations showed that the homomorphic SI systems had little impact on the amount of biparental inbreeding in the population especially when compared to the overall reduction in
Giesbrecht, Gordon G.
Objective: Every year about 400 people die in submersed vehicles in North America and this number increases to 2,000–5,000 in all industrialized nations. The best way to survive is to quickly exit through the windows. An Automatic Window Opening System (AWOS; patent protected) was designed to sense when a vehicle is in water and to open the electric windows, but only when the vehicle is upright. Methods: The AWOS consists of a Detection Module (DM), in the engine compartment, and a Power Window Control Module (PWCM) inside the driver’s door. The DM contains a Water Sensor, a Level Sensor and a Microcontroller Unit (MCU). The Level Sensor provides the angular orientation of the car using a 3-axis acceleration sensor and prevents automatic window opening if the car is outside the orientation range (±20° in the roll axis, ±30° in the pitch axis, with a 2 s delay). Systems were installed on two cars and one SUV. A crane lowered vehicles in water either straight down (static tests) or by swinging the vehicles to produce forward movement (dynamic tests). Results: In all tests, when the vehicles landed upright, windows opened immediately and effectively. When vehicles landed inverted, or at a very steep angle, the system did not engage until an upright and level position was attained. Conclusions: This system may help decrease drowning deaths in sinking vehicles. If occupants do not know, or forget, what to do, the open window could hopefully prompt them to exit safely through that window.
Full Text Available Andrea Ries Thurman, Meredith R Clark, Jennifer Hurlburt, Gustavo F Doncel CONRAD, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA, USA Abstract: There is a renewed interest in delivering pharmaceutical products via intravaginal rings (IVRs. IVRs are flexible torus-shaped drug delivery systems that can be easily inserted and removed by the woman and that provide both sustained and controlled drug release, lasting for several weeks to several months. In terms of women's health care products, it has been established that IVRs effectively deliver contraceptive steroids and steroids for the treatment of postmenopausal vaginal atrophy. A novel application for IVRs is the delivery of antiretroviral drugs for the prevention of human immunodeficiency virus (HIV genital infection. Microbicides are antiviral drugs delivered topically for HIV prevention. Recent reviews of microbicide IVRs have focused on technologies in development and optimizing ring design. IVRs have several advantages, including the ability to deliver sustained drug doses for long periods of time while bypassing first pass metabolism in the gut. IVRs are discreet, woman-controlled, and do not require a trained provider for placement or fitting. Previous data support that women and their male sexual partners find IVRs highly acceptable. Multipurpose prevention technology (MPT products provide protection against unintended/mistimed pregnancy and reproductive tract infections, including HIV. Several MPT IVRs are currently in development. Early clinical testing of new microbicide and MPT IVRs will require a focus on safety, pharmacokinetics and pharmacodynamics. Specifically, IVRs will have to deliver tissue concentrations of drugs that are pharmacodynamically active, do not cause mucosal alterations or inflammation, and do not change the resident microbiota. The emergence of resistance to antiretrovirals will need to be investigated. IVRs should not
Gamal Abdulrhman Hassan
Full Text Available An increased incidence of Type 1 diabetes mellitus (T1DM is expected worldwide. Eventually, T1DM is fatal unless treated with insulin. The expansion of interventions to prevent diabetes and the use of alternative treatments to insulin is a dream to be fulfilled. The pathophysiology in T1DM is basically a destruction of beta cells in the pancreas, regardless of which risk factors or causative entities have been present. Individual risk factors can have separate patho-physiological processes to, in turn, cause this beta cell destruction. Currently, autoimmunity is considered the major factor in the pathophysiology of T1DM. In a genetically susceptible individual, viral infection may stimulate the production of antibodies against a viral protein that trigger an autoimmune response against antigenically similar beta cell molecules. Many components of the immune system have been implicated in autoimmunity leading to β-cell destruction, including cytotoxic and helper T-cells, B-cells, macrophages, and dendritic cells. The inflammatory process in early diabetes is thought to be initiated and propagated by the effect of Th1-secreted cytokines (e.g. g interferon and suppressed by Th2-secreted antiinflammatory cytokines (interleukins. Structure and function of β-cell may be modulated by using Th1/Th2-secreted cytokines. Several experimental and clinical trials of applying GAD65, Hsp60, peptide-MHC, pepetide-277 immunization, anti-CD3 infusion, and interleukins to modulate immune response in T1DM were done. Applying such trials in patients with prediabetes, will most likely be the future key in preventing Type 1 autoimmune diabetes.
Chang, Shiao-Ying; Chen, Yun-Wen; Zhao, Xin-Ping; Chenier, Isabelle; Tran, Stella; Sauvé, Alexandre; Ingelfinger, Julie R; Zhang, Shao-Ling
We investigated whether overexpression of catalase (CAT) in renal proximal tubular cells (RPTCs) could prevent the programming of hypertension and kidney disease in the offspring of dams with maternal diabetes. Male offspring of nondiabetic and diabetic dams from two transgenic (Tg) lines (Hoxb7-green fluorescent protein [GFP]-Tg [controls] and Hoxb7/CAT-GFP-Tg, which overexpress CAT in RPTCs) were studied from the prenatal period into adulthood. Nephrogenesis, systolic blood pressure, renal hyperfiltration, kidney injury, and reactive oxygen species (ROS) generation were assessed. Gene expression of transforming growth factor-β1 (TGF-β1), nuclear factor erythroid 2p45-related factor-2 (Nrf2), and heme oxygenase-1 (HO-1) was tested in both in vitro and in vivo studies. Renal dysmorphogenesis was observed in offspring of Hoxb7-GFP-Tg dams with severe maternal diabetes; the affected male offspring displayed higher renal ROS generation and developed hypertension and renal hyperfiltration as well as renal injury with heightened TGF-β1 expression in adulthood. These changes were ameliorated in male offspring of diabetic Hoxb7/CAT-GFP-Tg dams via the Nrf2-HO-1 defense system. CAT promoted Nrf2 nuclear translocation and HO-1 gene expression, seen in both in vitro and in vivo studies. In conclusion, CAT overexpression in the RPTCs ameliorated maternal diabetes-induced perinatal programming, mediated, at least in part, by triggering the Nrf2-HO-1 defense system.
Shigehiro, Nukatsuka; Osami, Watanabe
At the time of nuclear emergency, it is important to identify the type and the cause of the accident. Besides with these, it is also important to provide adequate information for the emergency response organization to support decision making by predicting and evaluating the development of the event and the influence of the release of radioactivity for the environment. Recently, a new type of nuclear disaster prevention support system called MEASURES (Multiple Radiological Emergency Assistance System for Urgent Response) was developed which provides not only the current state of the nuclear power plant and the influence of the radioactivity for the environment, but also the future prediction of the accident development. In order to provide the accurate results of these analyses quickly, MEASURES utilizes various techniques, such as multiple nesting method which narrows down the calculation area gradually, and parallel processing computer for three dimensional analyses, such as air current distribution analysis. In this paper, the outline and the feature of MEASURES are presented, especially focused on the usage of parallel processing computer for the three dimensional air current distribution analysis. (authors)
Gunningberg, Lena; Bååth, Carina; Sving, Eva
To describe staff's perceptions of a continuous pressure mapping system to prevent pressure injury in a hospital ward. Pressure injury development is still a problem in hospitals. It is important to understand how new information and communication technologies can facilitate pressure injury prevention. A descriptive design with qualitative focus group interviews was used. Five categories were identified: "Need of information, training and coaching over a long period of time," "Pressure mapping - a useful tool in the prevention of pressure injury in high risk patients," "Easy to understand and use, but some practical issues were annoying," "New way of working and thinking," and "Future possibilities with the pressure mapping system." The pressure mapping system was an eye-opener for the importance of pressure injury prevention. Staff appreciated the real-time feedback on pressure points, which alerted them to the time for repositioning, facilitated repositioning and provided feedback on the repositioning performed. A continuous pressure mapping system can be used as a catalyst, increasing staff's competence, focus and awareness of prevention. For successful implementation, the nurse managers should have a shared agenda with the clinical nurse leaders, supporting the sustaining and spread of the innovation. © 2017 John Wiley & Sons Ltd.
Gray, Mikel; Omar, Amin; Buziak, Brenton
The purpose of this study was to compare contamination of the immediate environment with Clostridium difficile spores and vegetative cells from 2 stool management systems over a period of 30 days in a controlled laboratory setting. In vitro, comparison trial. Two stool management systems were compared over a 30-day period in a controlled laboratory setting. Sixteen systems were filled with sterile loose canine stool inoculated with 10 colony-forming units (CFUs) per milliliter of C difficile; specially prepared culture media were used to detect C difficile contamination on various surfaces of the device and in the immediate environment. Containment bags were changed daily and devices were refilled with inoculated stool to more closely imitate use in the clinical setting. A dichotomous outcome variable (growth vs no growth) was used to analyze contamination on a daily basis via the generalized estimating equation; devices were also compared on days 3, 10, 20, and 30 by measuring CFUs per device surface. Logistic regression analysis was used to analyze growth over time. When observations showed no growth, the Cochran-Mantel Haenszel test was used to compare study devices. Analysis revealed that 20.8% of anterior surfaces of the collection bags for device 1 were contaminated versus 83.9% of collection bags for device 2 (P < .001). Comparison of the tubing/hub interface resulted in similar findings; 20.8% of device 1 group were contaminated versus 86.3% of device 2 group (P < .001). Analysis of an absorbent pad placed under the device during daily changes found that 0.5% of device 1 were contaminated versus 38.1% of pads placed under device 2 (P < .001). Findings from this in vitro study show that stool management systems can limit or prevent environmental contamination of C difficile. Results also reveal significant differences in the 2 systems tested; we hypothesize that these differences are attributable to the interface between the tubing and collection bag, the
Garimella, Manasa G; Kour, Supinder; Piprode, Vikrant; Mittal, Monika; Kumar, Anil; Rani, Lekha; Pote, Satish T; Mishra, Gyan C; Chattopadhyay, Naibedya; Wani, Mohan R
Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammatory synovitis leading to joint destruction and systemic bone loss. The inflammation-induced bone loss is mediated by increased osteoclast formation and function. Current antirheumatic therapies primarily target suppression of inflammatory cascade with limited or no success in controlling progression of bone destruction. Mesenchymal stem cells (MSCs) by virtue of their tissue repair and immunomodulatory properties have shown promising results in various autoimmune and degenerative diseases. However, the role of MSCs in prevention of bone destruction in RA is not yet understood. In this study, we investigated the effect of adipose-derived MSCs (ASCs) on in vitro formation of bone-resorbing osteoclasts and pathological bone loss in the mouse collagen-induced arthritis (CIA) model of RA. We observed that ASCs significantly inhibited receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis in both a contact-dependent and -independent manner. Additionally, ASCs inhibited RANKL-induced osteoclastogenesis in the presence of proinflammatory cytokines such as TNF-α, IL-17, and IL-1β. Furthermore, treatment with ASCs at the onset of CIA significantly reduced clinical symptoms and joint pathology. Interestingly, ASCs protected periarticular and systemic bone loss in CIA mice by maintaining trabecular bone structure. We further observed that treatment with ASCs reduced osteoclast precursors in bone marrow, resulting in decreased osteoclastogenesis. Moreover, ASCs suppressed autoimmune T cell responses and increased the percentages of peripheral regulatory T and B cells. Thus, we provide strong evidence that ASCs ameliorate inflammation-induced systemic bone loss in CIA mice by reducing osteoclast precursors and promoting immune tolerance. Copyright © 2015 by The American Association of Immunologists, Inc.
Schwabe, Lars; Tegenthoff, Martin; Höffken, Oliver; Wolf, Oliver T
Accumulating evidence suggests that stress may orchestrate the engagement of multiple memory systems in the brain. In particular, stress is thought to favor dorsal striatum-dependent procedural over hippocampus-dependent declarative memory. However, the neuroendocrine mechanisms underlying these modulatory effects of stress remain elusive, especially in humans. Here, we targeted the role of the mineralocorticoid receptor (MR) in the stress-induced modulation of dorsal striatal and hippocampal memory systems in the human brain using a combination of event-related functional magnetic resonance imaging and pharmacologic blockade of the MR. Eighty healthy participants received the MR antagonist spironolactone (300 mg) or a placebo and underwent a stressor or control manipulation before they performed, in the scanner, a classification task that can be supported by the hippocampus and the dorsal striatum. Stress after placebo did not affect learning performance but reduced explicit task knowledge and led to a relative increase in the use of more procedural learning strategies. At the neural level, stress promoted striatum-based learning at the expense of hippocampus-based learning. Functional connectivity analyses showed that this shift was associated with altered coupling of the amygdala with the hippocampus and dorsal striatum. Mineralocorticoid receptor blockade before stress prevented the stress-induced shift toward dorsal striatal procedural learning, same as the stress-induced alterations of amygdala connectivity with hippocampus and dorsal striatum, but resulted in significantly impaired performance. Our findings indicate that the stress-induced shift from hippocampal to dorsal striatal memory systems is mediated by the amygdala, required to preserve performance after stress, and dependent on the MR. © 2013 Society of Biological Psychiatry.
Rizzi, Matteo; Kullgren, Anders; Tingvall, Claes
Several studies have reported the benefits of motorcycle antilock braking systems (ABS) in reducing injury crashes, due to improved stability and braking performance. Both aspects may prevent crashes but may also reduce the crash severity when a collision occurs. However, it is still unknown to what extent the reductions in injury crashes with ABS may be due to a combination of these mechanisms. Swedish hospital and police reports (2003-2012) were used. The risk for permanent medical impairment (RPMI) was calculated, showing the risk of at least 1 or 10% permanent medical impairment. In total, 165 crashes involving ABS-equipped motorcycles were compared with 500 crashes with similar motorcycles without ABS. The analysis was performed in 3 steps. First, the reduction in emergency care visits with ABS was calculated using an induced exposure approach. Secondly, the injury mitigating effects of ABS were investigated. The mean RPMI 1+ and RPMI 10+ were analyzed for different crash types. The distributions of impairing injuries (PMI 1+) and severely impairing injuries (PMI 10+) were also analyzed. In the third step, the total reduction of PMI 1+ and PMI 10+ injured motorcyclists was calculated by combining the reductions found in the previous steps. An additional analysis of combined braking systems (CBS) together with ABS was also performed. The results showed that emergency care visits were reduced by 47% with ABS. In the second step, it was found that the mean RPMI 1+ and RPMI 10+ with ABS were 15 and 37% lower, respectively. Finally, the third step showed that the total reductions in terms of crash avoidance and mitigation of PMI 1+ and PMI 10+ injured motorcyclists with ABS were 67 and 55%, respectively. However, PMI 1+ and PMI 10+ leg injuries were not reduced by ABS to the same extent. Indications were found suggesting that the benefits of ABS together with CBS may be greater than ABS alone. This article indicated that motorcycle ABS reduced impairing injuries
Van Minh, Hoang; Do, Young Kyung; Bautista, Mary Ann Cruz; Tuan Anh, Tran
The primary care system in Vietnam has been shown to play a crucial role in disease prevention and health promotion. This study described the primary care system in a selected rural area in Vietnam in terms of its capacity for prevention and control of non-communicable diseases (NCDs). The study was conducted in 2011 in Dong Hy district, Thai Nguyen province-a rural community located in northern Vietnam. Mixed methods were used, including quantitative and qualitative and literature review approaches, to collect data on the current status of the six building blocks of the primary care system in Dong Hy district. Selected health workers and stakeholders in the selected healthcare facilities were surveyed. A description of Dong Hy district's primary care capacity for NCD prevention and control is reported. (i) Service delivery: The current practice in NCD prevention and treatment is mainly based on a single risk factor rather than a combination of cardiovascular disease risks. (ii) Governance: At the primary care level, multi-sectoral collaborations are limited, and there is insufficient integration of NCD preventive activities. (iii) Financing: A national budget for NCD prevention and control is lacking. The cost of treatment and medicines is high, whereas the health insurance scheme limits the list of available medicines and the reimbursement ceiling level. Health workers have low remuneration despite their important roles in NCD prevention. (iv) Human resources: The quantity and quality of health staff working at the primary care level, especially those in preventive medicine, are insufficient. (v) Information and research: The health information system in the district is weak, and there is no specific information system for collecting population-based NCD data. (vi) Medical products and technology: Not all essential equipment and medicines recommended by the WHO are always available at the commune health centre. The capacity of the primary care system in Vietnam
Eglajs, A.; Salmins, A.
This report provides an overview of the practical and legal aspects of the use of radiation sources. The existing regulatory infrastructure is briefly analysed and proposed systems are described. The proposed interactions between the regulatory body and the advisory board are presented and some details about joint activities of different institutions concerning radiation safety are given. An implementation example of the supervisory system in combating illicit trafficking is analysed and the essential components in the prevention of illicit trafficking are assessed. Some findings of investigations are quoted regarding improvements in protection and prevention on the national and the international level. (author)
Womack, Sarah K; Armstrong, Thomas J
The present study evaluates the effectiveness of a decision support system used to evaluate and control physical job stresses and prevent re-injury of workers who have experienced or are concerned about work-related musculoskeletal disorders. The software program is a database that stores detailed job information such as standardized work data, videos, and upper-extremity physical stress ratings for over 400 jobs in the plant. Additionally, the database users were able to record comments about the jobs and related control issues. The researchers investigated the utility and effectiveness of the software by analyzing its use over a 20-month period. Of the 197 comments entered by the users, 25% pertained to primary prevention, 75% pertained to secondary prevention, and 94 comments (47.7%) described ergonomic interventions. Use of the software tool improved primary and secondary prevention by improving the quality and efficiency of the ergonomic job analysis process.
.... 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...
Bhutani, V K
Passage of fetal bowel movement (meconium) is common (in about one out of six births), and in some the staining of the amniotic fluid is a sign of fetal distress. Inhalation of meconium (aspiration syndrome, in upto one out of five to eight such births) just before or at birth may be preventable by a coordinated approach by well-trained and informed birth attendants. Respiratory failure secondary to meconium aspiration syndrome (MAS) remains a major cause of morbidity and mortality in the neonatal population. Infants with hypoxemic respiratory failure because of MAS, persistent pulmonary hypertension of the newborn and pneumonia/sepsis have an increased survival with extracorporeal membrane oxygenation (ECMO). Other treatment options earlier limited to inotropic support, continuous airway pressure (CPAP), conventional ventilatory management, respiratory alkalosis, paralysis and intravenous vasodilators have been replaced by synchronized intermittent mandatory ventilation (SIMV), high-frequency oscillatory ventilation (HFOV), surfactant and inhaled nitric oxide (iNO). HFOV has been advocated for use to improve lung inflation while potentially decreasing lung injury through volutrauma. Other reports describe the enhanced efficacy of HFOV when combined with iNO. Subsequent to studies reporting that surfactant deficiency or inactivation may contribute to neonatal respiratory failure, exogenous surfactant therapy has been implemented with apparent success. Recent studies have shown that iNO therapy in the neonate with hypoxemic respiratory failure can result in improved oxygenation and decreased need for ECMO. However, these innovative interventions are costly, require a sophisticated infrastructure and are not universally accessible. In this paper, a context of systems-approach for prenatal, natal and postnatal management of babies delivered through meconium stained amniotic fluid (MSAF) so that adverse outcomes are minimized and the least number of babies require
Suzich, Joann A.; Ghim, Shin-Je; Palmer-Hill, Frances J.; White, Wendy I.; Tamura, James K.; Bell, Judith A.; Newsome, Joseph A.; Bennett Jenson, A.; Schlegel, Richard
Infection of mucosal epithelium by papillomaviruses is responsible for the induction of genital and oral warts and plays a critical role in the development of human cervical and oropharyngeal cancer. We have employed a canine model to develop a systemic vaccine that completely protects against experimentally induced oral mucosal papillomas. The major capsid protein, L1, of canine oral papillomavirus (COPV) was expressed in Sf9 insect cells in native conformation. L1 protein, which self-assembled into virus-like particles, was purified on CsCl gradients and injected intradermally into the foot pad of beagles. Vaccinated animals developed circulating antibodies against COPV and became completely resistant to experimental challenge with COPV. Successful immunization was strictly dependent upon native L1 protein conformation and L1 type. Partial protection was achieved with as little as 0.125 ng of L1 protein, and adjuvants appeared useful for prolonging the host immune response. Serum immunoglobulins passively transferred from COPV L1-immunized beagles to naive beagles conferred protection from experimental infection with COPV. Our results indicate the feasibility of developing a human vaccine to prevent mucosal papillomas, which can progress to malignancy.
Joshipura, Ishan; Johnson, Alexander; Ayers, Hudson; Dickey, Michael
This work explores the wetting behavior of an oxide-coated liquid metal, eutectic alloy of gallium and indium (`EGaIn'), which remains a liquid at room temperature. Liquid metals uniquely combine fluidity with metallic properties. Combined, these properties enable soft, stretchable, and shape reconfigurable electronics with `softer than skin' interfaces. Ga forms spontaneously a thin surface oxide that alters its wetting behavior and makes it difficult to move across surfaces without leaving residue behind. We examine the effects of surface roughness (i.e., Cassie-Baxter state) and lubrication to minimize adhesion of Ga oxide to surfaces. Lubricated surfaces create a `slip-layer' of liquid between the metal and surface that also inhibits wetting. This slip layer allows the metal to move reversibly through microchannels by preventing adhesion of the oxide. The metal may be pumped or moved by using low voltages or pneumatic actuation. Optical microscopy confirms the importance of the slip-layer, which enables non-stick motion of the metal through capillaries. Finally, electrochemical impedance spectroscopy characterizes the electrohydrodynanic motion of EGaIn in capillary systems.
Cao, S.; Zhang, L.; Liu, Y.; Li, Y. [Chongqing University, Chongqing (China)
From an analysis of data on fatal accidents in small coal mines in a southern region of China over a period of three years, the time and type of accidents was discussed by applying statistical methods. It is shown that accidents frequently occur at the end of spring and all through summer. Roof accidents and gas disasters constitute severe accidents and traffic accidents are also important. It was found that most accidents are caused by dangerous behaviour of personnel and the unsafe state of equipment combined with economic interest. The three-factor causing model (TFC model) was proposed. Unsafe behaviour is a direct cause influenced by staff and workers while the unsafe nature of equipment is an indirect cause of accidents influence by natural conditions and the level of technical equipment in the mines. A system of accident prevention in small coal collieries was established with the TFC model. In this, scientific management is an important factor. 13 refs., 4 figs., 1 tab.
In this thesis a study of the HVDC related phenomenon core saturation instability and methods to prevent this phenomenon is performed. It is reason to believe that this phenomenon caused disconnection of the Skagerrak HVDC link 10 August 1993. Internationally, core saturation instability has been reported at several HVDC schemes and thorough complex studies of the phenomenon has been performed. This thesis gives a detailed description of the phenomenon and suggest some interesting methods to prevent the development of it. Core saturation instability and its consequences can be described in a simplified way as follows: It is now assumed that a fundamental harmonic component is present in the DC side current. Due to the coupling between the AC side and the DC side of the HVDC converter, a subsequent second harmonic positive-sequence current and DC currents will be generated on the AC side. The DC currents will cause saturation in the converter transformers. This will cause the magnetizing current to also have a second harmonic positive-sequence component. If a high second harmonic impedance is seen from the commutation bus, a high positive-sequence second harmonic component will be present in the commutation voltages. This will result in a relatively high fundamental frequency component in the DC side voltage. If the fundamental frequency impedance at the DC side is relatively low the fundamental component in the DC side current may become larger than it originally was. In addition the HVDC control system may contribute to the fundamental frequency component in the DC side voltage, and in this way cause a system even more sensitive to core saturation instability. The large magnetizing currents that eventually will flow on the AC side cause large zero-sequence currents in the neutral conductors of the AC transmission lines connected to the HVDC link. This may result in disconnection of the lines. Alternatively, the harmonics in the large magnetizing currents may cause
Darrow, William W; Montanea, Julie E; Sánchez-Braña, Elizabeth
Racial and Ethnic Approaches to Community Health (REACH) 2010 provided a unique opportunity for minority community-based organizations (CBOs) to work together to eliminate disparities in HIV disease. A coalition was formed in Broward County to respond to the REACH 2010 program announcement, a university was chosen to coordinate efforts, and contracts were negotiated with CBO partners to develop, implement, and evaluate a community action plan. Contract management provided stability, focus, and a mechanism for coalition partners to measure progress toward achieving project objectives. By emphasizing documentation as well as the delivery of services, however, contract conditions also placed a heavy burden on educational outreach workers, restricted the reimbursable activities of member organizations, and created friction between minority agencies and university staff. Although the coalition met many of its objectives, the introduction and enforcement of a mutually agreed on set of rules and obligations as a way of promoting systems change in Broward County failed to make a lasting impact among community partners. CBOs continued to compete with one another for HIV prevention project funding and stopped collaborating as closely with another when federal support for our REACH 2010 community demonstration project ran out.
Madrid, Eva; Urrútia, Gerard; Roqué i Figuls, Marta; Pardo-Hernandez, Hector; Campos, Juan Manuel; Paniagua, Pilar; Maestre, Luz; Alonso-Coello, Pablo
Inadvertent perioperative hypothermia is a phenomenon that can occur as a result of the suppression of the central mechanisms of temperature regulation due to anaesthesia, and of prolonged exposure of large surfaces of skin to cold temperatures in operating rooms. Inadvertent perioperative hypothermia has been associated with clinical complications such as surgical site infection and wound-healing delay, increased bleeding or cardiovascular events. One of the most frequently used techniques to prevent inadvertent perioperative hypothermia is active body surface warming systems (ABSW), which generate heat mechanically (heating of air, water or gels) that is transferred to the patient via skin contact. To assess the effectiveness of pre- or intraoperative active body surface warming systems (ABSW), or both, to prevent perioperative complications from unintended hypothermia during surgery in adults. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 9, 2015); MEDLINE (PubMed) (1964 to October 2015), EMBASE (Ovid) (1980 to October 2015), and CINAHL (Ovid) (1982 to October 2015). We included randomized controlled trials (RCTs) that compared an ABSW system aimed at maintaining normothermia perioperatively against a control or against any other ABSW system. Eligible studies also had to include relevant clinical outcomes other than measuring temperature alone. Several authors, by pairs, screened references and determined eligibility, extracted data, and assessed risks of bias. We resolved disagreements by discussion and consensus, with the collaboration of a third author. We included 67 trials with 5438 participants that comprised 79 comparisons. Forty-five RCTs compared ABSW versus control, whereas 18 compared two different types of ABSW, and 10 compared two different techniques to administer the same type of ABSW. Forced-air warming (FAW) was by far the most studied intervention.Trials varied widely regarding whether the interventions were
Full Text Available Ghrelin acylation by ghrelin O-acyltransferase (GOAT has recently been reported to be essential for the prevention of hypoglycemia during prolonged negative energy balance. Using a unique set of four different genetic loss-of-function models for the GOAT/ghrelin/growth hormone secretagogue receptor (GHSR system, we thoroughly tested the hypothesis that lack-of-ghrelin activation or signaling would lead to hypoglycemia during caloric deprivation.Male and female knockout (KO mice for GOAT, ghrelin, GHSR, or both ghrelin and GHSR (dKO were subjected to prolonged calorie restriction (40% of ad libitum chow intake. Body weight, fat mass, and glucose levels were recorded daily and compared to wildtype (WT controls. Forty-eight hour blood glucose profiles were generated for each individual mouse when 2% or less body fat mass was reached. Blood samples were obtained for analysis of circulating levels of acyl- and desacyl-ghrelin, IGF-1, and insulin.Chronic calorie restriction progressively decreased body weight and body fat mass in all mice regardless of genotype. When fat mass was depleted to 2% or less of body weight for 2 consecutive days, random hypoglycemic events occurred in some mice across all genotypes. There was no increase in the incidence of hypoglycemia in any of the four loss-of-function models for ghrelin signaling including GOAT KO mice. Furthermore, no differences in insulin or IGF-1 levels were observed between genotypes.The endogenous GOAT-ghrelin-GHSR system is not essential for the maintenance of euglycemia during prolonged calorie restriction.
Payne, Susan R. T.; Elliott, Delbert S.
There is widespread agreement that many school shootings could be prevented if authorities were informed that a student was planning or preparing to carry out an attack. A universal problem is that young people are highly reluctant to report on their peers. This code of silence represents a major barrier to prevention efforts. In response to the…
A. V. Mamaev
Full Text Available This article describes a solution for the protection of the temporary lifting of control over the target machine, while using information leakage detection and prevention systems. It is proposed to use a specially designed channel for alert’s signals through the computer’s power supply.
Bourdon, Pascal; Thiebaud, Sylvain; Doyen, Didier
This document proposes a convenient theoretical analysis of light modulation-based systems for prevention of illegal recordings in movie theaters. Although the works presented in this paper do not solve the problem of camcorder piracy, people in the security community may find them interesting for further work in this area.
Litt, Jonathan S.; Liu, Yuan; Sowers, Thomas S.; Owen, A. Karl; Guo, Ten-Huei
This paper describes a model-predictive automatic recovery system for aircraft on the verge of a loss-of-control situation. The system determines when it must intervene to prevent an imminent accident, resulting from a poor approach. It estimates the altitude loss that would result from a go-around maneuver at the current flight condition. If the loss is projected to violate a minimum altitude threshold, the maneuver is automatically triggered. The system deactivates to allow landing once several criteria are met. Piloted flight simulator evaluation showed the system to provide effective envelope protection during extremely unsafe landing attempts. The results demonstrate how flight and propulsion control can be integrated to recover control of the vehicle automatically and prevent a potential catastrophe.
V. S. Matveeva
Full Text Available It is suggested to implement an intrusion prevention system based on the access control mechanism of Microsoft Windows operating system to restrict the execution of malicious code. Most of the existing computer security facilities use behavioral and heuristic analyses based on an undocumented method of system calls interception that is not an uniform approach in designing of proactive security mechanism. The IPS is portable among different versions of the OS because it is implemented with documented functions only, it does not need to be updated and uses less system resources in comparison with another protection systems. The system protects from zero-day malware and therefore prevents companies from online-banking fraud that is a very actual problem of information security nowadays.
Full Text Available This paper proposed a new approach, combining root cause analysis (RCA, analytic hierarchy process (AHP, and event tree analysis (ETA in a loop to systematically evaluate various laboratory safety prevention strategies. First, 139 fire accidents were reviewed to identify the root causes and draw out prevention strategies. Most fires were caused due to runaway reactions, operation error and equipment failure, and flammable material release. These mostly occurred in working places of no prompt fire protection. We also used AHP to evaluate the priority of these strategies and found that chemical fire prevention strategy is the most important control element, and strengthening maintenance and safety inspection intensity is the most important action. Also together with our surveys results, we proposed that equipment design is also critical for fire prevention. Therefore a technical improvement was propounded: installing fire detector, automatic sprinkler, and manual extinguisher in the lab hood as proactive fire protections. ETA was then used as a tool to evaluate laboratory fire risks. The results indicated that the total risk of a fire occurring decreases from 0.0351 to 0.0042 without/with equipment taking actions. Establishing such system can make Environment, Health and Safety (EH&S office not only analyze and prioritize fire prevention policies more practically, but also demonstrate how effective protective equipment improvement can achieve and the probabilities of the initiating event developing into a serious accident or controlled by the existing safety system.
Kearney, Sarah; Leung, Loksee; Joyce, Andrew; Ollis, Debbie; Green, Celia
Issue addressed Our Watch led a complex 12-month evaluation of a whole school approach to Respectful Relationships Education (RRE) implemented in 19 schools. RRE is an emerging field aimed at preventing gender-based violence. This paper will illustrate how from an implementation science perspective, the evaluation was a critical element in the change process at both a school and policy level. Methods Using several conceptual approaches from systems science, the evaluation sought to examine how the multiple systems layers - student, teacher, school, community and government - interacted and influenced each other. A distinguishing feature of the evaluation included 'feedback loops'; that is, evaluation data was provided to participants as it became available. Evaluation tools included a combination of standardised surveys (with pre- and post-intervention data provided to schools via individualised reports), reflection tools, regular reflection interviews and summative focus groups. Results Data was shared during implementation with project staff, department staff and schools to support continuous improvement at these multiple systems levels. In complex settings, implementation can vary according to context; and the impact of evaluation processes, tools and findings differed across the schools. Interviews and focus groups conducted at the end of the project illustrated which of these methods were instrumental in motivating change and engaging stakeholders at both a school and departmental level and why. Conclusion The evaluation methods were a critical component of the pilot's approach, helping to shape implementation through data feedback loops and reflective practice for ongoing, responsive and continuous improvement. Future health promotion research on complex interventions needs to examine how the evaluation itself is influencing implementation. So what? The pilot has demonstrated that the evaluation, including feedback loops to inform project activity, were an
Posadzki, Pawel; Mastellos, Nikolaos; Ryan, Rebecca; Gunn, Laura H; Felix, Lambert M; Pappas, Yannis; Gagnon, Marie-Pierre; Julious, Steven A; Xiang, Liming; Oldenburg, Brian; Car, Josip
Automated telephone communication systems (ATCS) can deliver voice messages and collect health-related information from patients using either their telephone's touch-tone keypad or voice recognition software. ATCS can supplement or replace telephone contact between health professionals and patients. There are four different types of ATCS: unidirectional (one-way, non-interactive voice communication), interactive voice response (IVR) systems, ATCS with additional functions such as access to an expert to request advice (ATCS Plus) and multimodal ATCS, where the calls are delivered as part of a multicomponent intervention. To assess the effects of ATCS for preventing disease and managing long-term conditions on behavioural change, clinical, process, cognitive, patient-centred and adverse outcomes. We searched 10 electronic databases (the Cochrane Central Register of Controlled Trials; MEDLINE; Embase; PsycINFO; CINAHL; Global Health; WHOLIS; LILACS; Web of Science; and ASSIA); three grey literature sources (Dissertation Abstracts, Index to Theses, Australasian Digital Theses); and two trial registries (www.controlled-trials.com; www.clinicaltrials.gov) for papers published between 1980 and June 2015. Randomised, cluster- and quasi-randomised trials, interrupted time series and controlled before-and-after studies comparing ATCS interventions, with any control or another ATCS type were eligible for inclusion. Studies in all settings, for all consumers/carers, in any preventive healthcare or long term condition management role were eligible. We used standard Cochrane methods to select and extract data and to appraise eligible studies. We included 132 trials (N = 4,669,689). Studies spanned across several clinical areas, assessing many comparisons based on evaluation of different ATCS types and variable comparison groups. Forty-one studies evaluated ATCS for delivering preventive healthcare, 84 for managing long-term conditions, and seven studies for appointment reminders
Tapia-Conyer, Roberto; Gallardo-Rincón, Héctor; Saucedo-Martinez, Rodrigo
Mexico and other Latin American countries are currently facing a dramatic increase in the number of adults suffering from non-communicable diseases (NCDs) such as diabetes, cardiovascular disease (CVD) and chronic kidney disease (CKD), which require prolonged, continuous care. This epidemiological shift has created new challenges for health-care systems. Both the World Health Organization (WHO) and the United Nations (UN) have recognised the growing human and economic costs of NCDs and outlined an action plan, recognising that NCDs are preventable, often with common preventable risk factors linked to risky health behaviours. In line with international best practices, Mexico has applied a number of approaches to tackle these diseases. However, challenges remain for the Mexican health-care system, and in planning a strategy for combating and preventing NCDs, it must consider how best to integrate these strategies with existing health-care infrastructure. Shifting the paradigm of care in Mexico from a curative, passive approach to a preventive, proactive model will require an innovative and replicable system that guarantees availability of medicines and services, strengthens human capital through ongoing professional education, expands early and continuous access to care through proactive prevention strategies and incorporates technological innovations in order to do so. Here, we describe CASALUD: an innovative model in health-care that leverages international best practices and uses innovative technology to deliver NCD care, control and prevention. In addition, we describe the lessons learned from the initial implementation of the model for its effective use in Mexico, as well as the plans for wider implementation throughout the country, in partnership with the Mexican Ministry of Health. © Royal Society for Public Health 2013.
DePrince, Anne P; Chu, Ann T; Labus, Jennifer; Shirk, Stephen R; Potter, Cathryn
Girls in the child welfare system are at high risk of revictimization in adolescence. The present study compared two interventions designed to decrease revictimization in a diverse sample of adolescent child welfare-involved girls. The social learning/feminist (SL/F) intervention focused on concepts derived from social learning and feminist models of risk, such as sexism and beliefs about relationships. The risk detection/executive function (RD/EF) intervention focused on development of specific executive function abilities related to detecting and responding to risky situations/people. Participants were randomized to RD/EF (n = 67) or SL/F intervention (n = 67). A group of youth (n = 42) engaged in the research assessments only. Participants (n = 180) were assessed before intervention, immediately after intervention, 2 months after intervention, and 6 months after intervention. We examined revictimization (the presence/absence of sexual or physical assault in any relationship) over time. Adolescent girls in the RD/EF condition were nearly five times less likely to report sexual revictimization compared with girls in the no-treatment group. A trend suggested that girls who participated in the SL/F intervention were 2.5 times less likely to report sexual revictimization relative to the no-treatment group. For physical revictimization, the odds of not being physically revictimized were three times greater in the SL/F condition and two times greater in the RD/EF condition compared with the no-treatment group. The active interventions did not differ significantly from one another in rates of revictimization, suggesting that practitioners have at least two viable options to engage high-risk youth in revictimization prevention. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Anticancer immunotherapies are highly desired. Conversely, unwanted inflammatory or immune responses contribute to oncogenesis, tumor progression, and cancer-related death. For non-immunogenic therapies to inhibit tumor growth, they must promote, not prevent, the activation of anticancer immune...... responses. Here, the central immunoregulatory role of brain-specific stromal cells and neurons as well as their ability to maintain an immunological balance and prevent the development of glioblastoma is discussed....
Coastal Benthic Optical Properties (CoBOP) of Coral Reef Environments: Effects of Changes in the Spectral Quality and Quantity of the Underwater Light Field and Elevated Temperatures on Small Scale (0.01 to 0.1 m) Optical Properties of Corals
Utilization by Colonies of the Congeneric Hermatypic Corals , Montastraea faveolata and Montastraea cavernosa. (Limnology and Oceanography, in press) ...1 Coastal Benthic Optical Properties (CoBOP) of Coral Reef Environments: Effects of Changes in the Spectral Quality and Quantity of the Underwater...Light Field and Elevated Temperatures on Small Scale (0.01 to 0.1 m) Optical Properties of Corals Dr. Michael P. Lesser University of New Hampshire
Futagami, Toru; Omoto, Shohei; Hamamoto, Kenichirou
This research describes the risk communication towards improvement in the local disaster prevention power for Gobusho town in Marugame city which is only a high density city area in Kagawa Pref. Specifically, the key persons and authors of the area report the practice research towards improvement in the local disaster prevention power by the PDCA cycle of the area, such as formation of local voluntary disaster management organizations and implementation of an emergency drill, applying the fire spreading simulation system in case of a big earthquake. The fire spreading simulation system in case of the big earthquake which authors are developing describes the role and subject which have been achieved to BCP of the local community as a support system.
Son, Ki Chang; Shin, Hyun Kook; Lee, Nam Hoon; Baek, Seung Min; Kim, Hang Bae
The Advanced Digital Reactor Protection System (ADRPS) with diverse dual processors is being developed by the National Research Lab of KOPEC for ADRPS development. One of the ADRPS goals is to develop digital Plant Protection System (PPS) free of Common Mode Failure (CMF). To prevent CMF, the principle of diversity is applied to both hardware design and software design. For the hardware diversity, two different types of CPUs are used for Bistable Processor and Local Coincidence Logic Processor. The VME based Single Board Computers (SBC) are used for the CPU hardware platforms. The QNX Operating System (OS) and the VxWorks OS are used for software diversity. Rigorous Software Verification and Validation (V and V) is also required to prevent CMF. In this paper, software V and V methodology for the ADRPS is described to enhance the ADRPS software reliability and to assure high quality of the ADRPS software
Benvenuti, Francesco; Gatto, Mariele; Larosa, Maddalena; Iaccarino, Luca; Punzi, Leonardo; Doria, Andrea
Risk of developing cardiovascular disease (CVD) is increased in systemic lupus erythematosus (SLE) compared with the general population. Traditional risk factors cannot account for the totality of CV events and adequate prevention may be challenging. This review summarizes traditional and emerging risk factors of CVD in SLE patients and goes over potential pathogenic mechanisms involved in CVD development. Role of commonly used drugs and preventive strategies exploitable in everyday clinical practice are also discussed. SLE-related risk factors involve both disease- and treatment-related features, including disease activity, disease phenotype, corticosteroid misuse and alterations of innate and adaptive immunity. Primary prevention is mandatory in management of lupus patients through appropriate disease control, corticosteroid tapering, use of antimalarials and eventually vitamin D supplementation.
Full Text Available Introduction: The elderly population is at high risk of functional decline, which will induce significant costs due to long-term care. Dependency could be delayed by preventing one of its major determinants: falls. Light paths coupled with personal emergency response systems could prevent the functional decline through fall prevention. Methods: This study aimed to evaluate the effectiveness of light paths coupled with personal emergency response systems on the functional decline in an elderly population living at home. It is a secondary analysis on data from a previous cohort. In all, 190 older adults (aged 65 years or more living at home participated. Participants in the exposed group were equipped with home-based technologies: light paths coupled with personal emergency response systems. The participants’ functional status was assessed using the Functional Autonomy Measurement System scale at baseline (T0 and at the end of the study (T12-month. Baseline characteristics were evaluated by a comprehensive geriatric assessment. Results: After 1 year, 43% of the unexposed group had functional decline versus 16% of the exposed group. Light paths coupled with personal emergency response systems were significantly associated with a decrease in the functional decline (Δ Functional Autonomy Measurement System ⩾ 5 at home (odds ratio = 0.24, 95% confidence interval (0.11–0.54, p = 0.002. Discussion: This study suggests that light paths coupled with personal emergency response systems prevent the functional decline over 12 months. This result may encourage the prescription and use of home-based technologies to postpone dependency and institutionalization, but they need a larger cost-effectiveness study to demonstrate the efficiency of these technologies.
Maxson, Todd; Mabry, Charles D; Sutherland, Michael J; Robertson, Ronald D; Booker, James O; Collins, Terry; Spencer, Horace J; Rinker, Charles F; Sanddal, Teri L; Sanddal, Nels D
In July 2009, Arkansas began to annually fund $20 million for a statewide trauma system (TS). We studied injury deaths both pre-TS (2009) and post-TS (2013 to 2014), with attention to causes of preventive mortality, societal cost of those preventable mortality deaths, and benefit to tax payers of the lives saved. A multi-specialty trauma-expert panel met and reviewed records of 672 decedents (290 pre-TS and 382 post-TS) who met standardized inclusion criteria, were judged potentially salvageable, and were selected by a proportional sampling of the roughly 2,500 annual trauma deaths. Deaths were adjudicated into sub-categories of nonpreventable and preventable causes. The value of lives lost was calculated for those lives potentially saved in the post-TS period. Total preventable mortality was reduced from 30% of cases pre-TS to 16% of cases studied post-TS, a reduction of 14%. Extrapolating a 14% reduction of preventable mortality to the post-TS study period, using the same inclusion criteria of the post-TS, we calculate that 79 lives were saved in 2013 to 2014 due to the institution of a TS. Using a minimal standard estimate of $100,000 value for a life-year, a lifetime value of $2,365,000 per person was saved. This equates to an economic impact of the lives saved of almost $186 million annually, representing a 9-fold return on investment from the $20 million of annual state funding invested in the TS. The implementation of a TS in Arkansas during a 5-year period resulted in a reduction of the preventable death rate to 16% post-TS, and a 9-fold return on investment by the tax payer. Additional life-saving gains can be expected with ongoing financial support and additional system performance-improvement efforts. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
Valach, J.; Cacciotti, R.; Kuneš, P.; ČerÅanský, M.; Bláha, J.
The paper presents a project aiming to develop a knowledge-based system for documentation and analysis of defects of cultural heritage objects and monuments. The MONDIS information system concentrates knowledge on damage of immovable structures due to various causes, and preventive/remedial actions performed to protect/repair them, where possible. The currently built system is to provide for understanding of causal relationships between a defect, materials, external load, and environment of built object. Foundation for the knowledge-based system will be the systemized and formalized knowledge on defects and their mitigation acquired in the process of analysis of a representative set of cases documented in the past. On the basis of design comparability, used technologies, materials and the nature of the external forces and surroundings, the developed software system has the capacity to indicate the most likely risks of new defect occurrence or the extension of the existing ones. The system will also allow for a comparison of the actual failure with similar cases documented and will propose a suitable technical intervention plan. The system will provide conservationists, administrators and owners of historical objects with a toolkit for defect documentation for their objects. Also, advanced artificial intelligence methods will offer accumulated knowledge to users and will also enable them to get oriented in relevant techniques of preventive interventions and reconstructions based on similarity with their case.
Yaling, Jiang; Mingye, Feng; Lei, Cheng
Dental caries and periodontal diseases are common chronic infectious diseases that cause serious damage to oral health. Bacteria is the primary factor leading to such conditions. As a dental plaque control method, chemotherapeutic agents face serious challenges in dental care because of the specific physiological and anatomical characteristics of the oral cavity. Nanodrug delivery system is a series of new drug delivery systems at nanoscale, and it can target cells, promote sustainedrelease effects, and enhance biodegradation. This review focuses on research progress on nanodrug delivery systems for prevention and control of dental caries and periodontal diseases.
Wang, Wei-ming; Zhou, Hua-yun; Liu, Yao-bao; Cao, Yuan-yuan; Cao, Jun; Gao, Qi
To establish a system of the prevention and control of imported falciparum malaria in Jiangsu Prov- ince and provide the new scientific basis for the prevention and control of imported falciparum malaria. The data- bases for overseas labor companies and labors in Jiangsu Province were built and the health education was conducted to the overseas labors. The "1-3-7" elimination strategy was established. A weekly reporting system for malaria case details was es- tablished. A system for screening accompanies of imported malaria patients was established. At the end of 2013, the database of companies engaged in labor export was built and1 405 companies were incorporated into the database. The time interval between the symptom onset and the first health facility visit was reduced to 3.07 days in 2013. The time interval be- tween the first health facility visit to malaria diagnosis was reduced to 1.57 days in 2013. The rate of laboratory confirmation was increased to 100% in 2013, and there was a statistically significant difference among the rates of laboratory confirmation from 2009 to 2013 (χ2 = 36.35, P system of the prevention and control of imported falciparum malaria, which plays an important role in the prevention and control of overseas imported falciparum malaria.
Background Anti-lock Brake System (ABS) helps the equipped vehicles to stop under heavy braking, in a shorter distance and with a better control of direction. It was expected that this technology will reduce the rate of fatal road traffic crashes (RTC); however, the outcome is controversial in the real world. The aim of this study is to compare the claimed annual incidence rate and financial losses due to RTCs in ABS vs. non-ABS personal vehicles in Iran. Methods A telephone survey among drivers of two similar models of personal vehicles was arranged. The studied vehicles were of the same brand and type; but only one of them was equipped with ABS. The number of RTCs, subsequent financial loss, and drivers’ knowledge and perception about ABS were sought. The sample consisted of drivers of 1232 ABS and 3123 non-ABS vehicles. Results The annual incidence rate of RTC involving another vehicle was 145.1 (134.8-155.9) per 1000 vehicle-years and there was not a statistically significant difference between study groups. The incidence of RTC with another vehicle due to brake failure was 50.3 (42.9-58.5) for 1000 non ABS vehicle-years and 30.0 (21.2-41.2) for 1000 ABS equipped vehicle-years. The difference was statistically significant after adjustment for the driver and vehicle's age and the daily driving time. The attributable risk of RTC for non-ABS vehicles was 20/1000 vehicles and the excess fraction was 39.8%. The mean financial loss due to reported RTCs was $987.9 ± $1547.3 US Dollars and there was not a statistically significant difference between study groups. While 61.1% of ABS vehicle drivers reported situations in which they believed the ABS had prevented a crash, 44.1% of them however, they did not know how to use ABS efficiently. Conclusions Law enforcement to maintain safe distance and adhere to speed limit while driving, is needed to raise the effectiveness of ABS. This is as necessary as considering mandatory outfitting of ABS. Safety authorities
van der Beek, Christina M; Bloemen, Johanne G; van den Broek, Maartje A; Lenaerts, Kaatje; Venema, Koen; Buurman, Wim A; Dejong, Cornelis H
Short-chain fatty acids (SCFAs), fermentation products of undigested fibers, are considered beneficial for colonic health. High plasma concentrations are potentially harmful; therefore, information about systemic SCFA clearance is needed before therapeutic use of prebiotics or colonic SCFA administration. The aim of this study was to investigate the effect of rectal butyrate administration on SCFA interorgan exchange. Twelve patients (7 men; age: 66.4 ± 2.0 y; BMI 24.5 ± 1.4 kg/m(2)) undergoing upper abdominal surgery participated in this randomized placebo-controlled trial. During surgery, 1 group received a butyrate enema (100 mmol sodium butyrate/L; 60 mL; n = 7), and the other group a placebo (140 mmol 0.9% NaCl/L; 60 mL; n = 5). Before and 5, 15, and 30 min after administration, blood samples were taken from the radial artery, hepatic vein, and portal vein. Plasma SCFA concentrations were analyzed, and fluxes from portal-drained viscera, liver, and splanchnic area were calculated and used for the calculation of the incremental area under the curve (iAUC) over a 30-min period. Rectal butyrate administration led to higher portal butyrate concentrations at 5 min compared with placebo (92.2 ± 27.0 μmol/L vs. 14.3 ± 3.4 μmol/L, respectively; P butyrate-treated group, iAUCs of gut release (282.8 ± 133.8 μmol/kg BW · 0.5 h) and liver uptake (-293.7 ± 136.0 μmol/kg BW · 0.5 h) of butyrate were greater than in the placebo group [-16.6 ± 13.4 μmol/kg BW · 0.5 h (gut release) and 16.0 ± 13.8 μmol/kg BW · 0.5 h (liver uptake); P = 0.01 and P butyrate release did not differ between groups. After colonic butyrate administration, splanchnic butyrate release was prevented in patients undergoing upper abdominal surgery. These observations imply that therapeutic colonic SCFA administration at this dose is safe. The trial was registered at clinicaltrials.gov as NCT02271802. © 2015 American Society for Nutrition.
Khorasani-Zavareh, Davoud; Shoar, Saeed; Saadat, Soheil
Anti-lock Brake System (ABS) helps the equipped vehicles to stop under heavy braking, in a shorter distance and with a better control of direction. It was expected that this technology will reduce the rate of fatal road traffic crashes (RTC); however, the outcome is controversial in the real world. The aim of this study is to compare the claimed annual incidence rate and financial losses due to RTCs in ABS vs. non-ABS personal vehicles in Iran. A telephone survey among drivers of two similar models of personal vehicles was arranged. The studied vehicles were of the same brand and type; but only one of them was equipped with ABS. The number of RTCs, subsequent financial loss, and drivers' knowledge and perception about ABS were sought. The sample consisted of drivers of 1232 ABS and 3123 non-ABS vehicles. The annual incidence rate of RTC involving another vehicle was 145.1 (134.8-155.9) per 1000 vehicle-years and there was not a statistically significant difference between study groups.The incidence of RTC with another vehicle due to brake failure was 50.3 (42.9-58.5) for 1000 non ABS vehicle-years and 30.0 (21.2-41.2) for 1000 ABS equipped vehicle-years. The difference was statistically significant after adjustment for the driver and vehicle's age and the daily driving time. The attributable risk of RTC for non-ABS vehicles was 20/1000 vehicles and the excess fraction was 39.8%. The mean financial loss due to reported RTCs was $987.9 ± $1547.3 US Dollars and there was not a statistically significant difference between study groups. While 61.1% of ABS vehicle drivers reported situations in which they believed the ABS had prevented a crash, 44.1% of them however, they did not know how to use ABS efficiently. Law enforcement to maintain safe distance and adhere to speed limit while driving, is needed to raise the effectiveness of ABS. This is as necessary as considering mandatory outfitting of ABS. Safety authorities should first consider the global experience
Cheadle, Allen; Cromp, DeAnn; Krieger, James W; Chan, Nadine; McNees, Molly; Ross-Viles, Sarah; Kellogg, Ryan; Rahimian, Afsaneh; MacDougall, Erin
Initiatives that convene community stakeholders to implement policy, systems, environment, and infrastructure (PSEI) change have become a standard approach for promoting community health. To assess the PSEI changes brought about by the King County, Washington, Communities Putting Prevention to Work initiative and describe how initiative structures and processes contributed to making changes. The impact evaluation used a logic model design, linking PSEI changes to longer-term behavioral impacts in healthy eating active living and tobacco use and exposure. Qualitative methods, including stakeholder interviews and surveys, were used to identify initiative success factors. Communities Putting Prevention to Work activities occurred throughout King County, with a focus on 7 low-income communities in South Seattle/King County. The focus communities had a combined population of 652 000, or 35% of the county total, with lower incomes and higher rates of physical inactivity, tobacco use, poor diet, and chronic disease. Twenty-four PSEI strategies were pursued by organizations in sectors including schools, local governments, and community organizations, supported by the public health department. There were 17 healthy eating active living strategies (eg, enhancements to school menus, city planning policies) and 7 tobacco strategies (eg, smoke-free policies in schools, housing, and hospitals). PSEI changes made and numbers of residents reached. Twenty-two of the 24 strategies achieved significant progress toward implementing PSEI changes. The most common success factor was a "dyad" consisting of a dedicated technical assistance provider-either an outside consultant or public health department staff-working closely with a champion from the participating organizations to bring about PSEI changes. An initiative structure that creates and supports external consultant/internal organizational champion dyads in key community sectors offers a promising approach that may be adopted by
Aghezzaf, El-Houssaine; Khatab, Abdelhakim; Tam, Phuoc Le
This paper investigates the issue of integrating production and maintenance planning in a failure-prone manufacturing system. It is assumed that the system's operating state is stochastically predictable, in terms of its operating age, and that it can accordingly be preventively maintained during preplanned periods. Preventive maintenance is assumed to be imperfect, that is when performed, it brings the manufacturing system to an operating state that lies between ‘as bad as old’ and ‘as good as new’. Only an overhauling of the system brings it to a ‘as good as new’ operating state again. A practical integrated production and preventive maintenance planning model, that takes into account the system's manufacturing capacity and its operational reliability state, is developed. The model is naturally formulated as a mixed-integer non-linear optimization problem, for which an extended mixed-integer linear reformulation is proposed. This reformulation, while it solves the proposed integrated planning problem to optimality, remains quite demanding in terms of computational time. A fix-and-optimize procedure, that takes advantage of some properties of the original model, is then proposed. The reformulation and the fix-and-optimize procedure are tested on some test instances adapted from those available in the literature. The results show that the proposed fix-and-optimize procedure performs quite well and opens new research direction for future improvements. - Highlights: • Integration of production planning and imperfect preventive maintenance is explored. • Imperfect maintenance is modeled using a fitting age reduction hybrid hazard rate. • A practical approximate optimization model for this integration is proposed. • The resulting naturally MINL optimization model is reformulated and solved as a MILP. • An effective fix-and-optimize procedure is proposed for large instances of this MILP.
Wachter, Jan K; Yorio, Patrick L
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.
Bris, R.; Cepin, M.
Testing and maintenance activities of power electrical equipment are an important potential for both risk and cost reduction. A multi-objective maintenance optimization method is presented based on the Genetic Algorithms (GA) technique. The method determines the optimal schedule of preventive maintenance actions based on minimization both selected risk measure and cost. Applied cost model takes into account both preventive and corrective maintenance. This paper also presents application of the methodology to optimize maintenance of a real distribution network 22 kV. Conclusions and recommendations for practice are made on the basis of obtained results. (author)
Persson, Frederik; Lindhardt, Morten; Rossing, Peter
Hypothesis/objectives: Early prevention of diabetic nephropathy by way of blocking the renin-angiotensin system (RAS) in patients with normoalbuminuria seems rational, but trials have so far shown conflicting results. The present meta-analysis was undertaken to investigate if such treatment can p......-cause mortality(p=0.07). Conclusions: We conclude that in patients with type 2 diabetes and normoalbuminuria, early intervention with ACEis or ARBs reduces the risk for development of microalbuminuria.......Hypothesis/objectives: Early prevention of diabetic nephropathy by way of blocking the renin-angiotensin system (RAS) in patients with normoalbuminuria seems rational, but trials have so far shown conflicting results. The present meta-analysis was undertaken to investigate if such treatment can...
Allyson R. Alfonso, BS, BA
Full Text Available Summary:. Wounds of the foot challenge reconstructive surgeons to manage multiple factors: sensibility, stability, and durability. In this article, we focus on the insensate foot, which poses challenges to wound prevention with its propensity to develop pressure ulceration. The authors present the innovative use of a pressure-sensing smart insole system (SurroSense Rx, Orpyx Medical Technologies Inc., Calgary, Canada in the management of the insensate foot in a patient following foot reconstruction. The pressure-sensing smart insole system provided unique feedback to both patient and provider in ways that contributed to the prevention of pressure ulcer recurrence, as well as highlight the importance of prescribed footwear in both the affected and unaffected foot. Wearable real-time monitoring and feedback faces the challenge of patient adherence. Future studies are indicated to examine the specific behaviors that are associated with favorable outcomes and long-term behavior changes.
Reniers, Genserik L L; Ale, B. J.M.; Dullaert, W.; Foubert, B.
Solid major accident prevention management is characterized by efficient and effective risk assessments. As a means of addressing the efficiency aspect, decision support analysis software is becoming increasingly available. This paper discusses the results of a survey of decision support tools for
Spiel, Christiane; Strohmeier, Dagmar
As a result of a quick succession of several spectacular events in schools, and the ensuing public discussion on the high rates of bullying in Austria, a national strategy for violence prevention in schools and preschools has been developed. In formulating the strategy, a systematic procedure involving international experts and a number of local…
Yi, Chun-Xia; Heppner, Kristy M.; Kirchner, Henriette; Tong, Jenny; Bielohuby, Maximillian; Gaylinn, Bruce D.; Müller, Timo D.; Bartley, Erin; Davis, Harold W.; Zhao, Yongmei; Joseph, Anupama; Kruthaupt, Traci; Ottaway, Nickki; Kabra, Dhiraj; Habegger, Kirk M.; Benoit, Stephen C.; Bidlingmaier, Martin; Thorner, Michael O.; Perez-Tilve, Diego; Tschöp, Matthias H.; Pfluger, Paul T.
Objective: Ghrelin acylation by ghrelin O-acyltransferase (GOAT) has recently been reported to be essential for the prevention of hypoglycemia during prolonged negative energy balance. Using a unique set of four different genetic loss-of-function models for the GOAT/ghrelin/growth hormone
Chuang, Sheuwen; Howley, Peter P; Lin, Shih-Hua
Root cause analysis (RCA) is often adopted to complement epidemiologic investigation for outbreaks and infection-related adverse events in hospitals; however, RCA has been argued to have limited effectiveness in preventing such events. We describe how an innovative systems analysis approach halted repeated scabies outbreaks, and highlight the importance of systems thinking for outbreaks analysis and sustaining effective infection prevention and control. Following RCA for a third successive outbreak of scabies over a 17-month period in a 60-bed respiratory care ward of a Taiwan hospital, a systems-oriented event analysis (SOEA) model was used to reanalyze the outbreak. Both approaches and the recommendations were compared. No nosocomial scabies have been reported for more than 1975 days since implementation of the SOEA. Previous intervals between seeming eradication and repeat outbreaks following RCA were 270 days and 180 days. Achieving a sustainable positive resolution relied on applying systems thinking and the holistic analysis of the system, not merely looking for root causes of events. To improve the effectiveness of outbreaks analysis and infection control, an emphasis on systems thinking is critical, along with a practical approach to ensure its effective implementation. The SOEA model provides the necessary framework and is a viable complementary approach, or alternative, to RCA. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Odgaard, Peter Fogh; Stoustrup, Jakob
In this paper a scheme is presented for preventing violations of control signal constraints in a class of coupled systems. The scheme is an add-on solution to the existing control system; it works like a fault tolerant scheme, by accommodating the problem then occurring. The proposed scheme...... recomputes the reference values to the system such that control signal constraint violations are avoided. The new reference values are found using an energy balance of the system. The scheme is intended to handle rarely occurring constraint violations, so the only concern is that the system should be stable...... and not to optimize performance during all conditions. The scheme is applied to an example with a coal mill pulverizing coal for a power plant. ...
Fernández, María E; Melvin, Cathy L; Leeman, Jennifer; Ribisl, Kurt M; Allen, Jennifer D; Kegler, Michelle C; Bastani, Roshan; Ory, Marcia G; Risendal, Betsy C; Hannon, Peggy A; Kreuter, Matthew W; Hebert, James R
Although cancer research has advanced at a rapid pace, a gap remains between what is known about how to improve cancer prevention and control (CPC) and what is implemented as best practices within health care systems and communities. The Cancer Prevention and Control Research Network (CPCRN), with more than 10 years of dissemination and implementation research experience, aims to accelerate the uptake and use of evidence-based CPC interventions. The collective work of the CPCRN has facilitated the analysis and categorization of research and implementation efforts according to the Interactive Systems Framework for Dissemination and Implementation (ISF), providing a useful heuristic for bridging the gap between prevention research and practice. The ISF authors have called for examples of its application as input to help refine the model. We provide examples of how the collaborative activities supported by the CPCRN, using community-engaged processes, accelerated the synthesis and translation of evidence, built both general and innovation-specific capacity, and worked with delivery systems to advance cancer control research and practice. The work of the CPCRN has provided real-world examples of the application of the ISF and demonstrated that synthesizing and translating evidence can increase the potential that evidence-based CPC programs will be used and that capacity building for both the support system and the delivery system is crucial for the successful implementation and maintenance of evidence-based cancer control. Adoption and implementation of CPC can be enhanced by better understanding ISF systems and intervening to improve them. ©2014 American Association for Cancer Research.
Apostolopoulos, Yorghos; Lemke, Michael K; Barry, Adam E; Lich, Kristen Hassmiller
Given the complexity of factors contributing to alcohol misuse, appropriate epistemologies and methodologies are needed to understand and intervene meaningfully. We aimed to (1) provide an overview of computational modeling methodologies, with an emphasis on system dynamics modeling; (2) explain how community-based system dynamics modeling can forge new directions in alcohol prevention research; and (3) present a primer on how to build alcohol misuse simulation models using system dynamics modeling, with an emphasis on stakeholder involvement, data sources and model validation. Throughout, we use alcohol misuse among college students in the United States as a heuristic example for demonstrating these methodologies. System dynamics modeling employs a top-down aggregate approach to understanding dynamically complex problems. Its three foundational properties-stocks, flows and feedbacks-capture non-linearity, time-delayed effects and other system characteristics. As a methodological choice, system dynamics modeling is amenable to participatory approaches; in particular, community-based system dynamics modeling has been used to build impactful models for addressing dynamically complex problems. The process of community-based system dynamics modeling consists of numerous stages: (1) creating model boundary charts, behavior-over-time-graphs and preliminary system dynamics models using group model-building techniques; (2) model formulation; (3) model calibration; (4) model testing and validation; and (5) model simulation using learning-laboratory techniques. Community-based system dynamics modeling can provide powerful tools for policy and intervention decisions that can result ultimately in sustainable changes in research and action in alcohol misuse prevention. © 2017 Society for the Study of Addiction.
Filipova-Neumann, Lilia; Hoy, Michael
There is a prospect in the medium to long term future of substantial advancements in the understanding of the relationship between disease and genetics. We consider the implications of increased information from genetic tests about predisposition to diseases from the perspective of managing health care provision under a public health insurance scheme. In particular, we consider how such information may potentially improve the targeting of medical surveillance (or prevention) activities to improve the chances of early detection of disease onset. We show that the moral hazard implications inherent in surveillance and prevention decisions that are chosen to be privately rather than socially optimal may be exacerbated by increased information about person-specific predisposition to disease. Copyright © 2014 Elsevier B.V. All rights reserved.
Zhang, Cheng; Yang, Yu-Long; Ma, Yue-Feng; Zhang, Hong-Wei; Li, Jing-Yi; Lin, Mei-Ju; Shi, Li-Jun; Qi, Chun-Chun
Prophylactic pancreatic stents after endoscopic retrograde cholangiopancreatography (ERCP) can help prevent post-ERCP pancreatitis. However most of the pancreatic stents need to be removed by another ERCP. The aim of this observational study was to investigate the feasibility and effectiveness of the modified pancreatic stent system for prevention of post-ERCP pancreatitis. From November 2013 to November 2015, a total of 230 patients who had prophylactic pancreatic stent placed for prevention of post-ERCP pancreatitis at a single institution were identified and stratified. In this case-control design, 150 patients received an ordinary pancreatic stent, and 80 patients received the modified pancreatic stent. The main outcome measures were the difficulty level and complications of pancreatic stent placement and extraction between the two groups. In ordinary group, the average time of pancreatic stent and nasal biliary drainage placement was 3.5 ± 0.6 min. There were 13 cases of stent proximal migration (8.7%), 20 cases of stent spontaneous abscission (13.3%), 5 cases of acute pancreatitis (3.3%) (2 cases for stent abscission) and 7 cases of hyperamylasemia (4.7%) after ERCP. One hundred thirty patients received extra duodenoscope (86.7%) to remove the stent, and 4 cases had acute pancreatitis and 5 patients had hyperamylasemia after removing the proximal migratory stents. In modified group, the average time of pancreatic stent system placement was 4.9 ± 0.7 min, but there was only one case of stent abscission (1.3%), 2 cases of acute pancreatitis (2.5%) and 3 cases of hyperamylasemia (3.8%). The new pancreatic stents were removed directly under x-ray without complication. The modified pancreatic stent system has the same effect of preventing post-ERCP pancreatitis, lower rate of stents proximal migration and spontaneous abscission, and the advantage of easier removed compared with ordinary pancreatic stent.
from migraine, many people go untreated and do not seek care for the illness or self -manage the condition with over-the- counter products (Lipton...Hemodialysis DGD Peritoneal Dialysis DGE Ambulatory Nursing Services DGX Same Day Services Cost Pool DGZ Ambulatory Procedures Visits NEC DH...headaches. While the safety and efficacy of this treatment has been established, it is unclear what impact migraine prevention has on health care resource
Sarot, Adeline; Bouznah, Serge
Schools are a place within which teenagers' anxieties are expressed, as well as those of adults, in the difficult confrontation with otherness, in a context of conflictual globalisation. The school is a key player in the prevention of terrorism, through the elaboration of these tensions which it can allow. The Métisco team offers school mediation programs, in order to help professionals fulfil this mission. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Yuan, S.; Lai, M.C.; Heusel, K.
In 2006, the Hawai'i State Department of Health (DOH) received the Strategic Prevention Framework State Incentive Grant (SPF-SIG) from the Substance Abuse and Mental Health Services Administration (SAMHSA) to establish a comprehensive, coordinated, and sustainable substance abuse prevention infrastructure in Hawai'i. The SPF-SIG Project is funded…
Full Text Available In addition to clean transportation and energy savings, electric vehicles can inherently offer better performance in the field of active safety and dynamic stability control, thanks to the superior fast and accurate control characteristics of electric motors. With the novel wheel status parameter TA for electric vehicles proposed by the authors in an earlier publication, a new TA index (TAI-based rollover prevention method is presented in this paper to improve the driving performance of EVs equipped with in-wheel motors. A three-level electric vehicle control structure is used to analyze the effective control steps for rollover prevention with the newly proposed TAI method. The simulation is conducted using an in-house developed electric vehicle dynamic model. The simulation results prove the feasibility of using TAI to detect rollover. The experiment uses an electric vehicle equipped with four in-wheel motors in the authors’ research lab. The vehicle parameter and performance data are imported to CarSim, which is industrial standard vehicle dynamic analysis software to run the rollover test. The experimental results also demonstrate that TAI is an effective method of rollover prevention.
Thomas, Catherine M.
Zebra and quagga mussels are fresh water invaders that have the potential to cause severe ecological and economic damage. It is estimated that mussels cause $1 billion dollars per year in damages to water infrastructure and industries in the United States (Pimentel et al., 2004). Following their introduction to the Great Lakes in the late 1980s, mussels spread rapidly throughout the Mississippi River Basin and the Eastern U.S. The mussel invasion in the West is young. Mussels were first identified in Nevada in 2007, and have since been identified in California, Arizona, Colorado, Utah, and Texas. Western water systems are very different from those found in the East. The rapid spread of mussels through the eastern system was facilitated by connected and navigable waterways. Western water systems are less connected and are characterized by man-made reservoirs and canals. The main vector of spread for mussels in the West is overland on recreational boats (Bossenbroek et al., 2001). In response to the invasion, many western water managers have implemented preventative management programs to slow the overland spread of mussels on recreational boats. In Colorado, the Colorado Department of Wildlife (CDOW) has implemented a mandatory boat inspection program that requires all trailered boats to be inspected before launching in any Colorado water body. The objective of this study is to analyze the costs and benefits of the CDOW boat inspection program in Colorado, and to identify variables that affect the net benefits of preventative management. Predicting the potential economic benefits of slowing the spread of mussels requires integrating information about mussel dispersal potential with estimates of control costs (Keller et al., 2009). Uncertainty surrounding the probabilities of establishment, the timing of invasions, and the damage costs associated with an invasion make a simulation model an excellent tool for addressing "what if" scenarios and shedding light on the
Shimazu, Chisato; Hoshino, Satoshi; Furukawa, Taiji
We constructed an integrated personal identification workflow chart using both bar code reading and an all in-one laboratory information system. The information system not only handles test data but also the information needed for patient guidance in the laboratory department. The reception terminals at the entrance, displays for patient guidance and patient identification tools at blood-sampling booths are all controlled by the information system. The number of patient identification errors was greatly reduced by the system. However, identification errors have not been abolished in the ultrasound department. After re-evaluation of the patient identification process in this department, we recognized that the major reason for the errors came from excessive identification workflow. Ordinarily, an ultrasound test requires patient identification 3 times, because 3 different systems are required during the entire test process, i.e. ultrasound modality system, laboratory information system and a system for producing reports. We are trying to connect the 3 different systems to develop a one-time identification workflow, but it is not a simple task and has not been completed yet. Utilization of the laboratory information system is effective, but is not yet perfect for patient identification. The most fundamental procedure for patient identification is to ask a person's name even today. Everyday checks in the ordinary workflow and everyone's participation in safety-management activity are important for the prevention of patient identification errors.
A new method is proposed to compute all feasible robust stabilizing controllers for preventing the generation of limit cycle of nonlinear control systems with parametric uncertainties both in the linear plant and nonlinearity. The describing function analysis method is employed to approximate the behaviors of the nonlinearity. The Kharitonov theorem is utilized to characterize parametric uncertainties in the linear plant and nonlinearity. Necessary conditions for limit cycles are established. Boundaries for the generation of limit cycle and boundaries for asymptotic stability are portrayed exploiting the stability equation method. The region for prescribed limit cycle behavior and the region for asymptotic stability are located. An admissible specification-oriented Kharitonov region is found directly on the controller parameter plane. The region is non-conservative and constitutes all of the feasible controller gain sets to achieve robust prevention of limit cycle for the considered uncertain nonlinear control systems. The way to tune the controller gains is suggested. Finally, for comparison purpose, two illustrative examples proposed in the literature are given to show how the proposed algorithm can be effectively applied to tune a robust controller to achieve a prescribed limit cycle behavior and accomplish robust limit cycle amplitude suppression and prevention.
Oesterle, Sabrina; Hawkins, J David; Fagan, Abigail A; Abbott, Robert D; Catalano, Richard F
Communities That Care (CTC) is a universal, science-based community prevention system designed to reduce risk, enhance protection, and prevent adolescent health and behavior problems community wide. CTC has been found to have sustained effects on cigarette use and delinquent and violent behaviors in grade 10 in a panel of 4,407 students followed from fifth grade in a community randomized trial. It is important to test variation in the effects of this prevention system designed to be universal to understand for whom it is most effective and whether it fails to produce change or leads to iatrogenic effects for certain categories of individuals. The present study examined variation in the sustained effects of CTC on tenth-grade cigarette use and delinquent and violent behaviors. Interaction analyses suggest that the effect of CTC did not differ between those who had high levels of community-targeted risk factors at baseline or had already engaged in substance use, delinquency, or violence at baseline versus those who had not. Although CTC reduced the prevalence of both girls' and boys' problem behaviors, the effect on delinquency was marginally (p = 0.08) larger for boys than for girls.
Benjamin W. Van Voorhees
Full Text Available Efforts to prevent depression have become a key health system priority. Currently, there is a high prevalence of depression among adolescents, and treatment has become costly due to the recurrence patterns of the illness, impairment among patients, and the complex factors needed for a treatment to be effective. Primary care may be the optimal location to identify those at risk by offering an Internet-based preventive intervention to reduce costs and improve outcomes. Few practical interventions have been developed. The models for Internet intervention development that have been put forward focus primarily on the Internet component rather than how the program fits within a broader context. This paper describes the conceptualization for developing technology based preventive models for primary care by integrating the components within a behavioral vaccine framework. CATCH-IT (Competent Adulthood Transition with Cognitive-behavioral, Humanistic and Interpersonal Training has been developed and successfully implemented within various health systems over a period of 14 years among adolescents and young adults aged 13–24.
Dupont, Hervé; Mahjoub, Yazine; Chouaki, Taieb; Lorne, Emmanuel; Zogheib, Elie
The aim of this study was to identify the impact of antifungal prevention in critically ill immunocompetent adult patients on mortality and subsequent infection. A systematic review and meta-analysis of randomized controlled trials comparing any antifungal use versus placebo to prevent candidiasis in ICU patients were performed. Searches were performed on PubMed, Embase, Scopus, main conference proceedings, and ClinicalTrials.gov, as well as reference lists. The primary outcomes were mortality and invasive candidiasis. The secondary outcome was the rate of Candida albicans and nonalbicans strains after treatment. A random effect model was used, and sensitivity analysis was performed for both outcomes. Results are expressed as risk ratios and their 95% CIs. Nineteen trials (10 with fluconazole, four with ketoconazole, one with itraconazole, three with micafungin, and one with caspofungin) including 2,792 patients were identified. No individual trial showed a decreased mortality rate. Combined analysis showed that preventive antifungal did not decrease mortality (risk ratio, 0.88; 95% CI, 0.74-1.04; p = 0.14) but significantly decreased secondary fungal infections by 50% (risk ratio, 0.49; 95% CI, 0.35-0.68; p = 0.0001). No shift across nonalbicans strains was observed during treatment (risk ratio, 0.62; 95% CI, 0.19-1.97; p = 0.42). However, publication biases preclude any definite conclusions for prevention of infection. Antifungal prevention of systemic candidiasis in immunocompetent critically ill adults did not reduce mortality and may have decreased secondary fungal infection rates. However, significant publication bias was present.
Sugimoto-Matsuda, Jeanelle J; Hishinuma, Earl S; Momohara, Christie-Brianna K; Rehuher, Davis; Soli, Fa'apisa M; Bautista, Randy Paul M; Chang, Janice Y
Youth violence (YV) is a complex public health issue that spans geographic, ethnic, and socioeconomic lines. The Asian/Pacific Islander Youth Violence Prevention Center conducts qualitative and quantitative research on YV in Hawai'i. A critical element in YV prevention involves measuring YV and its risk-protective factors to determine the scope of the problem and to monitor changes across time. Under the Asian/Pacific Islander Youth Violence Prevention Center's (APIYVPC's) surveillance umbrella, a variety of methodologies are utilized. The major forms of active surveillance are a School-Wide Survey for youth, and a Safe Community Household Survey for adults. A variety of secondary data sources are accessed, such as the Centers for Disease Control and Prevention (Youth Risk Behavior Surveillance System), the Hawai'i State Department of the Attorney General, the Hawai'i State Department of Education, and the Hawai'i State Department of Health. State data are especially important for the Center, because most of these sources disaggregate ethnicity data for Asian Americans/Pacific Islanders. This paper details the surveillance methodologies utilized by the APIYVPC to monitor YV in one specific community and in Hawai'i, in comparison to the rest of the State and nation. Empirical results demonstrate the utility of each methodology and how they complement one another. Individually, each data source lends valuable information to the field of YV prevention; however, collectively, the APIYVPC's surveillance methods help to paint a more complete picture regarding violence rates and the relationship between YV and its risk-protective factors, particularly for minority communities.
Hulme, A; Salmon, P M; Nielsen, R O; Read, G J M; Finch, C F
There is a need for an ecological and complex systems approach for better understanding the development and prevention of running-related injury (RRI). In a previous article, we proposed a prototype model of the Australian recreational distance running system which was based on the Systems Theoretic Accident Mapping and Processes (STAMP) method. That model included the influence of political, organisational, managerial, and sociocultural determinants alongside individual-level factors in relation to RRI development. The purpose of this study was to validate that prototype model by drawing on the expertise of both systems thinking and distance running experts. This study used a modified Delphi technique involving a series of online surveys (December 2016- March 2017). The initial survey was divided into four sections containing a total of seven questions pertaining to different features associated with the prototype model. Consensus in opinion about the validity of the prototype model was reached when the number of experts who agreed or disagreed with survey statement was ≥75% of the total number of respondents. A total of two Delphi rounds was needed to validate the prototype model. Out of a total of 51 experts who were initially contacted, 50.9% (n = 26) completed the first round of the Delphi, and 92.3% (n = 24) of those in the first round participated in the second. Most of the 24 full participants considered themselves to be a running expert (66.7%), and approximately a third indicated their expertise as a systems thinker (33.3%). After the second round, 91.7% of the experts agreed that the prototype model was a valid description of the Australian distance running system. This is the first study to formally examine the development and prevention of RRI from an ecological and complex systems perspective. The validated model of the Australian distance running system facilitates theoretical advancement in terms of identifying practical system
Dassau, Eyal; Jovanovic, Lois; Doyle, Francis J; Zisser, Howard C
Intensive insulin therapy has an inherent risk of hypoglycemia that can lead to loss of consciousness, cardiac arrhythmia, seizure, and death ("dead-in-bed syndrome"). This risk of hypoglycemia is a major concern for patients, families, and physicians. The need for an automated system that can alert in the event of severe hypoglycemia is evident. In engineering systems, where there is a risk of malfunction of the primary control system, alert and safety mechanisms are implemented in layers of protection. This concept has been adopted in the proposed system that integrates a hypoglycemia prediction algorithm with a global position system (GPS) locator and short message service such that the current glucose value with the rate of change (ROC) and the location of the subject can be communicated to a predefined list. Furthermore, if the system is linked to the insulin pump, it can suspend the pump or decrease the basal insulin infusion rate to prevent the pending event. The system was evaluated on clinical datasets of glucose tracings from the DexCom Seven system. Glucose tracings were analyzed for hypoglycemia events and then a text message was broadcast to a predefined list of people who were notified with the glucose value, ROC, GPS coordinates, and a Google map of the location. In addition to providing a safety layer to a future artificial pancreas, this system also can be easily implemented in current continuous glucose monitors to help provide information and alerts to people with diabetes.
Audouze, Karine; Taboureau, Olivier; Grandjean, Philippe
The need to prevent developmental brain disorders has led to an increased interest in efficient neurotoxicity testing. When an epidemic of microcephaly occurred in Brazil, Zika virus infection was soon identified as the likely culprit. However, the pathogenesis appeared to be complex, and a larvi......The need to prevent developmental brain disorders has led to an increased interest in efficient neurotoxicity testing. When an epidemic of microcephaly occurred in Brazil, Zika virus infection was soon identified as the likely culprit. However, the pathogenesis appeared to be complex......). Especially in an acute situation like the microcephaly epidemic, where little toxicity documentation is available, new and innovative alternative methods, whether in vitro or in silico, must be considered. We have developed a network-based model using an integrative systems biology approach to explore...
Full Text Available The aim of this study is to explore whether risk perception or anticipated regret is responsible for intensifying the participants’ intention to adopt a tire pressure monitoring system (TPMS to prevent a tire-related accident, and whether the optimism bias has a moderator effect between risk perception/anticipated regret and intention. With 274 valid questionnaires and PLS-SEM (partial least squares structural equation modeling analysis, the results indicate a significant positive relationship between risk perception and intention to adopt TPMS, but not between anticipated regret and intention. The moderator effect of optimism bias on risk perception and anticipated regret is not found in the model. The findings will prove useful for public service advertising campaigns by providing a basis for an understanding of the role of cognitive and emotional factors in tire-blowout accident prevention, thereby increasing the motivation for drivers in Taiwan to take advantage of the protection afforded them by using TPMS.
This document reviews the scour protection systems required around port structures where these are to be used for the berthing of vessels powered by water jet systems. The development of a scour protection system at Poole Harbour in Dorset has been documented and reviewed and a series of laboratory investigations were then undertaken. This has enabled a greater understanding of the scour mechanisms from the water jet propulsion systems of High Speed Ships. This work has shown t...
Frerichs, Leah; Hassmiller Lich, Kristen; Young, Tiffany L; Dave, Gaurav; Stith, Doris; Corbie-Smith, Giselle
Engaging youth from racial and ethnic minority communities as leaders for change is a potential strategy to mobilize support for addressing childhood obesity, but there are limited curricula designed to help youth understand the complex influences on obesity. Our aim was to develop and pilot test a systems science curriculum to elicit rural African American youth perspectives on childhood obesity and enhance their understanding of and support for obesity prevention solutions. The curriculum was designed so it could be integrated with existing positive youth development curricula that help youth advocate for and implement identified solutions. We conducted four workshop sessions with youth that engaged them in systems learning activities such as guided systems diagramming activities. The participants ( n = 21) completed validated surveys presession and postsession that assessed their causal attributions of obesity and support for obesity prevention policies. The youths' perception that environmental factors cause obesity increased ( p < .05), and perceptions that individual behavior and biology cause obesity did not change. Their support for policies that addressed food access and food pricing significantly increased ( p < .05). The youths' system diagrams elucidated links between multilevel factors such as personal attitudes, social influence, and the built environment, which provides important information for designing synergistic solutions. The changes we observed in youths' perceptions of obesity and support for policy changes have important implications for youths' interest and willingness to advocate for social and environmental changes in their community. The strategies have a promising role in supporting community mobilization to address childhood obesity.
Wang Hongyan; Tan Mingliang; Zhu Zhenghe
The present calculational results of the temperature dependence of standard Gibbs free energy change ΔG 0 for the reactions of CO and H 2 with U, UO 2 , UO 3 and U 3 O 8 , respectively, instructively show that the uranium polyoxides surface will tend to a compact and stable coated with nearly UO 2 crystal so-called 'the bluntly thin skin' preventing further corrosion. It is presumably like the protecting aluminum surface with its oxidized layer. This conceptional model explored for the first-time has been confirmed by the latest works
Suicide as an individual and public health challenge in the U.S. Army. Psychiatry, 74(2), 110–4. doi:http://dx.doi.org.libproxy.nps.edu/10.1521/ psyc ...Interpersonal and Biological Processes, 74(2), 121–23. doi:http://dx.doi.org.libproxy.nps.edu/10.1521/ psyc .2011.74.2.121 Mastroianni, G. R., & Scott, W. J...Suicide prevention in a deployed military unit. Psychiatry, 74(2), 127–41. doi:http://dx.doi.org.libproxy.nps.edu/10.1521/ psyc .2011.74.2.127 130
Sjølie, A K; Dodson, P; Hobbs, F R R
Diabetes management has increasingly focused on the prevention of macrovascular disease, in particular for type 2 diabetes. Diabetic retinopathy, one of the main microvascular complications of diabetes, is also an important public health problem. Much of the care invested in retinopathy relates...... the primary trial end-points were not met, there was a clear trend to less severe retinopathy with RAS blockade. A smaller trial, RASS, reported reduced retinopathy progression in type 1 diabetes from RAS blockade with both the ARB losartan and the angiotensin converting enzyme (ACE) inhibitor enalapril...
Hashemi Toghroljerdi, Seyedmostafa; Østergaard, Jacob
to handle a high share of PV power. This paper provides an in-depth review of methods and strategies proposed to prevent overvoltage in LV grids with PV, and discusses the effectiveness, advantages, and disadvantages of them in detail. Based on the mathematical framework presented in the paper......, the overvoltage caused by high PV penetration is described, solutions to facilitate higher PV penetration are classified, and their effectiveness, advantages, and disadvantages are illustrated. The investigated solutions include the grid reinforcement, electrical energy storage application, reactive power...
Rio del Gonzalez, J. A.; Junquera Cimadevilla, B.
The aim of this article is to analyse the relations among quality management systems, environmental management systems and risk prevention actions. The results allow us to conclude that, in the same way as industrial companies in Spain have adapted to the quality requirements to continue to be competitive, in the future they are likely to take advantage of the synergies of the systems dedicated to this activity with the environment and, it is even possible that with risk prevention practices. (Author) 21 refs.
Full Text Available Diet plays a vital role in the management of cancer because they are the source of important physiologically functional components. Scientific observations support the idea that dietary supplement can prevent breast cancer recurrences. Strong correlations are established between the high intake of saturated fat and the incidence of different types of cancer. It is found that chronic alcohol consumption is associated with increased risk of cancers of oral cavity, pharynx, esophagus, and larynx. Again, some evidences are also found regarding phosphorous, glutamate level in the body, and incidence of cancer. Different physiologically functional components are found in the dietary materials. Fibers, the major dietary components, have long been recognized for the unique properties in the treatment of cancer, which are related to its antineoplastic functions. Antioxidant rich diet has been added to the list of cancer-preventing dietary components. Also, recently published research has shown that natural carotenoids in the diet leads to a normalization of body epithelial cells and protects against the risk of stomach and esophagus cancer, and improves the immune system′s response. Again, fruit juices, processed vegetable juices, orange peel, green tea, vitamins, flavonoids, and trace materials have cancer inhibitory properties. Clearly, there has been increasing recognition of chemoprotective functions. Now, it can be recognized for another kind of functionality for the improvement of the health of mankind.
Robert E. Smith
Full Text Available It is widely believed that consuming foods and beverages that have high concentrations of antioxidants can prevent cardiovascular diseases and many types of cancer. As a result, many articles have been published that give the total antioxidant capacities of foods in vitro. However, many antioxidants behave quite differently in vivo. Some of them, such as resveratrol (in red wine and epigallocatechin gallate or EGCG (in green tea can activate the nuclear erythroid-2 like factor-2 (Nrf2 transcription factor. It is a master regulator of endogenous cellular defense mechanisms. Nrf2 controls the expression of many antioxidant and detoxification genes, by binding to antioxidant response elements (AREs that are commonly found in the promoter region of antioxidant (and other genes, and that control expression of those genes. The mechanisms by which Nrf2 relieves oxidative stress and limits cardiac injury as well as the progression to heart failure are described. Also, the ability of statins to induce Nrf2 in the heart, brain, lung, and liver is mentioned. However, there is a negative side of Nrf2. When over-activated, it can cause (not prevent cardiovascular diseases and multi-drug resistance cancer.
Krista L. Thyberg
Full Text Available Waste management is a complex task involving numerous waste fractions, a range of technological treatment options, and many outputs that are circulated back into society. A systematic, interdisciplinary systems management framework was developed to facilitate the planning, implementation, and maintenance of sustainable waste systems. It aims not to replace existing decision-making approaches, but rather to enable their integration to allow for inclusion of overall sustainability concerns and address the complexity of solid waste management. The framework defines key considerations for system design, steps for performance monitoring, and approaches for facilitating continual system improvements. It was developed by critically examining the literature to determine what aspects of a management framework would be most effective at improving systems management for complex waste systems. The framework was applied to food waste management as a theoretical case study to exemplify how it can serve as a systems management tool for complex waste systems, as well as address obstacles typically faced in the field. Its benefits include the integration of existing waste system assessment models; the inclusion of environmental, economic, and social priorities; efficient performance monitoring; and a structure to continually define, review, and improve systems. This framework may have broader implications for addressing sustainability in other disciplines.
Full Text Available Here we report on the issue of Advanced Persistent Threats (APT, which use malware for the purpose of leaking the data of large corporations and government agencies. APT attacks target systems continuously by utilizing intelligent and complex technologies. To overthrow the elaborate security network of target systems, it conducts an attack after undergoing a pre-reconnaissance phase. An APT attack causes financial loss, information leakage, etc. They can easily bypass the antivirus system of a target system. In this paper, we propose a Multi-Layer Defense System (MLDS that can defend against APT. This system applies a reinforced defense system by collecting and analyzing log information and various information from devices, by installing the agent on the network appliance, server and end-user. It also discusses how to detect an APT attack when one cannot block the initial intrusion while continuing to conduct other activities. Thus, this system is able to minimize the possibility of initial intrusion and damages of the system by promptly responding through rapid detection of an attack when the target system is attacked.
Euphemio, Mauro; Montesanti, Jose Ricardo; Braganca, Elton Jorge; Almeida, Murilo Mesquita de; Coelho, Eduardo; Maia, Alexandre Rodrigues; Peres, Marcelo Borges [PETROBRAS, Rio de Janeiro, RJ (Brazil)
This paper will refer briefly to some key aspects considered for the design of an Electrically Heated Pipe-in-Pipe- EHPIP system integrated to an Electric Submersible Pump-ESP, to be located at 1800 m water depth in the Campos Basin. In this system, under normal operation the well will be producing through the ESP and in case of long well shut in and during well restart up, a percentage of the electrical power will be delivered to heat the PIP system. The electrical system will have a common sub sea power cable and an Electrical Switch Module, to switch power alternatively to the heating system or to the pump. The systems will not operate simultaneously. (author)
Choudhary, Pratik; Olsen, Birthe S; Conget, Ignacio
was avoided with this strategy, as well as to assess user acceptance of the system and its insulin management features. SUBJECTS AND METHODS: Forty subjects with type 1 diabetes used the system for 4 weeks. We retrospectively evaluated performance of the system, using downloaded pump and sensor data...... between paired SG and BG values was 10.9 ± 13.8%. Subjects felt confident using the system, agreed that it helped protect them from hypoglycemia, and wished to continue using it. CONCLUSIONS: Automatic insulin pump suspension as implemented in the MiniMed 640G system can help patients avoid hypoglycemia......BACKGROUND: The MiniMed 640G sensor-augmented insulin pump system (Medtronic, Inc., Northridge, CA) can automatically suspend insulin delivery in advance of predicted hypoglycemia and restart it upon recovery. The aims of this analysis were to determine the rate at which predicted hypoglycemia...
oxidation products. Efficients strategies to prevent lipid oxidation are therefore required. Such strategies include addition of antioxidants or the use of omega-3 delivery emulsions. However, antioxidant efficacy in complex omega-3 enriched foods are influenced by many factors including the lipophilicity...... of the antioxidants. Selection of the optimal antioxidant system is therefore a major challenge. Likewise, a range of factors can influence the ability of omega-3 delivery systems to protect the omega-3 fatty acids against oxidation after addition to food systems. These challenges will be discussed......Due to the health beneficial effects of marine omega-3 fatty acids there is an increasing interest in developing functional foods containing these healthy fatty acids. However, such foods are very susceptible to lipid oxidation, which will give rise to undesirable off-flavours and unhealthy...
Masilo, Daniel Tuelo
Children have the right to be brought up in safe environments. However, this right is often infringed by people who are supposed to provide love, care, and protection to children. These people can include biological fathers, step-fathers, brothers, cousins, aunts, mothers, and uncles. Violation of children takes place in a variety of ways, however, for the purpose of this paper, the focus is on child sexual abuse within the family system. A literature review is adopted as the methodology for the discussions in this paper. The purpose of this paper is firstly to demonstrate that child sexual abuse happens within the family system in South Africa, and secondly, to argue that the prevention of child sexual abuse should start within the family system and this can be achieved by conducting educational social group work sessions on child sexual abuse with the family members.
Paul W Denton
Full Text Available Successful antiretroviral pre-exposure prophylaxis (PrEP for mucosal and intravenous HIV-1 transmission could reduce new infections among targeted high-risk populations including discordant couples, injection drug users, high-risk women and men who have sex with men. Targeted antiretroviral PrEP could be particularly effective at slowing the spread of HIV-1 if a single antiretroviral combination were found to be broadly protective across multiple routes of transmission. Therefore, we designed our in vivo preclinical study to systematically investigate whether rectal and intravenous HIV-1 transmission can be blocked by antiretrovirals administered systemically prior to HIV-1 exposure. We performed these studies using a highly relevant in vivo model of mucosal HIV-1 transmission, humanized Bone marrow/Liver/Thymus mice (BLT. BLT mice are susceptible to HIV-1 infection via three major physiological routes of viral transmission: vaginal, rectal and intravenous. Our results show that BLT mice given systemic antiretroviral PrEP are efficiently protected from HIV-1 infection regardless of the route of exposure. Specifically, systemic antiretroviral PrEP with emtricitabine and tenofovir disoproxil fumarate prevented both rectal (Chi square = 8.6, df = 1, p = 0.003 and intravenous (Chi square = 13, df = 1, p = 0.0003 HIV-1 transmission. Our results indicate that antiretroviral PrEP has the potential to be broadly effective at preventing new rectal or intravenous HIV transmissions in targeted high risk individuals. These in vivo preclinical findings provide strong experimental evidence supporting the potential clinical implementation of antiretroviral based pre-exposure prophylactic measures to prevent the spread of HIV/AIDS.
Malakellis, Mary; Hoare, Erin; Sanigorski, Andrew; Crooks, Nicholas; Allender, Steven; Nichols, Melanie; Swinburn, Boyd; Chikwendu, Cal; Kelly, Paul M; Petersen, Solveig; Millar, Lynne
The Australian Capital Territory 'It's Your Move!' (ACT-IYM) was a three-year (2012-2014) systems intervention to prevent obesity among adolescents. The ACT-IYM project involved three intervention schools and three comparison schools and targeted secondary students aged 12-16 years. The intervention consisted of multiple initiatives at individual, community, and school policy level to support healthier nutrition and physical activity. Intervention school-specific objectives related to increasing active transport, increasing time spent physically active at school, and supporting mental wellbeing. Data were collected in 2012 and 2014 from 656 students. Anthropometric data were objectively measured and behavioural data self-reported. Proportions of overweight or obesity were similar over time within the intervention (24.5% baseline and 22.8% follow-up) and comparison groups (31.8% baseline and 30.6% follow-up). Within schools, two of three the intervention schools showed a significant decrease in the prevalence of overweight and obesity (pobesity among adolescents. Implications for public health: The incorporation of systems thinking has been touted as the next stage in obesity prevention and public health more broadly. These findings demonstrate that the use of systems methods can be effective on a small scale. © 2017 The Authors.
Bellis Mark A
Full Text Available Abstract Background Emergency department (ED data have the potential to provide critical intelligence on when violence is most likely to occur and the characteristics of those who suffer the greatest health impacts. We use a national experimental ED monitoring system to examine how it could target violence prevention interventions towards at risk communities and optimise acute responses to calendar, holiday and other celebration-related changes in nighttime assaults. Methods A cross-sectional examination of nighttime assault presentations (6.01 pm to 6.00 am; n = 330,172 over a three-year period (31st March 2008 to 30th March 2011 to English EDs analysing changes by weekday, month, holidays, major sporting events, and demographics of those presenting. Results Males are at greater risk of assault presentation (adjusted odds ratio [AOR] 3.14, 95% confidence intervals [CIs] 3.11-3.16; P 2 = 0.918; P Conclusions To date, the role of ED data has focused on helping target nightlife police activity. Its utility is much greater; capable of targeting and evaluating multi-agency life course approaches to violence prevention and optimising frontline resources. National ED data are critical for fully engaging health services in the prevention of violence.
Abidin, Norhaslinda Zainal; Zaibidi, Nerda Zura; Zulkepli, Jafri Hj
Obesity is a medical condition where an individual has an excessive amount of body fat. There are many factors contributing to obesity and one of them is the sedentary behaviour. Rapid development in industrialization and urbanization has brought changes to Malaysia's socioeconomic, especially the lifestyles of Malaysians. With this lifestyle transition, one of the impact is on weight and obesity. How does sedentary behaviour have an impact on the growth of Malaysian population's weight and obesity? What is the most effective sedentary behaviour preventing strategy to obesity? Is it through reduction in duration or frequency of sedentary behaviour? Thus, the aim of this paper is to design an intervention to analyse the effect of decreasing duration and frequency of sedentary behaviour on the population reversion trends of average weight (AW), average body mass index (ABMI), and prevalence of overweight and obesity (POVB). This study combines the different strands of sub-models comprised of nutrition, physical activity and body metabolism, and then synthesis these knowledge into a system dynamics of weight behaviour model, namely SIMULObese. Findings from this study revealed that Malaysian's adults spend a lot of time engaged in sedentary behaviour and this resulted in weight gain and obesity. Comparing between frequency and duration of sedentary behaviour, this study reported that reduced in duration or time spend in sedentary behaviour is a better preventing strategy to obesity compared to duration. As a summary, this study highlighted the importance of decreasing the frequency and duration of sedentary behaviour in developing guidelines to prevent obesity.
Ng, Wil; Brown, Adrian; Alexander, Doreen; Ho, Man Fan; Kerr, Bonnie; Amato, Michelle; Katz, Kevin
We assessed the effects of the components of a multifaceted and evidence-based caesarean-section surgical site infection (SSI) prevention program on the SSI rate after cesarean section using a postdischarge surveillance (PDS) system. Multiple prevention interventions were serially implemented. SSI case finding was undertaken through active inpatient surveillance and intensive PDS using a standardized form at the 6-week postdischarge visit. SSI diagnosis was made using the Centers for Disease Control and Prevention standardized criteria. All cesarean deliveries between July 2007 and December 2012 were included. Changes in SSI rate were analyzed using segmented regression analysis. Nine thousand four hundred forty-two cesarean sections were assessed during the study period. PDS forms were completed for 7,985 women (85%). SSI was detected in 451 cases (5.6%): 91% were superficial, 9% were deep/organ-space infections. The SSI rate decreased incrementally from 8.2% at baseline to 4.1%; significant decreases were observed after optimizing antibiotic prophylaxis timing, using a surgical safety checklist, and enhancing prenatal education to discourage prehospital self-removal of hair. Nonelective surgeries or those undertaken after >12 hours of rupture of membranes had a significantly higher rate compared with those without either risk factor (6.3% vs 3.2%; P section. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Miyo, Kengo; Nittami, Yuki S; Kitagawa, Yoichiro; Ohe, Kazuhiko
The purpose of this study was to develop a new alerting and recommender system for preventing medication errors. In recent years, alerting systems have been widely implemented, but because these systems apply a same static threshold for all patients in all cases, they produce excessive alerts and subject physicians to "alert fatigue". We believe that the most commonly-written prescription for a patient's status is the safest one. From this standpoint, we developed a real-time case-based medication alerting and recommender system linked to a database of past prescriptions. When a physician issues his or her prescription, our system dynamically compares it with past ones for similar patients in the database. An analysis of the 10 most frequently-used drugs in the University of Tokyo Hospital revealed that our system reduced the number of false alerts compared to the traditional static alert method. Our system contributes to the creation of alerts that are appropriate for patients' clinical conditions and based on physicians' empirical discretion.
Ennis, Andrew; Cleland, Ian; Patterson, Timothy; Nugent, Chris D; Cruciani, Federico; Paggetti, Cristiano; Morrison, Gareth; Taylor, Richard
Safety and security rank highly in the priorities of older people on both an individual and policy level. Older people are commonly targeted as victims of doorstep crime, as they can be perceived as being vulnerable. As a result, this can have a major effect on the victim's health and wellbeing. There have been numerous prevention strategies implemented in an attempt to combat and reduce the number of doorstep crimes. There is, however, little information available detailing the effectiveness of these strategies and how they impact on the fear of crime, particularly with repeat victims. There is therefore clear merit in the creation and piloting of a technology based solution to combat doorstep crime. This paper presents a developed solution to provide increased security for older people within their home.
de Miranda Prottes, Verônica; Oliveira, Nádia Cristina; de Oliveira Andrade, Alessandra Barbosa
This paper introduces the Ergonomic Work Analysis as a relevant instrument to identify the risks in occupational environments through the investigation of factors that influence the relationship between the worker and the productive process. It draws a parallel between the several aspects of risk identification in traditional tools of Health and Safety Management and the factors embraced by the Ergonomic Work Analysis, showing that the ergonomic methodology is able to go deeper in the scenarios of possible incident causes. This deepening enables the establishment of a relationship between the work context and the upcoming damage to the physical integrity of the worker. It acts as a complementary instrument in the traditional approach to the risk management. In order to explain the application of this methodology in a preventive way, it is presented a case study of a coal mill inspector in a siderurgic company.
The "ten principles", developed by the Federal Ministry of Labour in 1985, mark an important turning point in the government's efforts to reform the health-care system. Citizens' self-reliance became a central objective. The implementation of the idea of prevention--postulated in the principles as well--was generally welcomed, but accentuated in different ways by the various stakeholders. An extension of specific measures, for example in occupational medicine, was rejected by liberal business circles. Georg Thieme Verlag KG Stuttgart, New York.
Zhang, Ning; Melo, Mary A. S.; Chen, Chen; Liu, Jason; Weir, Michael D.; Bai, Yuxing; Xu, Hockin H. K.
Objectives The objectives of this study were to: (1) develop a novel adhesive for prevention of tooth root caries and secondary caries by possessing a combination of protein-repellent, antibacterial, and remineralization capabilities for the first time; and (2) investigate the effects of 2-methacryloyloxyethyl phosphorylcholine (MPC), dimethylaminohexadecyl methacrylate (DMAHDM), and nanoparticles of amorphous calcium phosphate (NACP) on dentine bond strength, protein-repellent properties, and dental plaque microcosm biofilm response. Methods MPC, DMAHDM and NACP were added into Scotchbond Multi-Purpose primer and adhesive. Dentine shear bond strengths were measured. Adhesive coating thickness, surface texture and dentine-adhesive interfacial structure were examined. Protein adsorption onto adhesive resin surface was determined by the micro bicinchoninic acid method. A human saliva microcosm biofilm model was used to investigate biofilm metabolic activity, colony-forming unit (CFU) counts, and lactic acid production. Results The resin with 7.5% MPC + 5% DMAHDM + 30% NACP did not adversely affect dentine shear bond strength (p > 0.1). The resin with 7.5% MPC + 5% DMAHDM + 30% NACP produced a coating on root dentine with a thickness of approximately 70 μm and completely sealed all the dentinal tubules. The resin with 7.5% MPC + 5% DMAHDM + 30% NACP had 95% reduction in protein adsorption, compared to SBMP control (p control. Significance The novel multifunctional adhesive with strong protein-repellent, antibacterial and remineralization properties is promising to coat tooth roots to prevent root caries and secondary caries. The combined use of MPC, DMAHDM and NACP may have wide applicability to bonding agents, cements, sealants and composites to inhibit caries. PMID:26187532
Hu, Junjie; Si, Chengyong; Lind, Morten
In this paper, a hierarchical management system is proposed to integrate electric vehicles (EVs) into a distribution grid. Three types of actors are included in the system: Distribution system operators (DSOs), Fleet operators (FOs) and EV owners. In contrast to a typical hierarchical control...... system where the upper level controller directly controls the lower level subordinated nodes, this study aims to integrate two common indirect control methods:market-based control and price-based control into the hierarchical electric vehicles management system. Specifically, on the lower level...... of the hierarchy, the FOs coordinate the charging behaviors of their EV users using a price-based control method. A parametric utility model is used on the lower level to characterize price elasticity of electric vehicles and thus used by the FO to coordinate the individual EV charging. On the upper level...
Matthew Lee eSmith
Full Text Available Among older adults, falls are the leading cause of injury-related deaths and emergency department visits, and the incidence of falls in the United States is rising as the number of older Americans increases. Research has shown that falls can be reduced by modifying fall risk factors using multifactorial interventions implemented in clinical settings. However, the literature indicates many providers feel they do not know how to conduct fall risk assessments or do not have adequate knowledge about fall prevention To help healthcare providers incorporate older adult fall prevention (i.e., falls risk assessment and treatment into their clinical practice, the Centers for Disease Control and Prevention’s (CDC Injury Center has developed the STEADI (Stopping Elderly Accidents, Deaths, and Injuries tool kit. This study was conducted to identify the practice characteristics and providers’ beliefs, knowledge, and fall-related activities before they received training on how to use the STEADI tool kit. Data were collected as part of a larger State Fall Prevention Project funded by CDC’s Injury Center. Completed questionnaires were returned by 38 medical providers from 11 healthcare practices within a large New York health system. Healthcare providers ranked falls as the lowest priority of five conditions, after diabetes, cardiovascular disease, mental health, and musculoskeletal conditions. Less than 40% of the providers asked most or all of their older patients if they had fallen during the past 12 months. Less than a quarter referred their older patients to physical therapists for balance or gait training, and less than 20% referred older patients to community-based fall prevention programs. Less than 16% reported they conducted standardized functional assessments with their older patients at least once a year. These results suggest that implementing the STEADI tool kit in clinical settings could address knowledge gaps and provide the necessary
Brandon D L Marshall
Full Text Available HIV transmission among injecting and non-injecting drug users (IDU, NIDU is a significant public health problem. Continuing propagation in endemic settings and emerging regional outbreaks have indicated the need for comprehensive and coordinated HIV prevention. We describe the development of a conceptual framework and calibration of an agent-based model (ABM to examine how combinations of interventions may reduce and potentially eliminate HIV transmission among drug-using populations.A multidisciplinary team of researchers from epidemiology, sociology, geography, and mathematics developed a conceptual framework based on prior ethnographic and epidemiologic research. An ABM was constructed and calibrated through an iterative design and verification process. In the model, "agents" represent IDU, NIDU, and non-drug users who interact with each other and within risk networks, engaging in sexual and, for IDUs, injection-related risk behavior over time. Agents also interact with simulated HIV prevention interventions (e.g., syringe exchange programs, substance abuse treatment, HIV testing and initiate antiretroviral treatment (ART in a stochastic manner. The model was constructed to represent the New York metropolitan statistical area (MSA population, and calibrated by comparing output trajectories for various outcomes (e.g., IDU/NIDU prevalence, HIV prevalence and incidence against previously validated MSA-level data. The model closely approximated HIV trajectories in IDU and NIDU observed in New York City between 1992 and 2002, including a linear decrease in HIV prevalence among IDUs. Exploratory results are consistent with empirical studies demonstrating that the effectiveness of a combination of interventions, including syringe exchange expansion and ART provision, dramatically reduced HIV prevalence among IDUs during this time period.Complex systems models of adaptive HIV transmission dynamics can be used to identify potential collective benefits
One limitation of existing information support systems is that the 'end user' (i.e., decision maker) is not properly accounted for in these systems. Therefore, it is needed to consider how the information to be provided by the system is going to be used and to recognize the cognitive decision making process. To discuss how to consider the end user as an integral part of decision support systems (DSS) a Technical Committee Meeting on 'User's Requirements for DSS' was organized by the IAEA in Vienna from 28 November - 1 December 1988. The meeting was attended by 45 participants from 22 countries and international organizations. Sixteen papers have been presented in three technical sessions, which addressed the following areas: Problem identification; design of DSS; user's considerations in DSSs. A separate abstract was prepared for each of these papers. Refs, figs and tabs
Thyberg, Krista; Tonjes, David
Waste management is a complex task involving numerous waste fractions, a range of technological treatment options, and many outputs that are circulated back into society. A systematic, interdisciplinary systems management framework was developed to facilitate the planning, implementation, and maintenance of sustainable waste systems. It aims not to replace existing decision-making approaches, but rather to enable their integration to allow for inclusion of overall sustainability concerns and ...
Fontell, E.; Kivisaari, T.; Christiansen, N.; Hansen, J.-B.; Pålsson, J.
In August 2002, Wärtsilä Corporation and Haldor Topsøe A/S entered into a co-operation agreement to start joint development program within the planar SOFC technology. The development program aims to bring to the market highly efficient, clean and cost competitive fuel cell systems with power outputs above 200 kW for distributed power generation with CHP and for marine applications. In this study, the product concept for a 250 kW natural gas-fuelled atmospheric SOFC plant has been studied. The process has been calculated and optimised for high electrical efficiency. In the calculations, system efficiencies more than 55-85% (electrical co-generation) have been reached. The necessary balance of plant (BoP) components have been identified and the concept for grid connection has been defined. The BoP includes fuel and air supply, anode re-circulation, start-up steam, purge gas, exhaust gas heat recovery, back-up power, power electronics and control system. Based on the analysed system and component information, a conceptual design and cost break down structure for the product have been made. The cost breakdown shows that the stack, system control and power electronics are the major cost factors, while the remaining BoP equipment stands for a minor share of the manufacturing cost. Finally, the feasibility of the SOFC plants has been compared to gas engines.
Lindhardt, Morten; Persson, Frederik; Currie, Gemma
INTRODUCTION: Diabetes mellitus affects 9% of the European population and accounts for 15% of healthcare expenditure, in particular, due to excess costs related to complications. Clinical trials aiming for earlier prevention of diabetic nephropathy by renin angiotensin system blocking treatment...
Gu, Beom W.; Choi, Su Y.; Yim, Man S.; Rim, Chun T. [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)
It becomes evident that severe accidents may occur by unexpected disasters such as tsunami, heavy flood, or terror. Once radioactive material is released from NPP through severe accidents, there are no ways to prevent the released radioactive gas spreading in the air. As a remedy for this problem, the idea on the portable filtered air suction system (PoFASS) for the prevention of released radioactive gas under severe accidents was proposed. In this paper, the conceptual design of a PoFASS focusing on the number of robot fingers and robot arm rods are proposed. In order to design a flexible robot suction nozzle, mathematical models for the gaps which represent the lifted heights of extensible covers for given convex shapes of pipes and for the covered areas are developed. In addition, the system requirements for the design of the robot arms of PoFASS are proposed, which determine the accessible range of leakage points of released radioactive gas. In this paper, the conceptual designs of the flexible robot suction nozzle and robot arm have been conducted. As a result, the minimum number of robot fingers and robot arm rods are defined to be four and three, respectively. For further works, extensible cover designs on the flexible robot suction nozzle and the application of the PoFASS to the inside of NPP should be studied because the radioactive gas may be released from connection pipes between the containment building and auxiliary buildings.
Full Text Available Annually, tens of millions of first-ever strokes occur in the world; however, currently there is lack of effective and widely applicable pharmacological treatments for stroke patients. Herbal medicines, characterized as multi-constituent, multi-target and multi-effect, have been acknowledged with conspicuous effects in treating stroke, and attract extensive interest of researchers although the mechanism of action is yet unclear. In this work, we introduce an innovative systems-pharmacology method that combines pharmacokinetic prescreening, target fishing and network analysis to decipher the mechanisms of action of 10 herbal medicines like Salvia miltiorrhizae, Ginkgo biloba and Ephedrae herba which are efficient in stroke treatment and prevention. Our systematic analysis results display that, in these anti-stroke herbal medicines, 168 out of 1285 constituents with the favorable pharmacokinetic profiles might be implicated in stroke therapy, and the systematic use of these compounds probably acts through multiple mechanisms to synergistically benefit patients with stroke, which can roughly be classified as preventing ischemic inflammatory response, scavenging free radicals and inhibiting neuronal apoptosis against ischemic cerebral damage, as well as exhibiting lipid-lowering, anti-diabetic, anti-thrombotic and antiplatelet effects to decrease recurrent strokes. Relying on systems biology-based analysis, we speculate that herbal medicines, being characterized as the classical combination therapies, might be not only engaged in multiple mechanisms of action to synergistically improve the stroke outcomes, but also might be participated in reducing the risk factors for recurrent strokes.
Full Text Available Since 2004, the Cicrp: “Centre Interrégional de Conservation et Restauration du Patrimoine”, located in Marseilles has been involved in an interdisciplinary research program dealing with infestation and re-infestation, on lining pastes used in painting conservation, by the Stegobium paniceum through a GIS system : a geographical information system called “StegoGIS”. The GIS helps understand the insects ethology in its environmental context, mainly in flour and semolina millings in order to determine analysis criteria to prevent, mitigate and fight infestation in the cultural property environment. Our approach is based on three main lines: 1- A transverse approach of infestation in any type of cultural heritage institution: archives, libraries, museums, historic buildings where organic material collections and environment are attractive on an “insect point of view”. 2 –An IPM strategy (Integrated Pest Management including conservation and management of collections and buildings also based on an infestation survey with actual or potential risks. 3- A “decision- making tool” in diagnosis, preventing methods and treatments for professional conservation staff.
Full Text Available Against the background of the EU2020 headline target of reducing early school leaving to 10% across Europe, this article examines the conceptual foundations of the understanding of inclusive systems for early school leaving prevention that has emerged in EU policy documents and research reports in recent years. Traditionally, inclusive education has referred to a focus on children with special educational needs. However, this conceptual review examines how inclusion is increasingly being examined in broader terms.This review seeks to critically reconstruct foundational understandings of systems and resilience in developmental and educational psychology. A systems focus on inclusion needs to address the neglect in psychology of system blockages and power imbalances. Resilience is typically framed as the capacity of the individual to navigate their way to environmental resources. This places the onus of accessibility onto the individual’s efforts rather than a concern with responsive systems accessible to marginalised groups. A concern with inclusive systems goes beyond not only the well-established framework of individual resilience in developmental psychology, but also beyond its expansion into resilient systems, as these omit a focus on outreach and multidisciplinary teams in systems of care for integrated services. Common principles for a framework of inclusive systems include children’s voices, equality and non-discrimination, parental involvement that is integrated holistically with family support, and lifelong learning principles for schools. Illustrative examples of these principles for reforming authoritarian teaching and discriminatory bullying, for opening schools to the local community and for targeting those with highest levels of need are highlighted.
Full Text Available The strength of pedicle screws attachment to the vertebrae is an important factor affecting their motion resistance and long term performance. Low bone quality, e.g. in osteopenic patients, keeps the screw bone interface at risk for subsidence and dislocation. In such cases, bone cement could be used to augment pedicle screw fixation. But its use is not free of risk. Therefore, clinicians, especially spine surgeons, radiologists, and internists should become increasingly aware of cement migration and embolism as possible complications. Here, we present an instructive case of cement embolism into the venous system after augmented screw fixation with fortunately asymptomatic clinical course. In addition we discuss pathophysiology and prevention methods as well as therapeutic management of this potentially life-threatening complication in a comprehensive review of the literature. However, only a few case reports of cement embolism into the venous system were published after augmented screw fixation.
... Healthy Living Healthy Living Healthy Living Nutrition Fitness Sports Oral Health Emotional Wellness Growing Healthy Sleep Safety & Prevention Safety & Prevention Safety and Prevention Immunizations At Home ...
How can we optimize a bedridden patient’s mattress? How can we make a passenger seat on a long distance flight or ride more comfortable? What qualities should a runner’s shoes have? To objectively address such questions using engineering and scientific methods, adequate virtual human body models for use in computer simulation of loading scenarios are required. The authors have developed a novel method incorporating subject studies, magnetic resonance imaging, 3D-CAD-reconstruction, continuum mechanics, material theory and the finite element method. The focus is laid upon the mechanical in vivo-characterization of human soft tissue, which is indispensable for simulating its mechanical interaction with, for example, medical bedding or automotive and airplane seating systems. Using the examples of arbitrary body support systems, the presented approach provides visual insight into simulated internal mechanical body tissue stress and strain, with the goal of biomechanical optimization of body support systems. ...
Stojan, George; Baer, Alan N
Systemic lupus erythematosus is a systemic autoimmune disease that primarily affects women in their reproductive age years. Pregnancy in systemic lupus erythematosus now has favorable outcomes for the majority of women. However, flares of disease activity, preeclampsia, fetal loss, intrauterine growth retardation and preterm birth are established risks of such pregnancies. Active lupus nephritis at the time of conception poses the greatest risk for disease flares and poor obstetric outcomes. Patients should delay conception until their lupus has been in remission for at least 6 months. In addition, certain lupus medications are potentially teratogenic and need to be stopped before conception. The signs and symptoms of a lupus flare may mimic those of normal pregnancy, impeding its recognition during pregnancy. Hydroxychloroquine, low-dose prednisone, pulse intravenous methylprednisolone and azathioprine are commonly used to treat lupus flares during pregnancy.
Choudhary, Pratik; Olsen, Birthe S; Conget, Ignacio; Welsh, John B; Vorrink, Linda; Shin, John J
The MiniMed 640G sensor-augmented insulin pump system (Medtronic, Inc., Northridge, CA) can automatically suspend insulin delivery in advance of predicted hypoglycemia and restart it upon recovery. The aims of this analysis were to determine the rate at which predicted hypoglycemia was avoided with this strategy, as well as to assess user acceptance of the system and its insulin management features. Forty subjects with type 1 diabetes used the system for 4 weeks. We retrospectively evaluated performance of the system, using downloaded pump and sensor data, and evaluated user acceptance via questionnaires. There were 2,322 suspend before low events (2.1 per subject-day). The mean (± SD) duration of pump suspension events was 56.4 ± 9.6 min, and the mean subsequent sensor glucose (SG) nadir was 71.8 ± 5.2 mg/dL. SG values following 1,930 (83.1%) of the predictive suspensions did not reach the preset low limit. Nadir SG values of ≤50 and ≤60 mg/dL were seen in 207 (8.9%) and 356 (15.3%) of the predictive suspensions, respectively. Blood glucose (BG) and SG values before and during the study were comparable (P > 0.05). The mean absolute relative difference between paired SG and BG values was 10.9 ± 13.8%. Subjects felt confident using the system, agreed that it helped protect them from hypoglycemia, and wished to continue using it. Automatic insulin pump suspension as implemented in the MiniMed 640G system can help patients avoid hypoglycemia, without significantly increasing hyperglycemia.
Zuckerwise, Lisa C; Lipkind, Heather S
Despite increasing awareness of obstetric safety initiatives, maternal mortality and severe maternal morbidity in the United States have continued to increase over the past 20 years. Since results from large-scale surveillance programs suggest that up to 50% of maternal deaths may be preventable, new efforts are focused on developing and testing early warning systems for the obstetric population. Early warning systems are a set of specific clinical signs or symptoms that trigger the awareness of risk and an urgent patient evaluation, with the goal of reducing severe morbidity and mortality through timely diagnosis and treatment. Early warning systems have proven effective at predicting and reducing mortality and severe morbidity in medical, surgical, and critical care patient populations; however, there has been limited research on how to adapt these tools for use in the obstetric population, where physiologic changes of pregnancy render them inadequate. In this article, we review the available obstetric early warning systems and present evidence for their use in reducing maternal mortality and severe maternal morbidity. We also discuss considerations and strategies for implementation and acceptance of these early warning systems for clinical use in obstetrics. Copyright © 2017 Elsevier Inc. All rights reserved.
Fuller, Jason C.; Chassin, David P.; Pratt, Robert G.; Hauer, Matthew; Tuffner, Francis K.
Disclosed herein are representative embodiments of methods, apparatus, and systems for distributing a resource (such as electricity) using a resource allocation system. One of the disclosed embodiments is a method for operating a transactive thermostatic controller configured to submit bids to a market-based resource allocation system. According to the exemplary method, a first bid curve is determined, the first bid curve indicating a first set of bid prices for corresponding temperatures and being associated with a cooling mode of operation for a heating and cooling system. A second bid curve is also determined, the second bid curve indicating a second set of bid prices for corresponding temperatures and being associated with a heating mode of operation for a heating and cooling system. In this embodiment, the first bid curve, the second bid curve, or both the first bid curve and the second bid curve are modified to prevent overlap of any portion of the first bid curve and the second bid curve.
... of the pictogram model. The data captured show that slight displacements in frequency caused large variations of answers delivered to the application. The various experiments conducted made the system performed to be specified, and suitable for the remote monitoring of self-care activities in patients with diabetic foot.
This review is on arsenic in agronomic systems, and covers processes that influence the entry of arsenic into the human food supply. The scope is from sources of arsenic (natural and anthropogenic) in soils, biogeochemical and rhizosphere processes that control arsenic speciatio...
He subject of the article is anti-corruption examination — a relatively new procedure in the struggle against corrupt practices, and its place in the system of counteracting corruption The article presents corruptio-nogenic factors and methods used to detect such factors in regulatory legal acts
Os, van E.A.; Postma, J.
Closed hydroponic systems are good alternatives for soil grown crops using methyl bromide in protected cultivation. Root-infecting pathogens may be dispersed over the nursery by the circulating nutrient solution, which was reason to disinfect the nutrient solution. The natural microflora in the
Ozon layer depletion and global warming by synthetic refrigerants forces refrigeration industries to switch over to natural but hazardous refrigerants like ammonia and hydrocarbons. A promising technology to safely use the latter refrigerants is the application of indirect refrigeration systems with
O'Cummings, Mindee; Therriault, Susan Bowles
Educators at all levels care deeply about helping students succeed academically, graduate on time, and emerge from school well prepared for college and careers. Today's emphasis on holding schools accountable for failure--while necessary--is at best a means to an end. Findings from local and statewide accountability systems can help state…
Karppinen, Pasi; Oinas-Kukkonen, Harri; Alahäivälä, Tuomas; Jokelainen, Terhi; Keränen, Anna-Maria; Salonurmi, Tuire; Savolainen, Markku
Obesity has become a severe health problem in the world. Even a moderate 5% weight loss can significantly reduce the prevalence of metabolic syndrome, which can be vital for preventing comorbidities caused by the obesity. Health Behavior Change Support Systems (hBCSS) emphasize an autogenous approach, where an individual uses the system to influence one's own attitude or behavior to achieve his or her own goal. Regardless of promising results, such health interventions technology has often been considered merely as a tool for delivering content that has no effect or value of its own. More research on actual system features is required. The objective of this study is to describe how users perceive persuasive software features designed and implemented into a support system. The research medium in this study is a web-based information system designed as a lifestyle intervention for participants who are at risk of developing a metabolic syndrome or who are already suffering from it. The system was designed closely following the principles of the Persuasive Systems Design (PSD) model and the Behavior Change Support Systems (BCSS) framework. A total of 43 system users were interviewed for this study during and after a 52 week intervention period. In addition, the system's login data and subjects' Body Mass Index (BMI) measures were used to interpret the results. This study explains in detail how the users perceived using the system and its persuasive features. Self-monitoring, reminders, and tunneling were perceived as especially beneficial persuasive features. The need for social support appeared to grow along the duration of the intervention. Unobtrusiveness was found to be very important in all stages of the intervention rather than only at the beginning. Persuasive software features have power to affect individuals' health behaviors. Through their systematicity the PSD model and the BCSS framework provide effective support for the design and development of
Sidibe, I.B.; Khatab, A.; Diallo, C.; Kassambara, A.
This paper investigates the optimal age replacement policy for used systems, such as second-hand products, which start their second life-cycle in a more severe environment with an initial age that is uncertain. This uncertain age is modelled as a random variable following continuous probability distributions. A mathematical model is developed to minimize the total expected cost per unit of time for these systems on an infinite time horizon. Optimality and existence conditions for a unique optimal solution are derived and used in a numerical procedure to solve the problem. Numerical experiments are provided to demonstrate the added value and the impacts of the random initial age on the optimal replacement policy.
Szabo, M.F.; Nutter, M.T.
The purpose of this project was to investigate the capability of various engineering changes to an existing vapor degreaser to reduce solvent emissions to the atmosphere while remaining within the established Air Force exposure limits for 1,1,1-trichloroethane (TCA). A 1970 vintage vapor degreasing system had been converted from trichloroethylene to TCA and fitted with a lip vent exhaust system to decrease worker exposure. Solvent consumption with this configuration was two to three 55-gallon drums weekly, all presumed to be emmitted to the atmosphere via the lip vent. In sequence, various modifications to the degreaser and operating procedures were instituted to define their capability to reduce emissions and comply with exposure limit requirement. They include decrease and elimination of lip vent suction, a freeboard extension, add-on chiller, and a freeboard extension plus add-on chiller.
Gittelsohn, Joel; Mui, Yeeli; Adam, Atif; Lin, Sen; Kharmats, Anna; Igusa, Takeru; Lee, Bruce Y
Systems modeling represents an innovative approach for addressing the obesity epidemic at the community level. We developed an agent-based model of the Baltimore City food environment that permits us to assess the relative impact of different programs and policies, alone and in combination, and potential unexpected consequences. Based on this experience, and a review of literature, we have identified a set of principles, potential benefits, and challenges. Some of the key principles include the importance of early and multilevel engagement with the community prior to initiating model development and continued engagement and testing with community stakeholders. Important benefits include improving community stakeholder understanding of the system, testing of interventions before implementation, and identification of unexpected consequences. Challenges in these models include deciding on the most important, yet parsimonious factors to consider, how to model food source and food selection behavior in a realistic yet transferable manner, and identifying the appropriate outcomes and limitations of the model.
Takahashi, Kenzo; Kanda, Hideyuki; Sugaya, Nagisa
At the end of 2013, a Japanese newspaper reported that 4,173 children were unidentified or missing in Japan. The article concluded that child abuse was a matter of national concern. In examining the strengths and weaknesses of Japan's welfare system in regard to child abuse, it would seem that a weakness exists with regard to its ambiguity on the roles of different officers who contact suspected cases. Although three types of officer (health, welfare, and police officers) can take charge, child abuse cases might be missed because the division of labor varies between the different types of officer. However, a strength exists in the periodical pediatric health check system that is in place in each of Japan's 1,742 municipalities. To efficiently implement early intervention for child abuse, it is necessary to rearrange the division of labor among the three types of officers to clarify who should intervene in suspected cases.
Full Text Available The article explores the way that the Inter-American human rights system assumes the “responsibility to protect” in the context of serious violations of human rights that can be characterized as war crimes, crimes against humanity, genocide, and ethnic cleansing. The essay describes how the Inter-American Commission on Human Rights and the Inter-American Court of Human Rights have responded to such situations by using the ample powers granted to them by the OAS member states. The authors consider that these organs have been some of the most effective tools with which this region has confronted such situations by seeking system has contributed to building democratic regimes in the majority of the countries of the hemisphere. This has been crucial to avoiding serious violations of human rights such as those mentioned above, which would have required urgent international intervention to overcome.
Hayashi, M.; Nagatani, I.; Watanabe, T.; Tadono, T.; Miyoshi, H.; Watanabe, M.; Koyama, C.; Shimada, M.; Ogawa, T.; Ishii, K.; Higashiuwatoko, T.; Miura, M.; Okonogi, H.; Adachi, K.; Morita, T.
Satellite observation is an efficient method for monitoring deforestation, and a synthetic aperture radar (SAR) is useful especially in cloudy tropical forest regions. In this context, JICA and JAXA cooperate to operate the deforestation monitoring system acquired data by the Phased Array type L-band SAR-2 (PALSAR-2) onboard the Advanced Land Observing Satellite-2 (ALOS-2), which is named as "JICA-JAXA Forest Early Warning System in the Tropics" (JJ-FAST), and it have been released on November 2016. JJ-FAST detects deforestation areas, and provides their positional information for 77 countries, which is covering almost all tropical forests. It uses PALSAR-2 ScanSAR observation mode (wide-observation swath width) image, which is 50 m spatial resolution acquired at 1.5 months interval. The dark change areas compared with in two acquisitions by PALSAR-2 HV-polarization images are identified as deforestations in the system. We conducted field surveys to validate detection accuracy of the JJ-FAST in Peru (November and December, 2016), Botswana (April, 2017), and Gabon (July, 2017). As the results, 15 of 18 detected areas were correct deforestation areas, therefore user's accuracy could be confirmed as 83.3 % from limited number of the validation data. Erroneous detection areas were caused by seasonal change in agricultural land and open burning in grass land. For improvement of the accuracy, such areas must be excluded from the analysis by additional algorithms e.g. estimation of accurate masking for non-forested areas. Therefore, we are revising the forest map used for pre-processing step in the system. The JJ-FAST can be expected to contribute to monitor and reduce illegal deforestation activities in tropical forests.
Petersen, Poul Erik; Bourgeois, Denis; Bratthall, Douglas; Ogawa, Hiroshi
This article describes the essential components of oral health information systems for the analysis of trends in oral disease and the evaluation of oral health programmes at the country, regional and global levels. Standard methodology for the collection of epidemiological data on oral health has been designed by WHO and used by countries worldwide for the surveillance of oral disease and health. Global, regional and national oral health databanks have highlighted the changing patterns of ora...
Obata, M.; Kimura, M.; Shima, S.; Kanno, M.
The water projection type shot peening system and remotely driven robots were developed to be operated under water, in order to apply shot peening to reactor internals (shroud) in boiling water reactors (BWRs). The effects of processing parameters on the residual stress depth profiles were examined to obtain the optimum processing conditions to suppress stress corrosion cracking (SCC). Creviced bent beam (CBB) type stress corrosion tests showed that the SCC resistance in Type 304 stainless steel was remarkable increased by the shot peening. It was ascertained by several fundamental experiments that the shot peening had no detrimental effects on the other material characteristics and had sufficient applicability to the practical shroud. The reliable processing system which the accelerated shots by the pressurized water could be supplied, completely sucked and repeatedly used in order to reduce radioactive waste was developed. Two types of remote handling robots were also developed to positioning to follow the complicated shape of the core shroud welds, and for processing efficiency by reducing radiation exposure , one for processing the inner surface of the cylindrical core shroud, and the other for processing the outer surface in the narrow annulus region. The system and robots were successfully applied to the core shrouds of Hamaoka Unit- 1 and Unit-2 of Chubu Electric Power Co., Ltd. (author)
Yano, Terdsak; Phornwisetsirikun, Somphorn; Susumpow, Patipat; Visrutaratna, Surasing; Chanachai, Karoon; Phetra, Polawat; Chaisowwong, Warangkhana; Trakarnsirinont, Pairat; Hemwan, Phonpat; Kaewpinta, Boontuan; Singhapreecha, Charuk; Kreausukon, Khwanchai; Charoenpanyanet, Arisara; Robert, Chongchit Sripun; Robert, Lamar; Rodtian, Pranee; Mahasing, Suteerat; Laiya, Ekkachai; Pattamakaew, Sakulrat; Tankitiyanon, Taweesart; Sansamur, Chalutwan; Srikitjakarn, Lertrak
Aiming for early disease detection and prompt outbreak control, digital technology with a participatory One Health approach was used to create a novel disease surveillance system called Participatory One Health Disease Detection (PODD). PODD is a community-owned surveillance system that collects data from volunteer reporters; identifies disease outbreak automatically; and notifies the local governments (LGs), surrounding villages, and relevant authorities. This system provides a direct and immediate benefit to the communities by empowering them to protect themselves. The objective of this study was to determine the effectiveness of the PODD system for the rapid detection and control of disease outbreaks. The system was piloted in 74 LGs in Chiang Mai, Thailand, with the participation of 296 volunteer reporters. The volunteers and LGs were key participants in the piloting of the PODD system. Volunteers monitored animal and human diseases, as well as environmental problems, in their communities and reported these events via the PODD mobile phone app. LGs were responsible for outbreak control and provided support to the volunteers. Outcome mapping was used to evaluate the performance of the LGs and volunteers. LGs were categorized into one of the 3 groups based on performance: A (good), B (fair), and C (poor), with the majority (46%,34/74) categorized into group B. Volunteers were similarly categorized into 4 performance groups (A-D), again with group A showing the best performance, with the majority categorized into groups B and C. After 16 months of implementation, 1029 abnormal events had been reported and confirmed to be true reports. The majority of abnormal reports were sick or dead animals (404/1029, 39.26%), followed by zoonoses and other human diseases (129/1029, 12.54%). Many potentially devastating animal disease outbreaks were detected and successfully controlled, including 26 chicken high mortality outbreaks, 4 cattle disease outbreaks, 3 pig disease
Full Text Available Tina Karwalajtys1, Janusz Kaczorowski2,31Department of Family Medicine, McMaster University, Hamilton, ON, Canada; 2Primary Care & Community Research, Child & Family Research Institute, Vancouver, BC, Canada; 3Department of Family Practice, University of British Columbia, Vancouver, BC, CanadaAbstract: Cardiovascular disease (CVD is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.Keywords: risk factors, blood pressure determination, community health services, community health planning, public health practice
Jacob, Verughese; Thota, Anilkrishna B; Chattopadhyay, Sajal K; Njie, Gibril J; Proia, Krista K; Hopkins, David P; Ross, Murray N; Pronk, Nicolaas P; Clymer, John M
This review evaluates costs and benefits associated with acquiring, implementing, and operating clinical decision support systems (CDSSs) to prevent cardiovascular disease (CVD). Methods developed for the Community Guide were used to review CDSS literature covering the period from January 1976 to October 2015. Twenty-one studies were identified for inclusion. It was difficult to draw a meaningful estimate for the cost of acquiring and operating CDSSs to prevent CVD from the available studies ( n = 12) due to considerable heterogeneity. Several studies ( n = 11) indicated that health care costs were averted by using CDSSs but many were partial assessments that did not consider all components of health care. Four cost-benefit studies reached conflicting conclusions about the net benefit of CDSSs based on incomplete assessments of costs and benefits. Three cost-utility studies indicated inconsistent conclusions regarding cost-effectiveness based on a conservative $50,000 threshold. Intervention costs were not negligible, but specific estimates were not derived because of the heterogeneity of implementation and reporting metrics. Expected economic benefits from averted health care cost could not be determined with confidence because many studies did not fully account for all components of health care. We were unable to conclude whether CDSSs for CVD prevention is either cost-beneficial or cost-effective. Several evidence gaps are identified, most prominently a lack of information about major drivers of cost and benefit, a lack of standard metrics for the cost of CDSSs, and not allowing for useful life of a CDSS that generally extends beyond one accounting period. Published by Oxford University Press on behalf of the American Medical Informatics Association 2017. This work is written by US Government employees and is in the public domain in the US.
Di Napoli, Claudia; Piazza, Andrea; Antonacci, Gianluca; Todeschini, Ilaria; Apolloni, Roberto; Pretto, Ilaria
Road ice is a dangerous meteorological hazard to a nation's transportation system and economy. By reducing the pavement friction with vehicle tyres, ice formation on pavements increases accident risk and delays travelling times thus posing a serious threat to road users' safety and the running of economic activities. Keeping roads clear and open is therefore essential, especially in mountainous areas where ice is likely to form during the winter period. Winter road maintenance helps to restore road efficiency and security, and its benefits are up to 8 times the costs sustained for anti-icing strategies . However, the optimization of maintenance costs and the reduction of the environmental damage from over-salting demand further improvements. These can be achieved by reliable road weather forecasts, and in particular by the prediction of road surface temperatures (RSTs). RST is one of the most important parameters in determining road surface conditions. It is well known from literature that ice forms on pavements in high-humidity conditions when RSTs are below 0°C. We have therefore implemented an automatic forecast system to predict critical RSTs on a test route along the Adige Valley complex terrain, in the Italian Alps. The system considers two physical models, each computing heat and energy fluxes between the road and the atmosphere. One is Reuter's radiative cooling model, which predicts RSTs at sunrise as a function of surface temperatures at sunset and the time passed since then . One is METRo (Model of the Environment and Temperature of Roads), a road weather forecast software which also considers heat conduction through road material . We have applied the forecast system to a network of road weather stations (road weather information system, RWIS) installed on the test route . Road and atmospheric observations from RWIS have been used as initial conditions for both METRo and Reuter's model. In METRo observations have also been coupled to
Parker, Dorian S N; Kaiser, Ralf I; Troy, Tyler P; Kostko, Oleg; Ahmed, Musahid; Mebel, Alexander M
The reaction of the phenyl radical (C6H5) with molecular oxygen (O2) plays a central role in the degradation of poly- and monocyclic aromatic radicals in combustion systems which would otherwise react with fuel components to form polycyclic aromatic hydrocarbons (PAHs) and eventually soot. Despite intense theoretical and experimental scrutiny over half a century, the overall reaction channels have not all been experimentally identified. Tunable vacuum ultraviolet photoionization in conjunction with a combustion simulating chemical reactor uniquely provides the complete isomer specific product spectrum and branching ratios of this prototype reaction. In the reaction of phenyl radicals and molecular oxygen at 873 K and 1003 K, ortho-benzoquinone (o-C6H4O2), the phenoxy radical (C6H5O), and cyclopentadienyl radical (C5H5) were identified as primary products formed through emission of atomic hydrogen, atomic oxygen and carbon dioxide. Furan (C4H4O), acrolein (C3H4O), and ketene (C2H2O) were also identified as primary products formed through ring opening and fragmentation of the 7-membered ring 2-oxepinoxy radical. Secondary reaction products para-benzoquinone (p-C6H4O2), phenol (C6H5OH), cyclopentadiene (C5H6), 2,4-cyclopentadienone (C5H4O), vinylacetylene (C4H4), and acetylene (C2H2) were also identified. The pyranyl radical (C5H5O) was not detected; however, electronic structure calculations show that it is formed and isomerizes to 2,4-cyclopentadienone through atomic hydrogen emission. In combustion systems, barrierless phenyl-type radical oxidation reactions could even degrade more complex aromatic radicals. An understanding of these elementary processes is expected to lead to a better understanding toward the elimination of carcinogenic, mutagenic, and environmentally hazardous byproducts of combustion systems such as PAHs.
Li, Bin; Liu, Jiping; Shi, Lihong; Wang, Zhenfeng
A kind of formal system, which can express clearly a certain entity or information, is needed to express geographical concept. Besides, some rules explaining the interrelationship and action between different components are also required. Therefore, the conception of geo-object ontology is introduced. It is a shared formalization and display specification of conceptual knowledge system in the field of concrete application of spatial information science. It can constitute hierarchy structure, which derives from the concept classification system in the geographical area. Its concepts can be described by the property. Property sets can form a vector space with multi-dimensional characteristics. Geographic space is composed of different types of geographic entities. And its concept is formed by a series of geographic entities with the same properties and actions. Moreover, each of the geographic entities can be mapped to an object, and each object has its spatial property, time information and topology, semantic relationships associated with other objects. The biggest difference between ecumenical information ontology and geo-ontology is that the latter has the spatial characteristics. During the construction process of geo-object ontology, some important components, such as geographic type, spatial relation, spatial entity type and coordinates, time, should be included to make further research. Here, taking disaster as an example, by using Protégé and OWL, combined methods used by constructing the geo-object ontology in the form of being manual made by domanial experts and semi-automatic are investigated oriented to disaster to serve ultimately geographic information retrieval service driven by ontology.
Geanuracos, Catherine G; Cunningham, Shayna D; Weiss, George; Forte, Draco; Reid, Lisa M Henry; Ellen, Jonathan M
Geographic information system (GIS) analysis is an emerging tool for public health intervention planning. Connect to Protect, a researcher-community collaboration working in 15 cities to reduce HIV infection among youths, developed GIS databases of local health, crime, and demographic data to evaluate the geographic epidemiology of sexually transmitted infections and HIV risk among adolescents. We describe the process and problems of data acquisition, analysis, and mapping in the development of structural interventions, demonstrating how program planners can use this technology to inform and improve planning decisions. The Connect to Protect project's experience suggests strategies for incorporating public data and GIS technology into the next generation of public health interventions.
This thesis is devoted to the investigation of passive safety and inherent features of subcritical nuclear transmutation systems - accelerator-driven systems. The general objective of this research has been to improve the safety performance and avoid elevated coolant temperatures in worst-case scenarios like unprotected loss-of-flow accidents, loss-of-heat-sink accidents, and a combination of both these accident initiators. The specific topics covered are emergency decay heat removal by reactor vessel auxiliary cooling systems, beam shut-off by a melt-rupture disc, safety aspects from locating heat-exchangers in the riser of a pool-type reactor system, and reduction of pressure resistance in the primary circuit by employing bypass routes. The initial part of the research was focused on reactor vessel auxiliary cooling systems. It was shown that an 80 MW th Pb/Bi-cooled accelerator-driven system of 8 m height and 6 m diameter vessel can be well cooled in the case of loss-of-flow accidents in which the accelerator proton beam is not switched off. After a loss-of-heat-sink accident the proton beam has to be interrupted within 40 minutes in order to avoid fast creep of the vessel. If a melt-rupture disc is included in the wall of the beam pipe, which breaks at 150 K above the normal core outlet temperature, the grace period until the beam has to be shut off is increased to 6 hours. For the same vessel geometry, but an operating power of 250 MW th the structural materials can still avoid fast creep in case the proton beam is shut off immediately. If beam shut-off is delayed, additional cooling methods are needed to increase the heat removal. Investigations were made on the filling of the gap between the guard and the reactor vessel with liquid metal coolant and using water spray cooling on the guard vessel surface. The second part of the thesis presents examinations regarding an accelerator-driven system also cooled with Pb/Bi but with heat-exchangers located in the
Gbotolorun, O M; Dipo-Fagbemi, I M; Olojede, A O; Ebigwei, S; Adetoye, J O
This double-blind, randomized controlled study was done to assess the necessity of systemic antibiotics in the prevention of wound healing complications after intra-alveolar dental extraction. A consecutive recruitment method was used to allocate participants to two treatment groups. Subjects in group A (antibiotics group, n=75) received amoxicillin and metronidazole for 5 days postoperatively, while those in group B (placebo group, n=75) were given identical-looking placebo drugs in place of the antibiotics. Postoperative socket healing complications, pain, and compliance with postoperative instructions were assessed postoperatively. Healing was uneventful in 129 patients (86%). Twenty-one patients (14%) developed wound healing complications. Dry socket was the most common complication in the antibiotics group (six subjects), while acutely inflamed sockets was the most common in the placebo group (five subjects). Non-adherence to postoperative instructions and postoperative pain were found to be significantly associated with the development of wound healing complications. The prescription of antibiotics after routine intra-alveolar dental extraction in healthy patients may not play any significant role in preventing wound healing complications. However, non-compliance with postoperative instructions might be associated with increased wound healing complications. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Zink, Adriana Gledys; Diniz, Michele Baffi; Rodrigues Dos Santos, Maria Teresa Botti; Guaré, Renata Oliveira
The aim of the present study was to evaluate the use of the Picture Exchange Communication System (PECS) in individuals with autism spectrum disorder (ASD) in order to facilitate patient-professional communication during preventive procedures. In this study, 26 patients with ASD, between 5 and 19 years of age (10±3.3 y), were divided into two groups: G1 (n = 13) with no previous experience of dental treatment, and G2 (n = 13), with such previous experience. The initial approach followed the principles of the Son-Rise Program®. The seven PECSs presented the routine of the dental office: "room," "ground," "chair," "dentist," "mouth," "low," and "triple." Each PEC was used up to three times in order to acquire the skill proposed. It was verified that G2 required a greater number of times to achieve the acceptance of PECS "ground," "dentist," "mouth," and "triple" (p communication during preventive procedures, including for ASD patients with previous dental experience. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.
Mayor accidents caused by hazardous substances are great threat to public. The consequences are often very severe with great number of injured people or even deaths and a great material damage. Statistic data shows that the main cause of accidents in hazardous installations is 'human factor', including the possibility of terrorist attack, or classic military operations. In order to ensure effective chemical safety, the actions should be taken by industry, public authorities, communities and other stake holders to prevent industrial accidents. Safety should be an integral part of the business activities of an enterprise, and all hazardous installations should strive to reach the ultimate goal of zero incidents. Safety management systems (SMS) should include appropriate technology and processes, as well as establishing an effective organisational structure. To mitigate consequences of accidents, emergency planning, land-use planning and risk communication is necessary. Adequate response in the event of accident should limit adverse consequences to health, environment and property. Follow-up actions are needed to learn from the accidents and other unexpected events, in order to reduce future incidents. In this paper the author will discus the implementing of SEVESO II directive in obtaining two main goals: major accident prevention and mitigation of consequences for men and environment in case of possible terrorist actions or military activities. Some Croatian experiences in implementing of UNEP APELL Programme, and its connection with SEVESO II directive will be shown.(author)
Onland, Wes; Merkus, Maruschka P; Nuytemans, Debbie H; Jansen-van der Weide, Marijke C; Holman, Rebecca; van Kaam, Anton H
Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth with short-term and long-term adverse consequences. Although the glucocorticoid dexamethasone has been proven to be beneficial for the prevention of BPD, there are concerns about an increased risk of adverse neurodevelopmental outcome. Hydrocortisone has been suggested as an alternative therapy. The aim of the Systemic Hydrocortisone To Prevent Bronchopulmonary Dysplasia in preterm infants (SToP-BPD) trial is to assess the efficacy and safety of postnatal hydrocortisone administration for the reduction of death or BPD in ventilator-dependent preterm infants. The SToP-BPD study is a multicentre, double-blind, placebo-controlled hydrocortisone trial in preterm infants at risk for BPD. After parental informed consent is obtained, ventilator-dependent infants are randomly allocated to hydrocortisone or placebo treatment during a 22-day period. The primary outcome measure is the composite outcome of death or BPD at 36 weeks postmenstrual age. Secondary outcomes are short-term effects on pulmonary condition and long-term neurodevelopmental sequelae assessed at 2 years corrected age. Complications of treatment, other serious adverse events and suspected unexpected serious adverse reactions are reported as safety outcomes. This pre-specified statistical analysis plan was written and submitted without knowledge of the unblinded data. Netherlands Trial Register, NTR2768 . Registered on 17 February 2011. EudraCT, 2010-023777-19. Registered on 2 November 2010.
Nakamura, Kentaro; Tonouchi, Hidekazu; Sasayama, Akina; Ashida, Kinya
Low-carbohydrate, high-fat diets (ketogenic diets) might prevent tumor progression and could be used as supportive therapy; however, few studies have addressed the effect of such diets on colorectal cancer. An infant formula with a ketogenic composition (ketogenic formula; KF) is used to treat patients with refractory epilepsy. We investigated the effect of KF on cancer and cancer cachexia in colon tumor-bearing mice. Mice were randomized into normal (NR), tumor-bearing (TB), and ketogenic formula (KF) groups. Colon 26 cells were inoculated subcutaneously into TB and KF mice. The NR and TB groups received a standard diet, and the KF mice received KF ad libitum . KF mice preserved their body, muscle, and carcass weights. Tumor weight and plasma IL-6 levels were significantly lower in KF mice than in TB mice. In the KF group, energy intake was significantly higher than that in the other two groups. Blood ketone body concentrations in KF mice were significantly elevated, and there was a significant negative correlation between blood ketone body concentration and tumor weight. Therefore, KF may suppress the progression of cancer and the accompanying systemic inflammation without adverse effects on weight gain, or muscle mass, which might help to prevent cancer cachexia.
Full Text Available Low-carbohydrate, high-fat diets (ketogenic diets might prevent tumor progression and could be used as supportive therapy; however, few studies have addressed the effect of such diets on colorectal cancer. An infant formula with a ketogenic composition (ketogenic formula; KF is used to treat patients with refractory epilepsy. We investigated the effect of KF on cancer and cancer cachexia in colon tumor-bearing mice. Mice were randomized into normal (NR, tumor-bearing (TB, and ketogenic formula (KF groups. Colon 26 cells were inoculated subcutaneously into TB and KF mice. The NR and TB groups received a standard diet, and the KF mice received KF ad libitum. KF mice preserved their body, muscle, and carcass weights. Tumor weight and plasma IL-6 levels were significantly lower in KF mice than in TB mice. In the KF group, energy intake was significantly higher than that in the other two groups. Blood ketone body concentrations in KF mice were significantly elevated, and there was a significant negative correlation between blood ketone body concentration and tumor weight. Therefore, KF may suppress the progression of cancer and the accompanying systemic inflammation without adverse effects on weight gain, or muscle mass, which might help to prevent cancer cachexia.
Martin-Moreno, Jose M; Anttila, Ahti; von Karsa, Lawrence; Alfonso-Sanchez, Jose L; Gorgojo, Lydia
The aim of this paper is to elucidate the rationale for sustaining and expanding cost-effective, population-based screening services for breast, cervical and colorectal cancers in the context of the current financial crisis. Our objective is not only to promote optimal delivery of high-quality secondary cancer prevention services, but also to underline the importance of strengthening comprehensive cancer control, and with it, health system response to the complex care challenges posed by all chronic diseases. We focus primarily on issues surrounding planning, organisation, implementation and resources, arguing that given the growing cancer burden, policymakers have ample justification for establishing and expanding population-based programmes that are well-organised, well-resourced and well-executed. In a broader economic context of rescue packages, deficits and cutbacks to government entitlements, health professionals must intensify their advocacy for the protection of vital preventive health services by fighting for quality services with clear benefits for population health outcomes. Copyright © 2012 Elsevier Ltd. All rights reserved.
de Savigny, Don; Webster, Jayne; Agyepong, Irene Akua; Mwita, Alex; Bart-Plange, Constance; Baffoe-Wilmot, Aba; Koenker, Hannah; Kramer, Karen; Brown, Nick; Lengeler, Christian
There are striking similarities in health system and other contexts between Tanzania and Ghana that are relevant to the scaling up of continuous delivery of insecticide treated nets (ITNs) for malaria prevention. However, specific contextual factors of relevance to ITN delivery have led implementation down very different pathways in the two countries. Both countries have made major efforts and investments to address this intervention through integrating consumer discount vouchers into the health system. Discount vouchers require arrangements among the public, private and non-governmental sectors and constitute a complex intervention in both health systems and business systems. In Tanzania, vouchers have moved beyond the planning agenda, had policies and programmes formulated, been sustained in implementation at national scale for many years and have become as of 2012 the main and only publicly supported continuous delivery system for ITNs. In Ghana national-scale implementation of vouchers never progressed beyond consideration on the agenda and piloting towards formulation of policy; and the approach was replaced by mass distribution campaigns with less dependency on or integration with the health system. By 2011, Ghana entered a phase with no publicly supported continuous delivery system for ITNs. To understand the different outcomes, we compared the voucher programme timelines, phases, processes and contexts in both countries in reference to the main health system building blocks (governance, human resources, financing, informatics, technologies and service delivery). Contextual factors which provided an enabling environment for the voucher scheme in Tanzania did not do so in Ghana. The voucher scheme was never seen as an appropriate national strategy, other delivery systems were not complementary and the private sector was under-developed. The extensive time devoted to engagement and consensus building among all stakeholders in Tanzania was an important and
Weeks, Margaret R; Li, Jianghong; Liao, Susu; Zhang, Qingning; Dunn, Jennifer; Wang, Yanhong; Jiang, Jingmei
Social and public health scientists are increasingly interested in applying system dynamics theory to improve understanding and to harness the forces of change within complex, multilevel systems that affect community intervention implementation, effects, and sustainability. Building a system dynamics model based on ethnographic case study has the advantage of using empirically documented contextual factors and processes of change in a real-world and real-time setting that can then be tested in the same and other settings. System dynamics modeling offers great promise for addressing persistent problems like HIV and other sexually transmitted epidemics, particularly in complex rapidly developing countries such as China. We generated a system dynamics model of a multilevel intervention we conducted to promote female condoms for HIV/sexually transmitted infection (STI) prevention among Chinese women in sex work establishments. The model reflects factors and forces affecting the study's intervention, implementation, and effects. To build this conceptual model, we drew on our experiences and findings from this intensive, longitudinal mixed-ethnographic and quantitative four-town comparative case study (2007-2012) of the sex work establishments, the intervention conducted in them, and factors likely to explain variation in process and outcomes in the four towns. Multiple feedback loops in the sex work establishments, women's social networks, and the health organization responsible for implementing HIV/STI interventions in each town and at the town level directly or indirectly influenced the female condom intervention. We present the conceptual system dynamics model and discuss how further testing in this and other settings can inform future community interventions to reduce HIV and STIs.
Geanuracos, Catherine G.; Cunningham, Shayna D.; Weiss, George; Forte, Draco; Henry Reid, Lisa M.; Ellen, Jonathan M.
Geographic information system (GIS) analysis is an emerging tool for public health intervention planning. Connect to Protect, a researcher–community collaboration working in 15 cities to reduce HIV infection among youths, developed GIS databases of local health, crime, and demographic data to evaluate the geographic epidemiology of sexually transmitted infections and HIV risk among adolescents. We describe the process and problems of data acquisition, analysis, and mapping in the development of structural interventions, demonstrating how program planners can use this technology to inform and improve planning decisions. The Connect to Protect project’s experience suggests strategies for incorporating public data and GIS technology into the next generation of public health interventions. PMID:17901452
Yokoyama, Yoshie; Hakulinen, Tuovi; Sugimoto, Masako; Silventoinen, Karri; Kalland, Mirjam
Maternal well-being is an important issue not only for mothers but also for their offspring and whole families. This study aims to clarify differences in subjective well-being for mothers with infants and associated factors by comparing Japanese and Finnish mothers. In Finland, 101 mothers with infants who received health check-ups at child's age 4 months participated in the study. In Japan, 505 mothers with infants who should receive health check-ups at child's age 4 months and, whose age, age of the infant and number of children matched with the Finnish mothers were selected. The factors associated with maternal subjective well-being were explored by the linear regression analysis. All Finnish mothers had individual infant health check-ups by nurses in Child Health Clinics nearly monthly. The same nurse was responsible for following up the family throughout the years. All Japanese participants received group health check-up once at child's age 3 to 4 months, and a nurse did not cover same child and their mother. Finnish mothers showed significantly better subjective well-being compared with Japanese mothers. Whereas 85% of Finnish mothers responded that they had obtained childcare information from public health nurses, significantly fewer Japanese mothers indicated the same response (8%). Linear regression analyses disclosed that mothers' subjective well-being was associated with country, mothers' stress and age. Finnish mothers had better subjective well-being than Japanese mothers. Our results may indicate that the Finnish health care system supports mothers better than the Japanese health care system does. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Alonso, Carmen; Davies, Peter R; Polson, Dale D; Dee, Scott A; Lazarus, William F
Air filtration systems implemented in large sow herds have been demonstrated to decrease the probability of having a porcine reproductive and respiratory syndrome virus (PRRSV) outbreak. However, implementation of air filtration represents a considerable capital investment, and does not eliminate the risk of new virus introductions. The specific objectives of the study were: 1) to determine productivity differences between a cohort of filtered and non-filtered sow farms; and 2) to employ those productivity differences to model the profitability of filtration system investments in a hypothetical 3000 sow farm. Variables included in the study were production variables (quarterly) from respective herds; air filtration status; number of pig sites within 4.7 km of the farm; occurrence of a PRRSV outbreak in a quarter, and season. For the investment analyses, three Scenarios were compared in a deterministic spreadsheet model of weaned pig cost: (1) control, (2) filtered conventional attic, and (3) filtered tunnel ventilation. Model outputs indicated that a filtered farm produced 5927 more pigs than unfiltered farms. The payback periods for the investments, were estimated to be 5.35 years for Scenario 2 and 7.13 years for Scenario 3 based solely on sow herd productivity. Payback period sensitivity analyses were performed for both biological and financial inputs. The payback period was most influenced by the premium for weaned pig sales price for PRRSV-negative pigs, and the relative proportions of time that filtered vs. unfiltered farms produced PRRSV-negative pigs. A premium of $5 per pig for PRRS-negative weaned pigs reduced the estimated payback periods to 2.1 years for Scenario 2 and 2.8 years for Scenario 3. Copyright © 2013 Elsevier B.V. All rights reserved.
Saito, Takumi; Yamamoto, Yasuhiro; Feng, Guo-Gang; Kazaoka, Yoshiaki; Fujiwara, Yoshihiro; Kinoshita, Hiroyuki
Periodontal inflammation causes endothelial dysfunction of the systemic artery. However, it is unknown whether the use of local anesthetics during painful dental procedures alleviates periodontal inflammation and systemic endothelial function. This study was designed to examine whether the gingival or systemic injection of lidocaine prevents oxidative stress-induced endothelial dysfunction of the systemic artery in rats with intermittent periodontal inflammation caused by lipopolysaccharides (LPS). Some rats received 1500 µg LPS injections to the gingiva during a week interval from the age of 8 to 11 weeks (LPS group). Lidocaine (3 mg/kg), LPS + lidocaine (3 mg/kg), LPS + lidocaine (1.5 mg/kg), and LPS + lidocaine (3 mg/kg, IP) groups simultaneously received gingival 1.5 or 3 mg/kg or IP 3 mg/kg injection of lidocaine on the same schedule as the gingival LPS. Isolated aortas or mandibles were subjected to the evaluation of histopathologic change, isometric force recording, reactive oxygen species, and Western immunoblotting. Mean blood pressure and heart rate did not differ among the control, LPS, LPS + lidocaine (3 mg/kg), and lidocaine (3 mg/kg) groups. LPS application reduced acetylcholine (ACh, 10 to 10 mol/L)-induced relaxation (29% difference at ACh 3 × 10 mol/L, P = .01), which was restored by catalase. Gingival lidocaine (1.5 and 3 mg/kg) dose dependently prevented the endothelial dysfunction caused by LPS application (24.5%-31.1% difference at ACh 3 × 10 mol/L, P = .006 or .001, respectively). Similar to the gingival application, the IP injection of lidocaine (3 mg/kg) restored the ACh-induced dilation of isolated aortas from rats with the LPS application (27.5% difference at ACh 3 × 10 mol/L, P lidocaine (3 mg/kg), or the combination. The LPS induced a 4-fold increase in the protein expression of tumor necrosis factor-α in the periodontal tissue (P lidocaine (3 mg/kg) coadministration partly reduced the levels. Lidocaine application also decreased
Full Text Available Abstract Background The Solomon Islands National Malaria Programme is currently focused on intensified control and progressive elimination. Recent control efforts in Isabel Province have reduced their malaria incidence to 2.6/1,000 population in 2009 1 whereas most neighbouring provinces have much higher incidences. A malaria surveillance-response system that involves testing all travellers entering Isabel Province using rapid diagnostic tests (RDT to prevent cases being imported had been proposed by local health authorities. This study provides information on the feasibility and acceptability of implementing a new approach of surveillance and response in the context of low levels of indigenous malaria transmission in Isabel Province. Methods A total of 13 focus group discussions (FGD and 22 key informant interviews (KII were conducted in Isabel Province, Solomon Islands. Key topics included: the travel patterns of people to, from and within Isabel Province; the acceptability, community perceptions, attitudes and suggestions towards the proposed surveillance programme; and management of suspected malaria cases. This information was triangulated with data obtained from port authorities, airlines and passenger ships travelling to and from Isabel Province in the preceding two years. Results Travel within Isabel Province and to and from other provinces is common with marked seasonality. The majority of inter-provincial travel is done on scheduled public transport; namely passenger ships and aircrafts. In Isabel Province there is a healthy community spirit as well as high concern regarding malaria and its importation and there is currently effective malaria passive case detection and management. Conducting malaria screening at ports and airports would be acceptable to the community. Conclusion A robust surveillance-response system is essential when moving towards malaria elimination. Many factors contribute positively towards the feasibility of an
O'Sullivan, Matthew; Kenilorea, Geoffrey; Yamaguchi, Yuka; Bobogare, Albino; Losi, Landry; Atkinson, Jo-An; Vallely, Andrew; Whittaker, Maxine; Tanner, Marcel; Wijesinghe, Rushika
The Solomon Islands National Malaria Programme is currently focused on intensified control and progressive elimination. Recent control efforts in Isabel Province have reduced their malaria incidence to 2.6/1,000 population in 2009 1 whereas most neighbouring provinces have much higher incidences. A malaria surveillance-response system that involves testing all travellers entering Isabel Province using rapid diagnostic tests (RDT) to prevent cases being imported had been proposed by local health authorities. This study provides information on the feasibility and acceptability of implementing a new approach of surveillance and response in the context of low levels of indigenous malaria transmission in Isabel Province. A total of 13 focus group discussions (FGD) and 22 key informant interviews (KII) were conducted in Isabel Province, Solomon Islands. Key topics included: the travel patterns of people to, from and within Isabel Province; the acceptability, community perceptions, attitudes and suggestions towards the proposed surveillance programme; and management of suspected malaria cases. This information was triangulated with data obtained from port authorities, airlines and passenger ships travelling to and from Isabel Province in the preceding two years. Travel within Isabel Province and to and from other provinces is common with marked seasonality. The majority of inter-provincial travel is done on scheduled public transport; namely passenger ships and aircrafts. In Isabel Province there is a healthy community spirit as well as high concern regarding malaria and its importation and there is currently effective malaria passive case detection and management. Conducting malaria screening at ports and airports would be acceptable to the community. A robust surveillance-response system is essential when moving towards malaria elimination. Many factors contribute positively towards the feasibility of an RDT based malaria surveillance system in Isabel Province. Due to
Koohi-Kamali, Sam; Rahim, Nasrudin Abd
Highlights: • A new power management system is proposed. • The novel idea of using energy storage systems to prevent under frequency load shedding is presented. • A method to estimate rate of change of frequency in islanding mode and to dispatch battery plant is introduced. • Two effective outer control loops are proposed for governor to synchronize the microgrid with main grid. • Solar photovoltaic and battery plants bring the voltage regulation ancillary service for microgrid. - Abstract: This work presents a smart microgrid consisting of diesel, photovoltaic (PV), and battery storage plants. One of the key features of smart grid is to provide a redundant high quality power for the consumers. In islanded microgrid, the under frequency and/or voltage collapse, caused by power deficiency, can lead to power outage. The current practice is to shed the load demand until the frequency and voltage are restored. However, the redundancy in supplying power has no meaning as long as the loads are shed. The main objective of this paper is to propose a power management system (PMS) that protects the microgrid against the load shedding. PMS is able to control the microgrid in both centralized and decentralized fashions. To prevent under frequency load shedding (UFLS), this work proposes using battery energy storage system (BESS) to compensate for the power mismatch in the islanded microgrid. A method is presented to estimate the rate of change of frequency and to calculate the power deficiency. The approximated value is exploited as the set-point to dispatch BESS. PV and battery plants are supposed to share the reactive power demand proportionally and thus regulate the voltage at the load bus. This work also suggests two outer control loops, namely, frequency restoration loop (FRL) and difference angle compensator (DAC). These loops ensure microgrid smooth transition from islanded mode to grid-connected mode. The microgrid is configured to investigate the effective
Koay, Swee Peng; Fukuoka, Hiroshi; Tien Tay, Lea; Murakami, Satoshi; Koyama, Tomofumi; Chan, Huah Yong; Sakai, Naoki; Hazarika, Hemanta; Jamaludin, Suhaimi; Lateh, Habibah
Every year, hundreds of landslides occur in Malaysia and other tropical monsoon South East Asia countries. Therefore, prevention casualties and economical losses, by rain induced slope failure, are those countries government most important agenda. In Malaysia, millions of Malaysian Ringgit are allocated for slope monitoring and mitigation in every year budget. Besides monitoring the slopes, here, we propose the IT system which provides hazard map information, landslide historical information, slope failure prediction, knowledge on natural hazard, and information on evacuation centres via internet for user to understand the risk of landslides as well as flood. Moreover, the user can obtain information on rainfall intensity in the monitoring sites to predict the occurrence of the slope failure. Furthermore, we are working with PWD, Malaysia to set the threshold value for the landslide prediction system which will alert the officer if there is a risk of the slope failure in the monitoring sites by calculating rainfall intensity. Although the IT plays a significant role in information dissemination, education is also important in disaster prevention by educating school students to be more alert in natural hazard, and there will be bottom up approach to alert parents on what is natural hazard, by conversion among family members, as most of the parents are busy and may not have time to attend natural hazard workshop. There are many races living in Malaysia as well in most of South East Asia countries. It is not easy to educate them in single education method as the level of living and education are different. We started landslides education workshops in primary schools in rural and urban area, in Malaysia. We found out that we have to use their mother tongue language while conducting natural hazard education for better understanding. We took questionnaires from the students before and after the education workshop. Learning from the questionnaire result, the students are
Vidal, Blanca; Vázquez-Roque, Rubén A; Gnecco, Dino; Enríquez, Raúl G; Floran, Benjamin; Díaz, Alfonso; Flores, Gonzalo
Curcuma is a natural compound that has shown neuroprotective properties, and has been reported to prevent aging and improve memory. While the mechanism(s) underlying these effects are unclear, they may be related to increases in neural plasticity. Morphological changes have been reported in neuronal dendrites in the limbic system in animals and elderly humans with cognitive impairment. In this regard, there is a need to use alternative therapies that delay the onset of morphologies and behavioral characteristics of aging. Therefore, the objective of this study was to evaluate the effect of curcuma on cognitive processes and dendritic morphology of neurons in the prefrontal cortex (PFC), the CA1 and CA3 regions of the dorsal hippocampus, the dentate gyrus, and the basolateral amygdala (BLA) of aged rats. 18-month-old rats were administered curcuma (100 mg/kg) daily for 60 days. After treatment, recognition memory was assessed using the novel object recognition test. Curcuma-treated rats showed a significant increase in the exploration quotient. Dendritic morphology was assessed by Golgi-Cox staining and followed by Sholl analysis. Curcuma-treated rats showed a significant increase in dendritic spine density and dendritic length in pyramidal neurons of the PFC, the CA1 and CA3, and the BLA. The preservation of dendritic morphology was positively correlated with cognitive improvements. Our results suggest that curcuma induces modification of dendritic morphology in the aforementioned regions. These changes may explain how curcuma slows the aging process that has already begun in these animals, preventing deterioration in neuronal morphology of the limbic system and recognition memory. © 2016 Wiley Periodicals, Inc.
Ionescu, C.; Dumitru, G.; Oprescu, T.; Ana, E.; Sofilca, N.; Grigore, D.
Full text: The Romanian seismicity is dominated by the Vrancea deep (60-200 km) earthquakes which take place in a small volume located at the bend of Carpathian mountains, the place where three tectonic units are interacting: East-European, Intra-Alpine plates and Moesic sub-plate. Two or three events per century are devastating; having high energy they are felt over large and highly populated areas. The achievement of a seismic vulnerability reduction system for industrial and technological processes in the nuclear field intends to reduce possible after-earthquake damages which can take place in nuclear facilities situated in an extended area as compared to the usual one affected by Vrancea earthquakes. In this situation there are nuclear specific facilities like: - Van de Graaff Accelerator of IFIN-HH at Magurele; - TRIGA reactor operated at Pitesti, Mioveni, Jud. Arges; - Experimental Pilot Plant for tritium and deuterium separation of ICSI at Ramnicu Valcea; - Heavy water plant Drobeta Turnu Severin, Mehedinti. We intend to implement EEWS in the above sites in order to have a warning decision for earthquakes produced in Vrancea, Campulung Muscel and Herculane areas and its error-free transmission for activating the safety regulations for these facilities. (authors)
Background Male circumcision (MC) has been shown to reduce the risk of HIV acquisition among heterosexual men, with WHO recommending MC as an essential component of comprehensive HIV prevention programs in high prevalence settings since 2007. While Papua New Guinea (PNG) has a current prevalence of only 1%, the high rates of sexually transmissible diseases and the extensive, but unregulated, practice of penile cutting in PNG have led the National Department of Health (NDoH) to consider introducing a MC program. Given public interest in circumcision even without active promotion by the NDoH, examining the potential health systems implications for MC without raising unrealistic expectations presents a number of methodological issues. In this study we examined health systems lessons learned from a national no-scalpel vasectomy (NSV) program, and their implications for a future MC program in PNG. Methods Fourteen in-depth interviews were conducted with frontline health workers and key government officials involved in NSV programs in PNG over a 3-week period in February and March 2011. Documentary, organizational and policy analysis of HIV and vasectomy services was conducted and triangulated with the interviews. All interviews were digitally recorded and later transcribed. Application of the WHO six building blocks of a health system was applied and further thematic analysis was conducted on the data with assistance from the analysis software MAXQDA. Results Obstacles in funding pathways, inconsistent support by government departments, difficulties with staff retention and erratic delivery of training programs have resulted in mixed success of the national NSV program. Conclusions In an already vulnerable health system significant investment in training, resources and negotiation of clinical space will be required for an effective MC program. Focused leadership and open communication between provincial and national government, NGOs and community is necessary to assist
Hammond, Wesley; Thurston, Marland; Hood, Christopher
The Titan 4 Space Launch Vehicle Program is one of many major weapon system programs that have modified acquisition plans and operational procedures to meet new, stringent environmental rules and regulations. The Environmental Protection Agency (EPA) and the Department of Defense (DOD) mandate to reduce the use of ozone depleting chemicals (ODC's) is just one of the regulatory changes that has affected the program. In the last few years, public environmental awareness, coupled with stricter environmental regulations, has created the need for DOD to produce environmental life-cycle cost estimates (ELCCE) for every major weapon system acquisition program. The environmental impact of the weapon system must be assessed and budgeted, considering all costs, from cradle to grave. The Office of the Secretary of Defense (OSD) has proposed that organizations consider Conservation, Cleanup, Compliance and Pollution Prevention (C(sup 3)P(sup 2)) issues associated with each acquisition program to assess life-cycle impacts and costs. The Air Force selected the Titan 4 system as the pilot program for estimating life-cycle environmental costs. The estimating task required participants to develop an ELCCE methodology, collect data to test the methodology and produce a credible cost estimate within the DOD C(sup 3)P(sup 2) definition. The estimating methodology included using the Program Office weapon system description and work breakdown structure together with operational site and manufacturing plant visits to identify environmental cost drivers. The results of the Titan IV ELCCE process are discussed and expanded to demonstrate how they can be applied to satisfy any life-cycle environmental cost estimating requirement.
Sato, Y.; Inami, I.; Suzuki, N.; Fujimori, A.; Wille, H.
At the Fukushima Dai-ichi Nuclear Power Station unit 3 and unit 2 of Tokyo Electric Power Company (TEPCO), the replacement of the core shroud and internals have been conducted respectively in the FY 1997 outage and in the FY 1998 outage. The replacement of the welded core internals in operating BWR plants is the first time in the world as complete countermeasure to improve SCC resistance. At present both units are operating smoothly. The developed technology concept is to restore those internals in air inside the reactor pressure vessel. To reduce the radiation dose rate inside the RPV, not only a shielding method was applied to cut the radiation from the irradiated structures but also a chemical decontamination method was applied to dissolve the radioactive crud deposit on the surface by using chemical agents. The CORD UV process was applied for this Full System Decontamination including operating the reactor recirculation pumps. The critical pass time required was approximately 7 days for each unit. In both units the radioactivity of 10 TBq (280 Ci) and the Fe, Ni, Cr crud of 60-70 kg as metal in total was dissolved and removed by 5 m 3 (175 ft 3 ) ion exchange resins as only waste generated. The obtained decontamination factor (DF) at the RPV bottom reached 40-100. As result, the dose rate decreased to approximately 0.1 mSv/h under water. Before and after the installation of the in-vessel shielding, a mechanical cleaning was extensively applied inside the RPV to remove the residual crud as well as the cutting particles. As result, the RPV bottom dose rate decreased further to 0.03 mSv/h under water and 0.2 mSv/h in air. A better working environment for human access than expected was established inside the RPV, resulting the 70, 140 man*Sv saving respectively at unit 3 (1F-3) and unit 2 (1F-2). (author)
Aridas, James D S; Yawno, Tamara; Sutherland, Amy E; Nitsos, Ilias; Ditchfield, Michael; Wong, Flora Y; Hunt, Rod W; Fahey, Michael C; Malhotra, Atul; Wallace, Euan M; Jenkin, Graham; Miller, Suzanne L
Perinatal asphyxia remains a principal cause of infant mortality and long-term neurological morbidity, particularly in low-resource countries. No neuroprotective interventions are currently available. Melatonin (MLT), a potent antioxidant, anti-inflammatory and antiapoptotic agent, offers promise as an intravenous (IV) or transdermal therapy to protect the brain. We aimed to determine the effect of melatonin (IV or transdermal patch) on neuropathology in a lamb model of perinatal asphyxia. Asphyxia was induced in newborn lambs via umbilical cord occlusion at birth. Animals were randomly allocated to melatonin commencing 30 minutes after birth (60 mg in 24 hours; IV or transdermal patch). Brain magnetic resonance spectroscopy (MRS) was undertaken at 12 and 72 hours. Animals (control n = 9; control+MLT n = 6; asphyxia n = 16; asphyxia+MLT [IV n = 14; patch n = 4]) were euthanised at 72 hours, and cerebrospinal fluid (CSF) and brains were collected for analysis. Asphyxia resulted in severe acidosis (pH 6.9 ± 0.0; lactate 9 ± 2 mmol/L) and altered determinants of encephalopathy. MRS lactate:N-acetyl aspartate ratio was 2.5-fold higher in asphyxia lambs compared with controls at 12 hours and 3-fold higher at 72 hours (P asphyxia; P = .02). Asphyxia significantly increased brain white and grey matter apoptotic cell death (activated caspase-3), lipid peroxidation (4HNE) and neuroinflammation (IBA-1). These changes were significantly mitigated by both IV and patch melatonin. Systemic or transdermal neonatal melatonin administration significantly reduces the neuropathology and encephalopathy signs associated with perinatal asphyxia. A simple melatonin patch, administered soon after birth, may improve outcome in infants affected by asphyxia, especially in low-resource settings. © 2018 The Authors. Journal of Pineal Research Published by John Wiley & Sons Ltd.
Papazoglou, I.A.; Bari, R.A.; Karol, R.; Shiu, K.
The authors present a risk evaluation of the ATWS Alternate 3A modification proposed by NRC staff in NUREG-0460 to the ATWS prevention/mitigation system in a BWR nuclear power plant. The evaluation is done relative to three risk indices: the frequency of core damage, the expected early fatalities, and the expected latent fatalities. The ATWS prevention tree includes: the mechanical subsystem of the reactor protection system, the electrical subsystem of the reactor protection system, the recirculation pump trip and the Alternate Rod Insertion System. The mitigation tree includes: standby liquid control system, opening of the relief valves, reclosing the relief valves, failure of coolant injection, inadvertent actuation of the automatic depressurization system, inadvertent operation of high-pressure injection system and containment heat removal
Zhang, Shaoru; Li, Xiaohong; Zhang, Tianhua; Wang, Xiangni; Liu, Weiping; Ma, Xuexue; Li, Yuelu; Fan, Yahui
College student community is the one with high risk of tuberculosis (TB). A systemic and standardized administration model for prevention and control of TB is significance in controlling TB spread in universities. Currently, the universities in China have not established the comprehensive and standardized administration system for TB prevention and control in college student community. Firstly, the literature research and brainstorming method (n=13) were used to construct the clause and sub-clause pool for the administration of TB prevention and control within college student community in 2014. Secondly, a total of twenty experts in the field of TB prevention and control who are representatives of the east, west, south and north parts of China were selected and invited to participate the Delphi letter-inquiry. After two rounds of letter-inquiry, the opinions of the experts reached a consensus and the framework for the administration system was constructed. A framework for the administration system was constructed, which included 8 first class indexes, 26 second class indexes and 104 third class indexes. The results are highly scientific and reliable, which can be helpful for improving the systemic and standardized levels for the administration of TB prevention and control in universities in China and perhaps in other developing counties with high TB burden as well.
Sembiring, N.; Panjaitan, N.; Angelita, S.
PT. XYZ is a company owned by non-governmental organizations engaged in the field of production of rubber processing becoming crumb rubber. Part of the production is supported by some of machines and interacting equipment to achieve optimal productivity. Types of the machine that are used in the production process are Conveyor Breaker, Breaker, Rolling Pin, Hammer Mill, Mill Roll, Conveyor, Shredder Crumb, and Dryer. Maintenance system in PT. XYZ is corrective maintenance i.e. repairing or replacing the engine components after the crash on the machine. Replacement of engine components on corrective maintenance causes the machine to stop operating during the production process is in progress. The result is in the loss of production time due to the operator must replace the damaged engine components. The loss of production time can impact on the production targets which were not reached and lead to high loss costs. The cost for all components is Rp. 4.088.514.505. This cost is really high just for maintaining a Mill Roll Machine. Therefore PT. XYZ is needed to do preventive maintenance i.e. scheduling engine components and improving maintenance efficiency. The used methods are Reliability Engineering and Maintenance Value Stream Mapping (MVSM). The needed data in this research are the interval of time damage to engine components, opportunity cost, labor cost, component cost, corrective repair time, preventive repair time, Mean Time To Opportunity (MTTO), Mean Time To Repair (MTTR), and Mean Time To Yield (MTTY). In this research, the critical components of Mill Roll machine are Spier, Bushing, Bearing, Coupling and Roll. Determination of damage distribution, reliability, MTTF, cost of failure, cost of preventive, current state map, and future state map are done so that the replacement time for each critical component with the lowest maintenance cost and preparation of Standard Operation Procedure (SOP) are developed. For the critical component that has been
Full Text Available Mofularity design has been applied in many European countries, especially in industrial assembling and manufacturing. Modularity design cause manufacture process and assembly process easier and cheaper. Many industries in Indonesia usually doing corrective maintenance or preventive maintenance. So, in this research, modularity design will be applied in preventive maintenance in fish mill Indonesian factory. In this research, corrective maintenance and preventive maintenance cost will be compared to preventive maintenance cost using modularity design. From the research, the application of preventive maintenance using modularity design reduces cost up to 35.98% from the initial condition (corrective maintenance Abstract in Bahasa Indonesia : Modularity design telah banyak diterapkan di negara-negara Eropa terutama dalam hal perakitan dan manufaktur di bidang industri. Modularity design menyebabkan proses manufaktur dan perakitannya lebih sederhana dan murah. Perusahaan-perusahaan di Indonesia biasanya lebih banyak melakukan kegiatan corrective maintenance atau preventive mainternance. Dalam penelitian ini, modularity design dicoba diterapkan dalam kegiatan preventive maintenance di perusahaan tepung ikan di Indonesia. Pada penelitian ini dibandingkan biaya yang diperlukan untuk kegiatan corrective maintenance, preventive maintenance dan preventive maintenance dengan modularity design. Hasil penelitian menunjukkan bahwa dengan penerapan preventive maintenance dengan modularity design dapat menurunkan biaya sebesar 35,98% dari keadaan awal (corrective maintenance. Kata kunci: corrective maintenance, preventive maintenance, modularity design.
Full Text Available Postoperative atrial fibrillation (AF is the most common arrhythmia following cardiac surgery with extracorporeal circulation. The pathogenesis of postoperative AF is multifactorial. Oxidative stress, caused by the unavoidable ischemia-reperfusion event occurring in this setting, is a major contributory factor. ROS-derived effects could result in lipid peroxidation, protein carbonylation or DNA oxidation of cardiac tissue, thus leading to functional and structural myocardial remodeling. The vulnerability of myocardial tissue to the oxidative challenge is also dependent on the activity of the antioxidant system. High ROS levels, overwhelming this system, should result in deleterious cellular effects, such as the induction of necrosis, apoptosis or autophagy. Nevertheless, tissue exposure to low to moderate ROS levels could trigger a survival response with a trend to reinforce the antioxidant defense system. Administration of n-3 polyunsaturated fatty acids (PUFA, known to involve a moderate ROS production, is consistent with a diminished vulnerability to the development of postoperative AF. Accordingly, supplementation of n-3 PUFA successfully reduced the incidence of postoperative AF after coronary bypass grafting. This response is due to an up-regulation of antioxidant enzymes, as shown in experimental models. In turn, non-enzymatic antioxidant reinforcement through vitamin C administration prior to cardiac surgery has also reduced the postoperative AF incidence. Therefore, it should be expected that a mixed therapy result in an improvement of the cardioprotective effect by modulating both components of the antioxidant system. We present available evidence supporting the view of an effective prevention of postoperative AF including a 2-step therapeutic strategy: n-3 PUFA followed by vitamin C supplementation to patients scheduled for cardiac surgery with extracorporeal circulation. The present study should encourage the design of clinical
Full Text Available Empirically validated interventions addressing childhood psychological problems are now readily available, but success likely depends in part on accurately identifying which children will benefit from which intervention. This pilot study examined the stress activation and response system, first as a way to differentiate high versus low-risk children, and second to explore indicators of the stress system associated with favorable intervention response. Method. Participants (N = 43, 58% male were school-aged children who qualified for inclusion in the Early Risers “Skills for Success” Prevention Program based on their elevated levels of aggressive and/or socially withdrawn behavior and a normally developing comparison group. Compared to the normally developing group, children who were participants in the intervention exhibited a more blunted cortisol response to the stress paradigm. However, for the children in the intervention group, elevated cortisol levels at the start of the stress paradigm were concurrently associated with internalizing problems and predictive of improvement in internalizing problems over time. These findings provide preliminary evidence that hypothalamic pituitary adrenal (HPA axis biological variables may be helpful tools for identifying children who would benefit from intervention and personalizing interventions.
Full Text Available Unlike fungal and bacterial diseases, no direct method is available to control viral diseases. The use of resistance-inducing compounds can be an alternative strategy for plant viruses. Here we studied the basal response of melon to Melon necrotic spot virus (MNSV and demonstrated the efficacy of hexanoic acid (Hx priming, which prevents the virus from systemically spreading. We analysed callose deposition and the hormonal profile and gene expression at the whole plant level. This allowed us to determine hormonal homeostasis in the melon roots, cotyledons, hypocotyls, stems and leaves involved in basal and hexanoic acid-induced resistance (Hx-IR to MNSV. Our data indicate important roles of salicylic acid (SA, 12-oxo-phytodienoic acid (OPDA, jasmonic-isoleucine, and ferulic acid in both responses to MNSV. The hormonal and metabolites balance, depending on the time and location associated with basal and Hx-IR, demonstrated the reprogramming of plant metabolism in MNSV-inoculated plants. The treatment with both SA and OPDA prior to virus infection significantly reduced MNSV systemic movement by inducing callose deposition. This demonstrates their relevance in Hx-IR against MNSV and a high correlation with callose deposition. Our data also provide valuable evidence to unravel priming mechanisms by natural compounds.
Date rape - prevention; Sexual assault - prevention ... Centers for Disease Control and Prevention website. Sexual assault and abuse and STDs. In: 2015 sexually transmitted diseases treatment guidelines 2015. www.cdc.gov/std/tg2015/sexual- ...
... Address What's this? Submit What's this? Submit Button Prevention Recommend on Facebook Tweet Share Compartir This photograph ... medications to treat a dengue infection. This makes prevention the most important step, and prevention means avoiding ...
... Healthcare Professionals Clinicians Public Health Officials Veterinarians Prevention History of Plague Resources FAQ Prevention Recommend on Facebook Tweet Share Compartir Reduce rodent habitat around your ...
Mårtensson, Solvej; Hansen, KH; Olsen, KR
INTRODUCTION: The primary purposes of preventive child health care in Denmark are to help ensure a healthy childhood and to create preconditions for a healthy adult life. The aim of this study is to examine whether participation in age-appropriate preventative child health care affects...... the association between the socioeconomic position of the family and subsequent use of specialised health care outside the hospital system. METHODS: The study population was children born in 1999 and living in Denmark between 1 January 2002 and 31 December 2006 (n=68,366). The study investigated whether...... was listed. RESULTS: If the children attended any preventive child health care visits, they had the same probability of contact with a specialist regardless of the parents' income. However, children from low-income families not participating in any preventive care had a lower probability of contact...
This New Source Review'' has been submitted by the US Department of Energy-Richland Operations Office (PO Box 550, Richland, Washington 99352), pursuant to WAC 173-403-050 and in compliance with the Department of Ecology Guide to Processing A Prevention Of Significant Deterioration (PSD) Permit'' for three new sources of radionuclide emissions at the Hanford Site in Washington State. The three new sources, the Fueled Clad Fabrication System (FCFS), the Radioisotope Power Systems Facility (RPSF), and the Fuel Assembly Area (FAA), will be located in one facility, the Fuels and Materials Examination Facility (FMEF) of the 400 Area. The FMEF was originally designed to provide for post-irradiation examination and fabrication of breeder reactor fuels. These FMEF missions were cancelled before the introduction of any fuel materials or any irradiated material. The current plans are to use the facility to fabricate power supplies for use in space applications and to produce Fast Flux Test Facility (FFTF) fuel and target assemblies. The FCFS and the RPSF will produce materials and assemblies for application in space. The FAA project will produce FFTF fuel and target assemblies. The FCFS and the RPSF will share the same building, stack, and, in certain cases, the same floor space. Given this relationship, these systems will be dealt with separately to the extent possible. The FAA is a comparatively independent operation though it will share the FMEF complex.
Abdalla, Fayrouz Mohammed; Omar, Mayeh Abu
Around 1.2 million children living in Sub-Saharan Africa have a hearing impairment (HI) or hearing loss (HL). Limited attention and scarce resources dedicated to this condition means that such children often receive no management for their problem. This has substantial negative effects on their development, and ultimately results in poverty. Half of the number of cases of HI in such countries results from preventable causes. Formulation of effective prevention strategies to address the causes requires an understanding of the factors that lead to the causes of HI in Sub-Saharan Africa. A number of preventable causes were shown to significantly contribute to the prevalence of HI. The most significant causes include perinatal problems, middle ear problems, infective diseases, and ototoxic drugs. These causes persist because there are few effective prevention strategies in place, and those which exist are poorly implemented. There is little public and health care worker awareness about HL and its prevention. Few resources are allocated to the prevention of HL, meaning that these issues are not addressed. Evidence have shown that current failings in the prevention of HI from such causes include widespread limited resources, inadequate staff training, and absent or ineffectual prevention guidelines. The burden of HL has been shown to be significantly reduced through effective prevention strategies, both in the developed and developing world, justifying the need for increased attention and more resources in Sub-Saharan Africa.
Bruins Slot, Karsten Mh; Berge, Eivind
Factor Xa inhibitors and vitamin K antagonists (VKAs) are now recommended in treatment guidelines for preventing stroke and systemic embolic events in people with atrial fibrillation (AF). This is an update of a Cochrane review previously published in 2013. To assess the effectiveness and safety of treatment with factor Xa inhibitors versus VKAs for preventing cerebral or systemic embolic events in people with AF. We searched the trials registers of the Cochrane Stroke Group and the Cochrane Heart Group (September 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (August 2017), MEDLINE (1950 to April 2017), and Embase (1980 to April 2017). We also contacted pharmaceutical companies, authors and sponsors of relevant published trials. We used outcome data from marketing authorisation applications of apixaban, edoxaban and rivaroxaban that were submitted to regulatory authorities in Europe and the USA. We included randomised controlled trials (RCTs) that directly compared the effects of long-term treatment (lasting more than four weeks) with factor Xa inhibitors versus VKAs for preventing cerebral and systemic embolism in people with AF. The primary efficacy outcome was the composite endpoint of all strokes and systemic embolic events. Two review authors independently extracted data, and assessed the quality of the trials and the risk of bias. We calculated a weighted estimate of the typical treatment effect across trials using the odds ratio (OR) with 95% confidence interval (CI) by means of a fixed-effect model. In case of moderate or high heterogeneity of treatment effects, we used a random-effects model to compare the overall treatment effects. We also performed a pre-specified sensitivity analysis excluding any open-label studies. We included data from 67,688 participants randomised into 13 RCTs. The included trials directly compared dose-adjusted warfarin with either apixaban, betrixaban, darexaban, edoxaban, idraparinux, idrabiotaparinux, or
Du, Yijuan; Grace, Anthony A
Schizophrenia is believed to arise from an interaction of genetic predisposition and adverse environmental factors, with stress being a primary variable. We propose that alleviating anxiety produced in response to stress during a sensitive developmental period may circumvent the dopamine (DA) system alterations that may correspond to psychosis in adults. This was tested in a developmental rat model of schizophrenia based on prenatal administration of the mitotoxin methyl azoxymethanol acetate (MAM). MAM administration leads to a hyperdopaminergic state consisting of an increase in the number of DA neurons firing spontaneously, which correlates with an increased behavioral response to amphetamine. MAM-treated rats exhibited a heightened level of anxiety during adolescence. Peripubertal administration of the antianxiety agent diazepam was found to prevent the increase in DA neuron activity and blunt the behavioral hyperresponsivity to amphetamine in these rats. These data suggest that the pathophysiological factors leading to the onset of psychosis in early adulthood may be circumvented by controlling the response to stress during the peripubertal period.
Du, Yijuan; Grace, Anthony A
Schizophrenia is believed to arise from an interaction of genetic predisposition and adverse environmental factors, with stress being a primary variable. We propose that alleviating anxiety produced in response to stress during a sensitive developmental period may circumvent the dopamine (DA) system alterations that may correspond to psychosis in adults. This was tested in a developmental rat model of schizophrenia based on prenatal administration of the mitotoxin methyl azoxymethanol acetate (MAM). MAM administration leads to a hyperdopaminergic state consisting of an increase in the number of DA neurons firing spontaneously, which correlates with an increased behavioral response to amphetamine. MAM-treated rats exhibited a heightened level of anxiety during adolescence. Peripubertal administration of the antianxiety agent diazepam was found to prevent the increase in DA neuron activity and blunt the behavioral hyperresponsivity to amphetamine in these rats. These data suggest that the pathophysiological factors leading to the onset of psychosis in early adulthood may be circumvented by controlling the response to stress during the peripubertal period. PMID:23612434
Almendros, Cristóbal; Guzmán, Noemí M; García-Martínez, Jesús; Mojica, Francisco J M
Archaea and bacteria harbour clustered regularly interspaced short palindromic repeats (CRISPR) loci. These arrays encode RNA molecules (crRNA), each containing a sequence of a single repeat-intervening spacer. The crRNAs guide CRISPR-associated (Cas) proteins to cleave nucleic acids complementary to the crRNA spacer, thus interfering with targeted foreign elements. Notably, pre-existing spacers may trigger the acquisition of new spacers from the target molecule by means of a primed adaptation mechanism. Here, we show that naturally occurring orphan CRISPR arrays that contain spacers matching sequences of the cognate (absent) cas genes are able to elicit both primed adaptation and direct interference against genetic elements carrying those genes. Our findings show the existence of an anti-cas mechanism that prevents the transfer of a fully equipped CRISPR-Cas system. Hence, they suggest that CRISPR immunity may be undesired by particular prokaryotes, potentially because they could limit possibilities for gaining favourable sequences by lateral transfer.
Itoh, Hiroko; Nakata, Fukuyoshi; Sasaki, Hiroyuki; Ito, Hitoshi
Reishi has been used for a roborant or the elixir of life from ancient times. In the present study, the preventive effects of Reishi on hematopoietic suppression from X-ray irradiation in mice were investigated. 5.0 Gy-irradiated mice induced the decrease of red blood cell, platelet, white blood cell, granulocytes, the index of spleen and thymus, and the number of spleen cells. Oral administration of Reishi tended to decrease these damage on hematopoiesis, and reticuloendothelial system. Reishi enhanced the degree of spleen cells-mediated sheep red blood cells (SRBC) hemolysis (quantitative hemolysis of SRBC). Reishi augmented the level of erythroid burst-forming cell (BFU-E), and accelerated the recovery of the number of BFU-E in X-irradiated mice, although Reishi did not influence red blood cell counts and colony-forming unit-erythropoetin dependent (CFU-E) number. A significant elevation in the CFU-GM (granulocytes-macrophages) level was observed. Histological examinations revealed that Reishi accerelated the hematopoietic recovery and decrease on damage of spleen and thymus. (author)
Graham, Kirstie J; Ba-Break, Maryam M
Factors limiting coverage of intermittent preventive treatment for malaria in pregnancy (IPTp) in Tanzania were explored from the perspective of health workers, in order to make recommendations to improve service delivery. Recent data estimates coverage of the recommended two doses of IPTp at 26.3%, far short of the national target of 80%. Semistructured interviews were conducted with 13 health workers and 2 health managers during June 2011 in Ikwiriri, southeast Tanzania. Delivery of sulfadoxine-pyrimethamine (SP) was severely constrained by drug shortages and widespread stock-outs, indicative of ongoing difficulties in the wider health system. While SP was well known and attitudes towards IPTp were positive, health workers were often not informed of up-to-date dosing schedules, limiting coverage. Recent literature suggests this could be due to inconsistent and conflicting national guidelines. In addition, it was found that two pills, instead of the recommended three pills, per dose of IPTp were frequently given to pregnant women, a finding previously unreported. To maximize IPTp coverage, sufficient and consistent supplies of SP to both public and private health facilities are a necessity, combined with effective communication of revised dosing schedules. Further research is warranted to investigate the aberrant administration of two pills per dose, as it may exacerbate drug resistance.
Meader, Emma; Mayer, Melinda J; Gasson, Michael J; Steverding, Dietmar; Carding, Simon R; Narbad, Arjan
Clostridium difficile is primarily a nosocomial pathogen, causing thousands of cases of antibiotic-associated diarrhoea in the UK each year. In this study, we used a batch fermentation model of a C. difficile colonised system to evaluate the potential of a prophylactic and a remedial bacteriophage treatment regime to control the pathogen. It is shown that the prophylaxis regime was effective at preventing the growth of C. difficile (p = viable C. difficile cells (p = <0.0001), but still resulted in a lower level of toxin production relative to the control. The numbers of commensal bacteria including total aerobes and anaerobes, Bifidobacterium sp., Bacteroides sp., Lactobacillus sp., total Clostridium sp., and Enterobacteriaceae were not significantly decreased by this therapy, whereas significant detrimental effects were observed with metronidazole treatment. Our study indicates that phage therapy has potential to be used for the control of C. difficile; it highlights the main benefits of this approach, and some future challenges. Copyright Â© 2010 Elsevier Ltd. All rights reserved.
Full Text Available There is epidemiological evidence for the cancer preventive effect of dietary calcium (Ca2+ and vitamin D. This effect is strongest in colorectal cancer (CRC. The active vitamin D metabolite, 1,25-dihydroxyvitamin D3 (1,25D3, bound to its receptor, the vitamin D receptor (VDR regulates the expression of hundreds of different genes in a cell- and tissue-specific manner. While Ca2+ acts through multiple mechanisms and pathways, some of its effects are mediated by the calcium-sensing receptor (CaSR. The joint action of Ca2+ and 1,25D3 is due to the fact that both regulate some of the main processes involved in the development of various cancers, such as proliferation, differentiation, apoptosis, migration, and inflammation. Moreover, 1,25D3, bound to VDR can induce translation of the CaSR, while the amount and activity of the CaSR affects 1,25D3 signalling. However, the complexity of the cross-talk between the CaSR and the vitamin D system goes beyond regulating similar pathways and affecting each other’s expression. Our aim was to review some of the mechanisms that drive the cross-talk between the vitamin D system and the CaSR with a special focus on the interaction in colorectal cancer cells. We evaluated the molecular evidence that supports the epidemiological observation that both vitamin D and calcium are needed for protection against malignant transformation of the colon and that their effect is modulated by the presence of a functional CaSR.
Anders, Sherry; Kinney, Dennis K
Extensive research implicates disturbed immune function and development in the etiology and pathology of schizophrenia. In addition to reviewing evidence for immunological factors in schizophrenia, this paper discusses how an emerging model of atypical immune function and development helps explain a wide variety of well-established - but puzzling - findings about schizophrenia. A number of theorists have presented hypotheses that early immune system programming, disrupted by pre- and perinatal adversity, often combines with abnormal brain development to produce schizophrenia. The present paper focuses on the hypothesis that disruption of early immune system development produces a latent immune vulnerability that manifests more fully after puberty, when changes in immune function and the thymus leave individuals more susceptible to infections and immune dysfunctions that contribute to schizophrenia. Complementing neurodevelopmental models, this hypothesis integrates findings on many contributing factors to schizophrenia, including prenatal adversity, genes, climate, migration, infections, and stress, among others. It helps explain, for example, why (a) schizophrenia onset is typically delayed until years after prenatal adversity, (b) individual risk factors alone often do not lead to schizophrenia, and (c) schizophrenia prevalence rates actually tend to be higher in economically advantaged countries. Here we discuss how the hypothesis explains 10 key findings, and suggests new, potentially highly cost-effective, strategies for treatment and prevention of schizophrenia. Moreover, while most human research linking immune factors to schizophrenia has been correlational, these strategies provide ethical ways to experimentally test in humans theories about immune function and schizophrenia. This article is part of a Special Issue entitled SI: Neuroimmunology in Health And Disease. Copyright © 2015 Elsevier B.V. All rights reserved.
Cheng, Sheng-Lin; Tsai, Tsung-Heng; Lee, Carina Jean-Tien; Hsu, Yu-Hsiang; Lee, Chih-Kung
A pressure ulcer is one of the most important concerns for wheelchair bound patients with spinal cord injuries. A pressure ulcer is a localized injury near the buttocks that bear ischial tuberosity oppression over a long period of time. Due to elevated compression to blood vessels, the surrounding tissues suffer from a lack of oxygen and nutrition. The ulcers eventually lead to skin damage followed by tissue necrosis. The current medical strategy is to minimize the occurrence of pressure ulcers by regularly helping patients change their posture. However, these methods do not always work effectively or well. As a solution to fundamentally prevent pressure ulcers, a smart air cushion system was developed to detect and control pressure actively. The air cushion works by automatically adjusting a patient's sitting posture to effectively relieve the buttock pressure. To analyze the correlation between the dynamic pressure profiles of an air cell with a patient's weight, a projection Moiré system was adopted to measure the deformation of an air cell and its associated stress distribution. Combining a full-field deformation imaging with air pressure measured within an air cell, the patient's weight and the stress distribution can be simultaneously obtained. By integrating a full-field optical metrology with a time varying pressure sensor output coupled with different active air control algorithms for various designs, we can tailor the ratio of the air cells. Our preliminary data suggests that this newly developed smart air cushion has the potential to selectively reduce localized compression on the tissues at the buttocks. Furthermore, it can take a patient's weight which is an additional benefit so that medical personnel can reference it to prescribe the correct drug dosages.
Lewis, Timothy J.; Mitchell, Barbara S.
Students with emotional and behavioral disorders are at great risk for long-term negative outcomes. Researchers and practitioners alike acknowledge the need for evidence-based, preventive, and early intervention strategies. Accordingly, in this chapter an expanded view of prevention is presented as a series of data driven decisions to guide…
... the appropriate standards from the following table: When The minimum BOP stack must include (1) The... without a secondary source of pneumatic supply, must be equipped with manual overrides, or alternately...
Faria, Rita; Spackman, Eldon; Burch, Jane; Corbacho, Belen; Todd, Derick; Pepper, Chris; Woolacott, Nerys; Palmer, Stephen
The National Institute for Health and Clinical Excellence (NICE) invited the manufacturer of dabigatran etexilate (Boehringer Ingelheim Ltd, UK) to submit evidence for the clinical and cost-effectiveness of this drug for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (AF) as part of the NICE single technology appraisal process. The Centre for Reviews and Dissemination and the Centre for Health Economics at the University of York were commissioned to act as the evidence review group (ERG). This article presents a summary of the manufacturer's submission, the ERG report and the subsequent development of NICE guidance for the use of dabigatran within the UK National Health Service. Dabigatran was granted marketing authorisation by the European Medicines Agency for a sequential dosing regimen (DBG sequential), in which patients under 80 years are treated with dabigatran 150 mg twice daily (DBG150) and patients 80 years and over are given dabigatran 110 mg twice daily (DBG110). NICE decisions are bound by the marketing authorisation; therefore, the decision problem faced by the committee was whether the DBG sequential regimen was effective and cost-effective compared with warfarin or aspirin for patients with non-valvular AF and one or more risk factors. The RE-LY trial, a large multi-centre non-inferiority randomised clinical trial, was the primary source of clinical evidence. DBG150 was shown to be non-inferior, and subsequently superior to warfarin, for the primary outcome of all stroke/systemic embolism. DBG110 was found to be non-inferior to warfarin. Results were presented for a post hoc subgroup analysis for patients under and over 80 years of age, where DBG110 showed a statistically significant reduction of haemorrhagic stroke and intracranial haemorrhage in comparison to warfarin in patients over 80 years of age. This post hoc subgroup analysis by age was the basis for the licensed DBG sequential regimen
Crone, M.R.; Vogels, A.G.C.; Hoekstra, F.; Treffers, P.D.A.; Reijneveld, S.A.
Background: Validated questionnaires can support the identification of psychosocial problems by the Preventive Child Health Care (PCH) system. This study assesses the validity and added value of four scoring methods used with the Strengths and Difficulties Questionnaire (SDQ) for the identification
Crone, Mathilde R.; Vogels, Anton G. C.; Hoekstra, Femke; Treffers, Philip D. A.; Reijneveld, Sijmen A.
Background: Validated questionnaires can support the identification of psychosocial problems by the Preventive Child Health Care (PCH) system. This study assesses the validity and added value of four scoring methods used with the Strengths and Difficulties Questionnaire (SDQ) for the identification
Bernhardt, Victoria L.; Hébert, Connie L.
Experts Bernhardt and Hébert's latest book demonstrates strategies to ensure your entire staff works together to design, implement, monitor, and evaluate a schoolwide prevention system with integrity and fidelity. Each step in this important resource is designed to help administrators, teachers, and other educators improve the learning of every…
Bernhardt, Victoria L.; Hebert, Connie L.
Ensure the success of your school and improve the learning of "all" students by implementing Response-to-Intervention (RTI) as part of a continuous school improvement (CSI) process. This book shows you how to get your entire staff working together to design, implement, and evaluate a schoolwide prevention system. With specific examples, CSI expert…
Pierre, Joseph D.
Information security systems (ISS) have been designed to protect assets from damages and from unauthorized access internally as well as externally. This research is promising similar protection from ISS methods that could prevent intoxicated individuals under the influence of alcohol from driving. However, previous research has shown significant…
Matthew Lee Smith
Full Text Available Although the concepts of systems change and sustainability are not new, little is known about the factors associated with systems change sustaining multi-state, multi-level fall prevention efforts. This exploratory study focuses on three State Departments of Health (DOH that were awarded 5-year funding from the Centers for Disease Control and Prevention to simultaneously implement four separate yet related evidence-based fall prevention initiatives at the clinical, community, and policy level. The purpose of this study was to examine changes in partnerships and collaborative activities that occurred to accomplish project goals (examining changes in the context of “before funding” and “after funding was received”. Additionally, this study explored changes in State DOH perceptions about action related to sustainability indicators in the context of “during funding” and “after funding ends.” Findings from this study document the partnership and activity changes necessary to achieve defined fall prevention goals after funding is received, and that the importance of sustainability indicator documentation is seen as relevant during funding, but less so after the funding ends. Findings from this study have practice and research implications that can inform future funded efforts in terms of sector and stakeholder engagement necessary for initiating, implementing, and sustaining community- and clinical-based fall prevention interventions.
Smith, Matthew Lee; Schneider, Ellen C.; Byers, Imani N.; Shubert, Tiffany E.; Wilson, Ashley D.; Towne, Samuel D.; Ory, Marcia G.
Although the concepts of systems change and sustainability are not new, little is known about the factors associated with systems change sustaining multi-state, multi-level fall prevention efforts. This exploratory study focuses on three State Departments of Health (DOH) that were awarded 5-year funding from the Centers for Disease Control and Prevention to simultaneously implement four separate yet related evidence-based fall prevention initiatives at the clinical, community, and policy level. The purpose of this study was to examine changes in partnerships and collaborative activities that occurred to accomplish project goals (examining changes in the context of “before funding” and “after funding was received”). Additionally, this study explored changes in State DOH perceptions about action related to sustainability indicators in the context of “during funding” and “after funding ends.” Findings from this study document the partnership and activity changes necessary to achieve defined fall prevention goals after funding is received, and that the importance of sustainability indicator documentation is seen as relevant during funding, but less so after the funding ends. Findings from this study have practice and research implications that can inform future funded efforts in terms of sector and stakeholder engagement necessary for initiating, implementing, and sustaining community- and clinical-based fall prevention interventions. PMID:28642861
Full Text Available INTRODUCTION: The objectives of the study were to evaluate the health system effectiveness of ANC for the delivery of a dose of IPTp and an ITN to women attending ANC during eligible gestation, and to identify the predictors of systems effectiveness. METHODS: A cross sectional study was undertaken in 10 health facilities including structured non-participant observations of the ANC process for 780 pregnant women followed by exit interviews. The proportion of pregnant women receiving a dose of IPTp-SP and an ITN was assessed. Predictors of each ineffective intermediate process were identified using multivariable logistic regression. RESULTS: Overall, 0% and 24.5% of pregnant women of eligible gestation on the first visit to ANC received a dose of IPTp-SP by DOT at the district and community levels respectively. Ineffective intermediate processes were 'given IPTp-SP at the ANC' 63.9% and 74.0% (95% CI 62.0, 83.3, and 'given IPTp-SP by DOT' 0% and 34.3% (95% CI 10.5, 69.8, at district and community levels, respectively. Delivery of ITNs was effective where they were in stock; however stock-outs were a problem. Predictors of receiving IPTp-SP at the district level were 4 to 6 months gestation, not reporting symptoms of malaria at ANC visit and the amount of money spent during the visit. At the community level, the predictors were 4 to 6 months gestation, maternal education below primary level, routine ANC visit (not for an illness, palpation of the abdomen, and expenditure of money in ANC. CONCLUSION: In Segou District, the delivery of IPTp-SP was ineffective; whilst ITN delivery was effective if ITNs were in stock. Predictors of receiving IPTp-SP at the district and community levels included gestational age, the amount of expenditure during the ANC visit and no illness.
Full Text Available Background and aims. The aim of the present study was to compare the inhibitory effects of two systemic doses of HESA-A on prevention of 4-NQO-induced tongue neoplasms in rats. This study evaluated weight and histopathological changes. Materials and methods. Forty-eight male Sprague Dawley rats were divided into four groups of A, B, C and D of each 12 rats. The rats in groups B to D received 30 ppm of 4-Nitroquinoline-1-oxide (4-NQO in drinking water for 12 weeks. When feeding with 4-NQO was initiated, the rats in groups B and C received HESA-A at doses of 250 and 500 mg/kg, respectively, 3 times a week. Body weights were measured three times a week. At the end, the rats were euthanized and the tongue was removed. Histological evaluations for carcinogenesis were carried out under a light microscope. Results. The mean body weights of rats in groups B, C and D were significantly lower than that in group A (P < 0.05. There were no significant differences in weight changes between groups B, C and D. In the present study, after 12 weeks of treatment, Tongue specimens in groups B and C did not exhibit severe dysplastic changes; however, concurrent hyperplasia, without atypia and mild-to-moderate dysplastic changes were detected. These changes were significantly less than those in group D, with significant differences between group D and groups A, B and C (P<0.001, P<0.01 and P<0.05, respectively. Conclusion. HESA-A has dose-dependent inhibitory effects on the development of neoplasms of the tongue.
Bull, Sheana; Thomas, Deborah Sk; Nyanza, Elias C; Ngallaba, Sospatro E
The prevention of mother-to-child transmission (PMTCT) of HIV requires innovative solutions. Although routine monitoring is effective in some areas, standardized and easy-to-scale solutions to identify and monitor pregnant women, test them for HIV, and treat them and their children is still lacking. Mobile health (mHealth) offers opportunities for surveillance and reporting in rural areas of low- and middle-income countries. The aim of this study was to document the preliminary impacts of the Tanzania Health Information Technology (T-HIT) system mHealth intervention aimed at health workers for PMTCT care delivery and capacity building in a rural area of Tanzania. We developed T-HIT as a tablet-based system for an electronic data collection system designed to capture and report PMTCT data during antenatal, delivery, and postnatal visits in Misungwi, Tanzania. T-HIT was tested by health workers in a pilot randomized trial comparing seven sites using T-HIT assigned at random to seven control sites; all sites maintained standard paper record-keeping during the pilot intervention period. We compared numbers of antenatal visits, number of HIV tests administered, and women testing positive across all sites. Health workers recorded data from antenatal visits for 1530 women; of these, 695 (45.42%) were tested for HIV and 3.59% (55/1530) tested positive. Health workers were unable to conduct an HIV test for 103 women (6.73%, 103/1530) because of lack of reagent, which is not captured on paper logs. There was no difference in the activity level for testing when comparing sites T-HIT to non-T-HIT sites. We observed a significant postintervention increase in the numbers of women testing positive for HIV compared with the preintervention period (P=.04), but this was likely not attributable to the T-HIT system. T-HIT had a high degree of acceptability and feasibility and is perceived as useful by health workers, who documented more antenatal visits during the pilot intervention
Abdalla, Fayrouz Mohammed; Omar, Mayeh Abu
Around 1.2 million children living in Sub-Saharan Africa have a hearing impairment (HI) or hearing loss (HL). Limited attention and scarce resources dedicated to this condition means that such children often receive no management for their problem. This has substantial negative effects on their development, and ultimately results in poverty. Half of the number of cases of HI in such countries results from preventable causes. Formulation of effective prevention strategies to address the causes...
Calixto, Giovana Maria Fioramonti; Duque, Cristiane; Aida, Kelly Limi; Dos Santos, Vanessa Rodrigues; Massunari, Loiane; Chorilli, Marlus
Formation of a dental biofilm by Streptococcus mutans can cause dental caries, and remains a costly health problem worldwide. Recently, there has been a growing interest in the use of peptidic drugs, such as peptide p1025, analogous to the fragments 1025-1044 of S. mutans cellular adhesin, responsible for the adhesion and formation of dental biofilm. However, peptides have physicochemical characteristics that may affect their biological action, limiting their clinical performance. Therefore, drug-delivery systems, such as a bioadhesive liquid-crystalline system (LCS), may be attractive strategies for peptide delivery. Potentiation of the action of LCS can be achieved with the use of bioadhesive polymers to prolong their residence on the teeth. In line with this, three formulations - polyoxypropylene-(5)-polyoxyethylene-(20)-cetyl alcohol, oleic acid, and Carbopol C974P in different combinations (F1C, F2C, and F3C) were developed to observe the influence of water in the LCS, with the aim of achieving in situ gelling in the oral environment. These formulations were assessed by polarized light microscopy, small-angle X-ray scattering, rheological analysis, and in vitro bioadhesion analysis. Then, p1025 and a control (chlorhexidine) were incorporated into the aqueous phase of the formulation (F + p1025 and F + chlorhexidine), to determine their antibiofilm effect and toxicity on epithelial cells. Polarized light microscopy and small-angle X-ray scattering showed that F1C and F2C were LCS, whereas F3C was a microemulsion. F1C and F2C showed pseudoplastic behavior and F3C Newtonian behavior. F1C showed the highest elastic and bioadhesive characteristics compared to other formulations. Antibiofilm effects were observed for F + p1025 when applied in the surface-bound salivary phase. The p1025-loaded nanostructured LCS presented limited cytotoxicity and effectively reduced S. mutans biofilm formation, and could be a promising p1025-delivery strategy to prevent the formation
Moore, Susan Fordney
The purpose of this paper is to provide the beginning counselor with an overview of prevention concepts. Prevention is a relatively new emphasis in community efforts to stem the rising costs of substance abuse and other high-risk behaviors. The paper discusses agent, host, and environmental prevention models and how they relate to causal theories…
Vojta, Deneen; Koehler, Timothy B; Longjohn, Matt; Lever, Jonathan A; Caputo, Nadine F
Twenty-six million U.S. adults have diabetes, and 79 million have prediabetes. A 2002 Diabetes Prevention Program research study proved the effectiveness of a lifestyle intervention that yielded a 58% reduction in conversion to type 2 diabetes. However, cost per participant was high, complicating efforts to scale up the program. UnitedHealth Group (UHG) and the YMCA of the USA, in collaboration with the CDC, sought to develop the infrastructure and business case to scale the congressionally authorized National Diabetes Prevention Program nationwide. Emphasis was placed on developing a model that maintained fidelity to the original 2002 Diabetes Prevention Program research study and could be deployed for a lower cost per participant while yielding similar outcomes. The UHG created the business case and technical and operational infrastructure necessary for nationwide dissemination of the YMCA's Diabetes Prevention Program (YMCA's DPP), as part of the National Diabetes Prevention Program. The YMCA's DPP is a group-based model of 16 core sessions with monthly follow-up delivered by trained lifestyle coaches. A variety of mechanisms were used to identify, screen, and encourage enrollment for people with prediabetes into the YMCA's DPP. Substantial investments were made in relationship building, business planning, technology, development, and operational design to deliver an effective and affordable 12-month program. The program intervention was conducted July 2010-December 2011. Data were collected on the participants over a 15-month period between September 2010 and December 2011. Data were analyzed in February 2012. The main outcome measures were infrastructure (communities involved and personnel trained); engagement (screening and enrollment of people with prediabetes); program outcomes (attendance and weight loss); and service delivery cost of the intervention. In less than 2 years, the YMCA's DPP was effectively scaled to 46 communities in 23 states. More than 500
Gschwind, Yves J.; Eichberg, Sabine; Marston, Hannah R.; Ejupi, Andreas; De Rosario Martínez, Helios; Kroll, Michael; Drobics, Mario; Annegarn, Janneke; Wieching, Rainer; Lord, Stephen R.; Aal, Konstantin; Delbaere, Kim
Background: Falls are very common, especially in adults aged 65 years and older. Within the current international European Commission's Seventh Framework Program (FP7) project 'iStoppFalls' an Information and Communication Technology (ICT) based system has been developed to regularly assess a person's risk of falling in their own home and to deliver an individual and tailored home-based exercise and education program for fall prevention. The primary aims of iStoppFalls are to assess the feasi...
Carrington, Melinda J; Kok, Simone; Jansen, Kiki; Stewart, Simon
A sustained epidemic of cardiovascular disease and related risk factors is a global phenomenon contributing significantly to premature deaths and costly morbidity. Preventative strategies across the full continuum of life, from a population to individual perspective, are not optimally applied. This paper describes a simple and adaptable 'traffic-light' system we have developed to systematically perform individual risk and need delineation in order to 'titrate' the intensity and frequency of healthcare intervention in a cost-effective manner. The GARDIAN (Green Amber Red Delineation of Risk and Need) system is an individual assessment of risk and need that modulates the frequency and intensity of future healthcare intervention. Individual assessment of risk and need for ongoing intervention and support is determined with reference to three domains: (1) clinical stability, (2) gold-standard management, and (3) a broader, holistic assessment of individual circumstance. This can be applied from a primary prevention, secondary prevention, or chronic disease management perspective. Our experience with applying and validating GARDIAN to titrate healthcare resources according to need has been extensive to date, with >5000 individuals profiled in a host of clinical settings. A series of clinical randomized trials will determine the impact of the GARDIAN system on important indices of healthcare utilization and health status. The GARDIAN model to delineating risk and need for varied intensity of management shows strong potential to cost effectively improve health outcomes for both individuals at risk of heart disease and those with established heart disease.
Grocott, Hilary P; Mathew, Joseph P; Carver, Elizabeth H; Phillips-Bute, Barbara; Landolfo, Kevin P; Newman, Mark F
In this trial we compared the hypothermia avoidance abilities of the Arctic Sun Temperature Management System (a servo-regulated system that circulates temperature-controlled water through unique energy transfer pads adherent to the patient's body) with conventional temperature control methods. Patients undergoing off-pump coronary artery bypass (OPCAB) surgery were randomized to either the Arctic Sun System alone (AS group) or conventional methods (control group; increased room temperature, heated IV fluids, convective forced air warming system) for the prevention of hypothermia (defined by a temperature temperature servo-regulated to a target of 36.8 degrees C. Temperature was recorded throughout the operative period and comparisons were made between groups for both the time and area under the curve (AUC) for a temperature control group = 15) were studied. The AS group had significantly less hypothermia than the control group, both for duration of time control group; P = 0.0008) as well as for AUCcontrol group; P = 0.002). The Arctic Sun Temperature Management System significantly reduced intraoperative hypothermia during OPCAB surgery. Importantly, this was achieved in the absence of any other temperature modulating techniques, including the use of IV fluid warming or increases in the ambient operating room temperature. The Arctic Sun Temperature Management System was more effective than conventional methods in preventing hypothermia during off-pump coronary artery bypass graft surgery.
Hall, S M; Wasserman, D A; Havassy, B E
Although knowledge about relapse prevention is still at an early stage, the extant data highlight the importance of several constructs. 1. Motivation for abstinence remains central. The construct itself is often clouded because of its association with mystical notions such as willpower and self-control. We know that manipulation of environmental events can increase motivation. These interventions are effective, however, only as long as the contingencies are in effect. We need to develop and evaluate strategies for transferring contingency management to the natural environment, that is, to institutions and groups that can perpetuate them for the long term. Also, clarification of the kinds of abstinence goals needed to prevent relapse is important. 2. Coping skills have been studied by several investigators, but research on these, except for job-finding skills, is not encouraging. The skills usually taught may be too basic. Skills training oriented to complex targets, such as building nondrug-using networks, may be useful and should be further explored. 3. Social support is clearly important, yet we do not know how best to use it to promote abstinence. The little research available suggests that both familial and nonfamilial systems should be mobilized. We need to define abstinence-promoting supportive behaviors, identify and engage important support systems in treatment, and help patients expand their nondrug-using contacts. 4. Negative affect may be causally related to relapse. We need to continue efforts to identify dysphoric patients and develop interventions to ameliorate dysphoria concurrent with drug abuse treatment (cf. Zweben and Smith 1989). 5. Drug cue reactivity and extinction to drug cues have been demonstrated in the laboratory. What is needed in this promising line of research are (1) investigation of cues and cue-reactivity phenomena in the natural environment or in conditions closely mimicking that environment and (2) extinction methods that transfer
Maeda, Hiroyuki; Iwase, Hideaki; Kanda, Akio; Morohashi, Itaru; Kaneko, Kazuo; Maeda, Mutsuhiro; Kakinuma, Yuki; Takei, Yusuke; Amemiya, Shota; Mitsui, Kazuyuki
After an emergency or disaster, subsequent trauma can cause severe bleeding and this can often prove fatal, so promptly stopping that bleeding is crucial to preventing avoidable trauma deaths. A tourniquet is often used to restrict blood flow to an extremity. In operation and hospital, the tourniquet systems currently in use are pneumatically actuated by an air compressor, so they must have a steady power supply. These devices have several drawbacks: they vibrate and are noisy since they are pneumatically actuated and they are far from portable since they are large and heavy. Presumably, the drawbacks of pneumatic tourniquets could be overcome by developing a small, lightweight, vibration-free, quiet, and battery-powered tourniquet system. The current study built a small, vibration-free electrohydrodynamic (EHD) pump and then used that pump to restrict blood flow to the leg of rats in an experiment. This study explored the optimal conditions for effective restriction of blood flow by assessing biochemical and musculoskeletal complications following the restriction of blood flow, and this study also examined whether or not an EHD pump could be used to actuate a tourniquet system. A tourniquet cuff (width 12 mm × length 150 mm, material: polyolefin) was placed on the thigh of Wistar rats and pressure was applied for 2 hours by a device that uses EHD phenomena to generate pressure (an EHD pump). Animals were divided into four groups based on how much compressive pressure was applied with a tourniquet: 40 kPa (300 mm Hg, n = 13), 30 kPa (225 mm Hg, n = 12), 20 kPa (150 mm Hg, n = 15), or 0 kPa (controls, n = 25). Tissue oxygen saturation (regional oxygen saturation, denoted here as rSO 2 ) was measured to assess the restriction of blood flow. To assess behavior once blood flow resumed, animal activity was monitored for third day and the amount of movement was counted with digital counters. Body weight was measured before and after the behavioral experiment, and
Teles, Marcus de Barros [Agencia Reguladora de Servicos Publicos Delegados do Estado do Ceara (ARCE), Fortaleza, CE (Brazil)
Leaks are the bigger problem in health, safety and environmental when the subject is gas distribution piping systems. Specially in high density human regions, like in the majority districts of Fortaleza, safety have to be the higher priority to the gas company responsible for the gas distribution piping systems. Leaks are able to cause accidents or incidents, depending on the circumstances which they happen. In order to be control the situation and overcome the luck factor, leaks must be previously avoided by the application of some security requirements. This paper present some suggestions to natural gas leak prevention in the Fortaleza's metropolitan region pipeline systems. First, the piping systems are analysed, observing the risk regions. Then, safety actions and basic requirements to avoid pipe corrosion are presented in order to improve safety in the gas distribution piping systems of Fortaleza's metropolitan region. (author)
The German system to prevent, detect and respond to illicit uses of nuclear materials and radioactive sources consists of a variety of different elements: International and national laws and regulations covering safeguards, physical protection, and import/export control; Licensing and regulatory supervision of all activities related to nuclear materials and radioactive sources, including import and export; Responsibility of the licensee to ensure compliance with licensing conditions; sanctions; Law enforcement by police, security and customs authorities; prosecution and penalties; Detection of illicitly trafficked radioactive materials through intelligence and technical means; analysis capabilities; Response arrangements for normal and for severe cases of illicit use of nuclear materials; Participation in international programmes and POC-systems. Safeguards measures have been implemented in Germany in accordance with the Non- Proliferation Treaty and with safeguards agreements based on INFCIRC/153. As Germany is a member of the European Union, the Euratom Treaty and the Euratom-Ordinance Nr. 3227/76 together with the Verification Agreement between the IAEA, the European Commission and the European Member States have led to safeguards measures jointly implemented by the IAEA and by Euratom. The relevant international law for the physical protection of nuclear material in force in Germany is the Convention on the Physical Protection of Nuclear Material. The recommendations on physical protection objectives and fundamentals and on physical protection measures specified in INFCIRC/225/Rev. 4 have been taken into account in various national regulations pertaining to the national design basis threat, the physical protection of LWR nuclear power plants, of interim spent fuel storage facilities, of facilities containing category III material, of nuclear material and radioactive waste transports by road or railway vehicles, aircraft or sea vessels; additional guidelines
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Full Text Available ... Injections PREVENTION Lifestyle Choices 10 Tips for a Healthy Back Smoking Weight Patient Safety Exercise Strengthening Strengthen Your Core! Stretching/Flexibility Aerobic Exercise ...
Full Text Available ... Watchful Waiting and Education Injection Treatments for Spinal Pain Epidural Steroid Injections Lumbar Zygapophysical (Facet) Joint Injections PREVENTION Lifestyle Choices 10 ...
Templeton, Anna Rose; Young, Linda; Bish, Alison; Gnich, Wendy; Cassie, Heather; Treweek, Shaun; Bonetti, Debbie; Stirling, Douglas; Macpherson, Lorna; McCann, Sharon; Clarkson, Jan; Ramsay, Craig
Dental caries is the most common chronic disease of adult and childhood, a largely preventable yet widespread, costly public health problem. This study identified patient-, organization-, and system-level factors influencing routine delivery of recommended care for prevention and management of caries in primary dental care. A convergent mixed-methods design assessed six guidance-recommended behaviours to prevent and manage caries (recording risk, risk-based recall intervals, applying fluoride varnish, placing preventive fissure sealants, demonstrating oral health maintenance, taking dental x-rays). A diagnostic questionnaire assessing current practice, beliefs, and practice characteristics was sent to a random sample of 651 dentists in National Health Service (NHS) Scotland. Eight in-depth case studies comprising observation of routine dental visits and dental team member interviews were conducted. Patient feedback was collected from adult patients with recent checkups at case study practices. Key informant interviews were conducted with decision makers in policy, funding, education, and regulation. The Theoretical Domains Framework within the Behaviour Change Wheel was used to identify and describe patient-, organization-, and system-level barriers and facilitators to care. Findings were merged into a matrix describing theoretical domains salient to each behaviour. The matrix and Behaviour Change Wheel were used to prioritize behaviours for change and plan relevant intervention strategies. Theoretical domains associated with best practice were identified from the questionnaire (N-196), case studies (N = 8 practices, 29 interviews), and patient feedback (N = 19). Using the study matrix, key stakeholders identified priority behaviours (use of preventive fissure sealants among 6-12-year-olds) and strategies (audit and feedback, patient informational campaign) to improve guidance implementation. Proposed strategies were assessed as appropriate for immediate
Echtner, E.; Bieger, K.
Bad smell that inevitably are connected with waste water treatment are becoming first range problems in the frame of European legislation and jurisprudence. Efficient deodorization systems are necessary to prevent sanctions and quarrels with administration and neighbours. Biological deodorization filters are a viable, proved, efficient and economic alternative to classical wastes gas treatment systems. With and appropriate design retention yields of>99% can be achieved. International studies show an increasing acceptance of these filters in waste water treatment plants. Indications about the most important characteristics in the design of the equipment's are given. (Author) 12 refs.
Righeto, Luzia F.P.; Minussi, Carlos R. [UNESP, Ilha Solteira, SP (Brazil). Dept. de Engenharia Eletrica
This work presents a model to be used in Electric Power System preventive control, taking into account the dynamic network aspects, the effects caused by great oscillations in the synchronous machines angles (transient stability), electric equipment outages, short-circuit, etc. The energy function will be used as a form of measure the system stability degree using a criterion defined as security margin. The used control action will be the load shedding. (author) 16 refs.; e-mail: minussi at dee.feis.unesp.br
Yang, R.; Fleetwood, K.; Haid, J. [Orica USA Inc., Watkins, CO (United States). Advanced Mining Solutions
This paper describes a systematic approach to prevent cast blast holes from detonating sympathetically through the use of the electronic initiation and expanded blast patterns. In-situ measurements were recorded from pressure probes, velocity of detonation probes and near field accelerometers, along with digital images generated from a high speed CCD camera. Large diameter angled drill holes were also checked for any measurable amount of deviation by a cable type borehole measurement tool. The field measurements provided the scientific evidence, statistical data, and documentation necessary to develop a sound method or a 'road map' that would minimize and in some situations prevent the occurrence of blast hole sympathetic detonation. 2 refs., 3 figs.
Rashid, Sherzad; Idris-Khodja, Noureddine; Auger, Cyril; Kevers, Claire; Pincemail, Joël; Alhosin, Mahmoud; Boehm, Nelly; Oswald-Mammosser, Monique; Schini-Kerth, Valérie B
Chronic liver diseases with portal hypertension are characterized by a progressive vasodilatation, endothelial dysfunction, and NADPH oxidase-derived vascular oxidative stress, which have been suggested to involve the angiotensin system. This study evaluated the possibility that oral intake of polyphenol-rich blackcurrant juice (PRBJ), a rich natural source of antioxidants, prevents endothelial dysfunction in a rat model of cirrhosis induced by chronic bile duct ligation (CBDL), and, if so, determined the underlying mechanism. Male Wistar rats received either control drinking water or water containing 60 mg/kg gallic acid equivalents of PRBJ for 3 weeks before undergoing surgery with CBDL or sham surgery. After 4 weeks, vascular reactivity was assessed in mesenteric artery rings using organ chambers. Both the acetylcholine-induced nitric oxide (NO)- and endothelium-dependent hyperpolarization (EDH)-mediated relaxations in mesenteric artery rings were significantly reduced in CBDL rats compared to sham rats. An increased level of oxidative stress and expression of NADPH oxidase subunits, COX-2, NOS, and of the vascular angiotensin system are observed in arterial sections in the CBDL group. Chronic intake of PRBJ prevented the CBDL-induced impaired EDH-mediated relaxation, oxidative stress, and expression of the different target proteins in the arterial wall. In addition, PRBJ prevented the CBDL-induced increase in the plasma level of proinflammatory cytokines (interleukin [IL]-1α, monocyte chemotactic protein 1, and tumor necrosis factor α) and the decrease of the anti-inflammatory cytokine, IL-4. Altogether, these observations indicate that regular ingestion of PRBJ prevents the CBDL-induced endothelial dysfunction in the mesenteric artery most likely by normalizing the level of vascular oxidative stress and the angiotensin system.
Sreedharan, Aswathy; Li, You; De, Jaysankar; Gutierrez, Alan; Silverberg, Rachael; Schneider, Keith R
Salmonella has been reported to be involved in several foodborne illness outbreaks, many of which resulted from consumption of raw tomatoes. This research aimed to optimize and evaluate the concentration of free chlorine (hypochlorous acid [HOCl]) used as a sanitizer to prevent cross-contamination of tomatoes inoculated with a cocktail of five rifampin-resistant Salmonella enterica serovars in a laboratory-based model flume system. Organic load, prepared using sterilized Scotts Premium Topsoil, was added in different quantities to the flume wash water to simulate real-world packinghouse conditions. In a typical packinghouse operation utilizing a recirculating flume system, the organic matter washed from tomato surfaces accumulates over time. In this study, different concentrations (0, 25, 50, 75, and 100 ppm) of HOCl were used as sanitizers under three organic load conditions (0, 650, and 1,000 mg/L chemical oxygen demand). Results showed that 100 ppm of HOCl was necessary to prevent Salmonella cross-contamination of uninoculated tomatoes in the model flume system in the presence of organic loading. Also, when treated with 100 ppm of HOCl, Salmonella levels were reduced by >4.5 log CFU per tomato from inoculated tomatoes in the presence of organic load. At 75 ppm of HOCl, Salmonella cross-contamination was prevented, but only in the absence of organic loading. In studies in which plate counts were negative, whole tomato enrichment studies were performed. No cross-contamination of uninoculated tomatoes was recorded when 100 ppm of HOCl was used, even in the presence of high organic load (1,000 mg/L chemical oxygen demand). Although sanitizer application reduces contamination on tomato surfaces, the primary function of sanitizers in the wash water is to prevent cross-contamination.
Kentaro Nakamura; Hidekazu Tonouchi; Akina Sasayama; Kinya Ashida
Low-carbohydrate, high-fat diets (ketogenic diets) might prevent tumor progression and could be used as supportive therapy; however, few studies have addressed the effect of such diets on colorectal cancer. An infant formula with a ketogenic composition (ketogenic formula; KF) is used to treat patients with refractory epilepsy. We investigated the effect of KF on cancer and cancer cachexia in colon tumor-bearing mice. Mice were randomized into normal (NR), tumor-bearing (TB), and ketogenic fo...
Dmitry Ye. Suetenkov
Full Text Available It is very important to study the problem of caries and gingivitis in adolescents who are being treated for orthodontic pathology with bracket systems. The method of combined treatment which incorporates the use of medicine and laser therapy has been proved effective in caries prevention. This research aims to study clinical aspects of the effectiveness of the combined influence of the low-intensity laser "OPTODAN" with a wavelength of 0.85 μm (Scientific Development and Production Center "VEND", Saratov, Russia in caries prevention. The research also aims to study the disinfection method of PAD with "FotoSan" ("CMS Dental", Denmark, with a wavelength of 625–635 nm, where toluidine blue is used as photosensitizer molecules combined with regular measure to prevent gingivitis in adolescents being treated for orthodontic pathology with bracket systems. This paper presents the results of 1.5 years of clinical study of 60 12–13-year-old children. They were examined before and after the orthodontic treatment: their decayed, missing, filled teeth (DMFT, decayed, missing, filled tooth surfaces (DMFS index and hygiene status (OHI-S were calculated, gum inflammations were detected. Before the orthodontic treatment, their mouths were sanitized. After orthodontic appliances were placed, the children were randomly divided into two groups of 30 each. Children of the first group, while being treated with braces, took traditional preventative measures against gum inflammation and caries: occupational hygiene, local antiseptics (0.05% chlorhexidine solution, the use of remineralizing and phosphorus containing applications four times a year. The children of the second group, along with the traditional scheme of preventive measures, were treated with the devices "FotoSan" and "Optodan". Results of clinical examination of the second group have accurately proved decrease in the growth of dental caries intensity and surface caries intensity (ΔDMFT, ΔDMFS and
... Prevention Listen Español Text Size Email Print Share Poison Prevention Page Content Article Body Post the Poison Help number 1-800-222-1222 on the ... or empty container of a toxic substance, call Poison Help immediately. More than a million American children ...
Boyce, M; Walther, M; Kirk, J; Smith, S; Warrington, S
To analyse users' experience of TOPS, an internet-based system that helps UK clinical research units to prevent healthy volunteers from participating in more than one non-therapeutic trial simultaneously, or starting a second trial too soon after the first. We sent to all units that currently use TOPS an anonymous questionnaire comprising 18 questions about the effectiveness and ease of use of the system. Of 35 units that currently use TOPS, 31 (85.7 %) returned questionnaires. Most users find TOPS easy to use, had increased their detection rate of over-volunteering, and had rejected subjects as a result of using TOPS. A GP reply alone is not enough to prevent over-volunteering. Ethics committees, the MHRA and sponsors know about TOPS and support its use. The results confirm that TOPS does prevent healthy subjects from over-volunteering. Consequently, the Health Research Authority has agreed to take over the management of TOPS. Ethics committee approval of a phase 1 trial and MHRA accreditation of the unit will henceforth be conditional on consistent and proper use of TOPS. That should enhance its effectiveness and improve the safety of volunteers in non-therapeutic trials in the UK.
Vaziri, Daryoush D; Aal, Konstantin; Ogonowski, Corinna; Von Rekowski, Thomas; Kroll, Michael; Marston, Hannah R; Poveda, Rakel; Gschwind, Yves J; Delbaere, Kim; Wieching, Rainer; Wulf, Volker
Falls are common in older adults and can result in serious injuries. Due to demographic changes, falls and related healthcare costs are likely to increase over the next years. Participation and motivation of older adults in fall prevention measures remain a challenge. The iStoppFalls project developed an information and communication technology (ICT)-based system for older adults to use at home in order to reduce common fall risk factors such as impaired balance and muscle weakness. The system aims at increasing older adults' motivation to participate in ICT-based fall prevention measures. This article reports on usability, user-experience and user-acceptance aspects affecting the use of the iStoppFalls system by older adults. In the course of a 16-week international multicenter study, 153 community-dwelling older adults aged 65+ participated in the iStoppFalls randomized controlled trial, of which half used the system in their home to exercise and assess their risk of falling. During the study, 60 participants completed questionnaires regarding the usability, user experience and user acceptance of the iStoppFalls system. Usability was measured with the System Usability Scale (SUS). For user experience the Physical Activity Enjoyment Scale (PACES) was applied. User acceptance was assessed with the Dynamic Acceptance Model for the Re-evaluation of Technologies (DART). To collect more detailed data on usability, user experience and user acceptance, additional qualitative interviews and observations were conducted with participants. Participants evaluated the usability of the system with an overall score of 62 (Standard Deviation, SD 15.58) out of 100, which suggests good usability. Most users enjoyed the iStoppFalls games and assessments, as shown by the overall PACES score of 31 (SD 8.03). With a score of 0.87 (SD 0.26), user acceptance results showed that participants accepted the iStoppFalls system for use in their own home. Interview data suggested that certain
Weeks, Margaret R.; Li, Jianghong; Liao, Susu; Zhang, Qingning; Dunn, Jennifer; Wang, Yanhong; Jiang, Jingmei
Social and public health scientists are increasingly interested in applying system dynamics theory to improve understanding and to harness the forces of change within complex, multilevel systems that affect community intervention implementation, effects, and sustainability. Building a system dynamics model based on ethnographic case study has the…
Dai, Zhaoxing; Yu, Xiaobo; Hong, Jiaxu; Liu, Xi [Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031 (China); Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai 200031 (China); Sun, Jianguo, E-mail: firstname.lastname@example.org [Research Center, Eye & ENT Hospital, Fudan University, Shanghai 200031 (China); Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai 200031 (China); State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 200031 (China); Sun, Xinghuai, E-mail: email@example.com [Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031 (China); Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai 200031 (China)
The formation of a scar after glaucoma surgery often leads to unsuccessful control of intraocular pressure, and should be prevented by using a variety of methods. We designed and developed a novel drug delivery system (DDS) comprising cyclosporine A (CsA) and poly(lactic-co-glycolic acid) (PLGA) based on a glaucoma drainage device (GDD) that can continuously release CsA to prevent postoperative fibrosis following glaucoma surgery. The CsA@PLGA@GDD DDS was observed by field emission scanning electron microscopy and revealed an asymmetric pore structure. Thermogravimetric analysis was performed to measure the weight loss and evaluate the thermal stability of the CsA@PLGA@GDD DDS. The in vitro drug release profile of the DDS was studied using high performance liquid chromatography, which confirmed that the DDS released CsA at a stable rate and maintained adequate CsA concentrations for a relatively long time. The biocompatibility of the DDS and the inhibitory effects on the postoperative fibrosis were investigated in vitro using rabbit Tenon's fibroblasts. The in vivo safety and efficacy of the DDS were examined by implanting the DDS into Tenon's capsules in New Zealand rabbits. Bleb morphology, intraocular pressure, anterior chamber reactions, and anterior chamber angiography were studied at a series of set times. The DDS kept the filtration pathway unblocked for a longer time compared with the control GDD. The results indicate that the CsA@PLGA@GDD DDS represents a safe and effective strategy for preventing scar formation after glaucoma surgery. - Highlights: • CsA@PLGA@GDD drug delivery system (DDS) was designed and prepared successfully. • The DDS released CsA at a stable rate for > 3 months. • The DDS kept filtration pathway unblocked for a longer time than control. • CsA@PLGA@GDD DDS prevented glaucoma scar formation as a safe and effective strategy.
Blake-Lamb, Tiffany; Boudreau, Alexy Arauz; Matathia, Sarah; Tiburcio, Etna; Perkins, Meghan E; Roche, Brianna; Kotelchuck, Milton; Shtasel, Derri; Price, Sarah N; Taveras, Elsie M
Obesity interventions may be most effective if they begin in the earliest stages of life, support changes across family, clinical, and public health systems, and address socio-contextual factors. The First 1000Days is a systematic program starting in early pregnancy lasting through the first 24months of infancy to prevent obesity among low-income mother-infant pairs in three community health centers in Massachusetts. The program uses a Collective Impact approach to create the infrastructure for sustained, system-wide changes for obesity prevention across early life clinical and public health services, including Obstetrics, Pediatrics, Adult Medicine, Behavioral Health, Nutrition, Community Health, the Women, Infants and Children (WIC) program, and the Maternal, Infant and Childhood Home Visiting program. Program components include 1) staff and provider training; 2) enhanced gestational weight gain and infant overweight tracking; 3) universal screening of adverse health behaviors and socio-contextual factors; 4) universal patient navigation to support individual behavior change and social needs, while strengthening integration of clinical and public health services; 5) individualized health coaching for mother-infant pairs at high risk of obesity; and 6) educational materials to support behavior change. A quasi-experimental evaluation design will examine changes, between 2015 and 2019, in gestational weight gain and prevalence of infant overweight from 0 to 24months of age. The First 1000Days program will examine the effectiveness of an early life obesity prevention program for mother-infant pairs. If successful, the program could provide a model for chronic disease prevention and health promotion among vulnerable families starting in early life. Copyright © 2017 Elsevier Inc. All rights reserved.
Arianna B. Lovati
Full Text Available S. epidermidis is responsible for biofilm-related nonunions. This study compares the response to S. epidermidis-infected fractures in rats systemically or locally injected with vancomycin or bone marrow mesenchymal stem cells (BMSCs in preventing the nonunion establishment. The 50% of rats receiving BMSCs intravenously (s-rBMSCs died after treatment. A higher cytokine trend was measured in BMSCs locally injected rats (l-rBMSCs at day 3 and in vancomycin systemically injected rats (l-VANC at day 7 compared to the other groups. At day 14, the highest cytokine values were measured in l-VANC and in l-rBMSCs for IL-10. µCT showed a good bony bridging in s-VANC and excellent both in l-VANC and in l-rBMSCs. The bacterial growth was lower in s-VANC and l-VANC than in l-rBMSCs. Histology demonstrated the presence of new woven bone in s-VANC and a more mature bony bridging was found in l-VANC. The l-rBMSCs showed a poor bony bridging of fibrovascular tissue. Our results could suggest the synergic use of systemic and local injection of vancomycin as an effective treatment to prevent septic nonunions. This study cannot sustain the systemic injection of BMSCs due to high risks, while a deeper insight into local BMSCs immunomodulatory effects is mandatory before developing cell therapies in clinics.
Nitta, T. [Kansai Electric Power Co. Inc., Osaka (Japan)
The paper studied measures to prevent the underground power cable from insect damage by termite. To search for the termite entering the cable, fiber inspection is good, but the length which fiber reaches and the margin of cable diameter are limited. Moreover, the termite prevention use PFP pipe has been developed, but termite invades inside from the joint in PFP pipe. In AP pipe, termite invades from the place where concrete placing is poor and from cracks. As to the method to search for termite, sounds which termite emit to threaten foreign enemies were gathered by microphone, and the frequency was analyzed. As a result, it was verified that it is possible to judge if there is termite or not by checking levels in the 50-1300Hz zone (the method to let termite emit the threatening sound has been unknown). Since the path of invasion of termite is limited to the joint of cable, a thing in which chemical is put on rubber band of cable joint was developed. The chemical which was a little put on the rubber band is a domestic use insecticide generally commercially available, and adopted pyrethroids base chemical the safety of which was estimated. There is no need for spray of termite prevention agent, and the chemical is lower-priced than a change to the termite prevention cable. (NEDO)
Dahl, Jørgen B; Kehlet, Henrik
This paper will discuss the concepts of pre-emptive and preventive analgesia in acute and persistent postsurgical pain, based on the most recent experimental and clinical literature, with a special focus on injury-induced central sensitization and the development from acute to chronic pain. Recent...... of preventive analgesia for persistent postoperative pain are promising. However, clinicians must be aware of the demands for improved design of their clinical studies in order to get more conclusive answers regarding the different avenues for intervention. Summary: The concept of preventive analgesia is still...
Ferguston, C.D.; Ouagrham, S.B.
An urgent need calls out for improved border security and export control systems in the Central Asian and Caucasus regions to prevent illicit nuclear and radioactive materials trafficking. Effective nuclear and radiological exports controls are essential because these regions contain numerous nuclear facilities and radioactive materials as well as lie at the crossroads between seekers and suppliers of technologies that could be employed in nuclear and radiological weapons. Porous and unprotected borders compound these concerns. Moreover, the states within these regions are struggling with forming new regulations and laws, obtaining sufficient portal monitoring equipment, training customs and border security personnel, and coordinating these activities with neighboring states. Building this infrastructure all at once can severely task any government. Thus, unsurprisingly, most of these states have inadequate export control and border security systems. To enable each state in these regions determine how to better prevent illicit nuclear and radiological materials trafficking, the authors have developed a prototype system dynamics model focused on evaluating and improving of effectiveness of export controls. System dynamics modeling, a management tool that grew out of the field of system engineering and nonlinear dynamics, uses two structures: causal loop diagrams and stock and flow diagrams. The former shows how endogenous systematic factors interact with each other to produce feedback mechanisms that results in either balancing or reinforcing loops. A classic example is a arms race, modeled as a vicious cycle or reinforcing loop. In addition to interacting with each other, causal loops influence the flow of stock, which is material concern. In the export control system dynamics model, the stock represents nuclear and radioactive materials. System dynamics modelling is an iterative process that is continually modified by user input. Therefore, export control