Setianingsih, A. I.; Sangaji, S.; Setyawan, A.
Road sector development policy in Bangka Belitung emphasis on equitable development, which is opening up new areas for industrial development zones of potential marine and coastal tourism, so that having an impact on the budget priority to build a new road. This led to a minimal budget provided for the maintenance of the existing road. This study aimed to evaluate the condition of the pavement both functionally and structurally, the growth of traffic density and the availability of existing road maintenance costs. Then, to analyze the influence of existing road conditions, traffic density and road maintenance costs to the type of road maintenance management. The results are compared with the results of the existing maintenance conducted by the Public Works Department of Bangka Belitung province. Evaluation of pavement conditions consists of visual assessment of pavement condition using IRI, pavement condition assessment functionally with deflection method using test data tool Benkelman Beam (BB) and the actual traffic load. IRI value, deflections and traffic growth gained from years 2011-2015 subsequently created regression models to obtain the relationship and the correlation coefficient. The analysis showed that using the same relative magnitude of the budget from 2011 to 2015, giving priority to the maintenance of the road with good conditions capable of providing the road with a steady state of 100%. Recommendations can be given that maintain the road with good conditions reflecting that preservation provide maximum results with the more efficient maintenance cost.
A Life Cycle Assessment Framework for Pavement Maintenance and Rehabilitation Technologies : or An Integrated Life Cycle Assessment (LCA) – Life Cycle Cost Analysis (LCCA) Framework for Pavement Maintenance and Rehabilitation
Qing Lu (ORCID ID 0000-0002-9120-9218) Given a huge amount of annual investment and large inputs of energy and natural resources in pavement maintenance and rehabilitation (M&R) activities, significant environmental improvement and budget saving can ...
Heerema-Poelman, Ankie; Stuive, Ilse; Wempe, Johan B.
PURPOSE: To evaluate adherence to a maintenance exercise program in patients with chronic obstructive pulmonary disease (COPD) and explore predictors for adherence. METHODS: Seventy patients with COPD were referred to a home-care maintenance exercise program after completing pulmonary rehabilitation
Wong, Eliza M L; Zhong, Xue Bing; Sit, Janet W H; Chair, Sek Ying; Leung, Doris Y P; Leung, Carmen; Leung, K C
This study examined the attitudes of Chinese patients with coronary heart disease (CHD) toward the outpatient cardiac rehabilitation program (OCRP), as well as their exercise behavior, intention, maintenance and related factors. A qualitative descriptive study design was used, and 22 CHD patients were recruited in Hong Kong in 2014. In-depth interviews and content analyses were conducted. The tripartite model of attitudes was adopted as research framework. Two themes were identified: (1) informant attitude (perception, affection, and practice) toward the OCRP and (2) Exercise Behavior - intention, maintenance and its related factors. Most informants showed positive perception and affection regarding the outpatient rehabilitation program, leading to regular practice of exercise in the program and at home. Peer, group dynamic, social support and Chinese culture influences on exercise behavior may serve as major facilitators to maintain exercise behavior. Positive attitude toward the OCRP enhanced the participation rate, whereas peer and social support from the family and workplace were useful to improve the maintenance of exercise behavior. Overall, this study provides insights into strategic planning for the OCRP and continual support for CHD patients in the community.
Full Text Available Yi Li,1,2 Jing Feng,3,4 Yuechuan Li,2 Wei Jia,2 Hongyu Qian2 1Graduate School, Tianjin Medical University, 2Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital, 3Respiratory Department, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 4Neuropharmacology Section, Laboratory of Toxicology and Pharmacology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA Background: The benefit of pulmonary rehabilitation (PR for patients with COPD diminishes over time. We investigated a new strategy involving home-visit and phone contact and compared this to usual care in maintenance of PR benefits.Methods: A total of 172 stable COPD patients receiving 8-week PR program were recruited for this prospective study. Patients were allocated into usual care group (UC and PR maintenance group (PRMG randomly. Patients in PRMG participated in maintenance strategy at home under supervision through home-visit and phone contact. The 6-minute walking test (6MWT, COPD assessment test (CAT, and modified Medical Research Council scale (mMRC scores were evaluated every 3 months.Results: Of the total, 151 patients completed 8-week PR program with satisfactory PR results (p<0.001, and 104 patients finished the follow-up. The clinical improvements in 6MWT, CAT, and mMRC scores were maintained (p<0.001 in PRMG. In comparison, the benefit of PR diminished gradually in UC. The differences in 6MWT, CAT, and mMRC scores between groups were observed 6, 9, and 6 months after PR, respectively (p<0.05. Total frequency of exacerbations in PRMG was lower than UC (p=0.021.Conclusion: Maintenance strategy involving home-visit and phone contact is superior to usual care to preserve PR benefits, and reduces the acute COPD exacerbation rate. Keywords: COPD, pulmonary rehabilitation, 6-minute walking test, COPD assessment test, maintenance
Dr Pardeep Kumar Gupta
Full Text Available ABSTRACT In India the road traffic volume has increased manifolds during the post-independence period. The traffic axle loading may also in many cases be much heavier than the specified limit. As a result of which the existing road network has been subjected to severe deterioration leading to premature failure of the pavements.In such a scenario development of the effective pavement management strategies would furnish useful information to ensure the compatible and cost- effective decisions so as to keep the existing road network intact. The pavement deterioration models can prove to be an effective tool which can assist highway agencies to forecast economic and technical outcome of possible investment decisions regarding maintenance management of pavements. The optimum maintenance and rehabilitation strategies developed in this study would be useful in planning pavement maintenance strategies in a scientific manner and ensuring rational utilization of limited maintenance funds. Once this strategy for urban road network is implemented and made operational this would serve as window to the other urban road network of different regions.
Fakhar, A. M. M.; Asmaniza, A.
There are many types of ground rehabilation and improvement that can be consider and implement in engineering construction works for soil improvement in order to prevent road profile deformation in later stage. However, when comes to road maintenance especially on operated expressways, not all method can be apply directly as it must comply to opreation's working window and lane closure basis. Key factors that considering ideal proposal for ground rehabilitation are time, cost, quality and most importantly practicality. It should provide long lifespan structure in order to reduce continuous cycle of maintenance. Thus, this paper will present two approaches for ground rehabilitation, namely Polyurethane (PU) Foam Injection System and Geocrete Soil Stabilization. The first approach is an injection system which consists two-parts chemical grout of Isocynate and Polyol when mixed together within soil structure through injection will polymerized with volume expansion. The strong expansion of grouting causes significant compression and compacting of the surrounding soil and subsequently improve ground properties and uplift sunken structure. The later is a cold in-place recyclying whereby mixture process that combines in-situ soil materials, cement, white powder (alkaline) additive and water to produce hard yet flexible and durable ground layer that act as solid foundation with improved bearing capacity. The improvement of the mechanical behaviour of soil through these two systems is investigated by an extensive testing programme which includes in-situ and laboratory test in determining properties such as strength, stiffness, compressibility, bearing capacity, differential settlement and etc.
Heerema-Poelman, Ankie; Stuive, Ilse; Wempe, Johan B
To evaluate adherence to a maintenance exercise program in patients with chronic obstructive pulmonary disease (COPD) and explore predictors for adherence. Seventy patients with COPD were referred to a home-care maintenance exercise program after completing pulmonary rehabilitation (PR) in the rehabilitation center. Adherence (yes/no) to the maintenance program was assessed by a self-reported questionnaire, where adherence was defined as attending the maintenance program 1 year after PR. Early dropouts received a self-reported questionnaire after 6 months and the remaining patients after 12 months. Lung function, exercise capacity, exercise self-efficacy, illness perceptions, health-related quality of life, levels of anxiety and depression, duration of PR, and the number of exacerbations were studied as possible predictors of adherence. Ten patients died or were lost to followup. Of the remaining 60 patients, 73.3% and 63.3% were adherent to the maintenance exercise program after 6 and 12 months, respectively. Forced expiratory volume in 1 second (FEV1) (P = .021), Hospital Anxiety and Depression Scale depression score (P = .025), and duration of PR (P = .018) were significant predictors of adherence to the maintenance program. Adherence to the maintenance exercise program included a 36.7% drop-out rate during the first year after completing PR. Experiencing exacerbations was the most reported reason for dropout. Poorer lung function, shorter initial PR course measured by reviewing patient records, and higher level of depressive symptoms were predictive of drop-out to the maintenance program. Adherence to the maintenance program needs to be improved for patients with lower FEV1, with signs of depression, or with a shorter initial PR course.
Hendhratmoyo, Andri; Syafi'i; Pungky Pramesti, Florentina
Due to the limited budget of urban roads maintenance and rehabilitation, its prioritizationis inevitable. Many models have been developed to solve these problems. That is the reason why the purpose of this study was to evaluate the screening process in the decision making of the urban roads maintenance and rehabilitation priority. The prioritization that have to be taken into account on the effect of important criteria are road condition, traffic volume, budget processing and land use. 30 stakeholders were asked to fill in the questionnaires. The object of this case study are 188 urban roads sections at Ponorogo in order to examine the priorities. The researchers collected the data from Surface Distress Index (SDI), traffic volume, budget processing and land use of these road sections. Based on analysis, the weights of the criteria were: road condition (W1) = 0,411; traffic volume (W2) = 0,122; budget processing (W3) = 0,363 and land use (W4) = 0,105. The result of this study by the comparison of the index values of the alternatives priorities, Nyi Ageng Serang Street, was revealed to have the highest priority over the other streets regarding of maintenance and rehabilitation activities.
Stewart, Kelly F J; Meis, Jessie J M; van de Bool, Coby; Janssen, Daisy J A; Kremers, Stef P J; Schols, Annemie M W J
To explore determinants of behavior change maintenance of a physically active lifestyle in patients with chronic obstructive pulmonary disease (COPD) 8-11 months after completion of a 4-month outpatient pulmonary rehabilitation program. A qualitative descriptive study of semistructured interviews. Pulmonary rehabilitation assessment center. Patients with COPD. Semistructured interviews until data saturation, coded by 2 independent researchers. Patients were classified as responder (maintenance or improvement) or nonresponder (relapse or decrease), based on 3 quantitative variables reflecting exercise capacity (Constant Work Rate Test), health-related quality of life (Short-Form health survey [SF-36]), and self-management abilities (Self-Management Ability Scale [SMAS-30/Version 2]). Mean (SD) forced expiratory volume in the first second (FEV1) among interviewees was 52.5% (14.4%) predicted and the mean age was 63.5 years (range: 45-78). The group consisted of 15 responders and 7 nonresponders. Physical limitations reduced competence to engage in an active lifestyle and responders appeared to experience higher levels of perceived competence. Social support was found important and the experienced understanding from fellow patients made exercising together enjoyable. Particularly, responders expressed autonomous motivation and said they exercised because of the benefits they gain from it. Unexpectedly, only responders also experienced controlled motivation. Perceived competence and autonomous motivation are important determinants for maintenance of an active lifestyle in patients with COPD. In contrast to common theoretical assumptions, a certain threshold level of controlled motivation may remain important in maintaining a physically active lifestyle after a pulmonary rehabilitation program. Copyright © 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
Caswell, Dorte; Høybye-Mortensen, Matilde; Dall, Tanja
Rehabilitering som både begreb og indsats har været genstand for stigende fokus i de seneste år, på både politisk, organisatorisk og praksis-niveau. Fra januar 2013 træder en større reform af førtidspension og fleksjob i kraft, og med reformen etableres ’rehabilitering’ som både mål og middel i...
use and camping facilities, a boat launch and mooring area, sanitary facilities, and wells for drinking water at Conestoga Reservoir. Additional...gently sloping to very steep, well drained, loamy clay soils that formed in glacial till. The Sharpsburg series is a deep, moderately drained soil...Unfortunately, due to the number of potential sources ( sanitary wastewater, storm water, Conestoga Reservoir Rehabilitation Project U.S. Army Corps of
Bell, L.C. [Australian Centre for Minesite Rehabilitation Research, Kenmore, Qld. (Australia)
This chapter discusses the objectives of rehabilitation of lands in Australian disturbed by mining. It gives advice on rehabilitation planning and outlines the factors influencing post-mining land use and rehabilitation strategies, including climate, topography, hydrology, properties of soils, overburden and mineral processing wastes, flora and fauna and social considerations. Finally, the key elements of a rehabilitation plan are discussed, namely: landscape reconstruction; selective handling of overburden; and establishment and maintenance of a vegetative cover. 12 figs., 1 tab.
Lawton, Michelle; Sage, Karen; Haddock, Gillian; Conroy, Paul; Serrant, Laura
Therapeutic alliance refers to the interactional and relational processes operating during therapeutic interventions. It has been shown to be a strong determinant of treatment efficacy in psychotherapy, and evidence is emerging from a range of healthcare and medical disciplines to suggest that the construct of therapeutic alliance may in fact be a variable component of treatment outcome, engagement and satisfaction. Although this construct appears to be highly relevant to aphasia rehabilitation, no research to date has attempted to explore this phenomenon and thus consider its potential utility as a mechanism for change. To explore speech and language therapists' perceptions and experiences of developing and maintaining therapeutic alliances in aphasia rehabilitation post-stroke. Twenty-two, in-depth, semi-structured interviews were conducted with speech and language therapists working with people with aphasia post-stroke. Qualitative data were analysed using inductive thematic analysis. Analysis resulted in the emergence of three overarching themes: laying the groundwork; augmenting cohesion; and contextual shapers. Recognizing personhood, developing shared expectations of therapy and establishing therapeutic ownership were central to laying the groundwork for therapeutic delivery. Augmenting cohesion was perceived to be dependent on the therapists' responsiveness and ability to resolve both conflict and resistance, as part of an ongoing active process. These processes were further moulded by contextual shapers such as the patient's family, relational continuity and organizational drivers. The findings suggest that therapists used multiple, complex, relational strategies to establish and manage alliances with people with aphasia, which were reliant on a fluid interplay of verbal and non-verbal skills. The data highlight the need for further training to support therapists to forge purposive alliances. Training should develop: therapeutic reflexivity; inclusivity in
Luttosch, F; Baerwald, C
Rehabilitation in rheumatology focuses on prevention of functional disorders of the musculoskeletal system, maintenance of working ability and prevention of care dependency. Drug treatment alone rarely results in long-term remission, therefore rehabilitative measures must be integrated into rheumatic care. Rehabilitative therapy in rheumatology includes physiotherapy, patient education and occupational therapy. Positive effects of physical therapy methods have been proven by various studies. Patient education and occupational therapy are important tools for stabilizing the course of the disease. To maintain positive rehabilitative results patients have to be involved in the selection of treatment measures and should take an active part in the long-term treatment process. Despite proven efficacy of physical measures there is evidence for a lack of utilization of rehabilitative therapy due to increasing cost pressure in the health care system which will further increase over time.
Antypas, Konstantinos; Wangberg, Silje C
An increase in physical activity for secondary prevention of cardiovascular disease and cardiac rehabilitation has multiple therapeutic benefits, including decreased mortality. Internet- and mobile-based interventions for physical activity have shown promising results in helping users increase or maintain their level of physical activity in general and specifically in secondary prevention of cardiovascular diseases and cardiac rehabilitation. One component related to the efficacy of these interventions is tailoring of the content to the individual. Our trial assessed the effect of a longitudinally tailored Internet- and mobile-based intervention for physical activity as an extension of a face-to-face cardiac rehabilitation stay. We hypothesized that users of the tailored intervention would maintain their physical activity level better than users of the nontailored version. The study population included adult participants of a cardiac rehabilitation program in Norway with home Internet access and a mobile phone. The participants were randomized in monthly clusters to a tailored or nontailored (control) intervention group. All participants had access to a website with information regarding cardiac rehabilitation, an online discussion forum, and an online activity calendar. Those using the tailored intervention received tailored content based on models of health behavior via the website and mobile fully automated text messages. The main outcome was self-reported level of physical activity, which was obtained using an online international physical activity questionnaire at baseline, at discharge, and at 1 month and 3 months after discharge from the cardiac rehabilitation program. Included in the study were 69 participants. One month after discharge, the tailored intervention group (n=10) had a higher median level of overall physical activity (median 2737.5, IQR 4200.2) than the control group (n=14, median 1650.0, IQR 2443.5), but the difference was not significant
... REHABILITATION AND IMPROVEMENT FINANCING PROGRAM Standards for Maintenance of Facilities Involved in the Project... the project. (b) When the proceeds of a direct loan or an obligation guaranteed by the Administrator...
Langhorne, Peter; Bernhardt, Julie; Kwakkel, Gert
Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially beneficial treatment options for motor recovery of the arm include constraint-induced movement therapy and robotics. Promising interventions that could be beneficial to improve aspects of gait include fitness training, high-intensity therapy, and repetitive-task training. Repetitive-task training might also improve transfer functions. Occupational therapy can improve activities of daily living; however, information about the clinical effect of various strategies of cognitive rehabilitation and strategies for aphasia and dysarthria is scarce. Several large trials of rehabilitation practice and of novel therapies (eg, stem-cell therapy, repetitive transcranial magnetic stimulation, virtual reality, robotic therapies, and drug augmentation) are underway to inform future practice. Copyright © 2011 Elsevier Ltd. All rights reserved.
... rehab; Heart failure - cardiac rehab References Anderson L, Taylor RS. Cardiac rehabilitation for people with heart disease: ... of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed ...
Belagaje, Samir R
Rehabilitation is an important aspect of the continuum of care in stroke. With advances in the acute treatment of stroke, more patients will survive stroke with varying degrees of disability. Research in the past decade has expanded our understanding of the mechanisms underlying stroke recovery and has led to the development of new treatment modalities. This article reviews and summarizes the key concepts related to poststroke recovery. Good data now exist by which one can predict recovery, especially motor recovery, very soon after stroke onset. Recent trials have not demonstrated a clear benefit associated with very early initiation of rehabilitative therapy after stroke in terms of improvement in poststroke outcomes. However, growing evidence suggests that shorter and more frequent sessions of therapy can be safely started in the first 24 to 48 hours after a stroke. The optimal amount or dose of therapy for stroke remains undetermined, as more intensive treatments have not been associated with better outcomes compared to standard intensities of therapy. Poststroke depression adversely affects recovery across a variety of measures and is an important target for therapy. Additionally, the use of selective serotonin reuptake inhibitors (SSRIs) appears to benefit motor recovery through pleiotropic mechanisms beyond their antidepressant effect. Other pharmacologic approaches also appear to have a benefit in stroke rehabilitation. A comprehensive rehabilitation program is essential to optimize poststroke outcomes. Rehabilitation is a process that uses three major principles of recovery: adaptation, restitution, and neuroplasticity. Based on these principles, multiple different approaches, both pharmacologic and nonpharmacologic, exist to enhance rehabilitation. In addition to neurologists, a variety of health care professionals are involved in stroke rehabilitation. Successful rehabilitation involves understanding the natural history of stroke recovery and a
Krebs, H I; Volpe, B T
This chapter focuses on rehabilitation robotics which can be used to augment the clinician's toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual's functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost. Copyright © 2013 Elsevier B.V. All rights reserved.
Yang, Chao; Remenyte-Prescott, Rasa; Andrews, John D.
This paper presents a new pavement management system (PMS) to achieve the optimal pavement maintenance and rehabilitation (M&R) strategy for a highway network using genetic algorithms (GAs). Optimal M&R strategy is a set of pavement activities that both minimise the maintenance cost of a highway network and maximise the pavement condition of the road sections on the network during a certain planning period. NSGA-II, a multi-objective GA, is employed to perform pavement maintenance optimisatio...
Sanchis, H.; Aucher, P.
The maintenance method applied at the Hague is summarized. The method was developed in order to solve problems relating to: the different specialist fields, the need for homogeneity in the maintenance work, the equipment diversity, the increase of the materials used at the Hague's new facilities. The aim of the method is to create a knowhow formalism, to facilitate maintenance, to ensure the running of the operations and to improve the estimation of the maintenance cost. One of the method's difficulties is the demonstration of the profitability of the maintenance operations [fr
Full Text Available This paper presents a mathematical programming model for optimal pavement rehabilitation planning. The model maximized the rehabilitation area through a newly developed permutation algorithm, based on the procedures outlined in the harmony search (HS algorithm. Additionally, the proposed algorithm was based on an optimal solution method for the problem of multilocation rehabilitation activities on pavement structure, using empirical deterioration and rehabilitation effectiveness models, according to a limited maintenance budget. Thus, nonlinear pavement performance and rehabilitation activity decision models were used to maximize the objective functions of the rehabilitation area within a limited budget, through the permutation algorithm. Our results showed that the heuristic permutation algorithm provided a good optimum in terms of maximizing the rehabilitation area, compared with a method of the worst-first maintenance currently used in Seoul.
The paper describes how the CANDU-3 has incorporated, at the design stage, maintenance requirements such as component accessibility, standardization, ease of replacement, reduction in the number of components, and simplified component design. AECL is also active in the planned rehabilitation of the four units at Ontario Hydro's Bruce A nuclear generating station. In addition to conceptual design and development, detailed design and analysis, procurement and site assistance, AECL's Sheridan Park Laboratory will provide important development and mockup facilities. An AECL research and development program on reactor maintenance includes the identification and characterization of aging and degrading mechanisms, the tailoring of developed products to plant requirements, and the identification of areas of international cooperation and information exchange. 3 tabs., 1 fig
Kubo, Arthur S [BDM Corp., VA (United States); [Bikini Atoll Rehabilitation Committee, Berkeley, CA (United States)
The costs of radioactivity contamination control and other matters relating to the resettlement of Bikin atoll were reviewed for Bikini Atoll Rehabilitation Committee by a panel of engineers which met in Berkeley, California on January 22-24, 1986. This Appendix presents the cost estimates.
Kubo, Arthur S.
The costs of radioactivity contamination control and other matters relating to the resettlement of Bikin atoll were reviewed for Bikini Atoll Rehabilitation Committee by a panel of engineers which met in Berkeley, California on January 22-24, 1986. This Appendix presents the cost estimates
Boards of education must be convinced that spending money up front for preventive maintenance will, in the long run, save districts' tax dollars. A good program of preventive maintenance can minimize disruption of service; reduce repair costs, energy consumption, and overtime; improve labor productivity and system equipment reliability; handle…
Maintenance Mentor (MXM) is a research effort conducted by a joint AFRL/HESR and Northrop Grumman Information Technology team to identify the basic, high-level requirements necessary for improving flight line diagnostic capabilities...
Vellinger, R. J.; Burton, R.; Fritschy, B.
The objectives of this paper are the following: to present LLNL`s collection system and innovative approach to sanitary sewer rehabilitation; share issues identified and lessons learned from over four (4) years of rehabilitation work; and discuss proposed system standards for ongoing maintenance and repair activities.
It is essential to any research activity that accurate and efficient measurements be made for the experimental parameters under consideration for each individual experiment or test. Satisfactory measurements in turn depend upon having the necessary instruments and the capability of ensuring that they are performing within their intended specifications. This latter requirement can only be achieved by providing an adequate maintenance facility, staffed with personnel competent to understand the problems associated with instrument adjustment and repair. The Instrument Repair Shop at the Lawrence Berkeley Laboratory is designed to achieve this end. The organization, staffing and operation of this system is discussed. Maintenance policy should be based on studies of (1) preventive vs. catastrophic maintenance, (2) records indicating when equipment should be replaced rather than repaired and (3) priorities established to indicate the order in which equipment should be repaired. Upon establishing a workable maintenance policy, the staff should be instructed so that they may provide appropriate scheduled preventive maintenance, calibration and corrective procedures, and emergency repairs. The education, training and experience of the maintenance staff is discussed along with the organization for an efficient operation. The layout of the various repair shops is described in the light of laboratory space and financial constraints
Rehabilitation is concerned with lessening the impact of disabling conditions. These are particularly common in older people and considerable health gain can be achieved by successful rehabilitation. Hospital doctors and general practitioners should be aware of the core principles of rehabilitation, be able to recognise rehabilitation need in their patients, and have sufficient knowledge of their local rehabilitation services to trigger the referral process.
Beyer, Joachim; Seidel, Egbert J
An early, intensive rehabilitative therapy accelerates the recovery of the functions of patients. It contributes to a reduction in the complication rate as well as an improvement in physical and social functioning/participation in the long-term follow-up. Early rehabilitation must be strengthened on the basis of the existing structures: the creation and maintenance of adequately qualified early-stage rehabilitation facilities, at least in hospitals with priority and maximum supply contracts. Patients with long-term intensive care and polytrauma must be rehabilitated as soon as possible (intensive medical rehabilitation).Specialists in physical and rehabilitative medicine, rehabilitative geriatrists, neurologists, orthopaedists and accident surgeons and other regional physicians must cooperate in a targeted manner. Exclusion criteria using corresponding OPS codes must be canceled. Additional specialist physician groups (anesthetists and intensive care physicians, general practitioners, accident and thoracic surgeons, internists) must be sensitized to the importance of early rehabilitation.In the case of more than 500,000 hospital beds, 25,000 beds should be identified as age- and diagnosis-independent early-care beds in the country-specific bed-care plans. A cost-covering financing of the different, personal and cost-intensive early rehabilitation must be ensured. A phase model similar to the BAR guidelines for neurological-neurosurgical early rehabilitation is to be considered for other disease entities.In order to make the rehabilitation process as successful as possible, medical (acute) treatment, medical rehabilitation, occupational integration and social integration have to be understood as a holistic event and are effectively interrelated, as a continuous process which accompanies the entire disease phase-wise. For this purpose, a continuous case management or a rehabilitation guidance has to be established. © Georg Thieme Verlag KG Stuttgart · New York.
Hansen, Agnete Meldgaard
Care work for elderly people has been characterised as dirty work, owing to its proximity to the (dys)functions and discharges of aged bodies and the notions of disease, decay and death associated with the idea of ‘old age’. However, a wave of reform programmes in Danish municipalities promoting...... units, this article analyses how rehabilitative care practices, drawing on a narrative of the third age, provide an optimistic and anti-ageist framing of homecare work that informs the development of new occupational identities for care workers as coaches rather than carers in relation to citizens...
As part of the management of a utility, it is necessary to check, beyond the technical aspect, the economic suitability of deciding whether to perform the maintenance or rehabilitation of an installation. The decision criteria involved are to be found within the framework of the utility's management system itself. After having set out the decision-making process of hydroelectric power station maintenance or rehabilitation, the document goes on to give a description of the economic advantage of such an operation. The latter is determined after having properly defined the overall cost of maintenance or rehabilitation: direct expenses and induced costs, and expected savings: economic performance, short and medium-term reduction of expenses as a result of the profitability and productivity of the rehabilitation. The profitability is calculated as the ratio between the economic balance and the amount of the operation. Productivity means the improvement of the utility's management indicators. The random aspect of savings and a simple method making it possible to integrate them into a calculation is mentioned, as well as the classification and aggregation of various operations of a similar nature that have to come into the budget requirements of the utility. (Author)
Thomas , Edouard; Levrat , Eric; Iung , Benoît; Cocheteux , Pierre
International audience; Conventional maintenance strategies on a single component are being phased out in favour of more predictive maintenance actions. These new kinds of actions are performed in order to control the global performances of the whole industrial system. They are anticipative in nature, which allows a maintenance expert to consider non-already-planned maintenance actions. Two questions naturally emerge: when to perform a predictive maintenance action; how a maintenance expert c...
A site-wide network maintenance operation has been scheduled for Saturday 28 February. Most of the network devices of the general purpose network will be upgraded to a newer software version, in order to improve our network monitoring capabilities. This will result in a series of short (2-5 minutes) random interruptions everywhere on the CERN sites throughout the day. This upgrade will not affect the Computer Centre itself, Building 613, the Technical Network and the LHC experiments, dedicated networks at the pits. For further details of this intervention, please contact Netops by phone 74927 or e-mail mailto:Netops@cern.ch. IT/CS Group
A site wide network maintenance has been scheduled for Saturday 28 February. Most of the network devices of the General Purpose network will be upgraded to a newer software version, in order to improve our network monitoring capabilities. This will result in a series of short (2-5 minutes) random interruptions everywhere on the CERN sites along this day. This upgrade will not affect: the Computer centre itself, building 613, the Technical Network and the LHC experiments dedicated networks at the pits. Should you need more details on this intervention, please contact Netops by phone 74927 or email mailto:Netops@cern.ch. IT/CS Group
Rising operating costs has caused maintenance professionals to rethink their strategy for preventive maintenance (PM) programs. Maintenance Templates are pre-engineered PM task recommendations for a component type based on application of the component. Development of the maintenance template considers the dominant failure cause of the component and the type of preventive maintenance that can predict or prevent the failure from occurring. Maintenance template development also attempts to replace fixed frequency tasks with condition monitoring tasks such as vibration analysis or thermography. For those components that have fixed frequency PM intervals, consideration is given to the maintenance drivers such as criticality, environment and usage. This helps to maximize the PM frequency intervals and maximize the component availability. Maintenance Templates have been used at PECO Energy's Limerick Generating Station during the Reliability Centered Maintenance (RCM) Process to optimize their PM program. This paper describes the development and uses of the maintenance templates
Gunatilake, S; Ananth, J; Parameswaran, S; Brown, S; Silva, W
Schizophrenia is a maldevelopmental disorder of the brain that manifests in positive, negative, cognitive and affective symptoms. Currently, the mainstay of treatment involves pharmacotherapy. The limitations of antipsychotic treatment are that they can only control symptoms and cannot cure the illness, and 20% of patients do not respond, thus leading to the requirement of maintenance treatment. Patients that do respond continue to have disabling residual symptoms such as amotivation and isolation, maladaptive behavior, and impaired social functioning. These symptoms prevent patients from attaining educational, occupational, and social roles. Psychosocial interventions and models of quality of life in schizophrenia are based on the notion that increases in psychosocial functioning will be related to improvement in subjective experiences, such as self-esteem and satisfaction with life. The comparative effect of specific treatment methods and the additional benefits of multiple treatments need to be explored. Diversified techniques have also been employed, such as shaping, cognitive process therapy, mastery-oriented skill training, motivation and enhancement. Issues in designing psychosocial interventions and the role of various professionals in providing such interventions need to be carefully considered. Predictor variables and the indications for particular therapies in an individual need to be explored. Generalizability of the gains made by rehabilitation/recovery is also an important consideration. Patients in jail, chronic mental hospitals, private facilities, and the Veterans Administration system are all different in their ability to benefit, their motivations, and the severity of their psychopathology. Therefore, it is very difficult to generalize findings from one setting to another.
Kraatz, M.; Appelegate, R.J.
In the late 1960's and 1970's it was recognised that pollutants emanating from the abandoned Rum jungle uranium mine in the Northern Territory of Australia were responsible for severe environmental degradation of the Finniss River system. Products of acid mine drainage and low level radioactive material released from the tailings dam resulted in the virtual absence of flora and fauna species for ten kilometres downstream of the mine. In 1982 a joint Federal and Northern Territory government project was established to rehabilitate the abandoned Rum Jungle site. This project successfully achieved a major reduction in surface water pollution, public health hazard, (including radiation levels), pollution levels in the Open Cut water bodies and aesthetic improvement, including revegetation. Monitoring of the site is continuing up to the present date to determine the ongoing success of the project. This includes evaluation of the surface water quality, chemical activity and water balance within the overburden heaps, groundwater hydrology and an assessment of revegetation success, erosion control structures and cover stability. This document presents the results of monitoring activities conducted between 1986 and 1988 and outlines management and maintenance programs during that time. 36 refs., 40 figs., 47 tabs., 11 ills
Full Text Available ... Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation Pediatric Spinal ... Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation Pediatric Spinal ...
Ng, Yee Sien; Chew, Effie; Samuel, Geoffrey S; Tan, Yeow Leng; Kong, Keng He
Rehabilitation medicine is the medical specialty that integrates rehabilitation as its core therapeutic modality in disability management. More than a billion people worldwide are disabled, and the World Health Organization has developed the International Classification of Functioning, Disability and Health as a framework through which disability is addressed. Herein, we explore paradigm shifts in neurorehabilitation, with a focus on restoration, and provide overviews on developments in neuropharmacology, rehabilitation robotics, virtual reality, constraint-induced therapy and brain stimulation. We also discuss important issues in rehabilitation systems of care, including integrated care pathways, very early rehabilitation, early supported discharge and telerehabilitation. Finally, we highlight major new fields of rehabilitation such as spasticity management, frailty and geriatric rehabilitation, intensive care and cancer rehabilitation.
Palmer-Jones, Roland; Hopkins, Phil; Eyre, David [PENSPEN (United Kingdom)
An operator faced with an onshore pipeline that has extensive damage must consider the need for rehabilitation, the sort of rehabilitation to be used, and the rehabilitation schedule. This paper will consider pipeline rehabilitation based on the authors' experiences from recent projects, and recommend a simple strategy for planning pipeline rehabilitation. It will also consider rehabilitation options: external re-coating; internal lining; internal painting; programmed repairs. The main focus will be external re-coating. Consideration will be given to rehabilitation coating types, including tape wraps, epoxy, and polyurethane. Finally it will discuss different options for scheduling the rehabilitation of corrosion damage including: the statistical comparison of signals from inspection pigs; statistical comparison of selected measurements from inspection pigs and other inspections; the use of corrosion rates estimated for the mechanisms and conditions; expert judgement. (author)
Full Text Available ... Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal ... Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal ...
Full Text Available ... Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation ... Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation ...
Full Text Available ... Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions for Children with Spinal Cord Injury Patricia Mucia, RN Family Life After Pediatric Spinal Injury Dawn Sheaffer, MSW Rehabilitation ...
Millennium Challenge Corporation — The key research questions guiding our design of the RRRP evaluation are: • Did rehabilitating roads affect the quality of roads? • Did rehabilitating roads improve...
Starrfelt, Randi; Ólafsdóttir, Rannveig Rós; Arendt, Ida-Marie
that pure alexia was an easy target for rehabilitation efforts. We review the literature on rehabilitation of pure alexia from 1990 to the present, and find that patients differ widely on several dimensions like alexia severity, and associated deficits. Many patients reported to have pure alexia......-designed and controlled studies of rehabilitation of pure alexia....
Hansen, Helle Ploug; Tjørnhøj-Thomsen, Tine
A fundamental assumption behind cancer rehabilitation in many Western societies is that cancer survivors can return to normal life by learning to deal with the consequences of their illness and their treatment. This assumption is supported by increasing political attention to cancer rehabilitation...... and a growth in residential cancer-rehabilitation initiatives in Denmark (Danish Cancer Society 1999; Government of Denmark 2003). On the basis of their ethnographic fieldwork in residential-cancer rehabilitation courses, the authors examine the new rehabilitation discourse. They argue that this discourse has...
Shimomura, Taizo; Fujimori, Yuji; Kaito, Kiyoyuki; Obama, Kengo; Kobayashi, Kiyoshi
In this paper, an optimal management model is formulated for the performance-based rehabilitation/maintenance contract for airport concrete pavement, whereby two types of life cycle cost risks, i.e., ground consolidation risk and concrete depreciation risk, are explicitly considered. The non-homogenous Markov chain model is formulated to represent the deterioration processes of concrete pavement which are conditional upon the ground consolidation processes. The optimal non-homogenous Markov decision model with multiple types of risk is presented to design the optimal rehabilitation/maintenance plans. And the methodology to revise the optimal rehabilitation/maintenance plans based upon the monitoring data by the Bayesian up-to-dating rules. The validity of the methodology presented in this paper is examined based upon the case studies carried out for the H airport.
Discusses maintenance business plans, statements which provide accountability for facilities maintenance organizations' considerable budgets. Discusses the plan's components: statement of plan objectives, macro and detailed description of the facility assets, maintenance function descriptions, description of key performance indicators, milestone…
Sternloff, Robert E.
Current trends in park maintenance are overviewed, including maintenance impact statements, avoidance of cost through efficient use and national resource conservation, horticultural accomplishments that influence maintenance management, and vandalism prevention. (CB)
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N. A. Varako
Full Text Available ABSTRACT. The article reviews the history of neuropsychological rehabilitation. It begins with the description of first rehabilitation programs developed by Paul Broca and Shepherd Franz. Franz’s experimental work for motor recovery in monkeys and correlation between active movement or affected limb immobilization and rehabilitation outcomes are described in further details. Special focus is given on ideas of famous German neurologist and psychiatrist Kurt Goldstein, who laid the foundation for modern approach in rehabilitation. Goldstein developed the idea of connection between rehabilitation and patient’s daily life. He also pointed out the necessity of psychological care of patients with brain damage.Russian neuropsychological approach is presented by its founders L.S. Vygotskiy and A.R. Luriya. Aspects of higher mental processes structure and options of its correction such as “cognitive prosthesis” are described in the sense of the approach.Y. Ben-Yishay, G. Prigatano, B. Wilson represent neuropsychological rehabilitation of the second half of the 20th century. The idea of a holistic approach for rehabilitation consists of such important principles as patient’s active involvement in a process of rehabilitation, work of a special team of rehabilitation professionals, inclusion of patient’s family members. The short review of a new rehabilitation approach for patients in coma, vegetative states and critical patients under resuscitation is given.
Millennium Challenge Corporation — Gustavson Associates was retained by Millennium Challenge Georgia (MCG) to prepare a model to calculate the economic rate of return (ERR) for rehabilitation work...
Luxhoj, James T.; Thorsteinsson, Uffe; Riis, Jens Ove
An overview of trend in maintenance management and presentation of a situational model and an analytical tools for identification of managerial efforts in maintenance.......An overview of trend in maintenance management and presentation of a situational model and an analytical tools for identification of managerial efforts in maintenance....
In the recent past, the primary function of the preventive maintenance program at a nuclear power plant was to maintain the operability and reliability of the plant. Reducing overall maintenance costs by performing effective preventive maintenance, instead of more costly and disruptive corrective maintenance, instead of more costly and disruptive corrective maintenance, was a secondary consideration. In today's operating environment, the preventive maintenance program must meet the test of cost-effectiveness as well as many new standards for performance that are being required by rate regulators. The preventive maintenance program must be able to withstand the challenge of independent audit to a new standard of technical adequacy and compliance with recommendations from component vendors. In this new environment, the standard that is being applied at the San Onofre nuclear generating station (SONGS) is that the preventive maintenance program must meet the test of cost-effectiveness, improve equipment performance, support increased plant availability, and (a) literally implement the recommendations of the vendor, (b) provide other compensation for the vendor recommendation, or (c) provide technical justification for the deviation. The subject of this paper is the way that reliability-centered maintenance (RCM) is helping SONGS meet these challenges
Simonov, M; Delconte, G
This article is part of the Focus Theme of Methods of Information in Medicine on "New Methodologies for Patients Rehabilitation". The article presents the approach in which the rehabilitative exercise prepared by healthcare professional is encoded as formal knowledge and used by humanoid robot to assist patients without involving other care actors. The main objective is the use of humanoids in rehabilitative care. An example is pulmonary rehabilitation in COPD patients. Another goal is the automated judgment functionality to determine how the rehabilitation exercise matches the pre-programmed correct sequence. We use the Aldebaran Robotics' NAO humanoid to set up artificial cognitive application. Pre-programmed NAO induces elderly patient to undertake humanoid-driven rehabilitation exercise, but needs to evaluate the human actions against the correct template. Patient is observed using NAO's eyes. We use the Microsoft Kinect SDK to extract motion path from the humanoid's recorded video. We compare human- and humanoid-operated process sequences by using the Dynamic Time Warping (DTW) and test the prototype. This artificial cognitive software showcases the use of DTW algorithm to enable humanoids to judge in near real-time about the correctness of rehabilitative exercises performed by patients following the robot's indications. One could enable better sustainable rehabilitative care services in remote residential settings by combining intelligent applications piloting humanoids with the DTW pattern matching algorithm applied at run time to compare humanoid- and human-operated process sequences. In turn, it will lower the need of human care.
Sjölund, Bengt H; Kastrup, Marianne; Montgomery, Edith
survivors can be addressed from an evidence base generated both from traumatized and non-traumatized patient populations. Thus, trauma-focused cognitive behavioural therapy and/or eye movement desensitization and reprocessing, as well as interdisciplinary pain rehabilitation, should be components......, in December 2008. The main topics were: the context of torture; mental problems including psychotherapy; internet-based therapy and pharmaco-therapy; chronic pain; social integration and family; and functioning and rehabilitation. Available evidence highlights the importance of an interdisciplinary approach......, "Rehabilitating Torture Survivors", was organized by the Rehabilitation and Research Centre for Torture Victims (a rehabilitation clinic and global knowledge and research centre with government support) in collaboration with the Centre for Transcultural Psychiatry at Rigshospitalet in Copenhagen, Denmark...
Knecht, Stefan; Hesse, Stefan; Oster, Peter
Stroke is becoming more common in Germany as the population ages. Its long-term sequelae can be alleviated by early reperfusion in stroke units and by complication management and functional restoration in early-rehabilitation and rehabilitation centers. Selective review of the literature. Successful rehabilitation depends on systematic treatment by an interdisciplinary team of experienced specialists. In the area of functional restoration, there has been major progress in our understanding of the physiology of learning, relearning, training, and neuroenhancement. There have also been advances in supportive pharmacotherapy and robot technology. Well-organized acute and intermediate rehabilitation after stroke can provide patients with the best functional results attainable on the basis of our current scientific understanding. Further experimental and clinical studies will be needed to expand our knowledge and improve the efficacy of rehabilitation.
Christensen, Jan; Langberg, Henning; Doherty, Patrick
BACKGROUND: Knowledge about the organization and factors of importance to rehabilitation of veterans with lower limb amputation is sparse. The aim of this study was, therefore, to improve understanding of the influences of "military identity" on the organization of rehabilitation services...... and to investigate those factors influential in achieving successful rehabilitation, including interprofessional collaboration between different sectors involved in the rehabilitation of veterans with lower limb amputations. METHODS: We used a qualitative exploratory design, triangulating interviews and participant...... observation. Data were generated using in-depth semi-structured interviews (n = 6) exploring in-hospital and post-hospital rehabilitation in Danish veterans after unilateral lower limb amputation due to trauma. We conducted four sessions of participant observation, during weekly post...
Marston, T.U.; Gelhaus, F.; Burke, R.
The purpose of this paper is to provide the reader with an idea of the advanced maintenance research program at the Electric Power Research Institute (EPRI). A brief description of the maintenance-related activities is provided as a foundation for the advanced maintenance research projects. The projects can be divided into maintenance planning, preventive maintenance program development and implementation, predictive (or conditional) maintenance, and innovative maintenance techniques. The projects include hardware and software development, human factors considerations, and technology promotion and implementation. The advanced concepts include: the incorporation of artificial intelligence into outage planning; turbine and pump maintenance; rotating equipment monitoring and diagnostics with the aid of expert systems; and the development of mobile robots for nuclear power plant maintenance
Torgerson, D.F.; Charlebois, P.; Hopkins, J.
Plant life extension beyond the original design life is becoming an attractive economic consideration in the nuclear industry. Plant Life Management and life extension considerations have been built into the complete life cycle of the CANDU plant. The plant life management studies demonstrate that life extension for operating plants beyond 30 years is economically viable. The new CANDU designs benefit from this experience feedback and as a result, the plant design basis is now 40 years or better with potential for economical life extension. AECL is therefore confident that the new CANDU designs will exceed the performance record of the first generation CANDU 6 units and is committed to providing continued support and services during the operating life of the plant
during modifications to the end sill at the Old River Control Structure. Prefabricated steel armor units to slip over damaged baffle blocks have been...attach or anchor the prefabricated elements need to be reviewed. Of the fail- ures which have occurred, it has been the anchorages rather than the elements...concrete mass and overloading of abutments , the foundation, and adjacent monoliths. Scr ion.,, but noust ruCtural problems can also occur, e.g
Modern chest hospitals offer favourable conditions for the rehabilitation of asthmatic patients. In the Central Hospital for Heart- and Lung Diseases at Bad Berka 421 patients with asthma were rehabilitated under clinical conditions in 1972 and 1973. Their rehabilitation was based on individualized long-term plans for treatment taking in consideration environmental factors which might have triggered the attacks. We report on experiences with diagnostic and therapeutic procedures and the results of vocational rehabilitation. 284 patients (67.4%) could return to their work, 4.5% were disabled, 16.5% remained invalids and 11.6% were old-age pensioners or children. The results depended on age, on the type of asthma, on the severity of cardio-pulmonary impairment, on certain concomitant diseases and on the patients cooperation. Possibilities for elimination of factors starting an attack sometimes proved decisive. For the maintenance of rehabilitatory success subsequent ambulatory long-term care by a specialist is provided.
Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O
OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed...... and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....
Kanai, T.; Takahashi, Y.; Takahashi, K.; Nishino, M.; Takeshige, R.
The maintenance work management system supports the efficient drawing up of various documents for the maintenance work at nuclear power stations and the speeding up of the permission procedure. In addition, it improves the quality assurance of the safety and reliability of the maintenance work. Key merits of the system are: 1. Efficiently drawing up various documents for the maintenance work by using the stored data for the previous maintenance work and the pipe and instrument diagram (P and ID) data. 2. Supporting the management work for the completion of maintenance work safety by using the isolation information stored on the computer system. 3. Speeding up the permission procedure by electronic mail and electronic permission. 4. Displaying additional information such as the specifications of equipment, maintenance result, and maintenance plan by linking up with the database of another system. 5. Reducing the cost of hardware devices by using client/server network configurations of personal computers and a personal computer server. (author)
This draft manual describes an unsurfaced road maintenance management system for use on military installations. This system is available in either a manual or computerized mode (Micro PAVER). The maintenance standards prescribed should protect Govern...
The Winter Performance Index is a method of quantifying winter storm events and the DOTs response to them. : It is a valuable tool for evaluating the States maintenance practices, performing post-storm analysis, training : maintenance personnel...
Nerland, Annette Smørholm
Maintenance can be a contributing factor to unwanted events, as well as desired events and states. Human competence can be defined as the ability to perform a specific task, action or function successfully, and is therefore a key factor to proper execution of maintenance tasks. Hence,maintenance will have negative consequences if done wrong, and give positive results when done right. The purpose of this report is to study the many aspects of maintenance competence. Endeavoring to improve ...
Asphalt Inst., College Park, MD.
Maintenance methods that can be used equally well in all regions of the country have been developed for the use of asphalt in pavement maintenance. Specific information covering methods, equipment and terminology that applies to the use of asphalt in the maintenance of all types of pavement structures, including shoulders, is provided. In many…
The present conference paper deals with methods of optimizing the surface maintenance of steel-made offshore installations. The paper aims at identifying important approaches to the problems regarding the long-range planning of an economical and cost effective maintenance program. The methods of optimization are based on the obtained experiences from the maintenance of installations on the Norwegian continental shelf. 3 figs
Maintenance planning and management for the technological equipment of the Dukovany NPP are described. A Maintenance Control and Evaluation System has been developed and is in use to help manage the complex maintenance issue. Practical examples of outputs of the System, with a comprehensive use of the cost, reliability and safety related data, are presented. (author)
Full Text Available ... of Spinal Cord Injury Rehabilitation Kristine Cichowski, MS Occupational Therapy after Spinal Cord Injury Katie Powell, OT ... does not provide medical advice, recommend or endorse health care products or services, or control the information ...
Full Text Available ... How Peer Counseling Works Julie Gassaway, MS, RN Pediatric Injuries Pediatric Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions for Children ...
Full Text Available ... Rehabilitation Institute of Chicago play_arrow What's the most important thing for families to know right away? ... a spinal cord injury? play_arrow How do most patients learn the nature of their spinal cord ...
... at home and in the office. They recommend strategic modifications to the home and workplace to ensure accessibility, safety and convenience. Occupational therapists also evaluate and treat problems with thinking and memory . Cognitive rehabilitation Neuropsychologists — as well as ...
... language has been compromised. There is a strong consensus among rehabilitation experts that the most important element ... the brain are damaged, causing the transmission of false signals that result in the sensation of pain ...
... Review Resources AT Education Blind Rehab Chiropractic Service Polytrauma/TBI Prosthetics & Sensory Aids Recreation Therapy More Health ... Military Sexual Trauma PTSD Research (MIRECC) Military Exposures Polytrauma Rehabilitation Spinal Cord Injury Telehealth Womens Health Issues ...
Full Text Available ... Diane M. Rowles, MS, NP How Family Life Changes After Spinal Cord Injury Nancy Rosenberg, PsyD Understanding SCI Rehabilitation Donald Peck Leslie, MD Adjusting to Social Life in a Wheelchair Lisa Rosen, MS Spasticity, ...
Full Text Available ... Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal Experiences ...
... final outcome of rehabilitation depends on the person's motivation. Some people delay recovery to gain attention from ... the form of a living will, a durable power of attorney, or both. If people have an ...
The reports are connected wit urgent problems of health rehabilitation. The experience of different non-medical complex actions on support and renewing of ChNPP personnel and Slavutich town inhabitants functional working capability is generalized
Full Text Available ... Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics The Basics of Spinal Cord Injury Rehabilitation Adult Injuries Spinal Cord Injury 101 David ...
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Full Text Available ... Adult Injuries Spinal Cord Injury 101 David Chen, MD Preventing Pressure Sores Mary Zeigler, MS Transition from ... Rosenberg, PsyD Understanding SCI Rehabilitation Donald Peck Leslie, MD Adjusting to Social Life in a Wheelchair Lisa ...
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Antoni Jaume i Capó; Javier Varona Gómez; Gabriel Moyà; Francisco Perales
Research studies show that serious games help to motivate users in rehabilitation processes, and rehabilitation results are better when users are motivated. In long term rehabilitation for maintaining capacities, the demotivation of chronic patients is common. In this work, we have implemented balance rehabilitation video game for cerebral palsy patients. The video game was developed using the prototype development paradigm and following desirable features for rehabilitation serious games pre...
Preventive maintenance is very important in achieving high plant availability. For the European Pressurized Reactor (EPR) preventive maintenance has been carefully addressed in the design stage. This is particularly necessary because of the traditionally different maintenance strategies employed in France and Germany. This paper emphasizes the following features introduced in the ERP design to minimize the duration of the refueling outage: (1) containment accessibility during power operation; (2) overall plant layout to facilitate inspections and maintenances within the containment; and (3) safety system design for enabling preventive maintenance during power operation. (author)
Modern Electronic Maintenance Principles reviews the principles of maintaining modern, complex electronic equipment, with emphasis on preventive and corrective maintenance. Unfamiliar subjects such as the half-split method of fault location, functional diagrams, and fault finding guides are explained. This book consists of 12 chapters and begins by stressing the need for maintenance principles and discussing the problem of complexity as well as the requirements for a maintenance technician. The next chapter deals with the connection between reliability and maintenance and defines the terms fai
For utilities operating nuclear powerplants, the rules of the game continue to change. Conflicting regulatory pressures and a tougher competitive environment will make management's job more complicated and difficult in the 1990s. Dealing with these pressures successfully requires greater attention to maintenance effectiveness. Utilities can help shape their future environment by developing a well-planned strategy to guide their actions. Parts of the strategy that are discussed include developing a sound maintenance philosophy, selecting a service company, radiation exposure, and managing spare parts. This article also addresses the Swedish experience in maintenance, German philosophy regarding maintenance and the current maintenance practices of the Electricite de France
GEAMBASU Gabriel George
Full Text Available The paper presents the maintenance process that is done on an airplane, at a certain period of time, or after a number of flight hours or cycles and describes the checks performed behind each inspection. The first part of research describes the aircraft maintenance process that has to be done after an updated maintenance manual according with aircraft type, followed by a short introduction about maintenance hangar. The second part of the paper presents a hangar design with a foldable roof and walls, which can be folded or extended, over an airplane when a maintenance process is done, or depending on weather condition.
Full Text Available This paper analyzes the environmental regulatory reforms of the Republic of Moldova to restore roads and problems over time. Goals and objectives are the analysis of the current situation on road rehabilitation and environmental assessments in this area, as well as issues that require in rehabilitation and maintenance of roads in the Republic of Moldova.Are described briefly: general aspects of road rehabilitation issues; legislation and environmental regulations in the road; differences between Moldova and procedures of the World Bank's environmental assessment in the construction and rehabilitation of roads; problem of national legislative and normative acts harmonization to international requirements.The paper discusses specific environmental to appear on completion of the rehabilitation of roads in the Republic of Moldova. In the final part of the paper presents the conclusions and some suggestions on how to facilitate the rehabilitation of roads in accordance with Agenda 21 of the country and European and international requirements.
Rohan, M. de
This paper is concerned principally with Maintenance Management systems and their effective introduction into organisations. Maintenance improvement is basically a problem of managing the maintenance department in the broadest sense. Improvement does not only lie in the area of special techniques, systems or procedures; although they are valuable tools, but rather in a balanced attack, carefully guided by management. Over recent years, maintenance systems have received the major emphasis and in many instances the selection of the system has become a pre-occupation, whereas the importance of each maintenance function must be recognised and good management practices applied to all maintenance activities. The ingredients for success in the implementation of maintenance management systems are summarised as: having a management committee, clear objectives, project approach using project management techniques and an enthusiastic leader, user managed and data processing supported project, realistic budget and an understanding of the financial audit requirements. (author)
Sturm, A [Hamburgische Electacitaets-Werke AG Hamburg (Germany)
The establishment of maintenance strategies is of crucial significance for the reliability of a plant and the economic efficiency of maintenance measures. Knowledge about the condition of components and plants from the technical and business management point of view therefore becomes one of the fundamental questions and the key to efficient management and maintenance. A new way to determine the maintenance strategy can be called: Knowledge Based Maintenance. A simple method for determining strategies while taking the technical condition of the components of the production process into account to the greatest possible degree which can be shown. A software with an algorithm for Knowledge Based Maintenance leads the user during complex work to the determination of maintenance strategies for this complex plant components. (orig.)
Sturm, A. [Hamburgische Electacitaets-Werke AG Hamburg (Germany)
The establishment of maintenance strategies is of crucial significance for the reliability of a plant and the economic efficiency of maintenance measures. Knowledge about the condition of components and plants from the technical and business management point of view therefore becomes one of the fundamental questions and the key to efficient management and maintenance. A new way to determine the maintenance strategy can be called: Knowledge Based Maintenance. A simple method for determining strategies while taking the technical condition of the components of the production process into account to the greatest possible degree which can be shown. A software with an algorithm for Knowledge Based Maintenance leads the user during complex work to the determination of maintenance strategies for this complex plant components. (orig.)
second with line charges, and the third with a combina- tion line and concentrated charges. 191. Next, the instrumentation for monitoring the test...resurfacing concrete attempted to contract as a result of temperature, shrinkage, and autogenous volume changes, this restraint caused strains to develop...used on the job All other nozzlemen were required to have ha at least two weeks of "hands-on" training Each spray-up crew was required to demonstrate
Péter, Iván; Jagicza, Anna; Ajtay, Zénó; Boncz, Imre; Kiss, István; Szendi, Katalin; Kustán, Péter; Németh, Balázs
This study aimed to report a balneotherapy-based psoriasis rehabilitation protocol and assess its effectivity. Eighty psoriatic patients who underwent a 3-week-long inward balneotherapy-based rehabilitation were enrolled. Psoriasis Area and Severity Index (PASI) score and high sensitivity C-reactive protein (CRP) were determined on admission and before discharge. The mean PASI score and CRP level -determined on admission and before discharge-decreased significantly after the 3-week-long rehabilitation 7.15±7.3 vs. 2.62±3.05 (p<0.001) and 4.1±3.8 vs. 3.5±3.1 (p=0.026). A negative correlation was found between PASI delta and the number of spa therapies received (r=-0.228). After completing the 3-week-long spa therapy based rehabilitation, both PASI score and CRP levels showed improvement of psoriasis. The complex spa therapy used during the rehabilitation is an effective tool to reduce the symptoms of psoriasis and improve the patient's well-being. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
Kubsik-Gidlewska, Anna M; Klimkiewicz, Paulina; Klimkiewicz, Robert; Janczewska, Katarzyna; Woldańska-Okońska, Marta
The aim of the study is to present a strategy of rehabilitation in multiple sclerosis on the basis of the latest developments in the field of physiotherapy. The publications on the problem discuss a wide range of methods of physiotherapy that can be used in order to reduce the degree of disability and alleviate the symptoms associated with the disease. The complexity of the disease, the difficulty in determining the appropriate treatment and a wide range of symptoms require a comprehensive approach to the patient, which would include both pharmacology and neurorehabilitation. Rehabilitation, which includes psychotherapy and symptomatic therapy, is regarded nowadays as the best form of treatment for multiple sclerosis. An indepth diagnostic assessment of functional status and prognosis should be carried out before the start of the rehabilitation process. The prognosis should take into account the mental state, the neurological status and the awareness of the patient. The kinesiotherapy program in multiple sclerosis is based on a gradation of physiotherapy which assumes a gradual transition from basic movements to more complex ones till global functions are obtained. The most appropriate form of treatment is functional rehabilitation combined with physical procedures. Recent reports indicate the need for aerobic training to be included in the rehabilitation program. The introduction of physical activities, regardless of the severity of the disease, will reduce the negative effects of akinesia, and thus increase the functional capabilities of all body systems.
Exploring random maintenance models, this book provides an introduction to the implementation of random maintenance, and it is one of the first books to be written on this subject. It aims to help readers learn new techniques for applying random policies to actual reliability models, and it provides new theoretical analyses of various models including classical replacement, preventive maintenance and inspection policies. These policies are applied to scheduling problems, backup policies of database systems, maintenance policies of cumulative damage models, and reliability of random redundant systems. Reliability theory is a major concern for engineers and managers, and in light of Japan’s recent earthquake, the reliability of large-scale systems has increased in importance. This also highlights the need for a new notion of maintenance and reliability theory, and how this can practically be applied to systems. Providing an essential guide for engineers and managers specializing in reliability maintenance a...
Soares, C. Guedes; Duarte, J. Caldeira; Garbatov, Y.
the design and during the whole life span of operational use, within an integrated framework founded on risk and reliability based techniques. The document addresses designers, decision makers and professionals responsible for or involved in establishing maintenance plans. The purpose of this document......The present document presents a framework for maintenance planning. Maintenance plays a fundamental role in counteracting degradation effects, which are present in all infrastructure and industrial products. Therefore, maintenance planning is a very critical aspect to consider both during...... is to present maintenance as an integrated approach that needs to be planned, designed, engineered, and controlled by proper qualitative and quantitative techniques. This document outlines the basic premises for maintenance planning and provides the general philosophies that can be followed and points to a best...
Little, S. [Suncor Energy, Calgary, AB (Canada)
Fleet maintenance and reliability at Suncor Energy was discussed in this presentation, with reference to Suncor Energy's primary and support equipment fleets. This paper also discussed Suncor Energy's maintenance and reliability standard involving people, processes and technology. An organizational maturity chart that graphed organizational learning against organizational performance was illustrated. The presentation also reviewed the maintenance and reliability framework; maintenance reliability model; the process overview of the maintenance and reliability standard; a process flow chart of maintenance strategies and programs; and an asset reliability improvement process flow chart. An example of an improvement initiative was included, with reference to a shovel reliability review; a dipper trip reliability investigation; bucket related failures by type and frequency; root cause analysis of the reliability process; and additional actions taken. Last, the presentation provided a graph of the results of the improvement initiative and presented the key lessons learned. tabs., figs.
Software Evolution and Maintenance: A Practitioner's Approach is an accessible textbook for students and professionals, which collates the advances in software development and provides the most current models and techniques in maintenance.Explains two maintenance standards: IEEE/EIA 1219 and ISO/IEC14764Discusses several commercial reverse and domain engineering toolkitsSlides for instructors are available onlineInformation is based on the IEEE SWEBOK (Software Engineering Body of Knowledge)
Effective maintenance will be an essential ingredient in determining fusion system productivity. This level of productivity will result only after close attention is paid to the entire system as an entity and appropriate integration of the elements is made. The status of fusion maintenance is reviewed in the context of the entire system. While there are many challenging developmental tasks ahead in fusion maintenance, the required technologies are available in several high-technology industries, including nuclear fission
Boudreau, D A; Scheer, W D; Catrou, P G
The increasing level of technical sophistication and complexity found in clinical laboratory instrumentation today more than ever demands careful attention to maintenance service needs. The time-worn caution for careful definition of requirements for acquisition of a system should also carry over to acquisition of maintenance service. Guidelines are presented for specifications of terms and conditions for maintenance service from the perspective of the laboratorian in the automated clinical laboratory.
Zwingelstein, G.; Nguyen Van Nghi, B.
After a recall of the videodisc characteristics, this paper presents its utilization by Electricite de France in the framework of training and maintenance. The SICMA (Interactive Communication System in Maintenance) developed and tested by Electricte de France is presented as also its utilization. It has been tested on the sites of Dampierre and Paluel in the cases of training and maintenance (deconnexion of drive rods of control elements); the conclusions of this experimentation are finally given. 4 refs [fr
Unga, E. [Teollisuuden Voima Oy, Olkiluoto (Finland)
The disturbance-free operation of the turbine plant plays an important role in reaching good production results. In the turbine maintenance of the Olkiluoto nuclear power plant the lifetime and efficiency of turbine components and the lifetime costs are taken into account in determining the turbine maintenance and modernization/improvement program. The turbine maintenance program and improvement/modernization measures taken in the plant units are described in this presentation. (orig.)
Unga, E [Teollisuuden Voima Oy, Olkiluoto (Finland)
The disturbance-free operation of the turbine plant plays an important role in reaching good production results. In the turbine maintenance of the Olkiluoto nuclear power plant the lifetime and efficiency of turbine components and the lifetime costs are taken into account in determining the turbine maintenance and modernization/improvement program. The turbine maintenance program and improvement/modernization measures taken in the plant units are described in this presentation. (orig.)
Industrial plants have become more complex due to technological advancement. This has made the task of maintenance more difficult. The maintenance costs in terms of resources and downtime loss are so high that maintenance function has become a critical factor in a plant's profitability. Industry should devote as much forethought to the management of maintenance function as to production. Maintenance has grown from an art to a precise, technical engineering science. Planning, organizing scheduling and control of maintenance using modern techniques pays dividends in the form of reduced costs and increased reliability. The magnitude and the dimension of maintenance have multiplied due to development in the engineering technologies. Production cost and capacities are directly affected by the breakdown time. Total operating cost including the maintenance cost plays an important role in replacement dimension. The integrated system approach would bring forth the desired results of high maintenance standards. The standards once achieved and sustained, would add to the reliability of the plan and relieve heavy stresses and strains on the engineering logistic support. (author)
Laakso, K.; Simola, K.
The main topics of the presentation include: (1) an analysis model and methods to evaluate maintenance action programs and the support decision to make changes in them and (2) to understand the maintenance strategies in a systems perspective as a basis for future developments. The subproject showed how systematic models for maintenance analysis and decision support, utilising computerised and statistical tool packages, can be taken into use for evaluation and optimisation of maintenance of active systems from the safety and economic point of view
Department of Transportation — The Remote Maintenance and Monitoring System (RMMS) is a collection of subsystems that includes telecommunication components, hardware, and software, which serve to...
Gilbertson, Frank V
.... Used in conjunction with pertinent historical data and developed with Army transformation goals in mind, General Systems thinking can provide the framework for guiding maintenance transformation...
Guldager, Rikke; Poulsen, Ingrid
OBJECTIVES: The overall Ph.d.-study aims to investigate rehabilitation trajectories in adult patients with traumatic brain injury (TBI) and stroke, and to describe mechanisms behind the institutionalized (health care) part of inequality in health with emphasis on interfaces and critical transitions...... from time of accident to twelve month follow-up. The case study aims to explore the process of rehabilitation in a high status patient, related to professions in healthcare. The focus is on how a high status patient is perceived and handled in organizations and among professions, and strategies applied...... by the patient and relatives. METHODS: Observation and qualitative interview has been conducted of one patient following the patients’ trajectories though different phases of the rehabilitation process during admission at Traumatic Brain Unit. Interdisciplinary meetings are regarded as key elements...
Meillier, Lucette Kirsten; Nielsen, Kirsten Melgaard; Larsen, Finn Breinholt
in recruitment and participation among low educated and socially vulnerable patients must be addressed to lower inequality in post-MI health. Our aim was to improve referral, attendance, and adherence rates among socially vulnerable patients by systematic screening and by offering a socially differentiated...... to a standard rehabilitation programme (SRP). If patients were identified as socially vulnerable, they were offered an extended version of the rehabilitation programme (ERP). Excluded patients were offered home visits by a cardiac nurse. Concordance principles were used in the individualised programme elements......%. Patients were equally distributed to the SRP and the ERP. No inequality was found in attendance and adherence among referred patients. Conclusions: It seems possible to overcome unequal referral, attendance, and adherence in cardiac rehabilitation by organisation of systematic screening and social...
Kemp, Paul; Slopek, Richard [Canadian Projects Ltd., Calgary, (Canada); Guzwell, Robert [TransAlta, Calgary, (Canada)
The Ragged Chute development, located in northern Ontario, was originally constructed to provide compressed air to a local silver mining company. It was composed of a free overflow spillway, the air plant intake, a concrete gravity retaining wall and an earthfill dyke abutment. The advantage of the river flow and the head developed by the dam for the air plant was recently put to use by the addition of a hydro plant. This paper provided an overview of the use of the river flow over the years and described the recent rehabilitation work being done to upgrade the installations to current dam safety standards. Site inspections were carried out in 2006 as part of the dam safety review to assess the overall condition of the structures. The major operation of the rehabilitation work involved the upgrading of the original fixed crest spillway with a new labyrinth spillway structure. Canadian Hydro completed the dam safety safety rehabilitation work by October 2009.
In a chronic and disabling disease like multiple sclerosis, rehabilitation becomes of major importance in the preservation of physical, psychological and social functioning. Approximately 80% of patients have multiple sclerosis for more than 35 years and most will develop disability at some point......, a paradigm shift is taking place and it is now increasingly acknowledged that exercise therapy is both safe and beneficial. Robot-assisted training is also attracting attention in multiple sclerosis rehabilitation. Several sophisticated commercial robots exist, but so far the number of scientific studies...... promising. This drug has been shown to improve walking ability in some patients with multiple sclerosis, associated with a reduction of patients' self-reported ambulatory disability. Rehabilitation strategies involving these different approaches, or combinations of them, may be of great use in improving...
Institute for Information Studies, Falls Church, VA.
Intended for use by rehabilitation counselors and work supervisors, the sourcebook contains 173 problems and solutions provided by rehabilitation engineering. A section titled "Guidelines for Formulating Problem Statements" is intended to summarize the most effective ways for either disabled individuals or rehabilitation practitioners to…
Schmidt-Ohlemann, M; Schweizer, C
Domiciliary rehabilitation is an innovative form of outpatient medical rehabilitation. All components of service provision are delivered in the rehabilitant's home by a multidisciplinary team headed by a physician. The key context factors in the rehab process can be taken into account firsthand. The target group of domiciliary rehabilitation consists of multimorbid patients with severe functional limitations and complex assistance needs, whose rehabilitation options would be poor without this outreach service. Here, as suggested by the WHO concept of functional health, the interaction between health condition and environmental factors is kept in view much better than in other forms of rehabilitation. The positive effects and the efficiency of the rehabilitation measures provided can be assessed very well at a high descriptive level. This fact had been a precondition for legal establishment of domiciliary rehabilitation as a regular service. Domiciliary rehabilitation not only complies with key demands in the health and social policy fields, such as priority of outpatient over inpatient treatment or rehabilitation to precede and accompany long term care, it also constitutes an alternative concept challenging the traditional inpatient rehabilitation approach. The patient, hence, no longer is to fit into the institutional framework of outpatient or inpatient rehabilitation, but the team will fit into the specifics of the patient's unique social and material situation.
Shigematsu, Takashi; Fujishima, Ichiro
Dysphagia is a life-threatening disorder caused by many medical conditions such as stroke, neurological disorders, tumors, etc. The symptoms of dysphagia are quite variable and diagnosed by observation or through screening involving instrumental swallowing examinations such as video-fluoroscopy and video-endoscopy, to determine functional severity and treatment-prognosis. Direct- and indirect-therapy is used with and without food, respectively. Swallowing rehabilitation is very effective, and could be used in conjunction with compensatory techniques. Here we present an overview of dysphagia and swallowing rehabilitation.
... ency/patientinstructions/000435.htm Skilled nursing or rehabilitation facilities To use the sharing features on this page, ... to go to a Skilled Nursing or Rehabilitation Facility? Your health care provider may determine that you ...
Although the emphasis in European penal policy now lies on the rehabilitative aim of imprisonment, the concept of rehabilitation remains vague and is being interpreted differently in different European countries. This paper looks at rehabilitation from a legal perspective and aims to clarify the
Weidner, Theodore J.
In 2002, APPA published "Maintenance Staffing Guidelines for Educational Facilities," the first building maintenance trades staffing guideline designed to assist educational facilities professionals with their staffing needs. addresses how facilities professionals can determine the appropriate size and mix of their organization. Contents…
STAN IVAN F.E.
Full Text Available The paper includes a simplified economical and financial analysis of the buildings rehabilitation solutions, for heating and lighting. The most important economic and financial indicators analyzed and determined are: economic return on investment and payback period of investment in dynamic form, net present value, and internal rate of return economic residual value of the investment on thermal insulation, building maintenance costs, energy costs. In order to reduce the electricity consumption: the methods consisted in replacing inefficient lighting with some efficient energy and for heat consumption: the proposed solution was building rehabilitation (exterior wall insulation, floor insulation board. The analysis consists in determining the economical and financial indicators before and after the building rehabilitation. The 3 rooms apartment is located in Craiova town, (wind zone IV, 2nd floor, orientation is S.
Background: Opiate maintenance treatment (OMT) is being offered for rehabilitation purposes in the Norwegian society, including Norwegian prisons. The OMT program has been a controversial issue because of fear of the diversion of OMT medications and development of black markets for prescription drugs such as buprenorphine and methadone. The OTM program is seeking normalization through rehabilitation, and is therefore forced to observe their patients during the intake of buprenorphine and meth...
Derbonne, D.R.; Plunkett, T.F.; Simpson, J.R.
During fuel cycle 1 at River Bend station, considerable effort was expended to reduce corrective maintenance work orders (MWOs) to <1,000. This was done by complementing the plant staff with costly contract personnel. Coming out of the first refueling outage, most contract personnel were released. The change in MWO backlog started a steady rise. It became readily apparent that to avoid costly contract staff time, a maintenance improvement program (MIP) was necessary. The MIP Was primarily directed at two areas: crew efficiency improvements and improved preplanned MWO packages. The overall effect of the MIP was to achieve significant productivity improvements with reduced operation and maintenance cost by providing frequent accountability to all levels of maintenance supervision. The MIP also produced a feeling of pride among the maintenance department employees that had not really existed before. This was the best benefit of all
W.M.E. van de Sandt-Koenderman (Mieke)
textabstractThis thesis focusses on two types of aphasia rehabilitation, cognitive linguistic treatment (CLT) and AAC (Augmentative and Alternative Communication) training. In a study of the effect of nonlinguistic variables on the outcome of CLT, it was shown, that neuropsychological data
Full Text Available ... Abuse and Spinal Cord Injury Allen Heinemann, PhD How Peer Counseling Works Julie Gassaway, MS, RN Pediatric Injuries Pediatric Spinal ... difficult obstacle to overcome in rehabilitation? play_arrow How soon should people return to school or work after a spinal cord injury? play_arrow What’s ...
Full Text Available Abstract Background The majority of current portable orthotic devices and rehabilitative braces provide stability, apply precise pressure, or help maintain alignment of the joints with out the capability for real time monitoring of the patient's motions and forces and without the ability for real time adjustments of the applied forces and motions. Improved technology has allowed for advancements where these devices can be designed to apply a form of tension to resist motion of the joint. These devices induce quicker recovery and are more effective at restoring proper biomechanics and improving muscle function. However, their shortcoming is in their inability to be adjusted in real-time, which is the most ideal form of a device for rehabilitation. This introduces a second class of devices beyond passive orthotics. It is comprised of "active" or powered devices, and although more complicated in design, they are definitely the most versatile. An active or powered orthotic, usually employs some type of actuator(s. Methods In this paper we present several new advancements in the area of smart rehabilitation devices that have been developed by the Northeastern University Robotics and Mechatronics Laboratory. They are all compact, wearable and portable devices and boast re-programmable, real time computer controlled functions as the central theme behind their operation. The sensory information and computer control of the three described devices make for highly efficient and versatile systems that represent a whole new breed in wearable rehabilitation devices. Their applications range from active-assistive rehabilitation to resistance exercise and even have applications in gait training. The three devices described are: a transportable continuous passive motion elbow device, a wearable electro-rheological fluid based knee resistance device, and a wearable electrical stimulation and biofeedback knee device. Results Laboratory tests of the devices
Mavroidis, Constantinos; Nikitczuk, Jason; Weinberg, Brian; Danaher, Gil; Jensen, Katherine; Pelletier, Philip; Prugnarola, Jennifer; Stuart, Ryan; Arango, Roberto; Leahey, Matt; Pavone, Robert; Provo, Andrew; Yasevac, Dan
The majority of current portable orthotic devices and rehabilitative braces provide stability, apply precise pressure, or help maintain alignment of the joints with out the capability for real time monitoring of the patient's motions and forces and without the ability for real time adjustments of the applied forces and motions. Improved technology has allowed for advancements where these devices can be designed to apply a form of tension to resist motion of the joint. These devices induce quicker recovery and are more effective at restoring proper biomechanics and improving muscle function. However, their shortcoming is in their inability to be adjusted in real-time, which is the most ideal form of a device for rehabilitation. This introduces a second class of devices beyond passive orthotics. It is comprised of "active" or powered devices, and although more complicated in design, they are definitely the most versatile. An active or powered orthotic, usually employs some type of actuator(s). In this paper we present several new advancements in the area of smart rehabilitation devices that have been developed by the Northeastern University Robotics and Mechatronics Laboratory. They are all compact, wearable and portable devices and boast re-programmable, real time computer controlled functions as the central theme behind their operation. The sensory information and computer control of the three described devices make for highly efficient and versatile systems that represent a whole new breed in wearable rehabilitation devices. Their applications range from active-assistive rehabilitation to resistance exercise and even have applications in gait training. The three devices described are: a transportable continuous passive motion elbow device, a wearable electro-rheological fluid based knee resistance device, and a wearable electrical stimulation and biofeedback knee device. Laboratory tests of the devices demonstrated that they were able to meet their design
Zemdegs, R.T.; Chout, Q.B.
Approaches to the maintenance of nuclear power plants have undergone significant change in the past several decades. The traditional breakdown approach has been displaced by preventive (calendar-based) maintenance and more recently, by condition-based maintenance (CBM). This is largely driven by the fact that traditional maintenance programs, derived primarily from equipment vendor recommendations, are generally unsuccessful in controlling maintenance costs or equipment failures. Many advances in the maintenance field have taken place since the maintenance plans for Ontario Hydro's nuclear plants were initially established. Ontario Hydro nuclear plant operating costs can be substantially reduced and Incapability Factor improved with the application of modern maintenance processes and tools. Pickering is designated as the lead station for IMP. Of immediate concern is the fact that Pickering Nuclear Division has been experiencing a significant backlog of Operating Preventive Maintenance Callups. This backlog, over 2000, is unacceptable to both station management and the nuclear regulator, the Atomic Energy Control Board. In addition there are over 500 callups in various stages of revision (in hyperspace) without an adequate control nor reporting system to manage their completion. There is also considerable confusion about the classification of l icensing c allups, e.g. callups which are mandatory as a result of legal requirements. Furthermore the ineffectiveness of the Preventive Maintenance (PM) has been the subject of peer audits and Atomic Energy Control Board (AECB) findings over the past several years. The current preventive maintenance ratio PM2 /(PM+CM3) at Pickering ND is less than 20%, due to the current high load of equipment breakdown. This past summer, an Independent Integrated Performance Assessment (IIPA) review at Ontario Hydro confirmed these concerns. Over the past several years, Ontario Hydro nuclear staff have evaluated several programs to improve
Full Text Available Abstract Background The decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts. This study investigates to what extent the time spent on rehabilitation time prior to disability pension is associated with characteristics of the individual or the local employment and welfare office, measured as municipality variance. Methods A study of 2,533 40 to 42 year olds who received disability pension over a period of 18 years. The logarithm of the rehabilitation time before granting a disability pension was analysed with multilevel regression. Results The rehabilitation time before a disability pension was granted ranged from 30 to 5,508 days. Baseline health characteristics were only moderately associated with rehabilitation time. Younger people and people with unemployment periods had longer rehabilitation time before a disability pension was granted. There were only minor differences in rehabilitation time between men and women and between different levels of education. Approximately 2% of the total variance in rehabilitation time could be attributed to the municipality of residence. Conclusions There is a higher threshold for granting a disability pension to younger persons and those who are expecting periods of unemployment, which is reflected in the extended rehabilitation requirements for these groups. The longer rehabilitation period for persons with psychiatric disorders might reflect a lack of common knowledge on the working capacity of and the fitted rehabilitation programs for people with psychiatric disorders.
Støver, Morten; Pape, Kristine; Johnsen, Roar; Fleten, Nils; Sund, Erik R; Claussen, Bjørgulf; Ose, Solveig Osborg; Bjørngaard, Johan Håkon
The decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts. This study investigates to what extent the time spent on rehabilitation time prior to disability pension is associated with characteristics of the individual or the local employment and welfare office, measured as municipality variance. A study of 2,533 40 to 42 year olds who received disability pension over a period of 18 years. The logarithm of the rehabilitation time before granting a disability pension was analysed with multilevel regression. The rehabilitation time before a disability pension was granted ranged from 30 to 5,508 days. Baseline health characteristics were only moderately associated with rehabilitation time. Younger people and people with unemployment periods had longer rehabilitation time before a disability pension was granted. There were only minor differences in rehabilitation time between men and women and between different levels of education. Approximately 2% of the total variance in rehabilitation time could be attributed to the municipality of residence. There is a higher threshold for granting a disability pension to younger persons and those who are expecting periods of unemployment, which is reflected in the extended rehabilitation requirements for these groups. The longer rehabilitation period for persons with psychiatric disorders might reflect a lack of common knowledge on the working capacity of and the fitted rehabilitation programs for people with psychiatric disorders.
Jasiulewicz-Kaczmarek, M.; Stachowiak, A.
The performance and competitiveness of manufacturing companies is dependent on the availability, reliability and productivity of their production facilities. Low productivity, downtime, and poor machine performance is often linked to inadequate plant maintenance, which in turn can lead to reduced production levels, increasing costs, lost market opportunities, and lower profits. These pressures have given firms worldwide the motivation to explore and embrace proactive maintenance strategies over the traditional reactive firefighting methods. The traditional view of maintenance has shifted into one of an overall view that encompasses Overall Equipment Efficiency, Stakeholders Management and Life Cycle assessment. From practical point of view it requires changes in approach to maintenance represented by managers and changes in actions performed within maintenance area. Managers have to understand that maintenance is not only about repairs and conservations of machines and devices, but also actions striving for more efficient resources management and care for safety and health of employees. The purpose of the work is to present strategic analysis based on SWOT analysis to identify the opportunities and strengths of maintenance process, to benefit from them as much as possible, as well as to identify weaknesses and threats, so that they could be eliminated or minimized.
Strong, D.K. Jr; Wray, D.M.
This paper addresses improving the safety and reliability of power plants in a cost-effective manner by integrating the recently developed reliability centered maintenance techniques with the traditional predictive maintenance techniques of nuclear power plants. The topics of the paper include a description of reliability centered maintenance (RCM), enhancing RCM with predictive maintenance, predictive maintenance programs, condition monitoring techniques, performance test techniques, the mid-Atlantic Reliability Centered Maintenance Users Group, test guides and the benefits of shared guide development
Kaplan, D. I.; Jones, R. M.
The orbit maintenance problem is examined for two low-earth-orbiting space station concepts - the large, manned Space Operations Center (SOC) and the smaller, unmanned Science and Applications Space Platform (SASP). Atmospheric drag forces are calculated, and circular orbit altitudes are selected to assure a 90 day decay period in the event of catastrophic propulsion system failure. Several thrusting strategies for orbit maintenance are discussed. Various chemical and electric propulsion systems for orbit maintenance are compared on the basis of propellant resupply requirements, power requirements, Shuttle launch costs, and technology readiness.
Doyle, E.K.; Lee, C.-G.; Cho, D.
Variant forms of RCM (Reliability Centered Maintenance) have been the maintenance optimizing tools of choice in industry for the last 20 years. Several such optimization techniques have been implemented at the Bruce Nuclear Station. Further cost refinement of the Station preventive maintenance strategy whereby decisions are based on statistical analysis of historical failure data are now being evaluated. The evaluation includes a requirement to demonstrate that earlier optimization projects have long term positive impacts. This proved to be a significant challenge. Eventually a methodology was developed using Crowe/AMSAA (Army Materials Systems Analysis Activity) plots to justify expenditures on further optimization efforts. (authors)
Nuclear power plants maintenance now appears as an important factor contributing to the competitivity of nuclea energy. The articles published in this issue describe the way maintenance has been organized in France and how it led to an actual industrial activity developing and providing products and services. An information note about Georges Besse uranium enrichment plant (Eurodif) recalls that maintenance has become a main data not only for power plants but for all nuclear industry installations. (The second part of this dossier will be published in the next issue: vol. 1 January-February 1989) [fr
Maintenance work will be carried out on the CERN mobile network infrastructure (GSM) on the 23 and 24 July from 6 p.m. to 6 a.m. in order to replace discontinued equipment and to increase the bandwidth capacity of the GSM mobile network. All CERN GSM emitters (40 units) will be moved one by one to the new infrastructure during the maintenance. The call of a user connected to an emitter at the time of its maintenance will be cut off. However, the general overlapping of the GSM radio coverage should mean that users are able immediately to call again should their call be interrupted. IT/CS/CS
Doyle, E. Kevin; Tuomi, Vesa; Rowley, Ian
Since the 1980 s maintenance optimization has been centered around various formulations of Reliability Centered Maintenance (RCM). Several such optimization techniques have been implemented at the Bruce Nuclear Station. Further cost refinement of the Station preventive maintenance strategy includes evaluation of statistical optimization techniques. A review of successful pilot efforts in this direction is provided as well as initial work with graphical analysis. The present situation reguarding data sourcing, the principle impediment to use of stochastic methods in previous years, is discussed. The use of Crowe/AMSAA (Army Materials Systems Analysis Activity) plots is demonstrated from the point of view of justifying expenditures in optimization efforts. (author)
Ungi, T. [Heysham 2 Power Station, Nuclear Electric LTD (United Kingdom)
Plant maintenance is a very complex process which requires considerable effort from both within the maintenance process and also many support activities. It is important that the plant maintenance policy is translated into a maintenance programme which will define all relevant aspects of the maintenance. An aspect of this maintenance programme will be a maintenance catalogue which will define the maintenance activities to be carried out and at what frequencies. This paper is aimed at discussing the maintenance philosophy and resulting maintenance catalogues currently adopted in Nuclear Electric Ltd, and in particular at Heysham 2 Power Station. It goes on to consider whether these maintenance catalogues contain the optimum maintenance and if not should they be changed. If change is required, the process by which this change will be brought about is also discussed. (author)
The brochure presents, in full wording, 20 papers read at the experts' meeting ''Maintenance '83'' in Wiesbaden. Most of the papers discuss reliability data (acquisition, evaluation, processing) of nearly all fields of industry. (RW) [de
Lamarche, M.; Guillot, M.; Monier, M.
To improve the overall availability factor of nuclear power plants you have to cut either the forced outage role and the planned outage time or you need to reduce simultaneously the failures and the efforts devoted to avoiding them. Among other results, this goal leads to a decrease in the number of real or anticipated problems. Electricite de France policy, in this matter, is to focus on decreasing the compoents' maintenance needs through a comprehensive modification program, targeted to eliminating the weak points as revealed by the operation. Thereby one may reach, for simple equipment, a nearly maintenance-free condition in which the only maintenance needed is surveillance, which provides assurance that everything is operating properly. A good example of this type of equipment is the family of static components, drums, and pipes whose corrective maintenance is almost nil when their initial condition is good
Chou, Jui-Sheng; Le, Thanh-Son
Roadway pavement maintenance is essential for driver safety and highway infrastructure efficiency. However, regular preventive maintenance and rehabilitation (M and R) activities are extremely costly. Unfortunately, the funds available for the M and R of highway pavement are often given lower priority compared to other national development policies, therefore, available funds must be allocated wisely. Maintenance strategies are typically implemented by optimizing only the cost whilst the reliability of facility performance is neglected. This study proposes a novel algorithm using multi-objective particle swarm optimization (MOPSO) technique to evaluate the cost-reliability tradeoff in a flexible maintenance strategy based on non-dominant solutions. Moreover, a probabilistic model for regression parameters is employed to assess reliability-based performance. A numerical example of a highway pavement project is illustrated to demonstrate the efficacy of the proposed MOPSO algorithms. The analytical results show that the proposed approach can help decision makers to optimize roadway maintenance plans. - Highlights: →A novel algorithm using multi-objective particle swarm optimization technique. → Evaluation of the cost-reliability tradeoff in a flexible maintenance strategy. → A probabilistic model for regression parameters is employed to assess reliability-based performance. → The proposed approach can help decision makers to optimize roadway maintenance plans.
Chou, Jui-Sheng, E-mail: email@example.com [Department of Construction Engineering, National Taiwan University of Science and Technology (Taiwan Tech), 43 Sec. 4, Keelung Rd., Taipei 106, Taiwan (China); Le, Thanh-Son [Department of Construction Engineering, National Taiwan University of Science and Technology (Taiwan Tech), 43 Sec. 4, Keelung Rd., Taipei 106, Taiwan (China)
Roadway pavement maintenance is essential for driver safety and highway infrastructure efficiency. However, regular preventive maintenance and rehabilitation (M and R) activities are extremely costly. Unfortunately, the funds available for the M and R of highway pavement are often given lower priority compared to other national development policies, therefore, available funds must be allocated wisely. Maintenance strategies are typically implemented by optimizing only the cost whilst the reliability of facility performance is neglected. This study proposes a novel algorithm using multi-objective particle swarm optimization (MOPSO) technique to evaluate the cost-reliability tradeoff in a flexible maintenance strategy based on non-dominant solutions. Moreover, a probabilistic model for regression parameters is employed to assess reliability-based performance. A numerical example of a highway pavement project is illustrated to demonstrate the efficacy of the proposed MOPSO algorithms. The analytical results show that the proposed approach can help decision makers to optimize roadway maintenance plans. - Highlights: > A novel algorithm using multi-objective particle swarm optimization technique. > Evaluation of the cost-reliability tradeoff in a flexible maintenance strategy. > A probabilistic model for regression parameters is employed to assess reliability-based performance. > The proposed approach can help decision makers to optimize roadway maintenance plans.
Full Text Available SEFRE (Shoulder-Elbow-Forearm Robotics Economic rehabilitation system is presented in this paper. SEFRE Rehab System is composed of a robotic manipulator and an exoskeleton, so-called Forearm Supportive Mechanism (FSM. The controller of the system is developed as the Master PC consisting of five modules, that is, Intelligent Control (IC, Patient Communication (PC, Training with Game (TG, Progress Monitoring (PM, and Patient Supervision (PS. These modules support a patient to exercise with SEFRE in six modes, that is, Passive, Passive Stretching, Passive Guiding, Initiating Active, Active Assisted, and Active Resisted. To validate the advantages of the system, the preclinical trial was carried out at a national rehabilitation center. Here, the implement of the system and the preclinical results are presented as the verifications of SEFRE.
Grace, Sherry L.; Bennett, Stephanie; Ardern, Chris I.; Clark, Alexander
Cardiovascular disease is among the leading causes of mortality and morbidity in Canada. Cardiac rehabilitation (CR) has a long robust history here, and there are established clinical practice guidelines. While the effectiveness of CR in the Canadian context is clear, only 34% of eligible patients participate, and strategies to increase access for under-represented groups (e.g., women, ethnic minority groups) are not yet universally applied. Identified CR barriers include lack of referral and physician recommendation, travel and distance, and low perceived need. Indeed there is now a national policy position recommending systematic inpatient referral to CR in Canada. Recent development of 30 CR Quality Indicators and the burgeoning national CR registry will enable further measurement and improvement of the quality of CR care in Canada. Finally, the Canadian Association of CR is one of the founding members of the International Council of Cardiovascular Prevention and Rehabilitation, to promote CR globally. PMID:24607018
Chandler, W.P.; Middleton, B.A.
Rehabilitation work on areas denuded of vegetation during the exploration phase of the Olympic Dam project was used to test various methods for regeneration of vegetation cover in the arid zone. The test work carried out on drill pads and access tracks has indicated that, with adequate site preparation, natural regeneration is the most economical and effective method to ensure post-operational stability of the affected land-forms. An on-going monitoring regime, utilising a computer data base, has been set up to allow year-to-year comparison of rehabilitation effectiveness. The database also provides a catalogue of initial colonising plants and a measure of variations in species diversity with time
Bødker, Malene; Juul, Annegrete
Purpose – Telecare promises to deliver healthcare services more efficiently while, at the same time, improving the quality of care. The purpose of this paper is to challenge these promises by analysing the implications of introducing telecare in the rehabilitation of patients suffering from chronic...... obstructive pulmonary disease. Design/methodology/approach – Empirically, the paper is based on interviews with and observations of rehabilitation therapists and patients taking part in a Danish telerehabilitation programme. Theoretically, the paper draws on Science and Technology Studies. Findings...... one ends. Practical implications – Evaluations of telecare technologies should pay more attention to workand responsibility-related effects of introducing telecare in order better to account for predicted and unpredicted as well as desirable and undesirable socio-technical changes. Originality/value...
The concept of remote maintenance as it pertains to nuclear fuel fabrication facilities is quite unique. The future may require completely remote facilities where maintenance will be performed by hybrid manipulators/robots. These units will be capable of being preprogrammed for automatic operation or manually operated with the operator becoming a part of the closed loop control system. These robots will mesh television, computer control, and direct force feedback manual control in a usable new concept of robotics
Flude, J.W.; Nicholas, J.R.
This Predictive Maintenance Primer provides utility plant personnel with a single-source reference to predictive maintenance analysis methods and technologies used successfully by utilities and other industries. It is intended to be a ready reference to personnel considering starting, expanding or improving a predictive maintenance program. This Primer includes a discussion of various analysis methods and how they overlap and interrelate. Additionally, eighteen predictive maintenance technologies are discussed in sufficient detail for the user to evaluate the potential of each technology for specific applications. This document is designed to allow inclusion of additional technologies in the future. To gather the information necessary to create this initial Primer the Nuclear Maintenance Applications Center (NMAC) collected experience data from eighteen utilities plus other industry and government sources. NMAC also contacted equipment manufacturers for information pertaining to equipment utilization, maintenance, and technical specifications. The Primer includes a discussion of six methods used by analysts to study predictive maintenance data. These are: trend analysis; pattern recognition; correlation; test against limits or ranges; relative comparison data; and statistical process analysis. Following the analysis methods discussions are detailed descriptions for eighteen technologies analysts have found useful for predictive maintenance programs at power plants and other industrial facilities. Each technology subchapter has a description of the operating principles involved in the technology, a listing of plant equipment where the technology can be applied, and a general description of the monitoring equipment. Additionally, these descriptions include a discussion of results obtained from actual equipment users and preferred analysis techniques to be used on data obtained from the technology. 5 refs., 30 figs
During the last years Colombia has increased the use of nuclear techniques, instruments and equipment in ambitious health programs, as well as in research centers, industry and education; this has resulted in numerous maintenance problems. As an alternative solution IAN has established a Central Maintenance Laboratory for nuclear instruments within an International Atomic Energy Agency program for eight Latin American and nine Asian Countries. Established strategies and some results are detailed in this writing
Tjørnhøj-Thomsen, Tine; Hansen, Helle Ploug
There is widespread and increasing political interest in devising plans to support people who have or have had cancer to recover and recommence 'normal' lives. Educating cancer patients for this purpose is a central element in cancer rehabilitation in both Europe and the United States. One of the...... highlight the significance of the ritual site, its aesthetics, its exaggerations, and the social and temporal organization of the program....
Brown, T.G.; Casini, G.; Churakov, G.F.
The INTOR engineering design has been strongly influenced by considerations for assembly and maintenance. A maintenance philosophy was established at the outset of the conceptual design to insure that the tokamak configuration would be developed to accommodate maintenance requirements. The main features of the INTOR design are summarized in this paper with primary emphasis on the impact of maintenance considerations. The most apparent configuration design feature is the access provided for torus maintenance. Particular attention was given to the size and location of superconducting magnets and the location of vacuum boundaries. All of the poloidal field (PF) coils are placed outside of the bore of the toroidal field (TF) coils and located above and below an access opening between adjacent TF coils through which torus sectors are removed. A magnet structural configuration consisting of mechanically attached reinforcing members has been designed which facilitates the open access space for torus sector removal. For impurity control, a single null poloidal divertor was selected over a double null design in order to maintain sufficient access for pumping and maintenance of the collector. A double null divertor was found to severely limit access to the torus with the addition of divertor collectors and pumping at the top. For this reason, a single null concept was selected in spite of the more difficult design problems associated with the required asymmetric PF system and higher particle loadings
García-Molina, Alberto; Roig-Rovira, Teresa
The decrease in the rate of mortality due to brain damage during the First World War resulted in a large number of veterans with neurological or neuropsychological sequelae. This situation, which was unknown up until then, called for the development of new therapeutic approaches to help them reach acceptable levels of autonomy. This article reviews the relationship between neuropsychological rehabilitation and warfare, and describes the contributions made by different professionals in this field in the two great conflicts of the 20th century. The First World War was to mark the beginning of neuropsychological rehabilitation as we know it today. Some of the most outstanding contributions in that period were those made by Goldstein and Popplereuter in Germany or Franz in the United States. The Second World War was to consolidate this healthcare discipline, the leading figures at that time being Zangwill in England and Luria in the Soviet Union. Despite being of less importance, geopolitically speaking, the study also includes the Yom Kippur War, which exemplifies how warfare can stimulate the development of neuropsychological intervention programmes. Today's neuropsychological rehabilitation programmes are closely linked to the interventions used in wartime by Goldstein, Zangwill or Luria. The means employed may have changed, but the aims are still the same, i.e. to help people with brain damage manage to adapt to their new lives.
Weill-Chounlamountry, A; Soyez-Gayout, L; Tessier, C; Pradat-Diehl, P
The cognitive model of music processing has a modular architecture with two main pathways (a melody pathway and a time pathway) for processing the musical "message" and thus enabling music recognition. It also features a music-specific module for tonal encoding of pitch which stands apart from all other known cognitive systems (including language processing). To the best of our knowledge, rehabilitation therapy for amusia has not yet been reported. We developed a therapeutic method (inspired by work on word deafness) in order to determine whether specific rehabilitation based on melody discrimination could prompt the regression of amusia. We report the case of a patient having developed receptive, acquired amusia four years previously. His tone deafness disorder was assessed using the Montreal Battery of Evaluation of Amusia (MBEA), which revealed impairment of the melody pathway but no deficiency in the time pathway. A computer-assisted rehabilitation method was implemented; it used melody discrimination tasks and an errorless learning paradigm with progressively fading visual cues. After therapy, we noted an improvement in the overall MBEA score and its component subscores which could not be explained by spontaneous recovery (in view of the number of years since the neurological accident). The improvement was maintained at seven months post-therapy. Although post-therapy improvement in daily life was not systematically assessed, the patient started listening to his favourite music again. Specific amusia therapy has shown efficacy.
Nakai, Satoru; Nishio, Ryuichi; Uchihashi, Masaya; Kaneko, Yoshihisa; Yamashita, Hironobu; Yamaguchi, Atsunori; Aoki, Takayuki
A sodium cooled fast breeder reactor (FBR) has unique systems and components and different degradation mechanism from light water reactor (LWR) so that need to establish maintenance technology in accordance with its features. The examination of the FBR maintenance technology is carried out in the special committee for considering the maintenance for Monju established in the Japan Society of Maintenology (JSM). As a result of the study such as extraction of Monju maintenance feature, maintenance technology benchmark between Monju and LWR components and survey of LWR maintenance experience, it is clear that principles of maintenance are same as LWR, necessity of LWR maintenance experience reflection and points to be considered in Monju maintenance. The road map to establish a FBR maintenance technology in the technical aspect became clear and it is vital to acquire operation and maintenance experience of the plant to implement this road map, and to establish a fast reactor maintenance. (author)
... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY... for the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority...
Giggins, Oonagh M; Persson, Ulrik McCarthy; Caulfield, Brian
This paper reviews the literature relating to the biofeedback used in physical rehabilitation. The biofeedback methods used in rehabilitation are based on biomechanical measurements and measurements of the physiological systems of the body. The physiological systems of the body which can be measured to provide biofeedback are the neuromuscular system, the respiratory system and the cardiovascular system. Neuromuscular biofeedback methods include electromyography (EMG) biofeedback and real-time ultrasound imaging (RTUS) biofeedback. EMG biofeedback is the most widely investigated method of biofeedback and appears to be effective in the treatment of many musculoskeletal conditions and in post cardiovascular accident (CVA) rehabilitation. RTUS biofeedback has been demonstrated effective in the treatment of low back pain (LBP) and pelvic floor muscle dysfunction. Cardiovascular biofeedback methods have been shown to be effective in the treatment of a number of health conditions such as hypertension, heart failure, asthma, fibromyalgia and even psychological disorders however a systematic review in this field has yet to be conducted. Similarly, the number of large scale studies examining the use of respiratory biofeedback in rehabilitation is limited. Measurements of movement, postural control and force output can be made using a number of different devices and used to deliver biomechanical biofeedback. Inertial based sensing biofeedback is the most widely researched biomechanical biofeedback method, with a number of studies showing it to be effective in improving measures of balance in a number of populations. Other types of biomechanical biofeedback include force plate systems, electrogoniometry, pressure biofeedback and camera based systems however the evidence for these is limited. Biofeedback is generally delivered using visual displays, acoustic or haptic signals, however more recently virtual reality (VR) or exergaming technology have been used as biofeedback
Lee, Hackman Hon Yin; Scott, David
Effective management of building maintenance is a vital ingredient in ensuring a high quality built environment for any building's occupiers. However, maintenance is not high on the list of priorities for most organisations. Communication between top management personnel looking at maintenance issues from a strategic standpoint and maintenance staff considering them at an operational level is often not as good as it should be. When planning maintenance activities maintenance personnel often draw too heavily on their technical experience and expertise without taking sufficient account of wider organisational objectives or consulting effectively with top management. Senior managers also regularly complain about lack of managerial input from maintenance departments. Such barriers contribute to communication difficulties between top management at a strategic level and maintenance personnel at an operational level. Identifying where the key differences lie in senior managers' and maintenance personnel's viewpoints on maintenance strategy can prove invaluable in achieving some convergence of opinions and optimising the efficiency of the overall building maintenance process.
Full Text Available We have conducted a critical review on the development of rehabilitation robots to identify the limitations of existing studies and clarify some promising research directions in this field. This paper is presented to summarize our findings and understanding. The demands for assistive technologies for elderly and disabled population have been discussed, the advantages and disadvantages of rehabilitation robots as assistive technologies have been explored, the issues involved in the development of rehabilitation robots are investigated, some representative robots in this field by leading research institutes have been introduced, and a few of critical challenges in developing advanced rehabilitation robots have been identified. Finally to meet the challenges of developing practical rehabilitation robots, reconfigurable and modular systems have been proposed to meet the identified challenges, and a few of critical areas leading to the potential success of rehabilitation robots have been discussed.
Gobelet, C; Luthi, F; Al-Khodairy, A T; Chamberlain, M A
Vocational rehabilitation is by definition a multidisciplinary intervention in a process linked to the facilitation of return to work or to the prevention of loss of the work. Clinical staff in contact with a person who has lost his job (general practitioner, specialized physician) must promote vocational rehabilitation. Medical rehabilitation for those with disabilities, whether new or old, has to be followed without delay by vocational rehabilitation. It is even better if these two intertwined processes are overlapping. They involve many professionals including physiotherapists, occupational therapists, psychologists, vocational trainers, job counsellors, teachers, case-managers, job placement agencies. Vocational rehabilitation has a financial cost, borne by many state organizations (security, social system, social affairs) as well as by employers and private insurances, which are in case of accident, concerned by this process. However, the evidence suggests that this is recouped 2- to 10-fold as suggested by the British Society of Rehabilitation Medicine.
... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Rehabilitation facilities... Vocational Rehabilitation and Employment Service 871.208 Rehabilitation facilities. Charges by rehabilitation facilities for the rehabilitation services provided under 38 U.S.C. Chapter 31 are paid in the same manner as...
Izumo, Hironobu; Kato, Tomoaki; Kinase, Masami; Torii, Yoshiya; Murayama, Yoji
JRR-3(Japan Research Reactor No.3) has been operated for more than 15 years after the modification, without significant troubles by carrying out maintenance such as the preventive maintenance (mainly time-based maintenance) for the safety-grade equipments and the breakdown maintenance for the non-safety-grade equipments. Unscheduled shutdowns causes by aged non-safety-grade equipments have been increasing, and the resources such as budgets have been decreasing year by year. In this situation, JRR-3 maintenance program was reviewed about safety, reliability and economic efficiency. This report offers the policy of the maintenance review and the future direction of maintenance programs. (author)
Egan, Mary Y; Kessler, Dorothy; Ceci, Christine; Laliberté-Rudman, Debbie; McGrath, Colleen; Sikora, Lindsey; Gardner, Paula
Following stroke, re-engagement in personally valued activities requires some experience of risk. Risk, therefore, must be seen as having positive as well as negative aspects in rehabilitation. Our aim was to identify the dominant understanding of risk in stroke rehabilitation and the assumptions underpinning these understandings, determine how these understandings affect research and practise, and if necessary, propose alternate ways to conceptualise risk in research and practise. Alvesson and Sandberg's method of problematisation was used. We began with a historical overview of stroke rehabilitation, and proceeded through five steps undertaken in an iterative fashion: literature search and selection; data extraction; syntheses across texts; identification of assumptions informing the literature and; generation of alternatives. Discussion of risk in stroke rehabilitation is largely implicit. However, two prominent conceptualisations of risk underpin both knowledge development and clinical practise: the risk to the individual stroke survivor of remaining dependent in activities of daily living and the risk that the health care system will be overwhelmed by the costs of providing stroke rehabilitation. Conceptualisation of risk in stroke rehabilitation, while implicit, drives both research and practise in ways that reinforce a focus on impairment and a generic, decontextualised approach to rehabilitation. Implications for rehabilitation Much of stroke rehabilitation practise and research seems to centre implicitly on two risks: risk to the patient of remaining dependent in ADL and risk to the health care system of bankruptcy due to the provision of stroke rehabilitation. The implicit focus on ADL dependence limits the ability of clinicians and researchers to address other goals supportive of a good life following stroke. The implicit focus on financial risk to the health care system may limit access to rehabilitation for people who have experienced either milder or
Full Text Available Maintenance activities and pavement rehabilitation require the allocation of massive finances. Yet due to budget shortfalls, stakeholders and decision-makers must prioritize projects in maintenance and rehabilitation. This article addresses the prioritization of pavement maintenance alternatives by integrating the fuzzy analytic hierarchy process (AHP with the VIKOR method (which stands for ‘VlseKriterijumska Optimizacija I Kompromisno Resenje,’ meaning multi-criteria optimization and compromise solution for the process of multi-criteria decision analysis (MCDA by considering various pavement network indices. The indices selected include the pavement condition index (PCI, traffic congestion, pavement width, improvement and maintenance costs, and the time required to operate. In order to determine the weights of the indices, the fuzzy AHP is used. Subsequently, the alternatives’ priorities are ranked according to the indices weighted with the VIKOR model. The choice of these two independent methods was motivated by the fact that integrating fuzzy AHP with the VIKOR model can assist decision makers with solving MCDA problems. The case study was conducted on a pavement network within the same particular region in Tehran; three main streets were chosen that have an empirically higher maintenance demand. The most significant factors were evaluated and the project with the highest priority was selected for urgent maintenance. By comparing the index values of the alternative priorities, Delavaran Blvd. was revealed to have higher priority over the other streets in terms of maintenance and rehabilitation activities. Keywords: Maintenance and rehabilitation prioritization, Fuzzy analysis hierarchy process, VIKOR model, Pavement condition index, Multi-criteria decision analysis
Federal Laboratory Consortium — The Center for Rehabilitation Sciences Research (CRSR) was established as a research organization to promote successful return to duty and community reintegration of...
Rodriguez, Ricardo M
Geriatric patients present multiple age-related challenges and needs that must be taken into account during the rehabilitation process to achieve expected goals. This article examines the importance of identifying and managing psychosocial issues commonly observed in older adults and presents strategies to optimize their rehabilitation process. Depression, anxiety, fear of falling, adjustment issues, neurocognitive disorders, and caregiver support are discussed as a selection of factors that are relevant for geriatric patients undergoing rehabilitation. An argument is made for the importance of comprehensive geriatric assessment in older adults to identify salient issues that may impact rehabilitation and quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.
Life Management is based on the detection, monitoring and control of long-term degradation that affects individual plant components and important populations. Experience has shown that in many cases current maintenance practices do not attend to ageing directly; instead they deal with the consequences when it is already too late, when good Life Management is no longer practical. This has brought about the need for specific Maintenance Evaluation and Improvement Programmes to adjust to the basic objective of Life Management which is to project against, monitor and mitigate ageing that can affect the safe and profitable operating life of the facility. New regulatory requirements for ageing monitoring and effective maintenance to ensure safety (Maintenance Rule) have made it even more necessary to implement the Maintenance Evaluation Programme to cope with ageing, and to integrate that tasks in both programmes to optimise effort and use of tools. This paper presents a brief description of the objectives and methodologies of these Programmes which has been applied to plants around the world and in Spain at the Garona and Vandellos II plants in Spain as part of the PIE project for developing a Remanent Life Evaluation System for nuclear power plants. (Author)
Full Text Available Visuospatial neglect due to right hemisphere damage, usually a stroke, is a major cause of disability, impairing the ability to perform a whole range of everyday life activities. Conventional and long-established methods for the rehabilitation of neglect like visual scanning training, optokinetic stimulation or limb activation training have produced positive results, with varying degrees of generalisation to (untrained tasks lasting from several minutes up to various months after training. Nevertheless, some promising novel approaches to the remediation of left visuo-spatial neglect have emerged in the last decade. These new therapy methods can be broadly classified into 4 categories. First, non-invasive brain stimulation techniques by means of transcranial magnetic stimulation (TMS or transcranial direct current stimulation (tDCS, after a period of mainly diagnostic utilization, are increasingly applied as neurorehabilitative tools. Second, two classes of drugs, dopaminergic and noradrenergic, have been investigated for their potential effectiveness in rehabilitating neglect. Third, prism adaptation treatment has been shown to improve several neglect symptoms consistently, sometimes during longer periods of time. Finally, virtual reality technologies hold new opportunities for the development of effective training techniques for neglect. They provide realistic, rich and highly controllable training environments. In this paper the degree of effectiveness and the evidence gathered to support the therapeutic claims of these new approaches is reviewed and discussed. The conclusion is that for all these approaches there still is insufficient unbiased evidence to support their effectiveness. Further neglect rehabilitation research should focus on the maintenance of therapy results over time, on a more functional evaluation of treatment effects, on the design and execution of true replication studies and on the exploration of optimal combinations of
Pawsey, M. R.
Australian methods and formulas for funding building maintenance and management are outlined and found to be haphazard. Discussed are: ultimate costs of deferred maintenance, major plant replacements, life cycle costing, types of maintenance programs (including full preventive maintenance), use of computer programs for planning, and organization…
Biefang, S; Potthoff, P
Diagnostics and evaluation in medical rehabilitation should be based on methods that are as objective as possible. In this context quantitative methods are an important precondition. We conducted for the German Pensions Insurance Institutions (which are in charge of the medical and vocational rehabilitation of workers and employees) a survey on assessment methods for rehabilitation which included an evaluation of American literature, with the aim to indicate procedures that can be considered for adaptation in Germany and to define further research requirements. The survey identified: (1) standardized procedures and instrumented tests for the assessment of musculoskeletal, cardiopulmonary and neurophysiological function; (2) personality, intelligence, achievement, neuropsychological and alcoholism screening tests for the assessment of mental or cognitive function; (3) rating scales and self-administered questionnaires for the assessment of Activities of Daily Living and Instrumental Activities of Daily Living (ADL/IADL Scales); (4) generic profiles and indexes as well as disease-specific measures for the assessment of health-related quality of life and health status; and (5) rating scales for vocational assessment. German equivalents or German versions exist only for a part of the procedures identified. Translation and testing of Anglo-Saxon procedures should have priority over the development of new German methods. The following procedures will be taken into account: (a) instrumented tests for physical function, (b) IADL Scales, (c) generic indexes of health-related quality of life, (d) specific quality of life and health status measures for disorders of the circulatory system, metabolic system, digestive organs, respiratory tract and for cancer, and (e) vocational rating scales.
Izquierdo, J.J.; Chauvire, P.; Plessis, L.
Maintenance in the modern commercial reprocessing plants is a subject of the highest priority in order to guarantee availability for the whole life of the plant. The design concept of the UP3 reprocessing plant at La Hague identified several categories of equipment according to their maintenance design principles. Among them, Standard Process Equipment such as pumps, valves, ejectors and filters which need periodic maintenance. These equipment items are designed in removable modular form to avoid the need to disconnect piping. Removal is performed under shielding and without breach of containment through the use of a transfer cask that is connected to the cell containing the equipment to be removed. This transfer cask is called MERC (Mobile Equipment Replacement Cask). Containment is preserved by an air-tight system consisting of coupled doors, with a special connecting gasket. This system can remove and replace failed equipment, without spreading contamination to work areas. (author)
Kammerer, Catherine C.
Journal article about Reliability Centered Maintenance (RCM) methodologies used by United Space Alliance, LLC (USA) in support of the Space Shuttle Program at Kennedy Space Center. The USA Reliability Centered Maintenance program differs from traditional RCM programs because various methodologies are utilized to take advantage of their respective strengths for each application. Based on operational experience, USA has customized the traditional RCM methodology into a streamlined lean logic path and has implemented the use of statistical tools to drive the process. USA RCM has integrated many of the L6S tools into both RCM methodologies. The tools utilized in the Measure, Analyze, and Improve phases of a Lean Six Sigma project lend themselves to application in the RCM process. All USA RCM methodologies meet the requirements defined in SAE JA 1011, Evaluation Criteria for Reliability-Centered Maintenance (RCM) Processes. The proposed article explores these methodologies.
Bisio, R.; Hulsund, J. E.; Nilsen, S.
The maintenance of operating procedures in a NPP is a tedious and complicated task. Through the whole life cycle of the procedures they will be dynamic, 'living' documents. Several aspects of the procedure must be considered in a revision process. Pertinent details and attributes of the procedure must be checked. An organizational structure must be created and responsibilities allotted for drafting, revising, reviewing and publishing procedures. Available powerful computer technology provides solutions within document management and computerisation of procedures. These solutions can also support the maintenance of procedures. Not all parts of the procedure life cycle are equally amenable to computerized support. This report looks at the procedure life cycle in todays NPPs and discusses the possibilities associated with introduction of computer technology to assist the maintenance of procedures. (Author)
Luk, C.H.; Jette, M.A.
The maintenance of a distributed software system in a production environment involves: (1) maintaining software integrity, (2) maintaining and database integrity, (3) adding new features, and (4) adding new systems. These issues will be discussed in general: what they are and how they are handled. This paper will present our experience with a distributed resource management system that accounts for resources consumed, in real-time, on a network of heterogenous computers. The simulated environments to maintain this system will be presented relate to the four maintenance areas.
This lecture precises the method and means developed by EDF to ensure the training of maintenance personnel according to their initial educational background and their experience. The following points are treated: General organization of the training for maintenance personnel in PWR and GCR nuclear power stations and in Creys Malville fast breeder reactor; Basic nuclear training and pedagogical aids developed for this purpose; Specific training and training provided by contractors; complementary training taking into account the operation experience and feedback; Improvement of velocity, competence and safety during shut-down operations by adapted training. (orig.)
Full Text Available In the IBS building maintenance, the conventional methods to the project delivery and its failure to form effective communication channel between complementary knowledge on IBS construction and related members that is conducted in the sequential manner has resulted in ineffectiveness for managing building maintenance, where a paradigm shift within the IBS traditional approach is necessary. The research results described are concerned with i an integrated system to record, diagnose and analyse information for IBS building maintenance to detect patent or latent defect, select an effective repair method, provide appropriate planning decision and reduce risks of defect throughout the building lifetime. ii building a decision making support in diagnosis in IBS building maintenance based on robust data collection about concrete defects and causes including in the selection of a durable replacement design and material or the proper rehabilitation method. The system development was based on analysis of number of interviews and case studies conducted with professional engineers working in IBS building maintenance departments. The paper concludes that implementing a CMMS Expert using BIM can help improve the performance of IBS building design, construction and maintenance operations.
... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; List of... Addressed: Maintenance of State Financial Support [cir] Office of Special Education Programs Memorandum 10-5... special education and related services. Topic Addressed: Children in Private Schools [cir] Letter dated...
Pipe rehabilitation and trenchless pipe replacement technologies have seen a steady increase in use over the past 30 to 40 years and represent an increasing proportion of the approximately $25 billion annual expenditure on operations and maintenance of the nation’s water and wast...
The deployment of trenchless pipe rehabilitation technologies steadily increased over the past 30 to 40 years and continue to represent a growing proportion of the approximately $25 billion annual expenditure on operations and maintenance of the nation’s water and wastewater infr...
Dobkin, Bruce H
Rehabilitation after hemiplegic stroke has typically relied on the training of patients in compensatory strategies. The translation of neuroscientific research into care has led to new approaches and renewed promise for better outcomes. Improved motor control can progress with task-specific training incorporating increased use of proximal and distal movements during intensive practice of real-world activities. Functional gains are incorrectly said to plateau by 3-6 months. Many patients retain latent sensorimotor function that can be realised any time after stroke with a pulse of goal-directed therapy. The amount of practice probably best determines gains for a given level of residual movement ability. Clinicians should encourage patients to build greater strength, speed, endurance, and precision of multijoint movements on tasks that increase independence and enrich daily activity. Imaging tools may help clinicians determine the capacity of residual networks to respond to a therapeutic approach and help establish optimal dose-response curves for training. Promising adjunct approaches include practice with robotic devices or in a virtual environment, electrical stimulation to increase cortical excitability during training, and drugs to optimise molecular mechanisms for learning. Biological strategies for neural repair may augment rehabilitation in the next decade.
Barzilay, Ouriel; Wolf, Alon
In conventional neuromuscular rehabilitation, patients are required to perform biomechanical exercises to recover their neuromotor abilities. These physiotherapeutic tasks are defined by the physiotherapist, according to his estimate of the patient's pathologic neuromotor function. The definition of the task is mainly qualitative and it is often merely demonstrated to the patient as a gesture to reproduce. Success of the treatment relies then on the accuracy and repetition of the motor training. We propose a novel approach to neuromotor training by combining the advantages of a virtual reality platform with biofeedback information on the training subject from biometric equipment and with the computational power of artificial neural networks. In a calibration stage, the subject performs motor training on a known task to train the network. Once trained, the tuned network generates a new patient-specific task, based on the definition of the subject's expected performance dictated by the therapist. The system was tested for upper limb rehabilitation on healthy subjects. We measured a 33% improvement in the triceps performance (p = 0.027). The novelty of the proposed approach lies in its use of learning systems to the estimation of biological models. Copyright © 2012 Elsevier Ltd. All rights reserved.
Langhorne, P.; Bernhardt, J.; Kwakkel, G.
Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially
Baili, Paolo; Hoekstra-Weebers, Josette; Van Hoof, Elke; Bartsch, Hans Helge; Travado, Luzia; Garami, Miklos; Di Salvo, Francesca; Micheli, Andrea; Veerus, Piret
Little is known of cancer rehabilitation needs in Europe. EUROCHIP-3 organised a group of experts to propose a list of population-based indicators used for describing cancer rehabilitation across Europe. The aim of this study is to present and discuss these indicators. A EUROCHIP-3 expert panel
Martin, R.S.; Austin, D.G.
The design of today's nuclear generating plants involves many detailed design considerations. This includes comprehensive look at aging effects on plant components over their expected lifetimes. This is important to ensuring that the plant operates safely throughout its life. The effects of aging are required to be documented in detail in today's designs. This documentation provides assurance that safe operating conditions are maintained throughout the station life cycle. This requirement is analogous to the longer standing requirement to ensure pressure boundary integrity. The pressure boundary integrity requirement has existed in the industry since its inception. The subject of plant aging effects and the maintenance of functionality is known as Environmental Qualification (EQ). This paper will attempt to explain the wisdom of EQ and the potential for optimizing maintenance activities (to move from reactive to proactive activities), within the context of the overall maintenance program. It is the author's intent to encourage the active involvement of maintenance professionals in the effective implementation of the ongoing EQ program so that the benefits are maximized
variable Z; P-6 BIBLIOGRAPHY Argentine Air Force. Reglamento de Conduction Logistica RAC 9 (Logistics Management Regulation). Estado Mayor General de ...other hand, too many resources are expensive to acquire and maintain and difficult to transport . 1-1 Sizing the means needed to accomplish its...functional areas (maintenance, supply/inventory, transportation , etc), methodologies of operations research (simulation, mathematical programming
The traditional approach to preventive maintenance (PM) is based on adherence to manufacturers's requirements and recommended frequencies. When equipment fails, either new procedures are established or the frequency is increased. This leads to an increase in the number of PM activities, overloading not only maintenance resources, but support as well. There is no correlation between more PM and an increase in equipment reliability. More PM may actually induce failures. Reliability-centered maintenance, a new concept in utility maintenance, is based on identifying system/subsystem functions, failures, and dominant failure modes to develop or revise PM tasks. The activities described in this paper are based on actual implementation of this concept on an ongoing project to upgrade the PM program at one of the largest electric utilities in the country. Optimum PM activities are those that, when implemented, will minimize factors that c cause equipment to fail. One technique described illustrates how equipment performance, failure modes, and causes can be related to minimize the occurrence of failures. Operating history and service life of a component are key factors in determining the most effective PM activities, provided that the factors are related to failure modes and causes
Post Office Dept., Washington, DC.
Guidelines, methods and policies regarding the care and maintenance of post office building floors are overviewed in this handbook. Procedures outlined are concerned with maintaining a required level of appearance without wasting manpower. Flooring types and characteristics and the particular cleaning requirements of each type are given along with…
Flooring for institutional, commercial, and industrial use is described with regard to its selection, care, and maintenance. The following flooring and subflooring material categories are discussed--(1) resilient floor coverings, (2) carpeting, (3) masonry floors, (4) wood floors, and (5) "formed-in-place floors". The properties, problems,…
Campbell, J.J.; Zimmerman, C.M.
This paper describes a systematic approach to upgrading nuclear power plant maintenance procedures. The approach consists of four phases: diagnosis, program planning, program implementation, and program evaluation. Each phase is explained as a series of steps to ensure that all factors in a procedure upgrade program are considered
Equipment that is often unique, machines that are as old as the Laboratory, continuous and demanding performance requirements: these are the challenges faced by CERN’s accelerator maintenance teams. There are some twenty such teams, attached to different departments. A new project aims to standardise their procedures to make their work easier, and you can be a part of it. “For the past year or so, the Accelerator and Technologies Sector and the GS Department have been working together on identifying the needs of the different teams that perform maintenance on CERN’s equipment. We are now ready to provide computer support with detailed specifics about the processes that need to be set up,” explains Goran Perinić, one of the leaders in CERN’s new Maintenance Management project (MMP). Since the LHC entered operation, the responsibilities of the technical teams have been broadened to cover maintenance of the collider and that of its injectors...
railway infrastructure manager (InfraMan), whichis subcontracting maintenance tasks to other companies. InfraMan has implemented various central elements in managing their subcontractors. The latter are required to present a safety plan as part of their bid, they must be approved if they are to be awarded...
This Operations and Maintenance (O and M) Philosophy document is intended to establish a future O and M vision, with an increased focus on minimizing worker exposure, ensuring uninterrupted retrieval operations, and minimizing operation life-cycle cost. It is intended that this document would incorporate O and M lessons learned into on-going and future project upgrades
PARA 2 -104)) 44: (( JETCAL ANALYSIS SHOWS SYSTEM READS CORRECT) (REPLACE FAULTY PARTS)) 45: ((OVERTEMP EXCEEDED SERVICE LIMITS) 46: I(ENGINE CONTROL...CIRCUITS WITHIN LIMITS ON JETCAL ) (REPLACE FAULTY PARTS)) 47: (ADJUST EST AT AMPLIFIER AND CHECK TENP)) (SEND ENGINE TO HIGHER LEVEL MAINTENANCE)) 48: 2
Urgent maintenance work on CERN telephone exchanges will be performed on 24 March from 6 a.m. to 8 a.m. Telephone services may be disrupted or even interrupted during this time. For more details, please contact us by email at Standard.Telephone@cern.ch.
Washington TRU Solutions
This procedure provides instructions for performing inner containment vessel (ICV) and outer containment vessel (OCV) maintenance and periodic leakage rate testing on the following packaging seals and corresponding seal surfaces using a nondestructive helium (He) leak test. In addition, this procedure provides instructions for performing ICV and OCV structural pressure tests
Ballard, J. Barry; Burdette, Clarence E.
Presents two viewpoints on the question of using funding from the Vocational Education Act to maintain ongoing vocational programs. Ballard argues that programs have improved qualitatively because of additional program improvement monies, whereas Burdette argues that the ban on using funds for maintenance treats some states unfairly. (CH)
Kuhl, K.; Terwoert, J.; Cabecas, J.J.M.
Maintenance workers come into close contact with a broad variety of often hazardous chemicals. Depending on the specific type, these chemicals may not only cause diseases like skin sores or cancer, but many of them are highly flammable and explosive. This e-facts focuses on the specific risks
Fischer, Joseph; Messier, Joseph
Building maintenance is a basic two-year trade education course requiring 2 1/2 hours of study on each of 160 teaching days per year. Student abilities should range from those capable of the simplest custodial work to those who may eventually be superintendents of building complexes. The syllabus is organized in sections by traditional skills…
Description of the main regulations concerning the processes tied with maintenance and in service supervision of the pressure vessels in classical or nuclear power plants or of their accessories (essentially in order to fix the time-table of the hydraulic test procedures and the inspection chronology [fr
Antoni Jaume i Capó
Full Text Available Research studies show that serious games help to motivate users in rehabilitation processes, and rehabilitation results are better when users are motivated. In long term rehabilitation for maintaining capacities, the demotivation of chronic patients is common. In this work, we have implemented balance rehabilitation video game for cerebral palsy patients. The video game was developed using the prototype development paradigm and following desirable features for rehabilitation serious games presented in the literature. We have tested the video game with a set of users who abandoned therapy due to demotivation in the previous year. Results show that the set of users improved their balance and motivation.
Bloodworth, Donna; Pandit, Sindhu; Mullan, Patrick; Chiou-Tan, Faye
Rehabilitation traumatology has developed within the field of physical medicine and rehabilitation as a specialized area of knowledge in which the physiatrist works with the traumatology team to enhance the functional outcome of trauma patients. Based on the definition of traumatology in the American Heritage Dictionary, the authors propose rehabilitation traumatology be "the branch of medicine that deals with the treatment of serious wounds, injuries, and disabilities," "to restore [the patient] to good health or useful life." This article reviews the history of traumatology, special considerations of the traumatology patient through the continuum of care, and concepts toward the creation of a rehabilitation traumatology program. V. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Full Text Available Background: Sustainable development is about reaching a balance between economic, social, and environmental goals, as well as people's participation in the planning process in order to gain their input and support. For a company, sustainable development means adoption of such business strategy and actions that contribute to satisfying present needs of company and stakeholders, as well as simultaneous protection, maintenance and strengthening of human and environmental potential which will be needed in the future. This new approach forces manufacturing companies to change their previous management paradigms. New management paradigm should include new issues and develop innovative methods, practices and technologies striving for solving problem of shortages of resources, softening environment overload and enabling development of environment-friendly lifecycle of products. Hence, its realization requires updating existing production models as they are based on previously accepted paradigm of unlimited resources and unlimited regeneration capabilities. Maintenance plays a crucial role because of its impact on availability, reliability, quality and life cycle cost, thus it should be one of the main pillars of new business running model. Material and methods: The following paper is a result of research on the literature and observation of practices undertaken by a company within maintenance area. Results and conclusions: The main message is that considering sustainable manufacturing requires considerable expanding range of analysis and focusing on supporting processes. Maintenance offers numerous opportunities of decreasing influence of business processes on natural environment and more efficient resources utilization. The goal of maintenance processes realizing sustainable development strategy is increased profitability of exploitation and optimization of total lifecycle cost without disturbing safety and environmental issues.
The maintenance of systems, structures and components in nuclear power plants (NPPs) plays an important role in assuring their safe and reliable operation. Worldwide, NPP maintenance managers are seeking to reduce overall maintenance costs while maintaining or improving the levels of safety and reliability. Thus, the issue of NPP maintenance is one of the most challenging aspects of nuclear power generation. There is a direct relation between safety and maintenance. While maintenance alone (apart from modifications) will not make a plant safer than its original design, deficient maintenance may result in either an increased number of transients and challenges to safety systems or reduced reliability and availability of safety systems. The confidence that NPP structures, systems and components will function as designed is ultimately based on programmes which monitor both their reliability and availability to perform their intended safety function. Because of this, approaches to monitor the effectiveness of maintenance are also necessary. An effective maintenance programme ensures that there is a balance between the improvement in component reliability to be achieved and the loss of component function due to maintenance downtime. This implies that the safety level of an NPP should not be adversely affected by maintenance performed during operation. The nuclear industry widely acknowledges the importance of maintenance in NPP safety and operation and therefore devotes great efforts to develop techniques, methods and tools to aid in maintenance planning, follow-up and optimization, and in assuring the effectiveness of maintenance
Rice, Danielle; Janzen, Shannon; McIntyre, Amanda; Vermeer, Julianne; Britt, Eileen; Teasell, Robert
Few studies have considered the effectiveness of outpatient rehabilitation programs for stroke patients. The objective of this study was to assess the effectiveness of a hospital-based interdisciplinary outpatient stroke rehabilitation program with respect to physical functioning, mobility, and balance. The Comprehensive Outpatient Rehabilitation Program provides a hospital-based interdisciplinary approach to stroke rehabilitation in Southwestern Ontario. Outcome measures from physiotherapy and occupational therapy sessions were available at intake and discharge from the program. A series of paired sample t-tests were performed to assess patient changes between time points for each outcome measure. A total of 271 patients met the inclusion criteria for analysis (56.1% male; mean age = 62.9 ± 13.9 years). Significant improvements were found between admission and discharge for the Functional Independence Measure, grip strength, Chedoke-McMaster Stroke Assessment, two-minute walk test, maximum walk test, Timed Up and Go, Berg Balance Scale, and one-legged stance (P rehabilitation program was effective at improving the physical functioning, mobility, and balance of individuals after a stroke. A hospital-based, stroke-specific rehabilitation program should be considered when patients continue to experience deficits after inpatient rehabilitation. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
For the last two decades, rehabilitation of corrosion damaged concrete structures has been one of the most important challenges faced by the construction industry throughout the world. The extent of the damage is significant in cold climates and also in hot and humid climates. In both cases, the corrosion is invariably initiated by ingress of salts into the concrete either from de-icing salts used on roads, or from salt-laden air, soils or ground water. However, there is a contrast in sites of distress in the two climatic regions mentioned above. In cold climates, where de-icing salts are used, the damage is generally to superstructures and is therefore visible, but in hot, humid coastal regions damage is primarily in the substructures and may not be so clearly apparent. This paper presents the corrosion mechanism in concrete deterioration, the methods of evaluation of the damaged structures, and rehabilitation strategies. A case history of a concrete rehabilitation project is included together with some lessons learned in rehabilitation of corrosion damaged structures. Recommendations are made for maintenance of concrete structures and a warning is issued that salt run-off from roads in cold climates may cause distress in below ground concrete structures, similar to structures in hot and humid climates with saline groundwater and soils. (author)
Rachmad Hidayat; Nachnul Ansori; Ali Imron
Maintenance Activity Planning by Reability Centered Maintenance (RCM) II Method. This research discussmaintenance activity by using RCM II method to determine failure function risk at compresor screw. Calculation isgiven to magnitude optimum time maintenance interval by considering the cost maintenance and the cost reparation.From the research results with RPN points out that critical component that needs to get main priority in givemaintenance on compresor screw are bust logistic on timeworn...
Au-Yong Cheong Peng
Full Text Available In high-rise residential buildings, the quality of facilities management services is significant to the normal operation of the facilities. Unfortunately, lack of concern towards building maintenance, especially preventive maintenance, happens in domestic housing industry in Malaysia. Majority of the maintenance operations of condominiums suffer from lack of planning, lack of proactive maintenance plan, and lack of proper implementation. Thus, this paper reviews the implementation of preventive maintenance strategy, routine maintenance in specific. An extensive review of literature published in 1987 to 2014 is performed for the purpose of this research. The publications are sourced from journal articles, conference proceedings and books. The literature analysis confirms that the routine maintenance of facilities and building services is vital and it can be influential towards the maintenance performance. Subsequently, a theoretical framework is developed, which shows the relationship between routine maintenance of building facilities & services and maintenance performance. The building facilities & services are divided into two categories. They are essential facilities & services that ensure the safety, health, habitability, and operability of buildings; while value-added facilities & services deal with property value, return on investment, and quality living of buildings. Based on the findings, a future research is proposed, which aims to identify the appropriate routine of maintenance for the facilities and services in high-rise residential buildings to improve the maintenance performance.
Full Text Available Stroke is one of the major problems in medical and healthcare that can cause severe disability and death of patients especially for older population. Rehabilitation plays an important role in stroke therapy. However, most of the rehabilitative exercises are monotonous and tiring for the patients. For a particular time, they can easily get bored in doing these exercises. The role of patient’s motivation in rehabilitation is vital. Motivation and rehabilitative outcomes are strongly related. Digital games promise to help stroke patients to feel motivated and more engaged in rehabilitative training through motivational gameplay. Most of the commercial games available in the market are not well-designed for stroke patients and their motivational needs in rehabilitation. This study aims at understanding the motivational requirements of stroke patients in doing rehabilitative exercises and living in a post-stroke life. Based on the findings from the literature review, we report factors that can influence the stroke patients’ level of motivation such as social functioning, patient-therapist relationship, goal-setting, and music. These findings are insightful and useful for ideating and designing interactive motivation-driven games for stroke patients. The motivational factors of stroke patients in rehabilitation may help the game designers to design motivation-driven game contexts, contents, and gameplay. Moreover, these findings may also help healthcare professionals who concern stroke patient’s motivation in rehabilitative context. In this paper, we reported our Virtual Nursing Home (VNH concept and the games that we are currently developing and re-designing. Based on this literature review, we will present and test out the ideas how we can integrate these motivational factors in our future game design, development, and enhancement.
N. V. Galtseva
Full Text Available At the present time effectiveness of rehabilitation programs after heart surgery, myocardial infarction, and in some cases for coronary artery disease (CAD is undeniable. According to the researches, physical exercises, which underlie cardio rehabilitation of patients with CAD, reduce cardiac mortality. In the review accumulated scientific data about modern approaches to cardio rehabilitation is discussed: goals, indications, contraindications, its organization, advantages. Controlled training in patients with CAD, making a complex program of cardio rehabilitation, kinds of control during cardio training are described in details. In this review the second phase of physical rehabilitation after cardiac surgery – a stationary phase, protocols of which are subjective and often contested, is considered. More frequently physical rehabilitation after coronary artery bypass surgery is doing breathing exercises, as there is data that physical exercises, in which tangential force vector in or around the sternum appears, should be avoided for at least 3 months after surgery. On the other hand, avoiding of heaving during the first weeks after surgery leads to more pronounced atrophy of the chest muscles. But there is data, according to which, early beginning of an adapted program of cardio rehabilitation (1–2 weeks after surgery is safely, it accelerates recovery and does not increase problems with the sternum. In this review the following idea is suggested: in order to follow the stages of rehabilitation after cardiac surgery it is necessary to start it on the stationary stage, and control of load rehabilitation programs must be carried out using hemodynamic changes during exercises, energy, SF-36 questionnaire.
Dean, B; Rombos, P [Wardrop (W.L.) and Associates Ltd., Winnipeg, MB (Canada)
Two methodologies for maintenance task selection, Reliability Centre Maintenance (RCM) and Degradation Mode Analysis (DMA), are compared with regard to application in the nuclear industry and potential for application at CANDU nuclear power plants. RCM is the favoured one of the two methodologies. It is more thorough than DMA, is well supported within the US nuclear industry, and - with experience in application - is gaining cost effectiveness. There is interest in the use of RCM in other nations, including France and Japan, and it is already being implemented at Bruce A NGS and Bruce B NGS in Canada. DMA lags behind RCM in development and currently there is little experience to support claims of major benefits at reduced cost. Significant advantages over RCM need to be demonstrated if DMA is to gain acceptance in the nuclear industry. (author). 41 refs., 7 tabs., 8 figs.
Dean, B.; Rombos, P.
Two methodologies for maintenance task selection, Reliability Centre Maintenance (RCM) and Degradation Mode Analysis (DMA), are compared with regard to application in the nuclear industry and potential for application at CANDU nuclear power plants. RCM is the favoured one of the two methodologies. It is more thorough than DMA, is well supported within the US nuclear industry, and - with experience in application - is gaining cost effectiveness. There is interest in the use of RCM in other nations, including France and Japan, and it is already being implemented at Bruce A NGS and Bruce B NGS in Canada. DMA lags behind RCM in development and currently there is little experience to support claims of major benefits at reduced cost. Significant advantages over RCM need to be demonstrated if DMA is to gain acceptance in the nuclear industry. (author). 41 refs., 7 tabs., 8 figs
Gullett, C. C.
The health maintenance program for commercial flight crew personnel includes diet, weight control, and exercise to prevent heart disease development and disability grounding. The very high correlation between hypertension and overweight in cardiovascular diseases significantly influences the prognosis for a coronary prone individual and results in a high rejection rate of active military pilots applying for civilian jobs. In addition to physical fitness the major items stressed in pilot selection are: emotional maturity, glucose tolerance, and family health history.
Pasman, W.J.; Saris, W.H.M.; Westerterp-Plantenga, M.S.
Objective: To obtain predictors of weight maintenance after a weight-loss intervention. Research Methods and Procedures: An overall analysis of data from two-long intervention studies [n = 67 women; age: 37.9±1.0 years; body weight (BW): 87.0±1.2 kg; body mass index: 32.1±0.5 kg·m-2; % body fat:
Maintenance is an important economic activity, it can represent up to 40% of operating costs in some fabrication units. The opening of energy markets to competition has led main operators to center their activities on their basis business and to sub-contract subsidiary activities. Subcontracting with strong engagements from the sub-contractor about results, time allowed and costs is now currently applied in nuclear industry. (A.C.)
The evolution of the computer has and continues to have a great impact on industry. We are in an adjustment cycle with the current computer evolution, and will need to adapt to make the changes for the coming decade. Hardware and software are continually being enhanced. Computers are becoming more powerful and will eventually provide an effective man-machine interface. This paper shares experiences encountered during implementations of computerized maintenance systems
Murthy, D.N.P.; Karim, M.R.; Ahmadi, A.
Most businesses view maintenance as tasks carried out by technicians and the data collected is mostly cost related. There is a growing trend towards outsourcing of maintenance and the data collection issues are not addressed properly in most maintenance service contracts. Effective maintenance management requires proper data management - data collection and analysis for decision-making. This requires a proper framework and when maintenance is outsourced it raises several issues and challenges. The paper develops a framework for data management when maintenance is outsourced and looks at a real case study that highlights the need for proper data management. - Highlights: • Framework for data management in maintenance outsourcing. • Black-box to grey-box approaches for modelling. • Improvements to maintenance decision-making. • Case study to illustrate the approaches and the shortcomings in data collection
The purpose of this study was to evaluate Virginia's maintenance management system and to recommend modifications directed at improving it. The study revealed that (1) the current system of allocating maintenance monies is based upon centerline milea...
Hansen, Henrik; Bieler, Theresa; Beyer, Nina
BACKGROUND: Rehabilitation of patients with chronic obstructive pulmonary disease (COPD) is a key treatment in COPD. However, despite the existing evidence and a strong recommendation from lung associations worldwide, 50% of patients with COPD decline to participate in COPD rehabilitation program......, symptoms, anxiety and depression symptoms, disease specific and generic quality of life. Primary endpoint is 10/12 weeks from baseline, while secondary endpoints are 22, 36, 62 weeks from baseline assessments. DISCUSSION: The study will likely contribute to knowledge regarding COPD tele...... accessibility and compliance. The aim of this multicenter RCT study is to compare the potential benefits of a 10-week online COPD rehabilitation program (CORe) with conventional outpatient COPD rehabilitation (CCRe). METHODS: This study is a randomized assessor- and statistician blinded superiority multicenter...
Perez-Terzic, Carmen; Childers, Martin K
Modern rehabilitation medicine is propelled by newfound knowledge aimed at offering solutions for an increasingly aging population afflicted by chronic debilitating conditions. Considered a core component of future health care, the rollout of regenerative medicine underscores a paradigm shift in patient management targeted at restoring physiologic function and restituting normative impact. Nascent regenerative technologies offer unprecedented prospects in achieving repair of degenerated, diseased, or damaged tissues. In this context, principles of regenerative science are increasingly integrated in rehabilitation practices as illustrated in the present Supplement. Encompassing a growing multidisciplinary domain, the emergent era of "regenerative rehabilitation" brings radical innovations at the forefront of healthcare blueprints.
Kungl, D.; Loesser, D.; Heitzenroeder, P.; Cerdan, G.
TFTR plans to begin D-T experiments in mid 1990. The D-T experimental program will produce approximately one hundred shots, with a neutron generation rate of 10 19 neutrons per shot. This will result in high levels of activation in TFTR, especially in the vacuum vessel. The primary purpose of the Maintenance Manipulator is to provide a means of remotely performing certain defined maintenance and inspection tasks inside the vacuum torus so as to minimize personnel exposure to radiation. The manipulator consists of a six-link folding boom connected to a fixed boom on a movable carriage. The entire manipulator is housed in a vacuum antechamber connected to the vacuum torus, through a port formerly used for a vacuum pumping duct. The configuration extends 180 0 in either direction to provide complete coverage of the torus. The four 3500 l/s turbopumps which were formerly used in the pumping duct will be mounted on the antechamber. The manipulator will utilize two end effectors. The first, called a General Inspection Arm (GIA) provides a movable platform to an inspection camera and an in-vacuum leak detector. The second is a bilateral, force-reflecting pair of slave arms which utilize specially developed tools to perform several maintenance functions. All components except the slave arms are capable of operating in TFTR's vacuum environment and during 150 0 C bakeout of the torus. (orig.)
Zaiss, W.; Reuschle, K.; Baier, B.
The increasingly more expensive maintenance measures, cuts in the cost budget, and the loss of know-how on the part of vendors all require a change of policy with respect to maintenance concepts of the part of operators. This also applies to the existing valve concepts, the drives included. Under these aspects, the current drive, which is self-actuated and actuated by outside media, for a parallel-plate valve of a nomial width of 700 was reconsidered. The effort served to reduce maintenance costs and, at the same time, simplify the drive concept as well as cut back on the number of in-service inspections. Moreover, the number of active components were to be minimized and installation conditions in the plant were to be improved. When the boundary conditions to be observed with respect to process technology had been laid down, the competent technical department developed a concept of modification of the drive. A major constituent part was the demonstration of the functioning capability of the new drive under accident conditions. It was achieved mainly by an analytical approach. In the resultant drive concept, the same control valves are employed to actuate a driving cylinder by means of self-actuation or by an outside medium as a function of pressure. (orig.) [de
Giselle Póvoa Gomes
Full Text Available In implants, maintenance is a decisive factor for obtaining success when implant supported overdentures and dentures are used. The present stud presents, a clinical case of a patient, a 70 year-old white man, with a completely edentulous mandibular alveolar ridge, severe bone resorption with presence of basal bone only, and absence of vestibule. Initially, treatment consisted of the placement of a mandibular overdenture, supported on three implants in the anterior inter-foramen region, as the left implant was transfixed in the basal bone of 2 to 3 millimeters. Eleven years later, another two implants were placed in the anterior area and an immediate load was performed up to the first molars, for the placement of an implant supported fixed. Throughout the entire treatment, meticulous maintenance was carried out, with follow-up for fourteen years, interrupted by the patient’s death. From the third month after the opening the three implants initially placed, the presence of keratinized mucosa, definition of the vestibule, maturation of the alveolar ridge and bone formation in the mento region were observed. It was concluded that good planning, allied to mastery of the technique and adequate maintenance were the prerequisites necessary for obtaining favorable results, success of the present case, and for the patient to have a better quality of life.
Butterworth, G.; Anderson, T.M.
The Westinghouse Nuclear Services Integration Division managed maintenance services are described. Essential to the management and control of a total plant maintenance programme is the development of a comprehensive maintenance specification. During recent years Westinghouse has jointly developed total plant engineering-based maintenance specifications with a number of utilities. The process employed and the experience to date are described. To efficiently implement the maintenance programme Westinghouse has developed a computer software program specifically designed for day to day use at the power plant by maintenance personnel. This program retains an equipment maintenance history, schedules maintenance activities, issues work orders and performs a number of sophisticated analyses of the maintenance backlog and forecast, equipment failure rates, etc. The functions of this software program are described and details of Westinghouse efforts to support the utilities in reducing outage times through development of predefined outage plans for critical report maintenance activities are given. Also described is the experience gained in the training of specialized maintenance personnel, employing competency-based training techniques and equipment mock-ups, and the benefits experienced, in terms of improved quality and productivity of maintenance performed. The success experienced with these methods has caused Westinghouse to expand the use of these training techniques to the more routine skill areas of power plant maintenance. A significant reduction in the operating costs of nuclear power plants will only be brought about by a significant improvement in the quality of maintenance. Westinghouse intends to effect this change by expanding its international service capabilities and to make major investments in order to promote technological developments in the area of power plant maintenance. (author)
.... (Authority: 38 U.S.C. 3100) (c) Rehabilitation to the point of employability has been achieved. The veteran who has been found rehabilitated to the point of employability shall be declared rehabilitated if he... professional knowledge and skills obtained under the rehabilitation plan; or (3) Pursues additional education...
Shoulder-Arm Orthoses Several years ago, the Rehabilitation Engineering Research Center (RERC) on Rehabilitation Robotics in Delaware1 identified a... exoskeletal applications for persons with disabilities. 2. Create a center of expertise in rehabilitation technology transfer that benefits persons with...AD COOPERATIVE AGREEMENT NUMBER: DAMD17-94-V-4036 TITLE: National Rehabilitation Hospital Assistive Technology- Research Center PRINCIPAL
Honeywell, Inc., Minneapolis, Minn.
THIS HONEYWELL PAMPHLET DISCUSSES SOME ASPECTS OF PREVENTIVE MAINTENANCE OF AUTOMATIC CONTROLS, HEATING, VENTILATING, AND AIR CONDITIONING, AND COMPARES IN-PLANT WITH CONTRACT SERVICE, CONCLUDING THAT CONTRACT SERVICE IS PREFERABLE AND DESCRIBING A NUMBER OF MAINTENANCE PLANS WHICH THEY FURNISH. PREVENTIVE MAINTENANCE PROVIDES--(1) MORE EFFICIENT…
Under Australian environmental controls relating to the management of uranium tailings, it is no longer acceptable practice to search for a rehabilitation strategy at the end of production when the generation of tailings has ceased. The uranium projects currently in production and those being proposed are tightly regulated by the authorities. The waste management plans must consider site specific factors and must include selection of appropriate disposal sites and design for long term containment. The final encapsulation in engineered facilities must take into account the probable routes to the environment of the tailings. Rehabilitation shoud be undertaken by the mining and milling operators to standards approved by appropriate authorities. Appropriate administrative arrangements are required, by way of technical committees and financial bonds to ensure that agreed standards of rehabilitation may be achieved. Past and present experience with the rehabilitation of uranium tailings impoundments in Australia is discussed
Feb 16, 1991 ... sion 72,9% of patients were smokers, 26,3% had hypertension and 34,3% had ... Cardiac rehabilitation, including supervised exercise therapy, has become a .... sions on risk factor modification, diet, aspects of heart disease,.
Fode, Mikkel; Ohl, Dana A; Ralph, David
The pathophysiology of erectile dysfunction after radical prostatectomy (RP) is believed to include neuropraxia, which leads to temporarily reduced oxygenation and subsequent structural changes in penile tissue. This results in veno-occlusive dysfunction, therefore, penile rehabilitation programmes...
Lawrence, Maggie; Celestino Junior, Francisco T; Matozinho, Hemilianna Hs; Govan, Lindsay; Booth, Jo; Beecher, Jane
Stroke is a major health issue and cause of long-term disability and has a major emotional and socioeconomic impact. There is a need to explore options for long-term sustainable interventions that support stroke survivors to engage in meaningful activities to address life challenges after stroke. Rehabilitation focuses on recovery of function and cognition to the maximum level achievable, and may include a wide range of complementary strategies including yoga.Yoga is a mind-body practice that originated in India, and which has become increasingly widespread in the Western world. Recent evidence highlights the positive effects of yoga for people with a range of physical and psychological health conditions. A recent non-Cochrane systematic review concluded that yoga can be used as self-administered practice in stroke rehabilitation. To assess the effectiveness of yoga, as a stroke rehabilitation intervention, on recovery of function and quality of life (QoL). We searched the Cochrane Stroke Group Trials Register (last searched July 2017), Cochrane Central Register of Controlled Trials (CENTRAL) (last searched July 2017), MEDLINE (to July 2017), Embase (to July 2017), CINAHL (to July 2017), AMED (to July 2017), PsycINFO (to July 2017), LILACS (to July 2017), SciELO (to July 2017), IndMED (to July 2017), OTseeker (to July 2017) and PEDro (to July 2017). We also searched four trials registers, and one conference abstracts database. We screened reference lists of relevant publications and contacted authors for additional information. We included randomised controlled trials (RCTs) that compared yoga with a waiting-list control or no intervention control in stroke survivors. Two review authors independently extracted data from the included studies. We performed all analyses using Review Manager (RevMan). One review author entered the data into RevMan; another checked the entries. We discussed disagreements with a third review author until consensus was reached. We used
Momsen, A.-M.; Nielsen, C.V.; Rasmussen, J.O.
Objectives: To systematically investigate current scientific evidence about the effectiveness of multidisciplinary team rehabilitation for different health problems. Data sources: A comprehensive literature search was conducted in Cochrane, Medline, DARE, Embase, and Cinahl databases, and research...... for adults, without restrictions in terms of study population or outcomes. The most recent reviews examining a study population were selected. Data extraction: Two reviewers independently extracted information about study populations, sample sizes, study designs, rehabilitation settings, the team...
Lych, G.M.; Babosov, E.M.; Firsakova, S.K.
In the chapter the system of management of socio economical development of contaminated territories in conditions of transition of the republic to market economy is described. The scientific substantiation of the complex programs of rehabilitation of both Bragin and Vetka areas of the Gomel Region is given. The methods of social support and socio psychological rehabilitation of the population having suffered after the Chernobyl accident are offered
Barnes, M P
Head injury is a common disabling condition but regrettably facilities for rehabilitation are sparse. There is now increasing evidence of the efficacy of a comprehensive multidisciplinary rehabilitation team compared to natural recovery following brain injury. This chapter outlines some basic concepts of rehabilitation and emphasises the importance of valid and reliable outcome measures. The evidence of the efficacy of a rehabilitation programme is discussed in some detail. A number of specific rehabilitation problems are outlined including the management of spasticity, nutrition, pressure sores and urinary continence. The increasingly important role of assistive technology is illustrated, particularly in terms of communication aids and environmental control equipment. However, the major long-term difficulties after head injury focus around the cognitive, intellectual, behavioural and emotional problems. The complex management of these disorders is briefly addressed and the evidence of the efficacy of some techniques discussed. The importance of recognition of the vegetative stage and avoidance of misdiagnosis is emphasised. Finally, the important, but often neglected, area of employment rehabilitation is covered.
Ageets, V.Yu.; Kenigsberg, Ya.Eh.; Skurat, V.V.; Tikhonova, L.E.; Shevchuk, V.E.; Ipat'ev, V.A.; Klimova, T.A.
The purpose of the activity is development of the scientific reasonable projects of socio-economic and social-psychological rehabilitation of specific areas and populated localities on the contaminated territories of the both Gomel and Mogilev Regions. The results of economic researches allow to decrease expenses for realization of protective measures, to increase feedback of counter-measures, to speed up process of development of the plans and their realization, to decrease the labour input of planning of the rehabilitation measures, to increase quantity of considered alternative variants of strategy of the contaminated regions rehabilitation. On the basis of the sociological and psychological researches the recommendations for the most effective formation of adaptation strategies of behaviour of the people on the contaminated territories, formation of post accidental culture and active life image at teenagers, ways of fastening of youth in these areas, more address specialized social support and protection of the irradiated persons, perfection of social demographic policy on rehabilitated territories are offered. In the report are described following directions: scientific ground and development of the complex programmes of rehabilitation of administrative regions on the contaminated territories; development of administration system of the social economical development of the territories having suffered after the Chernobyl accident; social support and socio-psychological rehabilitation of the population of Belarus
Murie-Fernández, M; Irimia, P; Martínez-Vila, E; John Meyer, M; Teasell, R
the high incidence of stroke results in significant mortality and disability leading to immense health care costs. These costs lead to socioeconomic, budgetary, and staffing repercussions in developing countries. Improvements in stroke management focus mainly on acute neurological treatment, admission to stroke units, fibrinolytic treatment for ischaemic strokes and rehabilitation processes. Among these, rehabilitation has the longest therapeutic window, can be applied in both ischaemic and haemorrhagic strokes, and can improve functional outcomes months after stroke. Neurologists, because of their knowledge in neuroanatomy, physiopathology, neuro-pharmacology, and brain plasticity, are in an ideal position to actively participate in the neurorehabilitation process. Several processes have been shown to play a role in determining the efficacy of rehabilitation; time from stroke onset to rehabilitation admission and the duration and intensity of treatment. neurorehabilitation is a sub-speciality in which neurologists should be incorporated into multidisciplinary neurorehabilitation teams. Early time to rehabilitation admission and greater intensity and duration of treatment are associated with better functional outcomes, lower mortality/institutionalisation, and shorter length of stay. In order to be efficient, a concerted effort must be made to ensure patients receive neurorehabilitation treatment in a timely manner with appropriate intensity to maximize patient outcomes during both inpatient and outpatient rehabilitation. Published by Elservier España, S.L. All rights reserved.
... settings, including the community, rehabilitation service- delivery institutions, vocational rehabilitation...) Vocational rehabilitation (VR) practices that contribute to improved employment outcomes for individuals with... or more priorities, we designate the type of each priority as absolute, competitive preference, or...
Groeneveld, Iris F.; Meesters, Jorit J. L.; Arwert, Henk J.; Roux-Otter, Nienke; Ribbers, Gerard M.; van Bennekom, Coen A. M.; Goossens, Paulien H.; Vliet Vlieland, Thea P. M.
To describe practice variation in the structure of stroke rehabilitation in 4 specialized multidisciplinary rehabilitation centres in the Netherlands. A multidisciplinary expert group formulated a set of 23 elements concerning the structure of inpatient and outpatient stroke rehabilitation,
... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview.... Alexa Posny, Assistant Secretary for Special Education and Rehabilitative Services. [FR Doc. 2010-9626... education and training for rehabilitation personnel; (3) Disseminate, in a cost-effective manner...
Full Text Available John Nyland, Emily Brand, Brent FisherDepartment of Orthopaedic Surgery, Division of Sports Medicine, University of Louisville, Louisville, KY, USAAbstract: As anterior cruciate ligament (ACL reconstruction has evolved to less invasive, more anatomical approaches, rehabilitation of the injured athlete has likewise become more progressive and innovative, with a sound understanding of graft and fixation strength and biologic healing-remodeling constraints. This review discusses these innovations including specific considerations before surgery, when planning rehabilitation timetables, and the importance of reestablishing nonimpaired active and passive knee range of motion and biarticular musculotendinous extensibility in positions of function. Concepts of self-efficacy or confidence and reestablishing the “athlete role” are also addressed. Since ACL injury and reinjury are largely related to the influence of structure-form-function on dynamic knee joint stability, the interrelationships between sensorimotor, neuromuscular, and conventional resistance training are also discussed. Although pivot shift “giving way” relates to function loss following ACL injury, anterior translational laxity often does not. Although there is growing evidence that progressive eccentric training may benefit the patient following ACL reconstruction, there is less evidence supporting the use of functional ACL knee braces. Of considerable importance is selecting and achieving a criteria-based progression to sports-specific training, reestablishing osseous homeostasis and improved bone density, blending open and closed kinetic chain exercises at the appropriate time period, and appreciating the influence of the trunk, upper extremities, and sports equipment use on knee loads. We believe that knee dysfunction and functional recovery should be considered from a local, regional, and global perspective. These concepts are consolidated into our approach to prepare
Nyland, John; Brand, Emily; Fisher, Brent
As anterior cruciate ligament (ACL) reconstruction has evolved to less invasive, more anatomical approaches, rehabilitation of the injured athlete has likewise become more progressive and innovative, with a sound understanding of graft and fixation strength and biologic healing-remodeling constraints. This review discusses these innovations including specific considerations before surgery, when planning rehabilitation timetables, and the importance of reestablishing nonimpaired active and passive knee range of motion and biarticular musculotendinous extensibility in positions of function. Concepts of self-efficacy or confidence and reestablishing the “athlete role” are also addressed. Since ACL injury and reinjury are largely related to the influence of structure-form-function on dynamic knee joint stability, the interrelationships between sensorimotor, neuromuscular, and conventional resistance training are also discussed. Although pivot shift “giving way” relates to function loss following ACL injury, anterior translational laxity often does not. Although there is growing evidence that progressive eccentric training may benefit the patient following ACL reconstruction, there is less evidence supporting the use of functional ACL knee braces. Of considerable importance is selecting and achieving a criteria-based progression to sports-specific training, reestablishing osseous homeostasis and improved bone density, blending open and closed kinetic chain exercises at the appropriate time period, and appreciating the influence of the trunk, upper extremities, and sports equipment use on knee loads. We believe that knee dysfunction and functional recovery should be considered from a local, regional, and global perspective. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training. PMID:24198553
Built 20 years ago, the airport section of the Geneva motorway bypass is now in need of maintenance work and alterations to bring it into line with the new standards. Two-lane traffic will be maintained in both directions during the work, which will be carried out in 2006 and 2007, but there will be various temporary special traffic arrangements in force. We should like to thank you in advance for your understanding. Civil Engineering Department, DAEL, State of Geneva More information: tel. 163 or www.autoroute-aeroport.ch Fewer cars, fewer traffic jams, with www.covoiturage.ch
Chavez, G.; Perla, H.F.
A well-planned maintenance-management program can bring organized yet flexible scheduling, improved productivity, and a ready-access data bank. The system detailed in the article, developed for a nuclear power plant, has application to any equipment-intensive facility. Key features of the system include: documentation of all work requirements and their completion; automated prioritizing of work orders; automatic generation of work orders for repetitive work, when due; work lists in priority sequence; deferred, standby, and outage work reports; labor and work-order backlog information; equipment work histories and cumulative failure data
The use of a neutron moisture meter for the determination of the water content of soil necessitates the installation of an access tube down which the probe can be lowered. Errors in neutron count rate will be introduced if water enters the air gap between a loose fitting tube and the soil. Errors may also be caused by changes in the soil structure resulting from the techniques for soil removal and from driving the access hole. Access tube materials and dimensions, methods of installation and maintenance of the site are discussed
During the last four years of operations, low technical downtime has been one of the relevant records of the Paranal Observatory. From the beginning of the Very Large Telescope (VLT) project, European Southern Observatory (ESO) has considered the implementation of a proper maintenance strategy a fundamental point in order to ensure low technical down time and preserve the Observatory's assets. The implementation of the maintenance strategy was based on the following aspects: - Strong maintenance sense during the design stage. Line Replacement Unit (LRU) concept, standardization and modularity of the Observatory equipment - Creation of a dedicated team for Maintenance - The implementation of a Computerized Maintenance Management System After four operational years, the result of these aspects has exceeded the expectations; the Observatory has been operating with high availability under a sustainable strategy. The strengths of the maintenance strategy have been based on modern maintenance concepts applied by regular production companies, where any minute of down time involves high cost. The operation of the actual Paranal Maintenance System is based mainly on proactive activities, such as regular inspections, preventive maintenance (PM) and predictive maintenance (PdM) plans. Nevertheless, it has been necessary to implement a strong plan for corrective maintenance (CM). The Spare Parts Strategy has also been an important point linked to the Maintenance Strategy and CMMS implementation. At present, almost 4,000 items related to the Observatory spare parts are loaded into the CMMS database. Currently, we are studying the implementation of a Reliability Centered Maintenance (RCM) project in one of our critical systems The following document presents the actual status of the Paranal Maintenance Strategy and which have been the motivations to implement the established strategy.
Ennion, Liezel; Johannesson, Anton
There is a known shortage of rehabilitation staff in rural settings and a sharp increase in the number of lower limb amputations being performed. A lack of adequate pre-prosthetic rehabilitation will result in worse physical and psychological outcomes for a person with a lower limb amputation, and they will not be eligible to be fitted with a prosthesis. To explore therapists' experiences with providing pre-prosthetic rehabilitation in a rural setting. A qualitative descriptive approach was used to collect and analyse data. Data were collected from 17 purposively sampled therapists in five district hospitals in a rural community in South Africa. Data were collected in two rounds of focus groups to explore the challenges of providing pre-prosthetic rehabilitation in rural South Africa. The main themes identified in the study were (1) a lack of government health system support, (2) poor socioeconomic circumstances of patients and (3) cultural factors that influence rehabilitation. These themes all negatively influence the therapists' ability to follow up patients for pre-prosthetic rehabilitation after discharge from hospital. A lack of adequate pre-prosthetic rehabilitation is a substantial barrier to prosthetic fitting in rural South Africa. Patients who do not receive pre-prosthetic rehabilitation have a poorly shaped residuum or other complications such as knee or hip joint contractures which disqualifies them from being referred to prosthetic services. Therapists involved in this study identified the most important barriers to patients having access to prosthetic services. Clinical relevance Pre-prosthetic rehabilitation provides care of the residuum; maintenance or improvement of physical strength, joint range of motion and referral to a prosthetist. By exploring the challenges known to exist in this service, we can identify potential ways to reduce these barriers and improve the lives of those who use it.
Loughran, Kirsti; Rice, Sarah; Robinson, Lisa
Increasing numbers of people are living with incurable cancers. Symptoms, side effects, and treatment burdens impact on physical functioning, yet little is known about the impact on people's lives and how best to provide rehabilitation. A qualitative study employing a phenomenological approach explored the lived experience of incurable cancer. A purposive sample of six people participated in semi-structured interviews. The data were analysed thematically at a semantic level to identify the functional difficulties experienced by people living with incurable cancer, the meanings of those difficulties, and participants perceived rehabilitation needs. People living with incurable cancer described cancer-related issues spanning all five domains of the International Classification of Functioning, Disability and Health (ICF). Although highly valued amongst study participants, rehabilitation services were difficult to access, poorly utilised, and referrals were sporadic and consequential; indicative of poor awareness of rehabilitation for people with incurable cancer amongst potential referrers. Participants valued a change in terminology away from "palliative" towards more positive language in line with enhanced supportive care movements. Validated tools such as the Palliative Care Therapy Outcome Measure, which align with the ICF, would allow rehabilitation professionals to demonstrate maintenance or improvement in participation and wellbeing. Implications for Rehabilitation Incurable cancer leads to a fluctuating multifactorial disability. People living with incurable cancer can benefit from rehabilitation input throughout their illness. Offering flexible and varied rehabilitation options for people living with incurable cancer will increase physical and emotional well-being, function, and coping. Allied health professionals should take and create opportunities to promote rehabilitation for people living with incurable cancer and their services to other potentially
Since highly reliable operation is required in a nuclear power plant, monitoring during operation and periodical inspection are conducted carefully. The present invention provides maintenance and management systems for providing an aid so that these systems are combined effectively and operated rationally based on unified information management. That is, the system contains data bases comprising information for the design of the equipments and pipelines of a plant, information for the exchange of equipment parts, information for the history of plant operation, information for the monitoring and inspection, and information for the management of repair operation. In addition, it has an equipment part history management sub-system for managing equipment part exchange information, an operation history management sub-system for managing the operation state of the plant, an operation history management sub-system for managing equipment monitoring inspection data and operation management sub-system for managing periodical inspection/ repairing operation. These sub-systems are collectively combined to manage the maintenance and management jobs of the plant unitarily. (I.S.)
Honda, T.; Davis, F.; Lousteau, D.
This document is intended to describe the work conducted by the ITER Assembly and Maintenance (A and M) Design Unit and the supporting home teams during the ITER Conceptual Design Activities, carried out from 1988 through 1990. Its content consists of two main sections, i.e., Chapter III, which describes the identified tasks to be performed by the A and M system and a general description of the required equipment; and Chapter IV, which provides a more detailed description of the equipment proposed to perform the assigned tasks. A two-stage R and D program is now planned, i.e., (1) a prototype equipment functional tests using full scale mock-ups and (2) a full scale integration demonstration test facility with real components (vacuum vessel with ports, blanket modules, divertor modules, armor tiles, etc.). Crucial in-vessel and ex-vessel operations and the associated remote handling equipment, including handling of divertor plates and blanket modules will be demonstrated in the first phase, whereby the database needed to proceed with the engineering phase will be acquired. The second phase will demonstrate the ability of the overall system to execute the required maintenance procedures and evaluate the performance of the prototype equipment
Bok-Yae Chung, PhD, RN, APN
Conclusion: Rehabilitation of breast cancer patients deserves special attention to achieve optimal quality of life. Health care professionals need to be educated about rehabilitation as an effective intervention.
FitzGerald, M P; Kotarinos, R
Several urogynecologic syndromes are associated with the clinical finding of a short, painful, tender and weak pelvic floor and a variety of connective tissue abnormalities. Techniques for rehabilitation include the avoidance of perpetuating factors, rehabilitation of extrapelvic musculoskeletal abnormalities, the use of manual techniques and needling to promote resolution of connective tissue problems, closure of any diastasis recti, and transvaginal/transrectal manual release of muscular trigger points and contractures. Therapy can be facilitated by pudendal or epidural nerve block. Patients contribute to their success through home maintenance programs.
The main objective of this project was to transfer knowledge accumulated in Denmark about modern techniques of natural gas distribution to employees of the Lithuanian gas sector by informing them about modern measuring equipment and evaluating the results. The main objectives were: To improve the efficiency of maintenance and repair works of the distribution network in Kaunas; To decrease the number of leakages and to improve the operation of the cathodic protection system; To ensure protection of the pipelines and to avoid damages on other constructions and installations. The project consisted of four components which will all exert an influence on the future rehabilitation of steel pipe networks in the gas sector of Lithuania. The components were the following: Preparation of Operation and Maintenance Manual for Kaunas Gas Company; Cathodic measuring and pilot investigation; Analysis and improvement of the organisation of the Kaunas Gas Company; Training material for cathodic protection in Lithaunia. (au)
This Guide covers the organizational and procedural aspects of maintenance but does not give detailed technical advice on the maintenance of particular plant items. It gives guidance on preventive and remedial measures necessary to ensure that all structures, systems and components important to safety are capable of performing as intended. The Guide covers the organizational and administrative requirements for establishing and implementing preventive maintenance schedules, repairing defective plant items, providing maintenance facilities and equipment, procuring stores and spare parts, selecting and training maintenance personnel, reviewing and controlling plant modifications arising from maintenance, and for generating, collecting and retaining maintenance records. Maintenance shall be subject to quality assurance in all aspects important to safety. Because quality assurance has been dealt with in detail in other Safety Guides, it is only included here in specific instances where emphasis is required. Maintenance is considered to include functional and performance testing of plant, surveillance and in-service inspection, where these are necessary either to support other maintenance activities or to ensure continuing capability of structures, systems and components important to safety to perform their intended functions
Delivery T/E Table of Equipment TFSMS Total Force Structure Management System TFSP Total Force Structure Process TM Technical Manual T/O Table of...exercises each year, both on Okinawa and throughout the Pacific theater. When equipment requires maintenance beyond the organizational -level...demand was analyzed based on customer cycle time (i.e., time that equipment was in Third Maintenance Battalion custody), maintenance cycle time during
CANDU units have long been recognized for their exceptional safety and reliability. Continuing development in the maintenance area has played a key role in achieving this performance level. For over two decades, safety system availability has been monitored closely and system maintenance programs adjusted accordingly to maintain high levels of performance. But as the plants approach mid life in a more competitive environment and component aging becomes a concern, new methods and techniques are necessary. As a result, recent developments are moving the maintenance program largely from a corrective and preventive approach to predictive and condition based maintenance. The application of these techniques is also being extended to safety related systems. These recent developments include use of reliability centred methods to define system maintenance requirements and strategies. This approach has been implemented on a number of systems at Canadian CANDU plants with positive results. The pilot projects demonstrated that the overall maintenance effort remained relatively constant while the system performance improved. It was also possible to schedule some of the redundant component maintenance during plant operation without adverse impact on system availability. The probabilistic safety assessment was found to be useful in determining the safety implications of component outages. These new maintenance strategies are now making use of predictive and condition based maintenance techniques to anticipate equipment breakdown and schedule preventive maintenance as the need arises rather than time based. Some of these techniques include valve diagnostics, vibration monitoring, oil analysis, thermography. Of course, these tools and techniques must form part of an overall maintenance management system to ensure that maintenance becomes a living program. To facilitate this process and contain costs, new information technology tools are being introduced to provide system engineers
Moghei, Mahshid; Turk-Adawi, Karam; Isaranuwatchai, Wanrudee; Sarrafzadegan, Nizal; Oh, Paul; Chessex, Caroline; Grace, Sherry L
Despite the clinical benefits of cardiac rehabilitation (CR) and its cost-effectiveness, it is not widely received. Arguably, capacity could be greatly increased if lower-cost models were implemented. The aims of this review were to describe: the costs associated with CR delivery, approaches to reduce these costs, and associated implications. Upon finalizing the PICO statement, information scientists were enlisted to develop the search strategy of MEDLINE, Embase, CDSR, Google Scholar and Scopus. Citations identified were considered for inclusion by the first author. Extracted cost data were summarized in tabular format and qualitatively synthesized. There is wide variability in the cost of CR delivery around the world, and patients pay out-of-pocket for some or all of services in 55% of countries. Supervised CR costs in high-income countries ranged from PPP$294 (Purchasing Power Parity; 2016 United States Dollars) in the United Kingdom to PPP$12,409 in Italy, and in middle-income countries ranged from PPP$146 in Venezuela to PPP$1095 in Brazil. Costs relate to facilities, personnel, and session dose. Delivering CR using information and communication technology (mean cost PPP$753/patient/program), lowering the dose and using lower-cost personnel and equipment are important strategies to consider in containing costs, however few explicitly low-cost models are available in the literature. More research is needed regarding the costs to deliver CR in community settings, the cost-effectiveness of CR in most countries, and the economic impact of return-to-work with CR participation. A low-cost model of CR should be standardized and tested for efficacy across multiple healthcare systems. Copyright © 2017 Elsevier B.V. All rights reserved.
Tomita, Jinji; Ike, Masae; Nakayama, Kenji; Kato, Hisatomo
Toshiba is making active efforts for the continuing improvement of reliability and maintainability of operating nuclear power plants. As a part of these efforts, the company has developed new maintenance administration systems, diagnostic monitoring facilities for plant equipments, computer-aided expert systems, and remote-controlled machines for maintenance work. The maintenance administration systems provide efficient work plans and data acquisition capabilities for the management of personnel and equipments involved in nuclear power plant maintenance. The plant diagnostic facilities monitor and diagnose plant conditions for preventive maintenance, as well as enabling rapid countermeasures to be carried out should they be required. Expert systems utilizing artificial intelligence (AI) technology are also employed. The newly developed remote-controlled machines are useful tools for the maintenance inspection of equipment which can not be easily accessed. (author)
Fischer, Jane P
The pervasive negative impact of cardiovascular disease in the United States is well documented. Although advances have been made, the campaign to reduce the occurrence, progression, and mortality continues. Determining evidence-based data is only half the battle. Implementing new and updated clinical guidelines into daily practice is a challenging task. Cardiac rehabilitation is an example of a proven intervention whose benefit is hindered through erratic implementation. The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), the American College of Cardiology (ACC), and the American Heart Association (AHA) have responded to this problem by publishing the AACVPR/ACC/AHA 2007 Performance Measures on Cardiac Rehabilitation for Referral to and Delivery of Cardiac Rehabilitation/Secondary Prevention Services. This new national guideline recommends automatic referral to cardiac rehabilitation for every eligible patient (performance measure A-1). This article offers guidance for the initiation of an automatic referral system, including individualizing your protocol with regard to electronic or paper-based order entry structures.
Ontologies are an appropriate means to represent knowledge on the Web. Research on ontology engineering reached practices for an integrative lifecycle support. However, a broader success of ontologies in Web-based information systems remains unreached while the more lightweight semantic approaches are rather successful. We assume, paired with the emerging trend of services and microservices on the Web, new dynamic scenarios gain momentum in which a shared knowledge base is made available to several dynamically changing services with disparate requirements. Our work envisions a step towards such a dynamic scenario in which an ontology adapts to the requirements of the accessing services and applications as well as the user's needs in an agile way and reduces the experts' involvement in ontology maintenance processes.
Even though it may seem like something much more complex, maintenance is not more than the seed of continuity, the alchemy of eternal youth or the key to combating the cruel passage of time that haunts us all. Little does it matter where you are from or where you are going; it is irrelevant whether you are man, woman or machine. If you do not have a more or less sensible strategy of survival, reality can take you by surprise, without prior warning, at the wrong place and the wrong time. It is sad to see how what we thought was eternal, and thus do not care for and pamper as we should, eventually loses its qualities and functions over the years and fades away like a vague memory. (Author)
Chapaykina, S A; Ol' kov, P L; Pertsev, A N; Rodzevillo, I T; Rogacheva, O I; Zinov' yev, A P
A method is disclosed to lower the adherence of materials by reducing the viscosity of a preventive maintenance lubricant against adhesion of moist, freeflowing materials, containing extract of selective cleaning of oil fractions and asphalt. Gas oil of catalytic cracking is added having a boiling point of 190-300 degrees, with the following ratio of components (%): selective cleaning extract, 43-50; asphalt, 14-16; and gas oil of catalytic cracking, the remainder, Treating a surface with the proposed lubricant lowers the specific resistance to shift of rock compared with the prototype (g/cm/sup 2/): sand (moisture content, 18%) from 3.82 to 1.55; and clay (moisture content 16%), from 5.41 to 3.51.
This project presents a strategic analysis to maximize maintenance operations in Alcan Kitimat Works in British Columbia. The project studies the role of maintenance in improving its overall maintenance performance. It provides strategic alternatives and specific recommendations addressing Kitimat Works key strategic issues and problems. A comprehensive industry and competitive analysis identifies the industry structure and its competitive forces. In the mature aluminium industry, the bargain...
Abreu, Antonio; Calado, João; Requeijo, José
Nowadays, companies in global markets have to achieve high levels of performance and competitiveness to stay "alive".Within this assumption, the building maintenance cannot be done in a casual and improvised way due to the costs related. Starting with some discussion about lean management and building maintenance, this paper introduces a model to support the Lean Building Maintenance (LBM) approach. Finally based on a real case study from a Portuguese company, the benefits, challenges and difficulties are presented and discussed.
Sato, Kenji [Nuclear Energy Systems and Services Div., Toshiba Corp., Tokyo (Japan); Kobayashi, Masahiro [Toshiba Corp., Yokohama (Japan). Keihin Product Operations; Sano, Yuji; Kimura, Seiichiro [Power and Industrial Systems Research and Development Center, Toshiba Corp., Tokyo(Japan)
Toshiba places the highest priority on maintenance technologies for the reactor pressure vessel (RPV) and its internals in operating nuclear power plants. This paper summarizes the status of applied laser maintenance technologies, both preventive and repair. For laser peeing and laser desensitization treatment (LDT) technologies in particular, field applications are also described in detail. In the future, the area of field applications for preventive maintenance, repair, and inspection technologies will be further expanded. (author)
Gerner, P.; Zanner, G.
The deregulation of Europe's power market does force many utilities, and especially nuclear power plant operators, to introduce extensive cost-cutting measures in order to be able to compete within this new environment. The optimization of plant outages provides considerable potential for raising plant availability but can also lower operating costs by reducing e.g. expenditure on maintenance. Siemens Nuclear Power GmbH, in cooperation with plant operators, is currently implementing new and improved service concepts which can have a major effect on the way in which maintenance will be performed in the future. Innovative service packages for maintenance in nuclear power plants are available which can be used to perform a time- and cost-effective maintenance. The concepts encompass optimization of the overall sequence from planning in advance to the individual measures including reduction of the scope of maintenance activities, identification of cost cutting potential and bundling of maintenance activities. The main features of these maintenance activities are illustrated here using the examples of outage planning and integrated valve maintenance. In nuclear power plants approx. 5000 valves are periodically preventively, condition-based or breakdown-based maintained. Because of this large number of valves to be maintained a high potential of improvements and cost reductions can be achieved by performing an optimized, cost-effective maintenance based on innovative methods and tools. Siemens Nuclear Power GmbH has developed and qualified such tools which allow to reduce service costs while maintaining high standards of safety and availability. By changing from preventive to predictive (condition-based) maintenance - the number of valves to be maintained may be reduced considerably. The predictive maintenance is based on the Siemens Nuclear Power GmbH diagnostic and evaluation method (ADAM). ADAM is used to monitor the operability of valves by analytical verification of
White, J. [A.F. White Ltd., Brantford, ON (Canada)
Proactive treatment is required in the case of transformer oil, since the oil degrades over time, which could result in the potential failure of the transformer or costly repairs. A mineral-based oil is used for transformers because of its chemical properties and dielectric strength. Water and particulate are the main contaminants found in transformer oil, affecting the quality of the oil through reduced insulation. Acid that forms in the oil when reacting with oxygen is called oxidization. It reduces the heat dissipation of the transformer as the acid forms sludge which settles on the windings of the transformer. The first step in the preventive maintenance program associated with transformer oil is the testing of the oil. The base line is established through initial testing, and subsequent annual testing identifies any changes. The minimal requirements are: (1) dielectric breakdown, a measure of the voltage conducted by the oil; (2) neutralization/acid number, which detects the level of acid present in the oil; (3) interfacial tension, which identifies the presence of polar compounds; (4) colour, which displays quality, aging and the presence of contaminants; and (5) water, which decreases the dielectric breakdown voltage. The analysis of the gases present in the oil is another useful tool in a maintenance program for the determination of a possible fault such as arcing, corona or overheated connections and is accomplished through Dissolved Gas Analysis (DGA). Remediation treatment includes upgrading the oil. Ideally, reclamation should be performed in the early stages of the acid buildup before sludging occurs. Onsite reclamation includes Fuller's earth processing and degasification, a process briefly described by the author.
Guntur, G.; Sambah, A. B.; Arisandi, D. M.; Jauhari, A.; Jaziri, A. A.
Coastal ecosystems are vulnerable to environmental degradation including the declining water quality in the coastal environment due to the influence of human activities where the river becomes one of the input channels. Some areas in the coastal regions of East Java directly facing the Madura Strait indicate having experienced the environmental degradation, especially regarding the water quality. This research was conducted in the coastal area of Probolinggo Regency, East Java, aiming to analyze the water quality as the basis for coastal rehabilitation planning. This study was carried out using survey and observation methods. Water quality measurement results were analyzed conforming to predetermined quality standards. The coastal area rehabilitation planning as a means to restore the degraded water quality parameters is presumably implemented through mangrove planting. Thus, the mangrove mapping was also devised in this research. Based on 40 sampling points, the results illustrate that according to the quality standard, the water quality in the study area is likely to be deteriorated. On account of the mapping analysis of mangrove distribution in the study area, the rehabilitation of the coastal zone can be done through planning the mangrove forest plantation. The recommended coastal area maintenance is a periodic water quality observation planning in the river region which is divided into three zones to monitor the impact of fluctuating changes in land use or human activities on the coastal water quality.
Yamaji, Yoshihiro; Abe, Norihiko
The Mitsubishi Electric Co., Ltd. has developed to introduce various computer systems for desk-top business assistance in a power plant such as system isolation assisting system, operation parameter management system, and so on under aiming at business effectiveness since these ten and some years. Recently, by further elapsed years of the plants when required for further cost reduction and together with change of business environment represented by preparation of individual personal computer, further effectiveness, preparation of the business environment, and upgrading of maintenance in power plant business have been required. Among such background, she has carried out various proposals and developments on construction of a maintenance and management system integrated the business assistant know-hows and the plant know-hows both accumulated previously. They are composed of three main points on rationalization of business management and document management in the further effectiveness, preparation of business environment, TBM maintenance, introduction of CBM maintenance and introduction of maintenance assistance in upgrading of maintenance. Here was introduced on system concepts aiming at the further effectiveness of the nuclear power plant business, preparation of business environment, upgrading of maintenance and maintenance, and so on, at a background of environment around maintenance business in the nuclear power plants (cost-down, highly elapsed year of the plant, change of business environment). (G.K)
Tada, Eisuke; Shibanuma, Kiyoshi
This paper describes the overall ITER remote maintenance design concept developed mainly for in-vessel components such as diverters and blankets, and outlines the ITER R and D program to develop remote handling equipment and radiation hard components. Reactor structures inside the ITER cryostat must be maintained remotely due to DT operation, making remote handling technology basic to reactor design. The overall maintenance scenario and design concepts have been developed, and maintenance design feasibility, including fabrication and testing of full-scale in-vessel remote maintenance handling equipment and tool, is being verified. (author)
Tada, Eisuke [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Shibanuma, Kiyoshi
This paper describes the overall ITER remote maintenance design concept developed mainly for in-vessel components such as diverters and blankets, and outlines the ITER R and D program to develop remote handling equipment and radiation hard components. Reactor structures inside the ITER cryostat must be maintained remotely due to DT operation, making remote handling technology basic to reactor design. The overall maintenance scenario and design concepts have been developed, and maintenance design feasibility, including fabrication and testing of full-scale in-vessel remote maintenance handling equipment and tool, is being verified. (author)
Baili, Paolo; Hoekstra-Weebers, Josette; Van Hoof, Elke
, but to obtain comparable data across European countries it will be necessary to administer a questionnaire to randomly selected samples of patients from population-based cancer registry databases. However, three factors complicate questionnaire studies: patients may not be aware that they have cancer......Little is known of cancer rehabilitation needs in Europe. EUROCHIP-3 organised a group of experts to propose a list of population-based indicators used for describing cancer rehabilitation across Europe. The aim of this study is to present and discuss these indicators. A EUROCHIP-3 expert panel...... reached agreement on two types of indicators. (a) Cancer prevalence indicators. These were proposed as a means of characterising the burden of cancer rehabilitation needs by time from diagnosis and patient health status. These indicators can be estimated from cancer registry data or by collecting data...
Guillian Barre syndrome (GBS) is the most common form of neuromuscular paralysis. It mostly affects young people and can cause long-term residual disability. This article outlines the rehabilitation treatment for patients recovering from GBS. Recovery from GBS can be prolonged. Early rehabilitation intervention ensures medical stability, appropriate treatment and preventive measures to minimise long term complications. Specific problems include deep venous thrombosis prevention, complications of immobility, dysautonomia, de-afferent pain syndromes, muscle pain and fatigue. Longer-term issues include psychosocial adjustment, return to work and driving, and resumption of the role within the family and community. Effective communication between the GP and rehabilitation physicians is imperative for improved functional outcomes and successful social reintegration.
Zwisler, Ann-Dorthe; Rossau, Henriette Knold; Nakano, Anne
hospitals annually, with 75% receiving one or more outpatient rehabilitation services by 2015. The database has not yet been running for a full year, which explains the use of approximations. CONCLUSION: The DHRD is an online, national quality improvement database on CR, aimed at patients with CHD......AIM OF DATABASE: The Danish Cardiac Rehabilitation Database (DHRD) aims to improve the quality of cardiac rehabilitation (CR) to the benefit of patients with coronary heart disease (CHD). STUDY POPULATION: Hospitalized patients with CHD with stenosis on coronary angiography treated...... with percutaneous coronary intervention, coronary artery bypass grafting, or medication alone. Reporting is mandatory for all hospitals in Denmark delivering CR. The database was initially implemented in 2013 and was fully running from August 14, 2015, thus comprising data at a patient level from the latter date...
Deenen, R.E.M.; Van Daalen, C.E.; Koene, E.G.C.
This paper presents a case study of an analysis of a Corrective Maintenance process to realize performance improvement. The Corrective Maintenance process is supported by SAP, which has indicated the performance realisation problem. System Dynamics is used in a Group Model Building process to
Koochaki, Javid; Bokhorst, Jos A. C.; Wortmann, Hans; Klingenberg, Warse
Condition based maintenance (CBM) uses the operating condition of a component to predict a failure event. Compared to age based replacement (ABR), CBM usually results in higher availability and lower maintenance costs, since it tries to prevent unplanned downtime and avoid unnecessary preventive
Høybye, Mette Terp; Dalton, Susanne Oksbjerg; Christensen, Jane
rate at baseline was 86% (n = 1876). Most participants were younger women with breast cancer. They were generally well educated and working. The cancer survivors reported having comprehensive social networks and being physically active. Several cancer-related symptoms were reported by women...... site, sex, age, family, working status and social position. These challenges might be addressed optimally in multi-dimensional rehabilitation programmes....... of the cancer survivors with respect to cancer site, sociodemographic variables, social network, lifestyle, self-rated health and the prevalence of cancer-related late effects. The study is part of the FOCARE research project, in which the long-term effects of the rehabilitation programme are evaluated...
Full Text Available Lymphedema is an important pathology for rehabilitation medecine, especially for the patients who underwent a mastectomy for breast cancer. His frequency is higher when mastectomy is combined with lymph node disection and irradiation of the lymph nodes. Symptoms include heaviness, numbness, pain, stiffness and weakness in the affected limb. Complications of lymphedema include infections such as cellulitis, erysipelas and lymphangitis. Treatment must be instituted as soon as possible and preventive measures are essential. The rehabilitation treatment consists of skin care measures, manual lymphatic massage, elastic compression of the affected limb and kinetotherapy.
Dionyssiotis, Y; Dontas, I A; Economopoulos, D; Lyritis, G P
Falls are one of the most common geriatric problems threatening the independence of older persons. Elderly patients tend to fall more often and have a greater tendency to fracture their bones. Fractures occur particularly in osteoporotic people due to increased bone fragility, resulting in considerable reduction of quality of life, morbidity, and mortality. This article provides information for the rehabilitation of osteoporotic fractures pertaining to the rehabilitation of the fractured patient, based on personal experience and literature. It also outlines a suggested effective and efficient clinical strategy approach for preventing falls in individual patients.
Sharovarov, G.A.; Minyuk, Z.P.
The results of the investigations of rehabilitation soil polluted with radioactive nuclides carried out in Joint Institute for Power and Nuclear Research - Sosny (Minsk, Belarus) are represented in the report. Methods of soil rehabilitation are analysed. It has been made a conclusion that bioremediation is the only possible method for the cleaning of the large territories. The opportunity of usage a principle of the biopump for cleaning of the large territories polluted with radioactive nuclides and other harmful substances is proved in the report. (authors)
Eliziario, J.S.; Pereira Roders, A.R.; Valverde, I.; Bragança, L.; Pinheiro, M.; Mateus, R.; Amoêda, R.; Correia Guedes, M.
Rehabilitation design is not an activity restrictedly practiced in Architectural offices, but also taught and practiced at Architecture schools. Architects and students have to define their own method to approach rehabilitation design developments; however, they can be theoretically supported. The
National Stroke Association’s Guide to Choosing Stroke Rehabilitation Services Rehabilitation, often referred to as rehab, is an important part of stroke recovery. Through rehab, you: Re-learn basic skills such ...
This paper describes computer-aided cognitive rehabilitation for mentally deficient persons. It lists motor, cognitive, emotional, and educational prerequisites to such rehabilitation and states advantages and disadvantages in using the prerequisites. (JDD)
Steensgaard, Randi; Dahl Hoffmann, Dorte
“Useful Method To Optimize The Rehabilitation Effort At A SCI Rehabilitation Centre” The Nordic Spinal Cord Society (NoSCoS) Meeting, Trondheim......“Useful Method To Optimize The Rehabilitation Effort At A SCI Rehabilitation Centre” The Nordic Spinal Cord Society (NoSCoS) Meeting, Trondheim...
... Rehabilitation of Individuals Who are Mentally Ill. 84.129J Rehabilitation Psychology. 84.129P Specialized... students with community-based rehabilitation service providers are encouraged. Projects must include an... Mentally Ill. 84.129J Rehabilitation 100,000 2 Psychology. 84.129P Specialized Personnel 100,000 3 for...
Cardol, M.; Jong, B.A. de; Ward, C.D.
To explore the concept of autonomy as a basis for social participation, with particular reference to rehabilitation. Method: A study of relevant literature from the field of rehabilitation, building on theory developed in other fields (ethics, social sciences), and deriving important concepts and strategies for rehabilitation practice. Results: The focus of rehabilitation for people with a chronic disabling condition is shifting from a biomedical to a client-centred perspective. Conceptions o...
G. Waeyenbergh; L. Pintelon; L. Gelders
Maintenance decision making becomes more and more a management concern. Some decades ago, maintenance was still often considered as an unavoidable side effect of production. The perception of maintenance has evolved considerably. One of the current issues is the maintenance concept, being the mix of maintenance interventions and the general framework for determining this mix. In this paper we describe a modular framework, called Knowledge Based Maintenance, for developing a customised mainten...
Mohammad Ali Ahmadi-Pajouh
Full Text Available Robotics is a tool to assist human in different applications from industry to medicine. There are many reasons that human tends to use these machines. They are very reliable in repetitive, high precision, preprogrammed and high risk jobs in which human is not too good enough. In medicine, robotic applications are evolving so fast that in near future nobody can imagine a surgery without a robot involved. In Rehabilitation we have the same scenario; there are commercialized robots to assist disable people to eat and perform daily activities. There are also clinical rehabilitation robots which can train handicaps. They can help subjects as a passive tool that improves low level impairments such as rigidity. On the other hand robots can train brain as an active tool to have a better movement again. We will see how robots can help therapist to apply repetitive passive movements in quadriplegic subject (i.e. in Brunnstrom stages 1 to 3. On the other hand they can teach subjects how to complete a task in an active manner (i.e. in stages 5 and 6 which can facilitate neuroplasticity. There are different robots designed for different organs; for example rehabilitation of upper extremities (e.g. Gloreha or lower extremities (e.g. Lokomat. There are also exoskeleton robots to help subjects to grip objects and perform ADLs easily (e.g. Bioservo or help paraplegic patient to walk again (e.g. Rewalk. In this talk, we will also discuss about how robots are helping rehab specialist to improve standard protocols. For example we will show how action observation therapy, bimanual therapy, assistive active therapy, proprioceptive facilitation and passive mobilization therapy are realized using an upper extremity rehabilitation robot. Robotics is the future of technology and rehabilitation needs this technology. Be part of this technology!
Sainero Garcia, J.; Hevia Ruperez, F.
The terms Residual Life Management, Life Cycle Management and Long-Term Management are synonymous with a concept which aims to establish efficient maintenance for the profitable and safe operation of a power plant for as long as possible. A Residual Life Management programme comprises a number of stages, of which Maintenance Evaluation focuses on how power plant maintenance practices allow the mitigation and control of component ageing. with this objective in mind, a methodology has been developed for the analysis of potential degradative phenomena acting on critical components in terms of normal power plant maintenance practices. This methodology applied to maintenance evaluation enables the setting out of a maintenance programme based on the Life Management concept, and the programme's subsequent up-dating to allow for new techniques and methods. Initial applications have shown that although, in general terms, power plant maintenance is efficient, the way in which Residual Life Management is approached requires changes in maintenance practices. These changes range from modifications to existing inspection and surveillance methods or the establishment of new ones, to the monitoring of trends or the performance of additional studies, the purpose of which is to provide an accurate evaluation of the condition of the installations and the possibility of life extension. (Author)
Myburgh, Corrie; Brandborg-Olsen, Dorthe; Albert, Hanne
To describe and interpret Danish Chiropractors' perspectives regarding the purpose and rationale for using MC (maintenance care), its content, course and patient characteristics.......To describe and interpret Danish Chiropractors' perspectives regarding the purpose and rationale for using MC (maintenance care), its content, course and patient characteristics....
Tomlingson, P.D. [Paul D. Tomingson Associates (United States)
The article written by a management consultant, discusses the art of successful planning and operation of maintenance in mines considering factors such as benchmaking, key performance indices (KPIs) and frequency of procedures which can help achieve 'world class maintenance'. 1 fig.
Describes recent research on language maintenance to provide broad, worldwide coverage of different language contact situations. Surveys various countries in which research within ethnic and minority language communities illuminates language maintenance or shift, or revitalization, for that group. (Author/VWL)
Full Text Available The key to good maintenance of historic buildings is a long-range maintenance plan. Long-range planning recognizes a responsibility to the future to prolong the useful life of a building by preserving it in its present condition and preventing or slowing deterioration and damage from natural or other causes.
Chou, Chih-Chin; Chan, Fong; Phillips, Brian; Chan, Jacob Yui Chung
Positive psychology has received increasing attention in rehabilitation counseling research and practice. The rehabilitation counseling philosophy shares a similar emphasis of personal assets and strengths, which provides a solid foundation for the integration of positive psychology into the professional practice of rehabilitation counseling. In…
Purpose: The author describes how rehabilitation counselor educators can incorporate the feminist perspective in teaching rehabilitation counselors-in-training by exploring history, core values, and training methods of feminism. Method: Based on a literature review, the author compares philosophy and concepts of rehabilitation counseling and…
... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Rehabilitation Act. 268.203 Section 268.203... Rehabilitation Act. (a) Model employer. The Board shall be a model employer of individuals with disabilities. The... Rehabilitation Act of 1973, as amended (29 U.S.C. 791), has been violated in a complaint alleging nonaffirmative...
... 29 Labor 4 2010-07-01 2010-07-01 false Rehabilitation Act. 1614.203 Section 1614.203 Labor... EMPLOYMENT OPPORTUNITY Provisions Applicable to Particular Complaints § 1614.203 Rehabilitation Act. (a... Rehabilitation Act of 1973, as amended (29 U.S.C. 791), has been violated in a complaint alleging nonaffirmative...
Olney, Marjorie F.; Gill, Kenneth J.
Purpose: In this article, we seek to determine whether psychiatric rehabilitation principles and practices have been more fully incorporated into the Council on Rehabilitation Education (CORE) standards, the extent to which they are covered in four rehabilitation counseling "foundations" textbooks, and how they are reflected in the…
Tetteroo, D.; Willems, L.; Markopoulos, P.; Fred, A.; Gamboa, H.; Elias, D.
The use of technology in stroke rehabilitation is increasingly common. An important aspect in stroke rehabilitation is feedback towards the patient, but research on how such feedback should be designed in stroke rehabilitation technology is scarce. Therefore, in this paper we describe an exploratory
Eldar, Reuben; Marincek, Crt; Kullmann, Lajos
Teamwork is the cornerstone of rehabilitation medicine. Rehabilitation workers in European countries are well educated in their own disciplines and attain appropriate professional knowledge; however, they lack educational opportunities for acquiring skills and attitudes necessary for effective teamwork, mainly communication, cooperation, and leadership. Consequently, teamwork is compromised and rehabilitation effectiveness reduced. Therefore, training in these components of professional compe...
Itoh, Masayoshi; Eason, Alice L.
The purpose of this manual is to introduce the general concepts and techniques in leprosy rehabilitation to physical therapy aides. Because of the lack of well-trained, qualified, physical therapists, the committee on leprosy rehabilitation considers it necessary to publish a teaching manual outlining leprosy rehabilitation for those who work with…
Lawton, Michelle; Haddock, Gillian; Conroy, Paul; Sage, Karen
To synthesize qualitative studies exploring patients' and professionals' perspectives and experiences of developing and maintaining therapeutic alliances in stroke rehabilitation. A systematic literature search was conducted using the following electronic databases: PsycINFO, CINAHL, Embase, MEDLINE, Allied and Complementary Medicine Database, Applied Social Sciences Index and Abstracts, and ComDisDome from inception to May 2014. This was supplemented by hand searching, reference tracking, generic web searching, and e-mail contact with experts. Qualitative peer reviewed articles reporting experiences or perceptions of the patient or professional in relation to therapeutic alliance construction and maintenance in stroke rehabilitation were selected for inclusion. After a process of exclusion, 17 publications were included in the synthesis. All text identified in the results and discussion sections of the selected studies were extracted verbatim for analysis in a qualitative software program. Studies were critically appraised independently by 2 reviewers. Articles were synthesized using a technique of meta-ethnography. Four overarching themes emerged from the process of reciprocal translation: (1) the professional-patient relationship: degree of connectedness; (2) asymmetrical contributions; (3) the process of collaboration: finding the middle ground; and (4) system drivers. The findings from the meta-ethnography suggest that the balance of power between the patient and professional is asymmetrically distributed in the construction of the alliance. However, given that none of the studies included in the review addressed therapeutic alliance as a primary research area, further research is required to develop a conceptual framework relevant to stroke rehabilitation, in order to determine how this construct contributes to treatment efficacy. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Trucks, H. F.
The Space Telescope (ST) represents a new concept regarding spaceborne astronomical observatories. Maintenance crews will be brought to the orbital worksite to make repairs and replace scientific instruments. For major overhauls the telescope can be temporarily returned to earth with the aid of the Shuttle. It will, thus, be possible to conduct astronomical studies with the ST for two decades or more. The five first-generation scientific instruments used with the ST include a wide field/planetary camera, a faint object camera, a faint object spectrograph, a high resolution spectrograph, and a high speed photometer. Attention is given to the optical telescope assembly, the support systems module, aspects of mission and science operations, unscheduled maintenance, contingency orbital maintenance, planned on-orbit maintenance, ground maintenance, ground refurbishment, and ground logistics.
Tada, Eisuke; Shibanuma, Kiyoshi
This paper both describes the overall design concept of the ITER remote maintenance system, which has been developed mainly for use with in-vessel components such as divertor and blanket, and outlines of the ITER R and D program, which has been established to develop remote handling equipment/tools and radiation hard components. In ITER, the reactor structures inside cryostat have to be maintained remotely because of activation due to DT operation. Therefore, remote-handling technology is fundamental, and the reactor-structure design must be made consistent with remote maintainability. The overall maintenance scenario and design concepts of the required remote handling equipment/tools have been developed according to their maintenance classification. Technologies are also being developed to verify the feasibility of the maintenance design and include fabrication and testing of a fullscale remote-handling equipment/tools for in-vessel maintenance. (author)
Laylavoix, F.; Madelmont, C.; Fache, P.; Manesse, D.; Camus, H.
A critical survey of the various rehabilitation methods is presented: mechanical cleanup, physico-chemical treatment, new direction of productions. Particular attention has been paid to the qualification of methods: equipment availability, decontamination efficiency, utilization and maintenance conditions. Two appendices are included: the former presents the broad scope of the RESSAC program (Rehabilitation of Soils and Surfaces following an Accident); the latter a review of the information available on the interventions on the CHERNOBYL site environment [fr
Preda, M.; Sabau, C.; Barbalata, E.
This work deals with the specific operation of equipment in radioactive environment or in conditions allowing radioactive contamination. The requirements of remote operation ensuring the operators' protection are presented. Also, the requirements of international standards issued by IAEA-Vienna are reviewed. The organizational withdraws of the maintenance activities, based on the standards and maintenance and repair directives still in force, are shown. It is emphasized the fact that this type of maintenance was adequate to a given level of technical development, characteristic for pre-computerized industry, but, at present, it is obsolete and uneconomic both in utilization and maintenance. Such a system constitutes already a burden hindering the efforts of maximizing the availability, maintenance, prolongation the service life of equipment and utilities, finally, of increasing the efficiency of complex installations. Moreover, the predictive maintenance techniques are strongly requested by the character of radioactive installations precluding the direct access in given zones (a potential risk of irradiation or radioactive contamination) of installations during operation. The results obtained by applying the predictive maintenance techniques in the operation of the double circuit irradiation loop, used in the TRIGA reactors, are presented
Wakabayashi, Hidetaka; Sakuma, Kunihiro
Malnutrition and sarcopenia often occur in rehabilitation settings. The prevalence of malnutrition and sarcopenia in older patients undergoing rehabilitation is 49–67 % and 40–46.5 %, respectively. Malnutrition and sarcopenia are associated with poorer rehabilitation outcome and physical function. Therefore, a combination of both rehabilitation and nutrition care management may improve outcome in disabled elderly with malnutrition and sarcopenia. The concept of rehabilitation nutrition as a c...
MacKenzie, Doris Layton; And Others
Reviews Louisiana's shock incarceration program used as alternative to standard prison incarceration. Program involves short period of imprisonment in a "boot camp" type atmosphere followed by three phases of intensive parole supervision. Examines the program in regard to its rehabilitative potential and compares program elements to…
Full Text Available A short introduction concerning the content of Assistive Technology and Rehabilitation Engineering is followed by a study of robotic systems which combine two or more assistive functions. Based on biomechanical aspects, a complex robotic system is presented, starting with the study of functionality and ending with the practical aspects of the prototype development.
Parker, Randall M.
This paper reviews current research concerning psychosocial adaptation to chronic illness and disability and presents recommendations for future development of theories in this area. First, those who craft or adapt theories must use nondisabling, respectful, and empowering language. Rehabilitation professionals must avoid terms that connote…
Vallery, Heike; Veneman, J.F.; van Asseldonk, Edwin H.F.; Ekkelenkamp, R.; Buss, Martin; van der Kooij, Herman
This article discusses the pros and cons of compliant actuation for rehabilitation robots on the example of LOPES, focusing on the cons. After illustrating the bandwidth limitations, a new result has been derived: if stability in terms of passivity of the haptic device is desired, the renderable
Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation. The reason to addict the internet or smartphone is personalized individual characters related personal psychological and emotional factors and social environmental factors around them. We have shown that 2 discernible approaches due to 2 different addiction causes: that is behavioral treatment and complementary treatment. In the behavioral treatment, cognitive behavioral approach (CBT) is representative methods for changing additive thoughts and behaviors. Motivational interviewing (MI) is also the brief approach for persons not ready to change their behavior. Mindfulness behavioral cognitive treatment (MBCT) also the adapted treatment based on CBT. There are different types following the emphatic point, mindfulness-based relapse prevention (MBRP) or mindfulness oriented recovery enhancement (MORE). It is apparent that therapeutic recreation, music therapy using drumming activity, and art therapy are useful complementary treatment. Exercise rehabilitation contained the systematic procedures and comprehensive activities compared to previous addiction treatments by contents and techniques. Exercise rehabilitation can treat both physical symptoms at first and mental problems in the next step. So more evidence-based exercise rehabilitation researches need to do, but it is highly probable that exercise rehab can apply for smartphone addiction.
Knoche, Hendrik; Hald, Kasper; Richter, Dorte
We designed and evaluated a whack-a-mole (WAM) style game (see Figure 1) in a clinical randomized controlled trial (RCT) with reminder-assisted but self-initiated use over the period of a month with 43 participants from a post-lesion pool. While game play did not moderate rehabilitative progress...
Thiago Brasileiro de Vasconcelos
Full Text Available The aim of this study was to conduct a literature review on the usefulness of aerobic exercise in pulmonary rehabilitation. This is an exploratory study of literature through the electronic databases Medline, Lilacs, Scielo, Pubmed and Google Scholar, published between 1996 and 2012, conducted during the period February to May 2012 with the following keywords: COPD, pulmonary rehabilitation, aerobic exercises, physical training, quality of life. The change in pulmonary function and dysfunction of skeletal muscles that result in exercise intolerance and reduced fitness and may cause social isolation, depression, anxiety and addiction. The training exercise is the most important component of the program of pulmonary rehabilitation where the aerobic training provides consistent results in clinical improvement in levels of exercise tolerance and decreased dyspnea generating more benefits to the body, reducing the chance of cardiovascular disease and improves quality and expectation of life. We demonstrated that the use of aerobic exercise in pulmonary rehabilitation program, allows an improvement of motor skills, decreased muscle fatigue and deconditioning, reducing sedentary lifestyle; however, has little or no effect on the reduction of strength and atrophy muscle.
Thiago Brasileiro de Vasconcelos
Full Text Available The aim of this study was to conduct a literature review on the usefulness of aerobic exercise in pulmonary rehabilitation. This is an exploratory study of literature through the electronic databases Medline, Lilacs, Scielo, Pubmed and Google Scholar, published between 1996 and 2012, conducted during the period February to May 2012 with the following keywords: COPD, pulmonary rehabilitation, aerobic exercises, physical training, quality of life. The change in pulmonary function and dysfunction of skeletal muscles that result in exercise intolerance and reduced fitness and may cause social isolation, depression, anxiety and addiction. The training exercise is the most important component of the program of pulmonary rehabilitation where the aerobic training provides consistent results in clinical improvement in levels of exercise tolerance and decreased dyspnea generating more benefits to the body, reducing the chance of cardiovascular disease and improves quality and expectation of life. We demonstrated that the use of aerobic exercise in pulmonary rehabilitation program, allows an improvement of motor skills, decreased muscle fatigue and deconditioning, reducing sedentary lifestyle; however, has little or no effect on the reduction of strength and atrophy muscle.
Ellsworth, Abigail A; Zoland, Mark P; Tyler, Timothy F
Evaluation and treatment of groin pain in athletes is challenging. The anatomy is complex, and multiple pathologies often coexist. Different pathologies may cause similar symptoms, and many systems can refer pain to the groin. Many athletes with groin pain have tried prolonged rest and various treatment regimens, and received differing opinions as to the cause of their pain. The rehabilitation specialist is often given a non-specific referral of "groin pain" or "sports hernia." The cause of pain could be as simple as the effects of an adductor strain, or as complex as athletic pubalgia or inguinal disruption. The term "sports hernia" is starting to be replaced with more specific terms that better describe the injury. Inguinal disruption is used to describe the syndromes related to the injury of the inguinal canal soft tissue environs ultimately causing the pain syndrome. The term athletic pubalgia is used to describe the disruption and/or separation of the more medial common aponeurosis from the pubis, usually with some degree of adductor tendon pathology. Both non-operative and post-operative treatment options share the goal of returning the athlete back to pain free activity. There is little research available to reference for rehabilitation guidelines and creation of a plan of care. Although each surgeon has their own specific set of post-operative guidelines, some common concepts are consistent among most surgeons. Effective rehabilitation of the high level athlete to pain free return to play requires addressing the differences in the biomechanics of the dysfunction when comparing athletic pubalgia and inguinal disruption. Proper evaluation and diagnostic skills for identifying and specifying the difference between athletic pubalgia and inguinal disruption allows for an excellent and efficient rehabilitative plan of care. Progression through the rehabilitative stages whether non-operative or post-operative allows for a focused rehabilitative program. As more
Rumrill, P D; Nutter, D L; Hennessey, M; Ware, M E
The article presents four case studies of employed women who have had breast cancer. Specifically, the authors examine respondents' career maintenance concerns in the areas of (a) worksite accessibility, (b) performance of essential job functions, (c) job mastery, and (d) job satisfaction. Post-employment strategies are presented to assist rehabilitation professionals in meeting the on-the-job needs of women with breast cancer.
able sealing material that has promising characteristics for coastal engineer- ing applications. Microfine Cement, a company which markets ultrafine...cement, claims the product can penetrate fine sand and is strong and durable with a 4- to 5-hr set tine. Fifty percent of Microfine Cement’s...sealant. The casing can be pierced at any selected point by firing an explosive-impelled projectile from a device lowered into the casing. d. Tubes A
In some companies, corrective maintenance is conducted in-house but preventive maintenance might be outsourced. This raises a need to optimise some parameters such as the number of contracts from a perspective of the equipment owner. This paper considers a maintenance policy for such a situation, analyses the roles of the parameters in a PM model, proposes approaches to defining bonus functions, and finally discusses special cases of both the PM policy and the bonus function. Numerical examples are also given to explore the impact of parameters on the expected lifecycle cost rate.
Karim Fareed M. A.
Full Text Available The pavement condition index (PCI is a simple, convenient and inexpensive way to monitor the condition of the surface of roads, identify maintenance and rehabilitation (M-and-R needs as well as ensure that road maintenance budgets are spent wisely. In this research, the pavement condition was evaluated in terms of the surface distresses existing at the time of the field evaluation. The PCI procedure was used in this research because it deals with the subject of pavement distress identification most comprehensively and is based on a sound statistical technique of pavement sampling.
Full Text Available In view of the state of hydromorphological preservation of river corridors in the Slovenian hydrographic network and because of demands imposed by domestic and European legislature concerning water resource management and environmental protection, certain sections of rivers and streams that were for various reasons regulated in the past, will have to be rehabilitated. Permanent solutions to such issues demand careful planning of rehabilitation on suitable sections of rivers and streams, adequate positioning within physical planning acts, as well as streamlined administrative procedures and devised maintenance of rehabilitation areas. Because the process demands the return of formerly taken water surfaces into the domain of water ecosystems and dynamics of hydromorphological processes, and consequentially maintenance of regained surfaces, the public becomes an important factor, which is a position, granted by domestic and European laws. Last, but not least, successful execution of rehabilitation of water corridors, besides planning, administration and consistent public participation, demands knowledge about good practices of project management, as well as technical execution of such projects.
The lecture shows the feature of WWER-440/213 units maintenance, the existing maintenance training system, the necessity of the change in maintenance training system at NPP Paks. The author introduces the would-be maintenance training centre, the training facilities and the main tasks related to the maintenance training. (author)
Full Text Available Burn injuries are a huge public health issue for children throughout the world, with the majority occurring in developing countries. Burn injuries can leave a pediatric patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. Rehabilitation is an essential and integral part of pediatric burn treatment. The aim of this article was to review the literature on pediatric burn rehabilitation from the Medline, CINAHL, and Web of Science databases. An attempt has been made to present the basic aspects of burn rehabilitation, provide practical information, and discuss the goals and conceptualization of rehabilitation as well as the development of rehabilitation philosophy and strategies.
Full Text Available Brain injury such as traumatic brain injury (TBI and stroke is the major cause of long-term disabilities in many countries. The increasing rate of brain damaged victims and the heterogeneity of impairments decrease rehabilitation effectiveness and competence resulting in higher cost of rehabilitation treatment. On the other hand, traditional rehabilitation exercises are boring, thus leading patients to neglect the prescribed exercises required for recovery. Therefore, we propose game-based approach to address these problems. This paper presents a rehabilitation gaming system (RGS for cognitive rehabilitation. The RGS is developed based on a proposed conceptual framework which has also been presented in this paper.
This Maintenance Implementation Plan (MIP) has been developed for maintenance functions associated with the 340 Facility. This plan is developed from the guidelines presented by Department of Energy (DOE) Order 4330.4B, Maintenance Management Program (DOE 1994), Chapter II. The objective of this plan is to provide baseline information for establishing and identifying Westinghouse Hanford Company (WHC) conformance programs and policies applicable to implementation of DOE order 4330.4B guidelines. In addition, this maintenance plan identifies the actions necessary to develop a cost-effective and efficient maintenance program at the 340 Facility. Primary responsibility for the performance and oversight of maintenance activities at the 340 Facility resides with Westinghouse Hanford Company (WHC). Maintenance at the 340 Facility is performed by ICF-Kaiser Hanford (ICF-KH) South Programmatic Services crafts persons. This 340 Facility MIP provides interface requirements and responsibilities as they apply specifically to the 340 Facility. This document provides an implementation schedule which has been developed for items considered to be deficient or in need of improvement. The discussion sections, as applied to implementation at the 340 Facility, have been developed from a review of programs and practices utilizing the graded approach. Biennial review and additional reviews are conducted as significant programmatic and mission changes are made. This document is revised as necessary to maintain compliance with DOE requirements
This Maintenance Implementation Plan (MIP) has been developed for maintenance functions associated with the 340 Facility. This plan is developed from the guidelines presented by Department of Energy (DOE) Order 4330.4B, Maintenance Management Program (DOE 1994), Chapter II. The objective of this plan is to provide baseline information for establishing and identifying Westinghouse Hanford Company (WHC) conformance programs and policies applicable to implementation of DOE order 4330.4B guidelines. In addition, this maintenance plan identifies the actions necessary to develop a cost-effective and efficient maintenance program at the 340 Facility. Primary responsibility for the performance and oversight of maintenance activities at the 340 Facility resides with Westinghouse Hanford Company (WHC). Maintenance at the 340 Facility is performed by ICF-Kaiser Hanford (ICF-KH) South Programmatic Services crafts persons. This 340 Facility MIP provides interface requirements and responsibilities as they apply specifically to the 340 Facility. This document provides an implementation schedule which has been developed for items considered to be deficient or in need of improvement. The discussion sections, as applied to implementation at the 340 Facility, have been developed from a review of programs and practices utilizing the graded approach. Biennial review and additional reviews are conducted as significant programmatic and mission changes are made. This document is revised as necessary to maintain compliance with DOE requirements.
Ewadh Hussein Ali
Full Text Available Increased demand for efficient maintenance of the existing roadway system needs optimal usage of the allocated funds. The paper demonstrates optimized methods for prioritizing maintenance implementation projects. A selected zone of roadway system in Kerbala city represents the study area to demonstrate the application of the developed prioritization process. Paver system PAVER integrated with GIS is used to estimate and display the pavement condition index PCI, thereby to establish a priority of maintenance. In addition to simple ranking method by PCI produced by the output of PAVER, the paper introduces PCI measure for each section of roadway. The paper introduces ranking by multiple measures investigated through expert knowledge about measures that affect prioritization and their irrespective weights due to a predesigned questionnaire. The maintenance priority index (MPI is related to cost of suitable proposed maintenance, easiness of proposed maintenance, average daily traffic and functional classification of the roadway in addition to PCI. Further, incremental benefit-cost analysis ranking provide an optimized process due to benefit and cost of maintenance. The paper introduces efficient display of layout and ranking for the selected zone of roadway system based on MPI index and incremental BCR method. Although the two developed methods introduce different layout display for priority, statistical test shows that no significant difference between ranking of all methods of prioritization.
A. M. Bronnikov
Full Text Available The avionics concept of the maintenance-free on-board equipment implies the absence of necessity to maintain onboard systems between scheduled maintenance, preserving the required operational and technical characteristics; it should be achieved by automatic diagnosis of the technical condition and the application of active means of ensuring a failsafe design, allowing to change the structure of the system to maintain its functions in case of failure. It is supposed that such equipment will reduce substantially and in the limit eliminate traditional maintenance of aircraft between scheduled maintenance, ensuring maximum readiness for use, along with improving safety. The paper proposes a methodology for evaluating the efficiency of maintenance-free between scheduled maintenance aircraft system with homogeneous redundancy. The excessive redundant elements allow the system to accumulate failures which are repaired during the routine maintenance. If the number of failures of any reserve is approaching a critical value, the recovery of the on-board system (elimination of all failures is carried out between scheduled maintenance by conducting rescue and recovery operations. It is believed that service work leads to the elimination of all failures and completely updates the on-board system. The process of system operational status changes is described with the discrete-continuous model in the flight time. The average losses in the sorties and the average cost of operation are used as integrated efficiency indicators of system operation. For example, the evaluation of the operation efficiency of formalized on-board system with homogeneous redundancy demonstrates the efficiency of the proposed methodology and the possibility of its use while analyzing the efficiency of the maintenance-free operation equipment between scheduled periods. As well as a comparative analysis of maintenance-free operation efficiency of the on-board system with excessive
Mohammed M. J. Alqahtani
Full Text Available Patient’ needs have been found to be crucial to the success of rehabilitation and recovery. To understand what patients want from their rehabilitation services should be addressed in the rehabilitation intervention. This study aims to examine patients’ needs for rehabilitation services as well as to examine the validity of a self-report questionnaire that developed to measure what patient needs from rehabilitation services in Saudi Arabia. Tow hundreds-eighty patients, from inpatients and outpatients, with stroke, spinal cord and brain injury completed the Patient’s Needs Questionnaire (PNQ. In general, the result showed that patients are in highly needs for Psychological Interventions, even before Rehabilitation and Treatment component. In detail, Psychological Intervention and Emotional Support were significantly greater in inpatients than in outpatients. Outpatients, in contrast, affirmed the Religious Support component significantly more than inpatients did. The statistical analysis of PNQ yielded four components: psychological interventions, rehabilitation and treatment, religious support, and explanation/reassurance. These components accounted for 48.71% of the total variances. Rehabilitation services is not only the component of rehabilitation intervention and medical treatments, indeed, it is a holistic intervention that understand the psychological, religious, and reassurance demands. The health provider in Saudi Arabia should develop a rehabilitation goal menu based on patient-centred care needs. The PNQ is a valuable and practical tool for the identification of patients’ needs from rehabilitation services.
in turn enable testing of helicopter rotor blades. The Army has also made investments in logistics software at all of its depots. According to the...maintenance and repair of structural helicopter airframes and blades; advanced composite technologies; flight controls and control surfaces; and...level maintenance on a wide range of vehicles and other military assets, including helicopters , combat vehicles, ships, aircraft, engines, and software
... (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering... Rehabilitation Act of 1973, as amended (Rehabilitation Act). Rehabilitation Engineering Research Centers Program... Rehabilitation Act. It does so by conducting advanced engineering research, developing and evaluating innovative...
... (NIDRR)--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering... authorized under the Rehabilitation Act of 1973, as amended (Rehabilitation Act). Rehabilitation Engineering... under the Rehabilitation Act. It does so by conducting advanced engineering research, developing and...
The remote maintenance strategy and the associated component design of the International Thermonuclear Experimental Reactor (ITER) have reached a high degree of completeness, especially with respect to those components that are expected to require frequent or occasional remote maintenance. Large-scale test stands, to demonstrate the principle feasibility of the remote maintenance procedures and to develop the required equipment and tools, were operational at the end of the Engineering Design Activities (EDA) phase. The initial results are highly encouraging: major remote equipment deployment and component replacement operations have been successfully demonstrated. (author)
As the safety and quality of atomic power facilities are more strongly required, the reliability improvement and preventive maintenance of radiation monitoring systems are important. This paper describes the maintenance of radiation monitoring systems delivered by Fuji Electric and the present status of preventive maintenance technology. Also it introduces the case that we developed a fault diagnosis function adopting a statistics technique and artificial intelligence (AI) and delivered a radiation monitoring system including this function. This system can output a fault analysis result and a countermeasure from the computer in real time. (author)
Palmer, Siobhan; Herbert, Camilla
Social re-integration after acquired brain injury is an important part of successful rehabilitation outcome, both in terms of return to work and emotional wellbeing. Residential rehabilitation often places individuals at a distance from their pre injury social context. Supporting the maintenance or development of intimate relationships is therefore a crucial aspect of neurobehavioural rehabilitation. However, the development of new relationships is not without risk. To provide a framework for considering interventions around personal and intimate relationships post brain injury, taking into account the complexities of risk assessment and risk management. The authors have used clinical case examples to develop a framework to support risk assessment and intervention planning. The framework has been used in a residential rehabilitation service to support the development and maintenance of intimate relationships post injury. No formal data collection was used. Case examples are used to illustrate how the framework can assist clinical practice. The authors provide a framework to assist clinicians working with complex clinical cases to think through options for intervention to maintain or develop friendships and intimacy whilst taking account of factors affecting risk management.
Jesus, Tiago S; Colquhoun, Heather L
Growing evidence points for the need to publish study protocols in the health field. To observe whether the growing interest in publishing study protocols in the broader health field has been translated into increased publications of rehabilitation study protocols. Observational study using publication data and its indexation in PubMed. Not applicable. Not applicable. PubMed was searched with appropriate combinations of Medical Subject Headings up to December 2014. The effective presence of study protocols was manually screened. Regression models analyzed the yearly growth of publications. Two-sample Z-tests analyzed whether the proportion of Systematic Reviews (SRs) and Randomized Controlled Trials (RCTs) among study protocols differed from that of the same designs for the broader rehabilitation research. Up to December 2014, 746 publications of rehabilitation study protocols were identified, with an exponential growth since 2005 (r2=0.981; p<0.001). RCT protocols were the most common among rehabilitation study protocols (83%), while RCTs were significantly more prevalent among study protocols than among the broader rehabilitation research (83% vs. 35.8%; p<0.001). For SRs, the picture was reversed: significantly less common among study protocols (2.8% vs. 9.3%; p<0.001). Funding was more often reported by rehabilitation study protocols than the broader rehabilitation research (90% vs. 53.1%; p<0.001). Rehabilitation journals published a significantly lower share of rehabilitation study protocols than they did for the broader rehabilitation research (1.8% vs.16.7%; p<0.001). Identifying the reasons for these discrepancies and reverting unwarranted disparities (e.g. low rate of publication for rehabilitation SR protocols) are likely new avenues for rehabilitation research and its publication. SRs, particularly those aggregating RCT results, are considered the best standard of evidence to guide rehabilitation clinical practice; however, that standard can be improved
Mohammad Ali Ahmadi-Pajouh
Robotics is a tool to assist human in different applications from industry to medicine. There are many reasons that human tends to use these machines. They are very reliable in repetitive, high precision, preprogrammed and high risk jobs in which human is not too good enough. In medicine, robotic applications are evolving so fast that in near future nobody can imagine a surgery without a robot involved. In Rehabilitation we have the same scenario; there are commercialized robots to assist dis...
Handberg, Charlotte; Maribo, Thomas; Jensen, Charlotte Maria
and the specifics of needs and plans facilitates targeted rehabilitation interventions. Implications: Systematic needs assessment in cancer rehabilitation unveil the requirement of physical rehabilitation. Supervised physical activity renders an intervention possible tailored the special needs cancer patients have......Background: Systematic assessment of rehabilitation needs is prerequisite for sufficient rehabilitation, but little is known about patients' needs. Purpose: The aim of this study was to describe specific stated rehabilitation needs and plans among patients with cancer at hospitals when diagnosed...... and when municipal rehabilitation begins. Methods: Needs-assessment-forms for rehabilitation from 188 cancer patients from two hospitals and two municipal cancer rehabilitation programmes were analysed. The forms included 1) stated needs: 58 fixed areas categorised in six domains and 2) an area to document...
Rohar, S.; Cepcek, S.
The maintenance represents one of the most important tools to ensure safe and reliable operation of nuclear power plants. The emphasis of Nuclear Regulatory Authority of the Slovak Republic to the maintenance issue is expressed by requirements in the regulations. The current practice of maintenance management in operated nuclear power plants in Slovak Republic is presented. Main aspects of maintenance, as maintenance programme, organization of maintenance, responsibilities for maintenance are described. Activities of nuclear regulatory authority in maintenance process are presented too. (author)
Modern Schools, 1976
Preventive maintenance can extend useful equipment life in a school building and keep systems running more efficiently. Points to consider before selecting a comprehensive energy management package are listed. (Author/MLF)
Presents some basic maintenance management techniques that can help schools meet their budgets, preserve staffing levels, meet productivity needs, and sustain quality services. Tips for staff recruitment, training, and retention are explored. (GR)
... Find & compare doctors, hospitals, & other providers Health Maintenance Organization (HMO) Plan In most HMO Plans, you generally ... certain service when needed. Related Resources Preferred Provider Organization (PPO) Private Fee-for-Service (PFFS) Special Needs ...
Roberts, D.F.; De Stefano, G.F.
This book contains several papers divided among three sections. The section titles are: Genetic Diversity--Its Dimensions; Genetic Diversity--Its Origin and Maintenance; and Genetic Diversity--Applications and Problems of Complex Characters
Lee, Woo Kyeong
There has been plenty of interest in cognitive rehabilitation for schizophrenia here in Korea since the year 2000. But the efficacy studies of cognitive remediation intervention are still deficient. The primary purpose of this study was to develop a computer-assisted cognitive remediation program and conduct a clinical trial in a group of schizophrenic patients. Sixty patients with schizophrenia were randomly assigned to a computerized cognitive rehabilitation (Cog-trainer) group plus usual rehabilitation (UR) or to a usual rehabilitation (UR) group only. Clinical, neuropsychological and functional outcome variables were assessed at baseline and after intervention. The Cog-trainer group received 20 sessions of computerized cognitive remediation training over 3 months. This training program consists of 10 units, with each unit being divided into three stages: (i) practice; (ii) application; and (iii) advanced. Compared to the UR group, the Cog-trainer exhibited a significant improvement in attention, concentration and working memory. The Cog-trainer group also showed improvement in the work quality subscale of the work behavior inventory. However, there were no significant benefits of computerized cognitive remediation where symptoms were concerned. These results indicate that computerized cognitive rehabilitation training can contribute to an improvement in the cognitive function of people with schizophrenia. The changes in cognitive outcomes can also contribute to improvement in job functioning. Further study of generalization to other functional outcome measures will be necessary. Long-term follow-up studies are needed to confirm the maintenance of such improvements. Copyright © 2013 Wiley Publishing Asia Pty Ltd.
Chiodo, Anthony; Wilke, Ruste; Bakshi, Rishi; Craig, Anita; Duwe, Doug; Hurvitz, Edward
Performance improvement is a mainstay of operations management and maintenance of certification. In this study at a University Hospital inpatient rehabilitation unit, Lean management techniques were used to manage throughput of patients into and out of the inpatient rehabilitation unit. At the start of this process, the average admission time to the rehabilitation unit was 5:00 p.m., with a median time of 3:30 p.m., and no patients received therapy on the day of admission. Within 8 mos, the mean admission time was 1:22 p.m., 50% of the patients were on the rehabilitation unit by 1:00 p.m., and more than 70% of all patients received therapy on the day of admission. Negative variance from this performance was evaluated, the identification of inefficient discharges holding up admissions as a problem was identified, and a Lean workshop was initiated. Once this problem was tackled, the prime objective of 70% of patients receiving therapy on the date of admission was consistently met. Lean management tools are effective in improving throughput on an inpatient rehabilitation unit.
Turner-Stokes, Lynne; Williams, Heather; Sephton, Keith; Rose, Hilary; Harris, Sarah; Thu, Aung
This article explores the rationale for choosing the instruments included within the UK Rehabilitation Outcomes Collaborative (UKROC) data set. Using one specialist neuro-rehabilitation unit as an exemplar service, it describes an approach to engaging the hearts and minds of clinicians in recording the data. Measures included within a national data set for rehabilitation should be psychometrically robust and feasible to use in routine clinical practice; they should also support clinical decision-making so that clinicians actually want to use them. Learning from other international casemix models and benchmarking data sets, the UKROC team has developed a cluster of measures to inform the development of effective and cost-efficient rehabilitation services. These include measures of (1) "needs" for rehabilitation (complexity), (2) inputs provided to meet those needs (nursing and therapy intervention), and (3) outcome, including the attainment of personal goals as well as gains in functional independence. By integrating the use of the data set measures in everyday clinical practice, we have achieved a very high rate of compliance with data collection. However, staff training and ongoing commitment from senior staff and managers are critical to the maintenance of effort required to provide assurance of data quality in the longer term.
Barbro Birgitta Johansson
Full Text Available The brain has a large capacity for automatic simultaneous processing and integration of sensory information. Combining information from different sensory modalities facilitates our ability to detect, discriminate, and recognize sensory stimuli, and learning is often optimal in a multisensory environment. Currently used multisensory stimulation methods in stroke rehabilitation include motor imagery, action observation, training with a mirror or in a virtual environment, or various kinds of music therapy. Several studies have shown positive effects been reported but to give general recommendation more studies are needed. Patient heterogeneity and the interactions of age, gender, genes and environment are discussed. Randomized controlled longitudinal trials starting earlier post stroke are needed. The advance in brain network science and neuroimaging enabling longitudinal studies of structural and functional networks are likely to have an important impact on patient selection for specific interventions in future stroke rehabilitation.
Sweet, Marshall L. [Partnership for Home Innovation, Upper Marlboro, MD (United States); Francisco, Abby [Partnership for Home Innovation, Upper Marlboro, MD (United States); Roberts, Sydney G. [Partnership for Home Innovation, Upper Marlboro, MD (United States)
Rea Ventures Group, LLC (Rea Ventures) partnered with Southface Energy Institute (Southface)—a member of the U.S. Department of Energy’s Partnership for Home Innovation Building America research team—to rehabilitate 418 low-income multifamily rental apartments located at 14 properties in Georgia (International Energy Conservation Code Climate Zones 2–4). These 22-year-old units with individual utility meters were arranged in row house or townhouse style. Rehabilitation plans were developed using a process prescribed by the U.S. Department of Agriculture (USDA) Rural Development program, which partially funded the building upgrades. The USDA is responsible for building, upgrading, and subsidizing housing in rural areas nationwide; this housing includes more than 14,000 existing multifamily housing developments. In 2012, more than $100 million in grants and loans were allocated for that purpose.
Tesini, A.; Palmer, J.
The aim of this paper is to summarize the ITER approach to machine components maintenance. A major objective of the ITER project is to demonstrate that a future power producing fusion device can be maintained effectively and offer practical levels of plant availability. During its operational lifetime, many systems of the ITER machine will require maintenance and modification; this can be achieved using remote handling methods. The need for timely, safe and effective remote operations on a machine as complex as ITER and within one of the world's most hostile remote handling environments represents a major challenge at every level of the ITER Project organization, engineering and technology. The basic principles of fusion reactor maintenance are presented. An updated description of the ITER remote maintenance system is provided. This includes the maintenance equipment used inside the vacuum vessel, inside the hot cell and the hot cell itself. The correlation between the functions of the remote handling equipment, of the hot cell and of the radwaste processing system is also described. The paper concludes that ITER has equipped itself with a good platform to tackle the challenges presented by its own maintenance and upgrade needs
Full Text Available Quality of life, health, and ability are often lost at the same time and most often in one decaying existential movement over 5 or 10 years. This “lost life” is mostly too slow to be felt as life threatening, but once awakened to reality, it provokes the deepest of fears in patients: the fear of death itself and destruction of our mere existence. The horrible experience of having “lost life”, often without even noticing how it happened, can be turned into a strong motivation for improvement. Personal development is about finding the life deeply hidden within in order to induce revitalization and rehabilitation. Rehabilitation is about philosophy of life with the integration of the repressed painful feelings and emotions from the past and the letting go of the associated negative beliefs and decisions. The holistic medical toolbox builds on existential theories (the quality of life theories, the life mission theory, the theory of character, the theory of talent, and the holistic process theory and seems to have the power to rehabilitate the purpose of life, the character of the person, and fundamental existential dimensions of man: (1 love; (2 strength of mind, feelings, and body; and 3 joy, gender, and sexuality; allowing the person once again to express and realize his talents and full potential. The principles of rehabilitation are not very different from other healing, but the task is often more demanding for the holistic physician as the motivation and resources often are very low and the treatment can take many years.
Lear, Scott A; Ignaszewski, Andrew
Abstract Cardiac rehabilitation (CR) is a commonly used treatment for men and women with cardiovascular disease. To date, no single study has conclusively demonstrated a comprehensive benefit of CR. Numerous individual studies, however, have demonstrated beneficial effects such as improved risk-factor profile, slower disease progression, decreased morbidity, and decreased mortality. This paper will review the evidence for the use of CR and discuss the implications and limitations of these stu...
Nielsen, Camilla Balslev; Lund, Henrik Hautop
We describe how playware and games may become adaptive to the interaction of the individual user and how therapists use this adaptation property to apply modular interactive tiles in rehabilitation practices that demand highly individualized training. Therapists may use the interactive modular...... patients modulating exercises and difficulty levels. We also find that in physical games there are individual differences in patient interaction capabilities and styles, and that modularity allows the therapist to adapt exercises to the individual patient’s capabilities....
Pratelli, Elisa; Cinotti, Irene; Pasquetti, Pietro
Vertebral fractures occur particularly in osteoporotic patients due to an increased bone fragility. Vertebral fractures influence the quality of life, mobility and mortality. Preventive training exercises and proprioception reeducation can be utilised for improving posture, balance and level of daily function and for decreasing pain. Quality of life is improved even beyond the active training period. This mini review provides information based on the literature for the rehabilitation of osteo...
Consumption of narcotic drugs has a long record in human societies. Drug addiction is considered as a social problem nowadays which has affected the economic-cultural and economic-social dimensions of the country. In examining the dimensions of drug addiction, one must pay attention to the issues of dependency on drugs, drug addicts and rehabilitation of drug addicts. In examining the phenomenon of addiction and its analysis as a social scourge, the issue can be analyzed at different leve...
Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation. The reason to addict the internet or smartphone is personalized individual characters related personal psychological and emotional factors and social environmental factors around them. We have shown that 2 discernible approaches due to 2 different addiction causes: that is behavioral treat...
The recovery of hand function is one of the most challenging topics in stroke rehabilitation. Although the robot-assisted therapy has got some good results in the latest decades, the development of hand rehabilitation robotics is left behind. Existing reviews of hand rehabilitation robotics focus either on the mechanical design on designers' view or on the training paradigms on the clinicians' view, while these two parts are interconnected and both important for designers and clinicians. In this review, we explore the current literature surrounding hand rehabilitation robots, to help designers make better choices among varied components and thus promoting the application of hand rehabilitation robots. An overview of hand rehabilitation robotics is provided in this paper firstly, to give a general view of the relationship between subjects, rehabilitation theories, hand rehabilitation robots, and its evaluation. Secondly, the state of the art hand rehabilitation robotics is introduced in detail according to the classification of the hardware system and the training paradigm. As a result, the discussion gives available arguments behind the classification and comprehensive overview of hand rehabilitation robotics. PMID:29230081
Stiers, William; Hanson, Stephanie; Turner, Aaron P; Stucky, Kirk; Barisa, Mark; Brownsberger, Mary; Van Tubbergen, Marie; Ashman, Teresa; Kuemmel, Angela
This article describes the methods and results of a national conference that was held to (1) develop consensus guidelines about the structure and process of rehabilitation psychology postdoctoral training programs and (2) create a Council of Rehabilitation Psychology Postdoctoral Training Programs to promote training programs' abilities to implement the guidelines and to formally recognize programs in compliance with the guidelines. Forty-six conference participants were chosen to include important stakeholders in rehabilitation psychology, representatives of rehabilitation psychology training and practice communities, representatives of psychology accreditation and certification bodies, and persons involved in medical education practice and research. Consensus guidelines were developed for rehabilitation psychology postdoctoral training program structure and process and for establishing the Council of Rehabilitation Psychology Postdoctoral Training Programs. The Conference developed aspirational guidelines for postdoctoral education and training programs in applied rehabilitation psychology and established a Council of Rehabilitation Psychology Postdoctoral Training Programs as a means of promoting their adoption by training programs. These efforts are designed to promote quality, consistency, and excellence in the education and training of rehabilitation psychology practitioners and to promote competence in their practice. It is hoped that these efforts will stimulate discussion, assist in the development of improved teaching and evaluation methods, lead to interesting research questions, and generally facilitate the continued systematic development of the profession of rehabilitation psychology. PsycINFO Database Record (c) 2012 APA, all rights reserved
Hahmann, H W
The goal of cardiac rehabilitation is to support heart patients using a multidisciplinary team in order to obtain the best possible physical and mental health and achieve long-term social reintegration. In addition to improving physical fitness, cardiac rehabilitation restores self-confidence, thus better equipping patients to deal with mental illness and improving their social reintegration ("participation"). Once the causes of disease have been identified and treated as effectively as possible, drug and lifestyle changes form the focus of cardiac rehabilitation measures. In particular diseases, rehabilitation offers the opportunity for targeted educational courses for diabetics or drug dose escalation, as well as special training for heart failure patients. A nationwide network of outpatient heart groups is available for targeted follow-up. Cardiac patients predominantly rehabilitated in follow-up rehabilitation are older and have greater morbidity than in the past; moreover, they generally come out of acute clinical care earlier and are discharged from hospital more quickly. The proportion of severely ill and multimorbid patients presents a diagnostic and therapeutic challenge in cardiac rehabilitation, although cardiac rehabilitation was not initially conceived for this patient group. The benefit of cardiac rehabilitation has been a well documented reduction in morbidity and mortality. However, hurdles remain, partly due to the patients themselves, partly due to the health insurers. Some insurance providers still refuse rehabilitation for non-ST-segment elevation infarction. In principle rehabilitation can be carried out in an inpatient or an outpatient setting. Specific allocation criteria have not yet been established, but the structure and process quality of outpatient rehabilitation should correspond to that of the inpatient setting. The choice between the two settings should be based on pragmatic criteria. Both settings should be possible for an individual
Manca, Andrea; Martinez, Gianluca; Cugusi, Lucia; Dragone, Daniele; Mercuro, Giuseppe; Deriu, Franca
Increasingly scholars and researchers are being solicited by predatory open access journals seeking manuscript submissions and abusing the author-pays model by charging authors with publishing fees without any or proper peer review. Such questionable editorial practices are threatening the reputation and credibility of scholarly publishing. To date, no investigation has been conducted on this phenomenon in the field of rehabilitation. This study attempts to identify specific predatory journals operating in this field to quantify the phenomenon and its geographic distribution. Beall's List has been used to this end which, although not perfect, is a comprehensive and up-to-date report of predatory publishers. Of the 1113 publishers on the list, 59 journals were identified, for a total of 5610 published articles. The median number of articles published by each journal was 21, and the median amount of article processing charges was $499. Only 1 out of 59 journals was included in the Directory of Open Access Journals, whereas 7 (12%) were indexed by PubMed. Most of the publishers were based in India (36%) followed by the United States (25%) and Pakistan (5%), and 25% were without a verifiable address. The data indicate that the threat of predatory publishing in rehabilitation is real. Physiatrists, physiotherapists, researchers, and academics operating in this field are advised to use the tools available to recognize predatory practices before considering publishing in open access journals. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Kokura, Yoji; Wakabayashi, Hidetaka; Maeda, Keisuke; Nishioka, Shinta; Nakahara, Saori
To determine whether the presence of a multidisciplinary rehabilitation nutrition team affects sarcopenia and cachexia evaluation and practice of rehabilitation nutrition. A cross-sectional study using online questionnaire among members of the Japanese Association of Rehabilitation Nutrition (JARN) was conducted. Questions were related to sarcopenia and cachexia evaluation and practice of rehabilitation nutrition. 677 (14.7%) questionnaires were analysed. 44.5% reported that their institution employed a rehabilitation nutrition team, 20.2% conducted rehabilitation nutrition rounds and 26.1% conducted rehabilitation nutrition meetings. A total of 51.7%, 69.7%, 69.0% and 17.8% measured muscle mass, muscle strength, physical function and cachexia, respectively. For those with a rehabilitation nutrition team, 63.5%, 80.7%, 82.4% and 22.9% measured muscle mass, muscle strength, physical function and cachexia, respectively, whereas 46.7%, 78.0% and 78.1% of the respondents reported implementation of nutrition planning strategies in consideration of energy accumulation, rehabilitation training in consideration of nutritional status and use of dietary supplements, respectively. Multivariate logistic regression analysis showed that the use of a rehabilitation nutrition team independently affected sarcopenia evaluation and practice of rehabilitation nutrition but not cachexia evaluation. The presence of a multidisciplinary rehabilitation nutrition team increased the frequency of sarcopenia evaluation and practice of rehabilitation nutrition. J. Med. Invest. 64: 140-145, February, 2017.
Migaud, D.; Hutin, J.P.; Jouette, I.; Eymond, P.; Devie, P.; Cudelou, C.; Magnier, S.; Frydman, M.
This document gathers different articles concerning the maintenance of the French nuclear power plants. The first article analyses the impact of the recent law on the energetic transition that sets the share of nuclear power at 50% of the electricity produced by 2025. A consequence may be the decommissioning of 17 to 20 reactors by 2025 and the huge maintenance program called 'Grand Carenage' whose aim is to extend operating life over 40 years will have to be re-considered in order to avoid useless expenses. The second article shows that in 2015 the French nuclear reactor fleet got very good results in terms of availability and safety. There were 49 scheduled outages and among them some ended ahead of time. The third article describes the specificities of the maintenance of a nuclear power plant, for instance the redundancy of some systems implies that maintenance has to deal with systems that have never functioned but must be ready to operate at any moment. Another specificity is the complexity of a nuclear power plant that implies an essential phase of preparation for maintenance operations. Because of safety requirements any maintenance operation has to be controlled, checked and may provide feedback. The fourth article presents the 'Grand Carenage' maintenance program that involves the following operations: the replacement of steam generators, the re-tubing of condensers, the replacement of the filtering drums used for cooling water, the testing of the reactor building, the hydraulic test of the primary circuit and the inspection of the reactor vessel. The fifth article focuses on the organization of the work-site for maintenance operations and the example of the Belleville-sur-Loire is described in the sixth article. Important maintenance operations like 'Grand Carenage' requires a strong collaboration with a network of specialized enterprises and as no reactor (except Flamanville EPR) is being built in France, maintenance
This lecture highlights my career in rehabilitation research. My principal efforts in rehabilitation have been to study (1) mechanisms of brain plasticity related to reorganization of the brain and recovery of function; (2) late postacute rehabilitation; (3) sensory substitution; and (4) rehabilitation engineering. A principal goal has been to aid in the development of a strong scientific base in rehabilitation.
... seeks to: (1) Improve the quality and utility of disability and rehabilitation research; (2) determine...; (3) identify research gaps; (4) identify mechanisms of integrating research and practice; and (5... DEPARTMENT OF EDUCATION National Institute on Disability and Rehabilitation Research-- Disability...
Conclusion: People attending metropolitan pulmonary rehabilitation, maintenance exercise classes and support groups had substantial technology engagement, with high device access and use, and good self-rated technology competence. The majority of participants were willing to use telerehabilitation, especially if they were regular users of technology devices. [Seidman Z, McNamara R, Wootton S, Leung R, Spencer L, Dale M, Dennis S, McKeough Z (2017 People attending pulmonary rehabilitation demonstrate a substantial engagement with technology and willingness to use telerehabilitation: a survey. Journal of Physiotherapy 63: 175–181
A detailed plan for the rehabilitation of the Mary Kathleen mining and processing site was developed prior to the closure of operations in late 1982. The plan was based on three basic principles of: making all areas safe for public access; removing all structures which could deteriorate and become unsightly or unsafe with time; and encouraging natural revegetation on erosion resistant surfaces. The aim was to leave the site in a safe and satisfactory condition, consistent with future land use in the area, requiring no foreseeable ongoing maintenance and a minimum of precautionary monitoring. When the programme has been completed, the only constraint on future land use will be the need to control building construction in the tailings/ evaporation, dumps and mine areas as a precaution against possible exposure to radon daughters. Appropriate radiation and water quality monitoring programmes were incorporated in the plan
Eplov, Lene; Petersen, Kirsten Schultz; Jespersen, Ejgil
The Danish Government Committee on Psychiatry states that recovery-oriented rehabilitation is an important framework and direction in psychiatry. Recovery-oriented rehabilitation means that the intervention is based on best practice. It is also based on four values: self-determination, person inv...... involvement, self-determination/choice and growth potential. A comprehensive national plan of action on how to develop a recovery-oriented rehabilitation to Danish citizens with mental disorders is recommended....
Jaylene Flint; Mark Flint; Colin James Limpus; Paul Mills
Rehabilitation of marine turtles in Queensland has multifaceted objectives. It treats individual animals, serves to educate the public, and contributes to conservation. We examined the outcome from rehabilitation, time in rehabilitation, and subsequent recapture and restranding rates of stranded marine turtles between 1996 and 2013 to determine if the benefits associated with this practice are cost-effective as a conservation tool. Of 13,854 marine turtles reported as stranded during this 18-...
Pallesen, Hanne; Buhl, Inge; Roenn-Smidt, Helle
Early neurorehabilitation is an interdisciplinary field. Thus, in order to eliminate unnecessary barriers for individuals with severe acquired brain injury in early rehabilitation, we need rehabilitation science that supports both quantitative and qualitative research methods. Participation can...... be studied directly and indirectly. This commentary proposes that active participation and the ‘‘lived body’’ are essential terms in early rehabilitation of severe ABI patients, and a description of how these terms are interpreted and handled in the practice is needed....
Alison Jennifer A
Full Text Available Abstract Background Pulmonary rehabilitation programs have been shown to increase functional exercise capacity and quality of life in COPD patients. However, following the completion of pulmonary rehabilitation the benefits begin to decline unless the program is of longer duration or ongoing maintenance exercise is followed. Therefore, the aim of this study is to determine if supervised, weekly, hospital-based exercise compared to home exercise will maintain the benefits gained from an eight-week pulmonary rehabilitation program in COPD subjects to twelve months. Methods Following completion of an eight-week pulmonary rehabilitation program, COPD subjects will be recruited and randomised (using concealed allocation in numbered envelopes into either the maintenance exercise group (supervised, weekly, hospital-based exercise or the control group (unsupervised home exercise and followed for twelve months. Measurements will be taken at baseline (post an eight-week pulmonary rehabilitation program, three, six and twelve months. The exercise measurements will include two six-minute walk tests, two incremental shuttle walk tests, and two endurance shuttle walk tests. Oxygen saturation, heart rate and dyspnoea will be monitored during all these tests. Quality of life will be measured using the St George's Respiratory Questionnaire and the Hospital Anxiety and Depression Scale. Participants will be excluded if they require supplemental oxygen or have neurological or musculoskeletal co-morbidities that will prevent them from exercising independently. Discussion Pulmonary rehabilitation plays an important part in the management of COPD and the results from this study will help determine if supervised, weekly, hospital-based exercise can successfully maintain functional exercise capacity and quality of life following an eight-week pulmonary rehabilitation program in COPD subjects in Australia.
The Maintenance Proficiency Evaluation Test Bank (MPETB) is an Electric Power Research Institute- (EPRJ-) operated, utility-sponsored means of developing, maintaining, and disseminating secure, high-quality written and performance maintenance proficiency tests. EPRTs charter is to ensure that all tests and test items that go into the Test Bank have been validated, screened for reliability, and evaluated to high standards of psychometric excellence. Proficiency tests of maintenance personnel.(mechanics, electricians, and instrumentation and control [I and C] technicians) are most often used to determine if an experienced employee is capable of performing maintenance tasks without further training. Such tests provide objective evidence for decisions to exempt an employee from what, for the employee, is unnecessary training. This leads to considerable savings in training costs and increased productivity because supervisors can assign personnel to tasks at which their competence is proven. The ultimate objective of proficiency evaluation is to ensure that qualified maintenance personnel are available to meet the maintenance requirements of the plant Numerous task-specific MPE tests (both written and performance) have been developed and validated using the EPRI MPE methodology by the utilities participating in the MPETB project A task-specific MPE consists of a multiple-choice written examination and a multi-step performance evaluation that can be used to assess an individual's present knowledge and skill level for a given maintenance task. The MPETB contains MPEs and test items for the mechanical, electrical, and I and C classifications that are readily available to participating utilities. Presently, utilities are placing emphasis on developing MPEs to evaluate outage-related maintenance tasks that demonstrate the competency and qualifications of plant and contractor personnel before the start of outage work. Utilities are also using the MPE methodology and process to
Mathieu Riou; Victor Planchon
Full text of publication follows: Current periodic inspections program carried out on the COGEMA LOGISTICS casks is required by regulations and approved by the competent Authority. Thus, Safety and casks conformity to the according certificate of approval are guaranteed. Nonetheless, based on experience it appeared that some maintenance operations did not seem relevant or were redundant. Then, it was decided to rethink completely our maintenance program to reach the following objectives: - Set up the 'a minima' required inspection operations required to guarantee Safety and conformity to the certificate of approval, - Optimize criteria and periodicities of inspections taking into account: operational feedback, routine inspections carried out for each transport, regulations, environmental impact (ALARA, waste reduction,...), cost-effectiveness (reduction of cask's immobilization period,...). - Set up a maintenance program in Safety Analysis Reports that: stands alone (no need to check the specification or the certificate of approval to have the complete list of inspections mandatory to guarantee Safety), gives objectives instead of means of controls. This approach needs then to be re-evaluated by the competent Authority. Study's scope has been limited to the TN TM 12 cask family which is intensely used. COGEMA LOGISTICS has a high operational feedback on these casks. After Authority agreement, and in accordance with its requirements, study will then be extended to the other casks belonging to the COGEMA LOGISTICS cask fleet. Actually, the term 'maintenance' is linked to 'Base maintenance' and 'Main maintenance' and implicitly means that the cask is immobilized for a given period. To emphasize the modifications, the term 'maintenance' is no longer used and is substituted by 'periodic upkeep'. By changing the name, COGEMA LOGISTICS wants to emphasize that: some operations can for instance be realized while the cask is unloaded, periodicities are thought in terms of
Maintenance optimization problem could not always settled mathematically and was obliged to use quasi-optimum solution with omitting non-formulated limiting condition or neglecting part of optimization object. In such a case knowledge engineering thinking was encouraged. Maintenance of complicated plant and artificial system should be considered from artificial object (equipment/facility hardware and system), technical information and knowledge base, and organizational and human aspect or society and institution. Comprehensive management system in organization and society was necessary not only for assuring integrity of equipment but also for attaining higher performance, reliability and economics of system. For better judgment it was important to share mechanism to make use of more information with organization or whole society. It was required to create database and data mining for knowledge base management system of maintenance. Maintenance was called 'last fortress' to assure quality such as reliability and safety of required function of equipment. Strategic approach to develop maintenance technology under cooperation was considered. Life extension R and D road map was launched in 2005. (T. Tanaka)
Rennich, M.J.; Nelson, B.E.
The Tokamak Physics Experiment machine design incorporates comprehensive planning for efficient and safe component maintenance. Three programmatic decisions have been made to insure the successful implementation of this objective. First, the tokamak incorporates radiation shielding to reduce activation of components and limit the dose rate to personnel working on the outside of the machine. This allows most of the ex-vessel equipment to be maintained through conventional ''hands-on'' procedures. Second, to the maximum extent possible, low activation materials will be used inside the shielding volume. This resulted in the selection of Titanium (Ti-6Al-4V) for the vacuum vessel and PFC structures. The third decision stipulated that the primary in-vessel components will be replaced or repaired via remote maintenance tools specifically provided for the task. The component designers have been given the responsibility of incorporating maintenance design and for proving the maintainability of the design concepts in full-scale mockup tests prior to the initiation of final fabrication. Remote maintenance of the TPX machine is facilitated by general purpose tools provided by a special purpose design team. Major tools will include an in-vessel transporter, a vessel transfer system and a large component transfer container. In addition, tools such as manipulators and remotely operable impact wrenches will be made available to the component designers by this group. Maintenance systems will also provide the necessary controls for this equipment
Haenninen, S.; Laakso, K.
The systematic analysis and documentation of operating experiences should be included in a living NPP life management program. Failure mode and effects and maintenance effects analyses are suitable methods for analysis of the failure and corrective maintenance experiences of equipment. Combined use of the information on occurred functional failures and the decision tree logic of the reliability centered maintenance identifies applicable and effective preventive maintenance tasks of equipment in an old plant. In this study the electrical motor drives of closing and isolation valves (MOV) of TVO and Loviisa nuclear power plants were selected to serve as pilot study objects. The study was limited to valve drives having actuators manufactured by AUMA in Germany. The fault and maintenance history of MOVs from 1981 up to and including October 1991 in different safety and process systems at TVO 1 and 2 nuclear power units was at first analyzed in a systematic way. The scope of the components studied was 81 MOVs in safety-related systems and 127 other MOVs per each TVO unit. In the case of the Loviisa plant, the observation period was limited to three years, i.e. from February 1989 up to February 1992. The scope of the Loviisa 1 and 2 components studied was 44 respectively 95 MOVs. (25 refs., 22 figs., 8 tabs.)
Full Text Available Spinal cord injury is a major trauma, with its short and long term effects and consequences to the patient, his friends and family. Spinal cord injury is addressed in the developed countries with standard trauma care system commencing immediately after injury and continuing to the specialized rehabilitation units. Rehabilitation is important to those with spinal injury for both functional and psychosocial reintegration. It has been an emerging concept in Nepal, which has been evident with the establishment of the various hospitals with rehabilitation units, rehabilitation centres and physical therapy units in different institutions. However, the spinal cord injury rehabilitation setting and scenario is different in Nepal from those in the developed countries since spinal cord injury rehabilitation care has not been adequately incorporated into the health care delivery system nor its importance has been realized within the medical community of Nepal. To name few, lack of human resource for the rehabilitation care, awareness among the medical personnel and general population, adequate scientific research evidence regarding situation of spinal injury and exorbitant health care policy are the important hurdles that has led to the current situation. Hence, it is our responsibility to address these apparent barriers to successful implementation and functioning of rehabilitation so that those with spinal injury would benefit from enhanced quality of life. Keywords: rehabilitation; spinal injury.
Full Text Available After a stroke many people have serious problems in motion activity, decline in cognitive activity, as well as a number of psychological problems that may accompany the man for many years. Motivational rehabilitation component plays a decisive role in the process of recovery after suffering a stroke. At present one of the most successful methods of rehabilitation is considered to be a recovery through "observation-imitation”, because this method enhances the plasticity of the brain and, as a result, rehabilitation potential. Modern rehabilitation using virtual reality had demonstrated good results to improve motor and cognitive skills, as well as the psychological condition
Petermann, F; Bauer, C-P
Against the background of rising prevalence of chronic diseases in childhood and adolescence, the rehabilitation of children and adolescents plays a major role in medical treatment. Early diagnosis and multimodal intervention are necessary to prevent a chronic course of disease and disease consequences for those affected and their families. In recent years, significant content and structural improvement of child and youth rehabilitation has been observed; currently some trends that affect not only the access to rehabilitation but also the quality of outcomes are becoming apparent. These include salutogenetic approaches, the development of specific diagnostic and treatment guidelines, the establishment of networks, integrated care, modularization, and flexibility of rehabilitation measures.
Full Text Available Stroke is a significant cause of long-term disability world-wide. The post-stroke disabilities are due to loss of locomotion, activity of daily living, cognition and communication skills. Rehabilitation is an integral part of medical management and continues longitudinally through acute care, post-acute care and community reintegration. The objectives of stroke rehabilitation are to maximize the functional independence, minimize the disabilities, reintegrate back into the home and community and improve the self-esteem of patient. A comprehensive stroke rehabilitation service should provide early assessment of impairments and disabilities, management and prevention of complications and well-organized rehabilitation program in both in-patient and out-patient settings. A multidisciplinary or interdisciplinary team approach is necessary to reduce the post-stroke disabilities. It has many members, including physicians, physical therapists, occupational therapists, speech and language pathologists, orthotist, psychotherapists, social workers, vocational rehabilitation therapists, rehabilitation nurse, patients, families and other caregivers. Physicians caring for patients with stroke during rehabilitation must be aware of potential medical complications, as well as a number of special problems that may complicate recovery, including cognitive deficits, aphasia, dysphagia, urinary incontinence, shoulder pain, spasticity, falls and depression. Involvement of patient and caregivers in the rehabilitation process is essential. This article outlines the salient features of the early comprehensive rehabilitation after stroke.
Full Text Available The aim of this review is to discuss the basic forms of neuropsychological rehabilitation for patients with traumatic brain injury (TBI. More broadly, we discussed cognitive rehabilitation therapy (CRT which constitutes a fundamental component in therapeutic interaction at many centres worldwide. Equally presented is a comprehensive model of rehabilitation, the fundamental component of which is CRT. It should be noted that the principles of this approach first arose in Poland in the 1970s, in other words, several decades before their appearance in other programmemes. Taken into consideration are four factors conditioning the effectiveness of such a process: comprehensiveness, earlier interaction, universality and its individualized character. A comprehensive programmeme of rehabilitation covers: cognitive rehabilitation, individual and group rehabilitation with the application of a therapeutic environment, specialist vocational rehabilitation, as well as family psychotherapy. These training programmemes are conducted within the scope of the ‘Academy of Life,’ which provides support for the patients in their efforts and shows them the means by which they can overcome existing difficulties. Equally emphasized is the close cooperation of the whole team of specialists, as well as the active participation of the family as an essential condition for the effectiveness of rehabilitation and, in effect, a return of the patient to a relatively normal life. Also presented are newly developing neurothechnologies and the neuromarkers of brain injuries. This enables a correct diagnosis to be made and, as a result, the selection of appropriate methods for neuropsychological rehabilitation, including neurotherapy.
Despite advances in the acute management of stroke, a large proportion of stroke patients are left with significant impairments. Over the coming decades the prevalence of stroke-related disability is expected to increase worldwide and this will impact greatly on families, healthcare systems and economies. Effective neuro-rehabilitation is a key factor in reducing disability after stroke. In this review, we discuss the effects of stroke, principles of stroke rehabilitative care and predictors of recovery. We also discuss novel therapies in stroke rehabilitation, including non-invasive brain stimulation, robotics and pharmacological augmentation. Many trials are currently underway, which, in time, may impact on future rehabilitative practice.
... responsibility of the State. The State may arrange for maintenance of such roads or portions thereof, by... 23 Highways 1 2010-04-01 2010-04-01 false Maintenance. 633.208 Section 633.208 Highways FEDERAL... PROVISIONS Federal-Aid Contracts (Appalachian Contracts) § 633.208 Maintenance. Maintenance of all highway...
The Fast Flux Test Facility (FFTF) was designed with maintainability as a primary parameter, and facilities and provisions were designed into the plant to accommodate the maintenance function. This paper describes the FFTF and its systems. Special maintenance equipment and facilities for performing maintenance on radioactive components are discussed. Maintenance provisions designed into the plant to enhance maintainability are also described
In this paper we set up a framework for lifetime oriented maintenance planning as an outcome and input for strategic housing stock management. The maintenance planning holds maintenance activities and costs in the longer term. We consider the maintenance planning as a tool to calculate and implement
Chiu, Chung-Yi; Tansey, Timothy N.; Chan, Fong; Strauser, David; Frain, Michael P.; Arora, Simran
Objectives: To examine the effect of rehabilitation technology interventions on the employment or job retention outcomes of individuals with multiple sclerosis (MS) served by the state-federal vocational rehabilitation program using a case-control study design. Participants: Data for this study were extracted from the Rehabilitation Services…
Barolin, G. S.
This discussion of geriatric rehabilitation stresses the importance of holistic and permanent rehabilitation with a fluent transition from the acute phase to the rehabilitation phase under one specialist's care and in one institution. Recommendations include mixed age groups in one ward; systematic education of relatives; follow-up rehabilitation…
... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview.... The Assistant Secretary for Special Education and Rehabilitative Services may change the maximum..., Assistant Secretary for Special Education and Rehabilitative Services. [FR Doc. 2010-9635 Filed 4-23-10; 8...
... and rehabilitation research; (2) foster an exchange of expertise, information, and training methods to... disabilities, as well as to build the research capacity of entities with close cultural and social connections... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Center on Research...
Full Text Available Maintenance decision making becomes more and more a management concern. Some decades ago, maintenance was still often considered as an unavoidable side effect of production. The perception of maintenance has evolved considerably. One of the current issues is the maintenance concept, being the mix of maintenance interventions and the general framework for determining this mix. In this paper we describe a modular framework, called Knowledge Based Maintenance, for developing a customised maintenance concept. After describing the general framework and its decision support use, some case experiences are given. This experience covers some elements of the proposed framework.
Hals, B.E. [Oceaneering International Services, (United Kingdom)
The topic of diverless maintenance will address subsea production facilities in this paper. The major factors that determine diverless maintainability are development economics, maintenance philosophy, subsea hardware design, subsea intervention hardware, and compatibility of subsea hardware and remote work capabilities. The opportunity for developing and implementing low cost diverless installable and maintenable subsea facilities exist. Designs, hardwares, and procedures exist althoughmany of these have been combined into powerful solutions. This paper addresses the issues that need to be considered and provides one set of solutions. There are a number of other solutions that can be combined in a different set to provide a parallel but different solution. The challenge is to establish a process that defines the requirement, identifies the resources/capabilities, executes the work. 3 refs., 10 figs.
Zwisler, Ann-Dorthe; Rossau, Henriette Knold; Nakano, Anne; Foghmar, Sussie; Eichhorst, Regina; Prescott, Eva; Cerqueira, Charlotte; Soja, Anne Merete Boas; Gislason, Gunnar H; Larsen, Mogens Lytken; Andersen, Ulla Overgaard; Gustafsson, Ida; Thomsen, Kristian K; Boye Hansen, Lene; Hammer, Signe; Viggers, Lone; Christensen, Bo; Kvist, Birgitte; Lindström Egholm, Cecilie; May, Ole
The Danish Cardiac Rehabilitation Database (DHRD) aims to improve the quality of cardiac rehabilitation (CR) to the benefit of patients with coronary heart disease (CHD). Hospitalized patients with CHD with stenosis on coronary angiography treated with percutaneous coronary intervention, coronary artery bypass grafting, or medication alone. Reporting is mandatory for all hospitals in Denmark delivering CR. The database was initially implemented in 2013 and was fully running from August 14, 2015, thus comprising data at a patient level from the latter date onward. Patient-level data are registered by clinicians at the time of entry to CR directly into an online system with simultaneous linkage to other central patient registers. Follow-up data are entered after 6 months. The main variables collected are related to key outcome and performance indicators of CR: referral and adherence, lifestyle, patient-related outcome measures, risk factor control, and medication. Program-level online data are collected every third year. Based on administrative data, approximately 14,000 patients with CHD are hospitalized at 35 hospitals annually, with 75% receiving one or more outpatient rehabilitation services by 2015. The database has not yet been running for a full year, which explains the use of approximations. The DHRD is an online, national quality improvement database on CR, aimed at patients with CHD. Mandatory registration of data at both patient level as well as program level is done on the database. DHRD aims to systematically monitor the quality of CR over time, in order to improve the quality of CR throughout Denmark to benefit patients.
Tanimoto, Keishi; Sugimoto, Yasuaki; Miyamoto, Shinya; Nada, Hideki; Hosoi, Yoshihiko
Recently, it is critical to manage deteriorating sewerage and road facilities efficiently and strategically. Since the sewerage pipes are mostly installed under road pavement, the works for the replacement of the sewerage pipes are partially common to the works for the road. This means that the replacement cost can be saved by coordinating the timing of the replacements by sewerage pipe and road pavement. The purpose of the study is to develop the model based on Markov decision process to derive the optimal group maintenance policy so as to minimize lifecycle cost. Then the model is applied to case study area and demonstrated to estimate the lifecycle cost using statistical data such as pipe replacement cost, road pavement rehabilitation cost, and state of deterioration of pipes and road pavement.
Full Text Available This paper reports the application of total productive maintenance method at Paccar Inc. truck’s plant in Victoria, Australia. The total productive maintenance method and total productive maintenance house are presented. The global equipment effectiveness is computed and exemplified. The production structure and organising maintenance are presented. Resultas of the variation of global equipment effectiveness and autonomous maintenance in a two weeks period of time are reported.
This paper reports the application of total productive maintenance method at Paccar Inc. truck’s plant in Victoria, Australia. The total productive maintenance method and total productive maintenance house are presented. The global equipment effectiveness is computed and exemplified. The production structure and organising maintenance are presented. Resultas of the variation of global equipment effectiveness and autonomous maintenance in a two weeks period of time are reported.
Pathirana, Shan; Abeygunawardane, Saranga Kumudu
In this paper, a probabilistic maintenance model is developed for inspection based preventive maintenance of diesel engines based on the practical model concepts discussed in the literature. Developed model is solved using real data obtained from inspection and maintenance histories of diesel engines and experts' views. Reliability indices and costs were calculated for the present maintenance policy of diesel engines. A sensitivity analysis is conducted to observe the effect of inspection based preventive maintenance on the life cycle cost of diesel engines.
Stanislav Vladimirovich Daletskiy; Stanislav Stanislavovich Daletskiy
The aircraft maintenance is realized by a rapid sequence of maintenance organizational and technical states, its re- search and analysis are carried out by statistical methods. The maintenance process concludes aircraft technical states con- nected with the objective patterns of technical qualities changes of the aircraft as a maintenance object and organizational states which determine the subjective organization and planning process of aircraft using. The objective maintenance pro- cess is ...
Md Azree Othuman Mydin; Siti Hajar Ismail; Norhidayah Md Ulang
An investment in the building maintenance aspect is massive throughout the world. In most of the countries, it signifies approximately 50% of the entire revenue of the construction industry. The value of buildings depends on the eminence of the maintenance invested in them. Maintenance management engages obtaining utmost advantage from the investment made on the maintenance activities. At the moment, maintenance in buildings in Malaysia is on the increase in spite of size, ...
Cox, J.H.; Chittenden, W.F.
BWR Services has implemented a five-phase program to increase plant availability and capacity factor in operating BWR's. One phase of this program is establishing a maintenance training program on NSSS equipment; the scope encompasses maintenance on both mechanical equipment and electrical control and instrumentation equipment. The program utilizes actual product line equipment for practical Hands-on training. A total of 23 formal courses will be in place by the end of 1979. The General Electric Company is making a multimillion dollar investment in facilities to support this training. These facilities are described
Full Text Available Enhancing the machines’ technical and technological performance through constructive improvements that allow for the automation of orders, contributes to the increasing of the production capacity of the system and for maintaining an optimal level of product costs. In order to achieve these goals, it is necessary to organize the maintenance work well, in order to quickly diagnose the malfunctions and to shorten the repair time. Given the scale of the phenomena, this paper seeks to answer two questions, namely: how will be the maintenance in future and also how to prepare this activity.
Miyahara, Masatoshi; Kanazawa, Masafumi
The article reports on information systems and related tools that support routine inspection and preventive maintenance activities, which contribute to safer plant operation and increase plant operating duty. Tools include the Mitsubishi Electric Reliability and Availability Upgrade Program-Nuclear (MELRAP-N), which supports the general evolution of industry operating experiences, periodic component replacement management, management of discontinued and modified components, periodic inspection item management, and periodic inspection workplace management. The article also introduces a comprehensive preventive maintenance management system currently under development. (author)
As we move towards the 21st century, those Manufacturing Industries that survive, will have changed their "efficiency" focus away from the conventional wisdom of "efficient individual tasks", to focus on the "effectiveness of a total manufacturing process". This seemingly insignificant change of emphasis, (from task to process) must include "the integration of process plant maintenance into the production process". Manufacturing companies, which do not include an effective plant maintenance strategy into their business strategy, will not survive the business environment of the 21st Century.
Povazhnaya, E L; Gusakova, E V; Moiseenko, S V
The present work is devoted to the prospects for attracting investments for the maintenance and development of the medical rehabilitation practices based at the Russian health resort facilities. The article describes the prerequisites for the enhancement of the investment attractiveness of the development of the system of medical rehabilitation in the said institutions including the formulation and strengthening of the legal and regulatory framework, the capacity for the organization of the second and third stages of medical rehabilitation in the existing spa and health resort facilities, the attraction of the funds of compulsory medical insurance as an additional source of the financial support. The main legal documents regulating the organization and provision of medical rehabilitation based at the spa and health resort facilities are presented. The results of the implementation of the investment concept of the development of medical rehabilitation in the framework of the system of health resort treatment as exemplified by the experience of JSC «The group of companies «Medsi» are discussed. It is shown that the development of medical rehabilitation based at the spa and health resort facilities greatly contributes to the significant expansion of the potential customer base and promotes the further growth of business scale.
Lynn, L. A.
Oil exploration in Alaska's Arctic has been conducted for more than 40 years, resulting in over 3,640 ha of gravel fill placed for roads, pads, and airstrips to support the industry. Likewise, tundra disturbance from burying power lines and by tundra vehicle travel are also common. Rehabilitation of disturbed sites began around 2002, with well over 150 ha that has been previously treated or is currently being rehabilitated. Two primary goals of rehabilitation efforts have been 1) revegetation by indigenous species, and 2) limiting thermokarst. Early efforts were concerned that removing gravel and having exposed bare ground would lead to extensive subsidence and eolian erosion. Native grass cultivars (e.g. Poa glauca, Arctagrostis latifolia, and Festuca rubra) were seeded to create vegetation cover quickly with the expectation that these grasses would survive only temporarily. The root masses and leaf litter were also expected to trap indigenous seed to enhance natural recolonization by indigenous plants. Due to the remote location of these sites, many of which are only accessible by helicopter, most are visited only two to three times following cultivation treatments, providing a limited data pool. At many sites, the total live seeded grass cover declined about 15% over the first 5¬-6 years (from around 30% to 15% cover), while total live indigenous vascular cover increased from no or trace cover to an average of 10% cover in that time. Cover of indigenous vascular plants at sites that were not seeded with native grass cultivars averaged just less than 10% after 10 years, showing no appreciable difference between the two approaches. Final surface elevations at the sites affect local hydrology and soil moisture. Other factors that influence the success of vegetation cover are proximity to the Arctic coast (salt effects), depth of remaining gravel, and changes in characteristics of the near-surface soil. Further development of rehabilitation techniques and the
Nielsen, Camilla Balslev; Lund, Henrik Hautop
We describe how playware and games may become adaptive to the interaction of the individual user and how therapists use this adaptation property to apply modular interactive tiles in rehabilitation practices that demand highly individualized training. Therapists may use the interactive modular......’s lung (COLD) patients and stroke patients in hospitals and in the private homes of patients and elderly. Through a qualitative research methodology of the new practice with the tiles, we find that therapists are using the modular aspect of the tiles for personalized training of a vast variety of elderly...
Peoples, Hanne; Satink, Ton; Steultjens, Esther
this perspective. METHODS AND MATERIALS: A systematic review of qualitative studies was performed. A literature search in MEDLINE, CINAHL, PsycINFO, and EMBASE was conducted. Suitability for inclusion was based on selected criteria: published qualitative studies written in English from 1990 to 2008 on stroke...... needs, 3) Physical and non-physical needs, 4) Being personally valued and treated with respect, 5) Collaboration with health care professionals and 6) Assuming responsibility and seizing control. DISCUSSION: The synthesis showed that stroke survivors' experiences of rehabilitation reflected individual...
Full Text Available Abstract Background Development and increasing acceptance of rehabilitation robots as well as advances in technology allow new forms of therapy for patients with neurological disorders. Robot-assisted gait therapy can increase the training duration and the intensity for the patients while reducing the physical strain for the therapist. Optimal training effects during gait therapy generally depend on appropriate feedback about performance. Compared to manual treadmill therapy, there is a loss of physical interaction between therapist and patient with robotic gait retraining. Thus, it is difficult for the therapist to assess the necessary feedback and instructions. The aim of this study was to define a biofeedback system for a gait training robot and test its usability in subjects without neurological disorders. Methods To provide an overview of biofeedback and motivation methods applied in gait rehabilitation, previous publications and results from our own research are reviewed. A biofeedback method is presented showing how a rehabilitation robot can assess the patients' performance and deliver augmented feedback. For validation, three subjects without neurological disorders walked in a rehabilitation robot for treadmill training. Several training parameters, such as body weight support and treadmill speed, were varied to assess the robustness of the biofeedback calculation to confounding factors. Results The biofeedback values correlated well with the different activity levels of the subjects. Changes in body weight support and treadmill velocity had a minor effect on the biofeedback values. The synchronization of the robot and the treadmill affected the biofeedback values describing the stance phase. Conclusion Robot-aided assessment and feedback can extend and improve robot-aided training devices. The presented method estimates the patients' gait performance with the use of the robot's existing sensors, and displays the resulting biofeedback
Egan, Mary Y; Laliberte Rudman, Debbie; Ceci, Christine; Kessler, Dorothy; McGrath, Colleen; Gardner, Paula; King, Judy; Lanoix, Monique; Malhotra, Ravi
Conceptualizations of risk in seniors' rehabilitation emphasize potential physical injury, functional independence and cost containment, shifting rehabilitation from other considerations essential to promoting a satisfying life. In a two-day multidisciplinary planning meeting we critically examined and discussed alternatives to dominant conceptualizations. Invitees reflected on conceptualizations of risk in stroke rehabilitation and low vision rehabilitation, identified and explored positive and negative implications and generated alternative perspectives to support rehabilitation approaches related to living a good life. Current risk conceptualizations help focus rehabilitation teamwork and make this work publically recognizable and valued. However, they also lead to practice that is depersonalized, decontextualized and restrictive. Further research and practice development initiatives should include the voices of clinicians and seniors to more adequately support meaningfully living, and foster safe spaces for seniors and clinicians to speak candidly, comprehensively and respectfully about risk. To ensure that seniors' rehabilitation targets a satisfying life as defined by seniors, increased focus on the environment and more explicit examination of how cost containment concerns are driving services is also necessary. This work reinforced current concerns about conceptualizations of risk in seniors' rehabilitation and generated ways forward that re-focus rehabilitation more on promoting a satisfying life. Implications for rehabilitation In seniors' rehabilitation, considerations of risk focus on physical injury, functional dependence and cost containment. Focus on provider-defined risk of physical injury limits examination of patient goals and patients' histories of judging and dealing with risk. Focus on functional dependence and cost containment may lead to practice that is depersonalized and decontextualized. Abandonment of ableist and ageist thinking and an
Beer, Serafin; Khan, Fary; Kesselring, Jürg
Multiple sclerosis is a complex, heterogeneous disease associated with long-term disability. Despite the availability of advanced disease-modifying and symptomatic therapies that may decrease activity and progression of disease and alleviate complaints to a certain extent, there is still a need for comprehensive rehabilitation interventions in order to reduce sequels and symptoms of the disease on personal activities and social participation to achieve the highest possible independence and the best quality of life. Timing and setting of rehabilitation interventions should be selected individually depending on disease phase, functional deficits, personal requirements, as well as specific goals. In addition, limitations and disease-specific characteristics that may influence rehabilitation outcome should be noted. Rehabilitation interventions should be considered early for maintaining functional capacity and reducing risk for losing important abilities or independence. Due to gradual failure of adaptive compensatory mechanisms along the course of disease, benefits of rehabilitation interventions are generally higher in earlier phases of MS. Inpatient and outpatient multidisciplinary rehabilitation has been shown to be beneficial in improving disability, participation and quality of life despite progression of the disease. Good evidence exists for different specific interventions improving physical and cognitive performance. Other important issues responsible for beneficial effects of comprehensive rehabilitation in MS include education, instruction, and information of patients and caregivers. Comprehensive assessment of health domains in MS patients using standardized framework and common language for describing the impact of disease at different levels, using International Classification of Functioning, Disability and Health (ICF) core sets may increase the knowledge of needs of these patients for more efficient and adapted rehabilitation interventions meeting these
Crespo Márquez, Adolfo
“The Maintenance Management Framework” describes and reviews the concept, process and framework of modern maintenance management of complex systems; concentrating specifically on modern modelling tools (deterministic and empirical) for maintenance planning and scheduling. It will be bought by engineers and professionals involved in maintenance management, maintenance engineering, operations management, quality, etc. as well as graduate students and researchers in this field.
Poppe, J.; Basten, R.J.I.; Boute, R.N.; Lambrecht, M.R.
Capital assets, such as manufacturing equipment, require maintenance to remain functioning. Maintenance can be performed when a component breaks down and needs replacement (i.e., corrective maintenance), or the maintenance and part replacement can be performed preventively. Preventive maintenance
Sweet, Marshall L. [Partnership for Home Innovation, Upper Marlboro, MD (United States); Francisco, Abby [Partnership for Home Innovation, Upper Marlboro, MD (United States); Roberts, Sydney G. [Partnership for Home Innovation, Upper Marlboro, MD (United States)
Rea Ventures Group, LLC, (Rea Ventures) partnered with Southface Energy Institute (Southface) on the rehabilitation of 418 low-income rental multifamily apartments located at 14 different properties in Georgia (Climate Zones 2-4). These 22-year old, individually-metered units were arranged in rowhouse or townhouse style units. Rehabilitation plans were developed using a process prescribed by the US Department of Agriculture (USDA) Rural Development program, who partially funded the building upgrades. The USDA is responsible for building, upgrading, and subsidizing housing in rural areas nationwide. In 2012, over $100 million was allocated in grants and loans. Due to the unique financing mechanism as well as long-term ownership requirements, property owners are especially motivated to invest in upgrades that will increase durability and tenant retention. These buildings represent a large stock of rural affordable housing that have the potential for significant energy and cost savings for property owners and tenants. Southface analyzed the energy upgrade potential of one stereotypical property in the Rea Ventures portfolio. This study will provide insight into the most cost-effective, implementable energy efficiency and durability upgrades for this age multifamily housing, having an enormous impact not only on the portfolio of Rea Ventures but on the vast USDA and larger Federal portfolio. Additionally, Southface will identify gaps in the current capital needs assessment process, examine available audit and simulation tools and protocols, and evaluate additional auditor training or certification needs.
Johansson, A; Johansson, A-K; Omar, R; Carlsson, G E
The purpose of this review was to evaluate the literature on the rehabilitation of tooth wear, with some pertinent historical, epidemiological and aetiological aspects of tooth wear provided as background information. In historical skull material, extensive tooth wear, assumed to be the result of coarser diets, was found even in relatively young individuals. Such wear is seldom seen in current populations. Although many of the factors associated with extensive tooth wear in historical material are no longer present or prevalent, new risk factors have emerged. In the young individual, the literature points to a global rise in soft drink consumption as the most significant factor in the development of tooth wear through dental erosion. Among older individuals, lifestyle changes and chronic diseases that are controlled with medications that may, in turn, result in regurgitation and/or dry mouth, are possible reasons amongst others for the widespread clinical impression of an increasing prevalence of tooth wear. The aetiology of tooth wear is multifactorial and the role of bruxism is not known. Clinical controlled trials of restorative and prosthodontic approaches for the range of clinical conditions that wear can give rise to, are limited in number and quality. Equally, the striking lack of evidence regarding the long-term outcomes of treatment methods and materials calls for caution in clinical decision-making. Notwithstanding these observations, clinicians have provided and continue to provide rehabilitative strategies for managing their patients' worn dentitions that range traditionally from extensive prosthodontics to an increasing reliance on adhesive techniques.
Full Text Available Consumption of narcotic drugs has a long record in human societies. Drug addiction is considered as a social problem nowadays which has affected the economic-cultural and economic-social dimensions of the country. In examining the dimensions of drug addiction, one must pay attention to the issues of dependency on drugs, drug addicts and rehabilitation of drug addicts. In examining the phenomenon of addiction and its analysis as a social scourge, the issue can be analyzed at different levels including the social structures, the relationship between the individual and the society and individual matters. Another theory considered in this article is the designation of the causality hierarchy. Two research methods have been used in this article for delineating and analyzing drug addiction. The first method is the content analysis method where one looks into the effective elements that lead to addiction and also its consequences. It also takes into consideration different theories related to the rehabilitation methods. Another method of analysis that is being used is related to detailed interviews and case studies conducted on drug addicts. Another method is the statistical method which elaborates on the phenomenon of addiction in a statistical way and depicts one-dimensional or two-dimensional charts focusing on variables. The relationship between these variables are evaluated through statistical tests and eventually proposes the strategy aimed at the elimination of drug addiction.
Rudnick, Abraham; Eastwood, Diane
As part of a rapidly spreading reform toward recovery-oriented services, mental health care systems are adopting Psychiatric/Psychosocial Rehabilitation (PSR). Accordingly, PSR education and training programs are now available and accessible. Although psychiatrists and sometimes other physicians (such as family physicians) provide important services to people with serious mental illnesses and may, therefore, need knowledge and skill in PSR, it seems that the medical profession has been slow to participate in PSR education. Based on our experience working in Canada as academic psychiatrists who are also Certified Psychiatric Rehabilitation Practitioners (CPRPs), we offer descriptions of several Canadian initiatives that involve physicians in PSR education. Multiple frameworks guide PSR education for physicians. First, guidance is provided by published PSR principles, such as the importance of self-determination (www.psrrpscanada.ca). Second, guidance is provided by adult education (andragogy) principles, emphasizing the importance of addressing attitudes in addition to knowledge and skills (Knowles, Holton, & Swanson, 2011). Third, guidance in Canada is provided by Canadian Medical Education Directives for Specialists (CanMEDS) principles, which delineate the multiple roles of physicians beyond that of medical expert (Frank, 2005) and have recently been adopted in Australia (Boyce, Spratt, Davies, & McEvoy, 2011). (PsycINFO Database Record (c) 2013 APA, all rights reserved).
Lu, Wenliang; Zhou, Ping; Zheng, Songbai; Xue, Di
Although many studies have discussed burnout in clinical physicians, the evidence literature about physical rehabilitation professionals is still limited in China. To understand the current status of rehabilitation services and burnout of rehabilitation professionals in Shanghai. Twenty-four hospitals located in three districts of Shanghai were selected for this study. The questionnaire surveys of 24 hospitals and their 221 rehabilitation professionals and 235 other medical professionals were conducted. The percentages of the hospitals that had rehabilitation departments in three districts of Shanghai ranged from 25.0% to 88.9%, suggesting a great variation in distribution of rehabilitation resources. Only one tertiary general hospital had 12 beds for inpatient rehabilitation. The surveyed rehabilitation professionals who had graduate or undergraduate education accounted for 64.90% as a whole, but 49.32% in community health centers, 66.67% in secondary general hospitals, and 77.78% in tertiary general hospitals. The average scores for emotional exhaustion, cynicism and low professional efficacy were 11.66, 7.48, and 10.36 respectively. This study reveals that the resources in the field of rehabilitation in Shanghai need to be enhanced to meet its future demands. It is also recommended that the managers in secondary general hospitals and the local government pay more attention to the rehabilitation professionals in the secondary general hospitals because they are reporting higher emotional exhaustion. Finally, the value of rehabilitation services to help persons with disabilities need to be better conveyed to all interested parties.
Engberg, Aase Worså; Liebach, Annette; Nordenbo, Annette Mosbæk
OBJECTIVES: To present results from the first 3 years of centralized subacute rehabilitation after very severe traumatic brain injury (TBI), and to compare results of centralized versus decentralized rehabilitation. MATERIAL AND METHODS: Prospectively, the most severely injured group of adults fr...
Surveyed 348 prison inmates about their needs or interests in rehabilitation programs, reasons for their needs, whether they deserved treatment, and why. Results suggest that prisoners view rehabilitation and reform as the major purpose of punishment or prison sentence. Need was endorsed most often as fairest criterion for program participation.…
Cardol, M.; Jong, B.A. de; Ward, C.D.
To explore the concept of autonomy as a basis for social participation, with particular reference to rehabilitation. Method: A study of relevant literature from the field of rehabilitation, building on theory developed in other fields (ethics, social sciences), and deriving important concepts and
Given that mobility impairment is a hallmark of multiple sclerosis, people with this disease are likely to benefit from rehabilitation therapy throughout the course of their illness. The review provides an update on rehabilitation focused on balance and walking impairment. Classical rehabilitation focusing on muscle rehabilitation, neurotherapeutic facilitation is effective and recommended. Other techniques did not prove their superiority: transcutaneal neurostimulation, repetitive magnetic stimulation, electromagnetic therapy, whole body vibration and robot-assisted gait rehabilitation and need more studies to conclude. Cooling therapy, hydrotherapy, orthoses and textured insoles could represent a complementary service to other techniques in specific conditions. Multidisciplinary rehabilitation program provides positive effects and high satisfaction for patients with multiple sclerosis but needs more evaluation. New technologies using serious game and telerehabilitation seem to be an interesting technique to promote physical activity, self-management and quality of life. Rehabilitation like other therapy needs regular clinical evaluation to adapt the program and propose appropriate techniques. Moreover, the objective of rehabilitation needs to be decided with the patient with realistic expectation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
This paper provides a synopsis of the general criteria by which the Supervising Scientist will determine the success of rehabilitation at Nabarlek. The paper also refers to standards that stakeholders, including the Supervising Scientist, are likely to refer to when assessing the progress of rehabilitation
... (MARK-TO-MARKET) Restructuring Plan § 401.472 Rehabilitation funding. (a) Sources of funds—(1) Project... has determined that funding from this source is available. (b) Statutory restrictions. Any... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Rehabilitation funding. 401.472...
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Settles, Robert B.; Crisler, Jack R.
Provision of training for an interdisciplinary rehabilitation team in a center serving mental patients was investigated. An autonomous service delivery rehabilitation team was formed and provided training in cooperative function. Findings indicate that the experimental team became a particularly cohesive functional unit, and that their support of…
Settles, Robert B.; Crisler, Jack R.
The traditional team concept in rehabilitation is a differentiated team in which each member performs a different function. In practice, such teams are rarely cooperative and their additive services are disjointed. Presented is the philosophic rationale for the revitalization of a large rehabilitation center serving mental patients. Reorganization…
Yang, M D; Su, T C
The major steps of sewerage rehabilitation include inspection of sewerage, assessment of structural conditions, computation of structural condition grades, and determination of rehabilitation methods and materials. Conventionally, sewerage rehabilitation planning relies on experts with professional background that is tedious and time-consuming. This paper proposes an automation model of planning optimal sewerage rehabilitation strategies for the sewer system by integrating image process, clustering technology, optimization, and visualization display. Firstly, image processing techniques, such as wavelet transformation and co-occurrence features extraction, were employed to extract various characteristics of structural failures from CCTV inspection images. Secondly, a classification neural network was established to automatically interpret the structural conditions by comparing the extracted features with the typical failures in a databank. Then, to achieve optimal rehabilitation efficiency, a genetic algorithm was used to determine appropriate rehabilitation methods and substitution materials for the pipe sections with a risk of mal-function and even collapse. Finally, the result from the automation model can be visualized in a geographic information system in which essential information of the sewer system and sewerage rehabilitation plans are graphically displayed. For demonstration, the automation model of optimal sewerage rehabilitation planning was applied to a sewer system in east Taichung, Chinese Taiwan.
Peter R. Robichaud; Jan L. Beyers; Daniel G. Neary
Spending on postfire emergency watershed rehabilitation has increased during the past decade. A west-wide evaluation of USDA Forest Service burned area emergency rehabilitation (BAER) treatment effectiveness was undertaken as a joint project by USDA Forest Service Research and National Forest System staffs. This evaluation covers 470 fires and 321 BAER projects, from...
Patterson, Jeanne Boland; Patrick, Adele; Parker, Randall M.
The concept of choice has evolved into legal mandates and ethical challenges for rehabilitation professionals during the latter part of the 20th century. This article identifies the ethical and legal issues related to choice, summarizes a pilot project on rehabilitation counselors' perceptions of choice, and provides recommendations for…
Vazquez-Ramos, Robinson; Leahy, Michael; Estrada Hernandez, Noel
Rehabilitation researchers have found in the application of the Delphi method a more sophisticated way of obtaining consensus from experts in the field on certain matters. The application of this research methodology has affected and certainly advanced the body of knowledge of the rehabilitation counseling practice. However, the rehabilitation…
Giesen, J. Martin; Cavenaugh, Brenda S.; Johnson, Cherie A.
Provides an outline of knowledge areas in rehabilitation counseling and rehabilitation teaching related to visual impairments such as: core areas; planning and delivery services; job development, placement, and follow-along; job engineering; Braille and other tactual systems; communication systems; computers for individuals with visual…
.... If specialized rehabilitative services such as but not limited to physical therapy, speech-language pathology, occupational therapy, and mental health rehabilitative services for mental illness and mental...
Järvinen, Margaretha; Miller, Gale
Drawing on qualitative interviews with drug addicts in Copenhagen, Denmark, this article offers a phenomenological reading of a methadone maintenance program. The program is set within the principles of harm reduction, meaning that its aim is not to cure the participants’ addiction but to keep them...
De Jong, A.
Unavailability of technical systems, such as aircraft, is expensive. Technical systems require maintenance to prevent and to remedy defects that cause unavailability. Users of technical systems usually bear the consequences of the risk of unavailability, in particular the loss of productivity. This
The Project Surveillance and Maintenance Plan (PSMP) describes the procedures that will be used by the US Department of Energy (DOE), or other agency as designated by the President to verify that inactive uranium tailings disposal facilities remain in compliance with licensing requirements and US Environmental Protection Agency (EPA) standards for remedial actions. The PSMP will be used as a guide for the development of individual Site Surveillance and Maintenance Plans (part of a license application) for each of the UMTRA Project sites. The PSMP is not intended to provide minimum requirements but rather to provide guidance in the selection of surveillance measures. For example, the plan acknowledges that ground-water monitoring may or may not be required and provides the [guidance] to make this decision. The Site Surveillance and Maintenance Plans (SSMPs) will form the basis for the licensing of the long-term surveillance and maintenance of each UMTRA Project site by the NRC. Therefore, the PSMP is a key milestone in the licensing process of all UMTRA Project sites. The Project Licensing Plan (DOE, 1984a) describes the licensing process. 11 refs., 22 figs., 8 tabs
A maintenance of CERN telephone exchanges will be performed on 21st, 22nd, 23rd, 24th of September from 7 p.m. to 9 p.m. Disturbances or even interruptions of telephony services may occur during this lapse of time. We apology in advance for any inconveniences that this may cause.
Because safety is related to electrical power systems maintenance, it seems reasonable to assume there could be legal issues if maintenance is not performed. OSHA has not yet taken the stand that not performing maintenance as required by the manufacturer, NFPA 70B, or ANSI/NETA MTS-07 constitutes a willful violation. OSHA defines a willful citation as one where: "the employer knowingly commits with plain indifference to the law. The employer either knows that what he or she is doing constitutes a violation, or is aware that a hazardous condition existed and made no reasonable effort to eliminate it". However, NFPA 70E 2009 requires this maintenance, and OSHA has stated on its Web site that NFPA 70E is "a guide for meeting the requirements of the OSHA electrical regulations". In addition, federal courts have found that NFPA 70E is "standard industry practice." Once a company receives and accepts a willful citation, especially if received as the result of an accident investigation, its worker's compensation protection no longer shields it. One definition given by a trial attorney for a willful citation was that it is equal to negligent behavior. Be smart: Maintain that equipment and save yourself major problems, including unscheduled shutdowns and possible litigation.
Department of JMTR project has developed the Maintenance Engineering System which evaluates the aging tendency of the facilities. The system is used for the repair plan and the replace period of parts, components, equipments or facilities. The system has the data-base which consists of the check data, the inspection data, the trouble data and the repair data at the JMTR since the virgin criticality. The system is utilized maintenance works and concludes the maintenance procedures for the failure components, equipments and facilities. This system has the following characteristics. (1) Anybody can operate the system as easily as word processor. (2) Data are put into by man-machine-interface. (3) The data sheets are with light color and the recognizable arrangements. (4) The system is cost-efficient using commercial personal computers and applications. The research card and the layouts of the input data sheet had been formatted. Data has been begun to be put into the system and to check its functions. The result demonstrates that the system is available for preventive maintenance at the JMTR. (author)
COMMUNICATIONS, AND COMPUTER SCIENCES I ,(AIRMICS) FO~SOFTWARE TOOLS (.o FOR SOF1 ’ARE MAINTENANCE (ASQBG-1-89-001) October, 1988 DTIC ELECTE -ifB...SUNWW~. B..c Program An~Iysw HA.c C-Tractr C Cobol Stncturing Facility VS Cobol 11 F-Scan Foctma Futbol Cobol Fortran Sltiuc Code Anaiyaer Fortran IS
A description is provided of the maintenance program developed for remote reconnaissance vehicles, such as RRV-1, in use at the Three Mile Island Unit 2. The described approach, which is simple, effective, and flexible, helped to make the effort successful. It will be applied to future projects
Mozos Fernandez, V.
The aim of this work is to prove that is not necessary a deep and complex knowledge to manage the centrifugal pumps maintenance. According to the author, only deep but single technical knowledge about causes of breakdowns in the different and simple component parts of the pumps, are required. (Author)
Palm Beach County Board of Public Instruction, West Palm Beach, FL.
This student learning guide contains one module for completing a course in building maintenance. It is designed especially for use in secondary schools in Palm Beach County, Florida. The module covers one task, and consists of a purpose, performance objective, enabling objectives, learning activities keyed to resources, information sheets, student…
Maehr, Bruno; Keilani, Mohammad; Wiltschke, Christoph; Hassler, Marco; Licht, Thomas; Marosi, Christine; Huetterer, Elisabeth; Cenik, Fadime; Crevenna, Richard
In Austria, cancer rehabilitation is an important issue in the management of cancer patients. Survival rates and survival time of cancer patients are increasing, and cancer rehabilitation is an important part in the treatment and care of cancer patients with the goal to improve functional status, quality of life, and (social) participation. Today, in Austria there are approximately 600 beds for inpatient rehabilitation. The field of outpatient rehabilitation will maybe be expanded after evaluating the existing pilot projects. Beside other specialities, the field of Physical Medicine and Rehabilitation (PM&R) plays an important role in cancer rehabilitation. In cancer rehabilitation, especially activating modalities from PM&R such as exercise are very important and well-accepted parts to improve functional status, quality of life, and participation of patients.
Diogo, António Freire; Barros, Luís Tiago; Santos, Joana; Temido, Jorge Santos
In the field of rehabilitation of separate sanitary sewer systems, a large number of technical, environmental, and economic aspects are often relevant in the decision-making process, which may be modelled as a multi-objective optimization problem. Examples are those related with the operation and assessment of networks, optimization of structural, hydraulic, sanitary, and environmental performance, rehabilitation programmes, and execution works. In particular, the cost of investment, operation and maintenance needed to reduce or eliminate Infiltration from the underground water table and Inflows of storm water surface runoff (I/I) using rehabilitation techniques or related methods can be significantly lower than the cost of transporting and treating these flows throughout the lifespan of the systems or period studied. This paper presents a comprehensive I/I cost-benefit approach for rehabilitation that explicitly considers all elements of the systems and shows how the approximation is incorporated as an objective function in a general evolutionary multi-objective optimization model. It takes into account network performance and wastewater treatment costs, average values of several input variables, and rates that can reflect the adoption of different predictable or limiting scenarios. The approach can be used as a practical and fast tool to support decision-making in sewer network rehabilitation in any phase of a project. The fundamental aspects, modelling, implementation details and preliminary results of a two-objective optimization rehabilitation model using a genetic algorithm, with a second objective function related to the structural condition of the network and the service failure risk, are presented. The basic approach is applied to three real world cases studies of sanitary sewerage systems in Coimbra and the results show the simplicity, suitability, effectiveness, and usefulness of the approximation implemented and of the objective function proposed
Full Text Available Ann-Dorthe Zwisler,1 Henriette Knold Rossau,1 Anne Nakano,2,3 Sussie Foghmar,4 Regina Eichhorst,5 Eva Prescott,6 Charlotte Cerqueira,7 Anne Merete Boas Soja,4 Gunnar H Gislason,8–10 Mogens Lytken Larsen,5 Ulla Overgaard Andersen,11 Ida Gustafsson,4 Kristian K Thomsen,12 Lene Boye Hansen,13 Signe Hammer,14 Lone Viggers,15 Bo Christensen,16 Birgitte Kvist,17 Cecilie Lindström Egholm,18 Ole May19 On behalf of the Working Group of Preventive Cardiology and Rehabilitation, Danish Society of Cardiology, and the Working Group of Cardiac Clinical Registries, Danish Society of Cardiology 1Danish Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Odense, 2Department of Clinical Epidemiology, Aarhus University Hospital, 3Registry Support Centre (West – Clinical Quality Improvement & Health Informatics, Aarhus, 4Department of Cardiology, Copenhagen University Hospital, Hvidovre, 5Department of Cardiology, Aalborg University Hospital, Aalborg, 6Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, 7Registry Support Centre (East – Epidemiology and Biostatistics, Research Centre for Prevention and Health, the Capital Region of Denmark, Glostrup, 8Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, 9The Danish Heart Foundation, Copenhagen, 10The National Institute of Public Health, University of Southern Denmark, 11Department of Cardiology, Holbaek Hospital, University of Copenhagen, Copenhagen, 12Department of Cardiology, Hospital of Southwest Jutland, Esbjerg, 13Department of Cardiology, Gentofte Hospital, Gentofte, 14Department of Occupational Therapy and Physiotherapy, Herlev Hospital, Herlev, 15Department of Nutrition, Regional Hospital West Jutland, Holstebro, 16Department of General Medicine, School of Public Health, Aarhus University, Aarhus, 17Department of Health Care and Prevention, Municipality of Frederikshavn, Frederikshavn, 18
Remote maintenance systems requirements are being developed to provide design guidelines for machine components, to define maintenance interfaces, and to quantify maintenance equipment and procedures needed
Spampinato, P.T.; Tabor, M.A.
Remote maintenance systems requirements are being developed to provide design guidelines for machine components, to define maintenance interfaces, and to quantify maintenance equipment and procedures needed
Maboeta, M S; Oladipo, O G; Botha, S M
Earthworms are bioindicators of soil pollution. The ecotoxicity of tailings from selected gold mines in South Africa was investigated utilizing Eisenia andrei bioassays and biomarkers. Samples were obtained from unrehabilitated, rehabilitated and naturally vegetated sites. Biomass, neutral red retention time (NRRT), survival and reproduction were assessed using standardized protocols. Earthworm biomass, NRRT and reproductive success in rehabilitated tailings (comparable to naturally vegetated site) were significantly higher (p tailings. In addition, significantly lower (p tailings compared to the unrehabilitated. Further, significantly lower (p tailings than the rehabilitated and naturally vegetated sites. Overall, reduced ecotoxicity effects were confirmed in rehabilitated compared to unrehabilitated tailings. This suggests that rehabilitation as a post-mining restorative strategy has strong positive influence on mine tailings.
Full Text Available The aim of the study was to improve the results of treatment of children with typical form of congenital clubfoot by optimizing of physical rehabilitation. The study included the following objectives: to make the algorithm work with the child, to justify the basis of physical rehabilitation, to study its effects, to develop a framework of implementation and optimization of the physical rehabilitation of children with congenital clubfoot. In the course of the study were 62 children involved with the typical form of congenital clubfoot: the main group (n = 42 and control group (n = 42. Age children from 4 years to 7 years. Physical rehabilitation was a logical continuation of treatment. Optimization analysis was performed by clinical examination, radiometric data and indicators of functional methods of research. Comparative analysis of the results of the physical rehabilitation of children with congenital clubfoot in both groups showed a trend more pronounced positive changes in children the main group in all respects.
Collinger, Jennifer L; Dicianno, Brad E; Weber, Douglas J; Cui, Xinyan Tracy; Wang, Wei; Brienza, David M; Boninger, Michael L
Rehabilitation engineers apply engineering principles to improve function or to solve challenges faced by persons with disabilities. It is critical to integrate the knowledge of biologics into the process of rehabilitation engineering to advance the field and maximize potential benefits to patients. Some applications in particular demonstrate the value of a symbiotic relationship between biologics and rehabilitation engineering. In this review we illustrate how researchers working with neural interfaces and integrated prosthetics, assistive technology, and biologics data collection are currently integrating these 2 fields. We also discuss the potential for further integration of biologics and rehabilitation engineering to deliver the best technologies and treatments to patients. Engineers and clinicians must work together to develop technologies that meet clinical needs and are accessible to the intended patient population. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Moore, Jennifer L; Shikako-Thomas, Keiko; Backus, Deborah
Advances in rehabilitation provide the infrastructure for research and clinical data to improve care and patient outcomes. However, gaps between research and practice are prevalent. Knowledge translation (KT) aims to decrease the gap between research and its clinical use. This special communication summarizes KT-related proceedings from the 2016 IV STEP conference, describes current KT in rehabilitation science, and provides suggestions for its application in clinical care. We propose a vision for rehabilitation clinical practice and research that includes the development, adaptation, and implementation of evidence-based practice recommendations, which will contribute to a learning health care system. A clinical research culture that supports this vision and methods to engage key stakeholders to innovate rehabilitation science and practice are described. Through implementation of this vision, we can lead an evolution in rehabilitation practice to ultimately prevent disabilities, predict better outcomes, exploit plasticity, and promote participation.
Nielsen, Liv [Oljedirektoratet, Stavanger (Norway)
With the unsteady oil prices and the possible consequences of the deregulation of the European energy markets one may expect further optimization of operating and maintenance costs. One may also expect extended use of various risk-based optimization techniques such as RCM (Reliability Centered Maintenance) and RBI (Risk Based Inspection). This presentation addresses the need for further research and development in this area. Maintenance work is necessary, but it can also create risk. The accident statistics show many examples of this. The Norwegian petroleum industry's ability to learn from previous incidents is questioned. Maintenance staff must be well trained and possess the necessary routines. Technical documentation must be updated. Uncertainties with respect to future oil and gas prices combined with the effect of the deregulation of the European energy markets will lead to even more focus on cost-effective operations and maintenance. The need for long-term research and development is stressed. Risk based techniques such as RCM and RBI are extensively used in the defence industry and the nuclear industry, but applying them to the petroleum industry requires improved risk models. Ageing effects such as corrosion, erosion, fatigue etc. can be expected, but the capability to predict, monitor and control them should be improved. At present, not even the most sophisticated risk analysis can model ageing effects. The importance of efficient use of information technology (IT) is stressed. Improving the product quality and safety often requires new technology and so research and development is important. Close cooperation with the industry is required.
Full Text Available Generalized aggressive periodontitis (GAP is a debilitating form of the disease and it results in deteriorating effects on the esthetic and functional aspects of the oral cavity. This case report describes the comprehensive rehabilitation of GAP patient using dental implants. The treatment planning involved thorough scaling and root planning (SRP with oral hygiene instructions. The patient was motivated to adhere to a strict oral hygiene regimen following which periodontal flap surgery employing guided tissue regeneration and bone grafts was performed. Bacterial culture for anaerobic microorganisms was done using a gas pack pre- and postperiodontal treatment to confirm the effectiveness of the periodontal treatment regimen and also to proceed with dental implant placement. The rigorous maintenance program ensured the stability of the periodontium following which immediate placement of dental implants in the maxillary and mandibular anterior region was done. The fixed metal-ceramic prosthesis was fabricated in a step-by-step process and the patient was recalled on a periodic basis over a 3-year follow-up duration. This case is a testimonial to the postperiodontal treatment long-term stability with excellent patient cooperation and strict maintenance protocol.
Full Text Available The current paper tackles the subject of developing maintenance-ready web applications. Maintenance is presented as a core stage in a web application’s lifecycle. The concept of maintenance-ready is defined in the context of web application development. Web application maintenance tasks types are enunciated and suitable task types are identified for further analysis. The research hypothesis is formulated based on a direct link between tackling maintenance in the development stage and reducing overall maintenance costs. A live maintenance-ready web application is presented and maintenance related aspects are highlighted. The web application’s features, that render it maintenance-ready, are emphasize. The cost of designing and building the web-application to be maintenance-ready are disclosed. The savings in maintenance development effort facilitated by maintenance ready features are also disclosed. Maintenance data is collected from 40 projects implemented by a web development company. Homogeneity and diversity of collected data is evaluated. A data sample is presented and the size and comprehensive nature of the entire dataset is depicted. Research hypothesis are validated and conclusions are formulated on the topic of developing maintenance-ready web applications. The limits of the research process which represented the basis for the current paper are enunciated. Future research topics are submitted for debate.
Khan, Fary; Amatya, Bhasker; Gosney, James; Rathore, Farooq A; Burkle, Frederick M
To present an evidence-based overview of the effectiveness of medical rehabilitation intervention in natural disaster survivors and outcomes that are affected. A literature search was conducted using medical and health science electronic databases (PubMed, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PsycINFO) up to September 2014. Two independent reviewers selected studies reporting outcomes for natural disaster survivors after medical rehabilitation that addressed functional restoration and participation. Two reviewers independently extracted data and assessed the methodologic quality of the studies using the Critical Appraisal Skills Program's appraisal tools. A meta-analysis was not possible because of heterogeneity among included trials; therefore, a narrative analysis was performed for best evidence synthesis. Ten studies (2 randomized controlled trials, 8 observational studies) investigated a variety of medical rehabilitation interventions for natural disaster survivors to evaluate best evidence to date. The interventions ranged from comprehensive multidisciplinary rehabilitation to community educational programs. Studies scored low on quality assessment because of methodologic limitations. The findings suggest some evidence for the effectiveness of inpatient rehabilitation in reducing disability and improving participation and quality of life and for community-based rehabilitation for participation. There were no data available for associated costs. The findings highlight the need to incorporate medical rehabilitation into response planning and disaster management for future natural catastrophes. Access to rehabilitation and investment in sustainable infrastructure and education are crucial. More methodologically robust studies are needed to build evidence for rehabilitation programs, cost-effectiveness, and outcome measurement in such settings. Copyright © 2015 American Congress of Rehabilitation Medicine
Stanislav Vladimirovich Daletskiy
Full Text Available The aircraft maintenance is realized by a rapid sequence of maintenance organizational and technical states, its re- search and analysis are carried out by statistical methods. The maintenance process concludes aircraft technical states con- nected with the objective patterns of technical qualities changes of the aircraft as a maintenance object and organizational states which determine the subjective organization and planning process of aircraft using. The objective maintenance pro- cess is realized in Maintenance and Repair System which does not include maintenance organization and planning and is a set of related elements: aircraft, Maintenance and Repair measures, executors and documentation that sets rules of their interaction for maintaining of the aircraft reliability and readiness for flight. The aircraft organizational and technical states are considered, their characteristics and heuristic estimates of connection in knots and arcs of graphs and of aircraft organi- zational states during regular maintenance and at technical state failure are given. It is shown that in real conditions of air- craft maintenance, planned aircraft technical state control and maintenance control through it, is only defined by Mainte- nance and Repair conditions at a given Maintenance and Repair type and form structures, and correspondingly by setting principles of Maintenance and Repair work types to the execution, due to maintenance, by aircraft and all its units mainte- nance and reconstruction strategies. The realization of planned Maintenance and Repair process determines the one of the constant maintenance component. The proposed graphical models allow to reveal quantitative correlations between graph knots to improve maintenance processes by statistical research methods, what reduces manning, timetable and expenses for providing safe civil aviation aircraft maintenance.
... DEPARTMENT OF EDUCATION Applications for New Awards; Rehabilitation Engineering Research Centers...)--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research... (Rehabilitation Act). Rehabilitation Engineering Research Centers Program (RERCs) The purpose of the RERC program...
...; (5) Rehabilitation social work; (6) Rehabilitation psychiatry; (7) Rehabilitation psychology; (8...; (12) Physical education; (13) Therapeutic recreation; (14) Community rehabilitation program personnel...; (20) Independent living; (21) Client assistance; (22) Administration of community rehabilitation...
conducted in the Great Pyramid of Cheops, Giza , Egypt. The Tomb is an existing structure of great national and patriotic significance, while the Great... Pyramid is one of the oldest existing structures built by man. Also, a comprehensive assessment of the foundation of Mill Creek Dam near Walla Walla
8217 flooring unlined spillway channels. 115. Rippability was proposed by Weaver (1975) as a rock mass classifi- cation system that enables the assessment...geological. features which govern the as- sessment of rippability are rock type, haidness, weathering, stcucture, and fabric. Saismic P-wave velocity...channel. Rippability should be combined with a factor 84 that describes lithostratigraphic continuity in order to derive the erosion potential of the
which breeds in swamps from the Culf of Mexico to Canada, and is particularly fond of birds (Karstad 1971). Several Aedes species have also proven to...misdiagnosed as tuberculosis (Stickley and Weeks 1985). Clinical cases fall into three major categories, acute pulmonary, chronic pulmonary, and...5% ’ .-,% 81 **% V4 % %*’.2’, % ’lil i 0 0 I N 0 *% N Fiur 7. Vebl trpfrrpos( adn n L tal reeae %L legs).~~~~ (Lfbr andM,, 193) 82 %* I, Figure 7
Discussion: The study results demonstrated some gender differences in baseline characteristics and psychological problems. Such differences may have important impacts on methadone treatment outcomes. Further studies are suggested.
plants, electrical transmission network, pipelines) • public buildings (e.g., schools, hospitals, post offices, police stations, fire houses, court...developed under REMR focused on concrete and steel materials, along with geotechnical, hydraulic, electrical and mechanical, environmental, and coastal...between the wet or dry kilning processes in ce- ment production cannot be discerned from the overall impacts associ- ated with concrete production. The
Vimal Kantilal Munot
Full Text Available The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth and surrounding bone because of surgery for oral cyst or tumor. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is defective. Anatomic deformities and unfavorable biomechanics encountered in the region of resection add to the misery. In such situation, a fixed-removable prosthesis allows favorable biomechanical stress distribution along with restoration of esthetics, phonetics, comfort, hygiene, and better postoperative care and maintenance. This article describes rehabilitation of two cases with mandibular defects with an attachment-retained fixed-removable hybrid prosthesis.
Munot, Vimal Kantilal; Nayakar, Ramesh P; Patil, Raghunath
The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth and surrounding bone because of surgery for oral cyst or tumor. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is defective. Anatomic deformities and unfavorable biomechanics encountered in the region of resection add to the misery. In such situation, a fixed-removable prosthesis allows favorable biomechanical stress distribution along with restoration of esthetics, phonetics, comfort, hygiene, and better postoperative care and maintenance. This article describes rehabilitation of two cases with mandibular defects with an attachment-retained fixed-removable hybrid prosthesis.
This work addresses the maintenance action selection process. Maintenance personnel need to evaluate maintenance actions and costs to keep the machines in working condition. Group of actions are evaluated together as maintenance plans. The maintenance plans as output provide information to the user about which actions to take if any and what future actions should be prepared for. The heuristic search method is implemented as part of general use toolbox for analysis of measurements from movable work machines. Impacts from machine's usage restrictions and maintenance activities are analysed. The results show that once put on a temporal perspective, the prioritized order of the actions is different and provide additional information to the user.
Mattu, R.K.; Cooper, S.E.; Lauderdale, J.R.
Maintenance planning for nuclear power plants is similar to that in other industrial plants but it is heavily influenced by regulatory rules, with consequent costs of compliance. Steps by the nuclear industry and the Nuclear Regulatory Commission to address that problem include development of guidelines for maintenance of risk-critical equipment, using PRA-based techniques to select a set of equipment that requires maintenance and reliability-centered maintenance (RCM) approaches for determining what maintenance is required. The result of the process is a program designed to ensure effective maintenance of the equipment most critical to plant safety. (author)
Mizumachi, Wataru; Kobayashi, Masahide
In many countries, online maintenance has been already introduced. Especially in US, online maintenance has been introduced to many nuclear plants which has (N+1) redundant safety systems as Japanese plants. There experience will contribute us to discuss how to introduce online maintenance in Japan. In IAEA's nuclear safety criteria and guidance, it is recognized that the outage of one safety system for maintenance is usual operation. This is normal sense in the world. In US, the risk when online maintenance is done is controlled mainly by PRA. We have to discuss how to introduce online maintenance in JAPAN under these conditions in the world. (author)
Varno, M.; McKinley, M.
Due to recent issuance of 10CFR50.65, the U.S. Nuclear Regulatory Commission maintenance rule (Rule), and the open-quotes Industry Guideline for Monitoring the Effectiveness of Maintenance at Nuclear Power Plantsclose quotes prepared by the Nuclear Management and Resources Council, many utilities are undertaking review or evaluation of current preventive maintenance (PM) programs. Although PM optimization and documentation are not specifically required by the Rule, an appropriate and effective PM program (PMP) will be the cornerstone of the successful and cost-effective implementation of the Rule. Currently, a project is being conducted at the Vermont Yankee Nuclear Power Station (VYNPS) in conjunction with Quadrex Energy Services to evaluate, optimize, and document the PMP. The project began in March 1993 and is scheduled for completion in mid-1995. The initial scope for the project is the evaluation of those structures, systems, and components that are within the scope of the Rule. Because of the number of systems to be evaluated (∼50), the desired completion schedule, and cost considerations, a streamlined approach to PM optimization and documentation is being utilized
Banu Bilge Sarihan
Full Text Available The concept of alimony; the dictionary defines as, the whole of what is needed to make a living; as the legal sense is defined as connected with one month to one court decision that obliged to provide for. Family members of a moral rule, first of all to help each other. This moral without often any coercion parties in the framework adapts to this rule, but in this case the legislator for the processing always smoothly, has made it a statutory duty by going to road regulations to help each other for certain family members. Assistance in the form of alimony and child support maintenance can be divided into two main groups. Support resulting from family law, commonly referred to as maintenance support. Maintenance alimony; temporary alimony, child maintenance and poverty alimony. The care and upbringing of children in the marital union is entitled to custody of the mother and father in the framework. Mother and father use custody together. Custody of minors and adult children must sometimes restricted to persons, about paying attention to both the goods and to represent them as a whole of the rights and obligations of the law have been installed on the parents. Common life of the spouses or by court order issued at the end of separation has occurred judge may give custody to one of the spouses. side with custody of children have been left to him is obliged to look after and educate them. However, not given custody of his side, must participate in their child's care and education expenses amount to be determined by the judge according to financial strength. Associates alimony, separation or nullity or divorce, child custody as a result of which he had left his wife, child care and the financial strength to participate in the rate training expenses. Associates alimony, not a liability connected to custody, is a natural consequence of being parents. Because spouses are obliged to take care of children's care and upbringing. Child maintenance is
Hakkennes, Sharon; Hill, Keith D; Brock, Kim; Bernhardt, Julie; Churilov, Leonid
This study aimed to identify factors that assessors considered important in decision-making regarding suitability for inpatient rehabilitation after acute severe stroke. Multi-site prospective observational cohort study. Consecutive acute, severe stroke patients and their assessors for inpatient rehabilitation. Rehabilitation assessors completed a questionnaire, rating the importance (10 point visual analogue scale) and direction (positive, negative or neutral) of 15 patient related and 2 organisational items potentially affecting their decision regarding patients' acceptance to rehabilitation. Of the 75 patients referred to rehabilitation and included in this study 61 (81.3%) were accepted for inpatient rehabilitation. The items considered to be most important in the decision to accept the patient for rehabilitation were pre-morbid cognition, pre-morbid mobility and pre-morbid communication. For those not accepted the most important items were current mobility, social support and current cognition. Factor analysis revealed 3 underlying factors, interpreted as post-stroke status, pre-morbid status, and social attributes, accounting for 61.8% of the total variance. All were independently associated with acceptance for rehabilitation (p decision making process for acceptance to rehabilitation following severe stroke. Future models for selection for rehabilitation should consider inclusion of these factors.
Florez, Juan Manuel; Shah, Manan; Moraud, Eduardo Martin; Wurth, Sophie; Baud, Laetitia; Von Zitzewitz, Joachim; van den Brand, Rubia; Micera, Silvestro; Courtine, Gregoire; Paik, Jamie
Robotic exoskeletons provide programmable, consistent and controllable active therapeutic assistance to patients with neurological disorders. Here we introduce a prototype and preliminary experimental evaluation of a rehabilitative gait exoskeleton that enables compliant yet effective manipulation of the fragile limbs of rats. To assist the displacements of the lower limbs without impeding natural gait movements, we designed and fabricated soft pneumatic actuators (SPAs). The exoskeleton integrates two customizable SPAs that are attached to a limb. This configuration enables a 1 N force load, a range of motion exceeding 80 mm in the major axis, and speed of actuation reaching two gait cycles/s. Preliminary experiments in rats with spinal cord injury validated the basic features of the exoskeleton. We propose strategies to improve the performance of the robot and discuss the potential of SPAs for the design of other wearable interfaces.
Tee, Kian Sek; E, Chun Zhi; Saim, Hashim; Zakaria, Wan Nurshazwani Wan; Khialdin, Safinaz Binti Mohd; Isa, Hazlita; Awad, M. I.; Soon, Chin Fhong
This paper proposes on the design of a walker for the prevention of falling among elderlies or patients during rehabilitation whenever they use a walker to assist them. Fall happens due to impaired balance or gait problem. The assistive device is designed by applying stability concept and an accelerometric fall detection system is included. The accelerometric fall detection system acts as an alerting device that acquires body accelerometric data and detect fall. Recorded accelerometric data could be useful for further assessment. Structural strength of the walker was verified via iterations of simulation using finite element analysis, before being fabricated. Experiments were conducted to identify the fall patterns using accelerometric data. The design process and detection of fall pattern demonstrates the design of a walker that could support the user without fail and alerts the helper, thus salvaging the users from injuries due to fall and unattended situation.
Pogosova, Nana; Saner, Hugo; Pedersen, Susanne S.
A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality....... Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening...... of life (HRQoL) and prognosis in patients with established CHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system...
Pogosova, N. V.; Saner, H.; Pedersen, S. S.
A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health- related quality....... Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening...... of life (HRQoL) and prognosis in patients with establishedCHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system...
The mining and treatment operation and disposal of waste products from the mining and treatment was carried out within the structures of the environmental regulations applying between 1954 and 1971. As a result, the operation left a legacy of continuing environmental pollution which the Rum Jungle Rehabilitation Project was aimed at alleviating. The problems at Rum Jungle consisted of three major elements: overburden heaps and copper heap leach pile were slowly oxidising producing acid mine drainage, the most serious form of pollution at Rum Jungle; water in the open cut pits became acidic and contained significant concentrations of heavy metals; the tailings dam was a low level source of radioactivity, aesthetically disastrous and a source of acids and heavy metals
This report describes the work on the subject 'pipeline ageing and rehabilitation' carried out by the Study Group 4.1 and related to the triennium 1997 - 2000. The report is focused on ageing and rehabilitation of natural gas transmission pipelines and more in detail on the following topics: - Definition of pipeline ageing; - Different ageing elements; - Main causes of ageing; - Inspections and monitoring; - Repair methods on ageing pipelines; - Programmes and strategies for pipeline maintenance and rehabilitation. The report includes the state of the art of the different techniques used to assess pipeline ageing such as pig inspection, landslide areas monitoring as well as advanced monitoring methods used nowadays by pipeline operators; a clarification of the concepts for different maintenance approaches is also presented. In addition the report gives some information regarding repair methods in use, the methodologies to evaluate the defects and the philosophy on which each repair system is based. The remaining topics deal with the strategies of pipelines and coating rehabilitation, locus the attention in the economical and technical considerations also beyond the ageing concept and describe in details the main causes of ageing as indicated by operators. A questionnaire on these topics was in fact distributed and the obtained results are included in this report. (author)
Full Text Available Pneumatic artificial muscles are pneumatic devices with practical and various applications as common actuators. They, as human muscles, work in agonistic-antagonistic way, giving a traction force only when supplied by compressed air. The state of the art of soft pneumatic actuators is here analyzed: different models of pneumatic muscles are considered and evolution lines are presented. Then, the use of Pneumatic Muscles (PAM in rehabilitation apparatus is described and the general characteristics required in different applications are considered, analyzing the use of proper soft actuators with various technical properties. Therefore, research activity carried out in the Department of Mechanical and Aerospace Engineering in the field of soft and textile actuators is presented here. In particular, pneumatic textile muscles useful for active suits design are described. These components are made of a tubular structure, with an inner layer of latex coated with a deformable outer fabric sewn along the edge. In order to increase pneumatic muscles forces and contractions Braided Pneumatic Muscles are studied. In this paper, new prototypes are presented, based on a fabric construction and various kinds of geometry. Pressure-force-deformation tests results are carried out and analyzed. These actuators are useful for rehabilitation applications. In order to reproduce the whole upper limb movements, new kind of soft actuators are studied, based on the same principle of planar membranes deformation. As an example, the bellows muscle model and worm muscle model are developed and described. In both cases, wide deformations are expected. Another issue for soft actuators is the pressure therapy. Some textile sleeve prototypes developed for massage therapy on patients suffering of lymph edema are analyzed. Different types of fabric and assembly techniques have been tested. In general, these Pressure Soft Actuators are useful for upper/lower limbs treatments
Shahsavari, Hooman; Shahriari, Mohsen; Alimohammadi, Nasrollah
Main suggested theories about patients' adherence to treatment regimens recognize the importance of motivation in positive changes in behaviors. Since cardiac diseases are chronic and common, cardiac rehabilitation as an effective prevention program is crucial in management of these diseases. There is always concern about the patients' adherence to cardiac rehabilitation. The aim of this study was to describe the motivational factors affecting the patients' participation and compliance to cardiac rehabilitation by recognizing and understanding the nature of patients' experiences. The participants were selected among the patients with cardiac diseases who were referred to cardiac rehabilitation in Isfahan Cardiovascular Research Center, Iran. The purposive sampling method was used and data saturation achieved after 8 semi-structured interviews. The three main concepts obtained from this study are "beliefs", "supporters" and "group cohesion". In cardiac rehabilitation programs, emphasis on motivational factors affects the patient's adherence. It is suggested that in cardiac rehabilitation programs more attention should be paid to patients' beliefs, the role of patients' supporters and the role of group-based rehabilitation.
Macías-Hernández, Salvador Israel; Morones-Alba, Juan Daniel; Miranda-Duarte, Antonio; Coronado-Zarco, Roberto; Soria-Bastida, María de Los Angeles; Nava-Bringas, Tania; Cruz-Medina, Eva; Olascoaga-Gómez, Andrea; Tallabs-Almazan, Laura Verónica; Palencia, Chanell
Glenohumeral osteoarthritis (GHOA) is a common cause of pain and functional disability of the shoulder. Despite the limited evidence, there are several options for the treatment of this pathology. The aim of this article is to provide current information on the characteristics of the disease and the pathophysiology, evidence based on medical and surgical treatments with emphasis on the rehabilitation process. It was performed with an extensive literature review, mainly clinical practice guidelines, randomized controlled trials, reviews, focusing on the rehabilitation management. There are few clinical practice guidelines that address GHOA as a pathology with unique characteristics. Evidence based treatment recommendations are mostly supported by low-quality evidence and experts' opinions, with few high levels of evidence studies guiding treatment decisions. Despite the lack of good quality evidence, rehabilitation programs have proven to be efficient and reliable, and this revision provides information and recommendations in this field. Implication of Rehabilitation Glenohumeral osteoarthritis is a common cause of pain and functional disability of the shoulder There are few clinical practice guidelines that address Glenohumeral Osteoarthritis as a pathology with unique characteristics, and recommendations for rehabilitation and therapeutic exercise are poor The paper provides current information on the characteristics of the disease, its rehabilitation process, and could be of interest for rehabilitation professionals to direct their practices in this field.
Gaber, Tarek A-Z K
Cortical blindness is a rare complication of posterior circulation stroke. However, its complex presentation with sensory, physical, cognitive and behavioural impairments makes it one of the most challenging. Appropriate approach from a rehabilitation standpoint was never reported. Our study aims to discuss the rehabilitation methods and outcomes of a cohort of patients with cortical blindness. The notes of all patients with cortical blindness referred to a local NHS rehabilitation service in the last 6~years were examined. Patients' demographics, presenting symptoms, scan findings, rehabilitation programmes and outcomes were documented. Seven patients presented to our service, six of them were males. The mean age was 63. Patients 1, 2 and 3 had total blindness with severe cognitive and behavioural impairments, wandering and akathisia. All of them failed to respond to any rehabilitation effort and the focus was on damage limitation. Pharmacological interventions had a modest impact on behaviour and sleep pattern. The 3 patients were discharged to a nursing facility. Patients 4, 5, 6 and 7 had partial blindness with variable severity. All of them suffered from significant memory impairment. However, none suffered from any behavioural, physical or other cognitive impairment. Rehabilitation efforts on 3 patients were carried out collaboratively between brain injury occupational therapists and sensory disability officers. All patients experienced significant improvement in handicap and they all maintained community placements. This small cohort of patients suggests that the rehabilitation philosophy and outcomes of these 2 distinct groups of either total or partial cortical blindness differ significantly.
The Australian Centre for Minesite Rehabilitation Research (ACMRR) is a joint venture between the Australian mining industry through the Australian Mineral Industries Research Association Ltd. (AMIRA) and three of the organizations working most actively in this area in Australia: CSIRO Minesite Rehabilitation Research Program; University of Queensland Centre for Mined Land Rehabilitation; and Curtin University Mulga Research Centre. The ACMRR was established in July 1993 to provide a national framework to conduct Strategic Research into minesite rehabilitation. It is an industry led and funded initiative. The Goals of the Centre include: to conduct strategic research into minesite rehabilitation to provide sustainable environmental solutions which are acceptable to industry, government and the community; to be recognized as a center of excellence undertaking commissioned research on minesite rehabilitation in an independent and thorough manner; to provide scientific and technological foundations to facilitate industry and government in setting acceptable standards; to act as networking and communications focus; and to enhance education and training in minesite rehabilitation. Strategic Research Programs in: Water Systems--downstream surface and groundwater quality; Land--the long-term behavior and stability of constructed landforms; Ecosystems--the long-term sustainability of constructed landforms; Waste--the long-term treatment and disposal of waste products; will allow the ACMRR to achieve these goals through specific research projects in these areas, developed with industry sponsors. This paper will discuss their progress to date, research projects underway, and plans for the future
This paper is about maintenance of nuclear power plants. In part one, the outage management of nuclear power plants has described. Meaning of the outage and objectives of outage management is given in introduction. The necessity of a long-term outage strategy is shown in chapter one. The main parts of an outage are as follows: Planning; Preparation; Execution, Each of them and also post-outage review have been explained in the followed chapters. Part two deals with technical details of main primary components of nuclear power plant type WWER. After an introduction about WWER reactors, in each chapter first the general and detailed description of main primary components has given and then their maintenance schedules and procedures. Chapter about reactor and steam generator is related to both types of WWER-440 and WWER-1000, but chapter about reactor coolant pump has specified to WWER-1000 to be more in details.(author)
Attaway, C.R.; Pope, R.B.; Wiliamson, A.C.; Medley, L.G.; Shappert, L.B.
In this paper, the results of three trade-off studies of alternative concepts for performing cask maintenance for Civilian Radioactive Waste Management System casks are presented. An earlier study resulted in a recommendation that a submerged pool concept for cask internal component removal be used in the design of a Cask Maintenance Facility. The first trade-off study resulted in confirming the previous recommendation that a submerged pool concept be used rather than an isolation cell; the basis for this continued recommendation is discussed. The second study provides an evaluation of the previously proposed facility for the capability of handling an increased quantity of OCRWM casks. The third study provides a preliminary concept for adding the capability to repaint the exterior cylindrical portions of casks
Malmqvist, Stefan; Leboeuf-Yde, Charlotte
of maintenance care. Previous studies have identified chiropractors' choices of case management strategies in response to different case scenarios. However, the rationale for these management strategies is not known. In other words, when presented with both the case, and different management strategies......Maintenance care is a well known concept among chiropractors, although there is little knowledge about its exact definition, its indications and usefulness. As an initial step in a research program on this phenomenon, it was necessary to identify chiropractors' rationale for their use......, there was consensus on how to match these, but if only the management strategies were provided, would chiropractors be able to define the cases to fit these strategies? The objective with this study was to investigate if there is a common pattern in Finnish chiropractors' case management of patients with low back...
The topics of this report are: on-site or off-site facilities. On-site facilities: workshops and special facilities. KWU's Service Center, a typical off-site supporting facility in Germany, capabilities and activities. A pool for special tools and equipment: devices for plugging of nozzles, for handling of RPU-studs and RPU internals etc. Devices for and management of radiological protection on-site for typical outage work. Spare parts and spare part management on site, typical examples. KWU's centralized spare part pools for components, generators and turbines etc. A computerized system for spare parts storage and maintenance planning. A system for mutual exchange of operational experience with respect to maintenance and repair activities. Systematic evaluation of failures and statistical results. (orig./GL)
After a general review of the operation experience in the history of more than 12 operating years, the organization in the plant will be shown with special aspect to quality assurance, capacity of the workshops and connected groups as radiation protection, chemical laboratories etc. The number, time intervals and manpower effort for the repeating tests will be discussed. Reasons and examples for back-fitting activities in the plant are given. Besides special repair and maintenance procedures as repair of the steam generators, in-service inspection of the reactor pressure vessel, repair of a feed-water pipe and repair of the core structure in the pressure vessel, the general system to handle maintenance and repair-work in the KWO-plant will be shown. This includes also the detailed planning of the annual refueling and revision of the plant. (orig./RW)
As early as 1977, the General Electric Company, USA, Nuclear Energy Operation was making plans to construct a maintenance-type simulator to support Training and Services. The Company's pioneering experience with control room simulators started in 1968 with the Dresden simulator and showed clearly the benefits of having such facilities for training, checkout of procedures and, in the case of maintenance, match-up of equipment or tools as needed. Since the dedication of the facility, it has proved to be an invaluable resource in the training of refuelling and servicing crews. The facility has also been extensively used as developmental and test facility for in-vessel servicing equipment and procedures. (author)
In recent years, there has been an increase in technically advanced systems and equipment and a need for highly skilled and knowledgeable maintenance technicians to maintain them. To implement an effective training program, training groups' and plant staffs' key to success must be cooperation and creativity. This paper deals with plant staff interface and how to effectively conduct performance-based training while holding the line on costs. This paper includes cost effective and innovative measures to produce performance-based training for maintenance disciplines including: Using the plants staff as a resource as subject matter experts in the development and verification of training materials. Using the plant staff as a resource for the construction of training aids. Using salvage and surplus to produce high quality, low cost training aids. Using cutaways for better understanding of he theory of equipment operation. These cost saving practices are currently being used at Gulf States Utilities' River Bend Nuclear Station
Accelerating site cleanup to reduce facility risks to the workers, the public and the environment during a time of declining federal budgets represents a significant technical and economic challenge to U.S. Department of Energy (DOE) Operations Offices and their respective contractors. A significant portion of a facility's recurring annual expenses are associated with routine, long-term surveillance and maintenance (S and M) activities. However, ongoing S and M activities do nothing to reduce risks and basically spend money that could be reallocated towards facility deactivation. This paper discusses the background around DOE efforts to reduce surveillance and maintenance costs, one approach used to perform cost reviews, lessons learned from field implementation and what assistance is available to assist DOE sites in performing these evaluations
Barton, P.H.; Lyerly, H.D.
Design of a nuclear power plant for safe, reliable and efficient operation involves much more than theory, regulations, regulatory guides, procedures, inspectors, and even quality assurance. It also involves a full knowledge and understanding of the activities which must be carried out to operate and maintain the plant. It must be remembered that a nuclear power plant is different from fossil designs and the designer must constantly keep in mind that access by people to every component is required for maintenance
Abed, Fidaa; Chen, Lin; Disser, Yann; Groß, Martin; Megow, Nicole; Meißner, Julie; Richter, Alexander T.; Rischke, Roman
We investigate the problem of scheduling the maintenance of edges in a network, motivated by the goal of minimizing outages in transportation or telecommunication networks. We focus on maintaining connectivity between two nodes over time; for the special case of path networks, this is related to the problem of minimizing the busy time of machines. We show that the problem can be solved in polynomial time in arbitrary networks if preemption is allowed. If preemption is restricted to integral t...
Tiago Bordeira Gaspar; Ana Sá; José Manuel Lopes; Manuel Sobrinho-Simões; Paula Soares; João Vinagre
Tumour cells can adopt telomere maintenance mechanisms (TMMs) to avoid telomere shortening, an inevitable process due to successive cell divisions. In most tumour cells, telomere length (TL) is maintained by reactivation of telomerase, while a small part acquires immortality through the telomerase-independent alternative lengthening of telomeres (ALT) mechanism. In the last years, a great amount of data was generated, and different TMMs were reported and explained in detail, benefiting from g...
the ground . Then figure out what your challenges are. We’ll have those” (Pappalardo, 2011). Another challenge facing the maintenance personnel...as assets aged as indicated by the pattern ‘B’ shown in Figure 2. With the increase in the mechanization of processes, more attention has been...concepts could be applied to the sustainment of the MM III as well as benefit its planned replacement, the Ground Based Strategic Deterrent (GBDS
Alabert, Constance; Groth, Anja
Stability and function of eukaryotic genomes are closely linked to chromatin structure and organization. During cell division the entire genome must be accurately replicated and the chromatin landscape reproduced on new DNA. Chromatin and nuclear structure influence where and when DNA replication...... initiates, whereas the replication process itself disrupts chromatin and challenges established patterns of genome regulation. Specialized replication-coupled mechanisms assemble new DNA into chromatin, but epigenome maintenance is a continuous process taking place throughout the cell cycle. If DNA...
Demirel, H.C.; De Ridder, H.A.J.
Technological advances, financial possibilities and changes of demands have increasingly affected the pavement maintenance environment for outsourcing in recent years. This induces complexity in the contracting methods of pavement maintenance activities. Despite the fact that current contracting
This advisory circular (AC) transmits a consolidated directory of all : certificated Federal Aviation Administration (FAA) repair stations and : manufacturer's maintenance facilities. The repair stations and manufacturer's : maintenance facilities we...
Antonella Del Rosso
GCO, GMIO, GSPO – ever heard of them? These acronyms stand for the “roles” that best practices identify as vital to successful maintenance management. CERN’s Maintenance Management Project (MMP) team is working with the technical departments to ensure that they implement these procedures when they deal with the maintenance of the collider and its injectors and infrastructure. The participants of the workshop on asset and maintenance management (AMMW2013), which took place at CERN in November. Since its creation in 2012, CERN’s Maintenance Framework Implementation Office (MFIO) has been promoting the deployment of harmonised maintenance management methods across the BE, GS, EN and TE Departments. “The definition and identification of the Group Coding Officers (GCO), Group Maintenance Information Officers (GMIO) and Group Spare Part Officers (GSPO) are one of the best practices that should be adopted each time a maintenance programme...
Jeffrey S Grzybowski
Full Text Available CONTEXT: Rehabilitation following hip arthroscopy is an integral component of the clinical outcome of the procedure. Given the increase in quantity, complexity, and diversity of procedures performed, a need exists to define the role of rehabilitation following hip arthroscopy.OBJECTIVES: 1 To determine the current rehabilitation protocols utilized following hip arthroscopy in the current literature, 2 to determine if clinical outcomes are significantly different based on different post-operative rehabilitation protocols; and 3 to propose the best-available evidence-based rehabilitation program following hip arthroscopy.DATA SOURCES: Per PRISMA guidelines and checklist, Medline, SciVerse Scopus, SportDiscus, and Cochrane Central Register of Controlled Trials were searched.STUDY SELECTION: Level I-IV evidence clinical studies with minimum two-year follow-up reporting outcomes of hip arthroscopy with post-operative rehabilitation protocols described were included. DATA EXTRACTION: All study, subject, and surgery parameters were collected. All elements of rehabilitation were extracted and analyzed. Descriptive statistics were calculated. Study methodological quality was analyzed using the Modified Coleman Methodology Score (MCMS.RESULTS: 18 studies were included (2,092 subjects; 52% male, mean age 35.1 +/- 10.6 years, mean follow-up 3.2 +/- 1.0 years. Labral tear and femoroacetabular impingement were the most common diagnoses treated and labral debridement and femoral/acetabular osteochondroplasty the most common surgical techniques performed. Rehabilitation protocol parameters (weight-bearing, motion, strengthening, and return-to-sport were poorly reported. Differences in clinical outcomes were unable to be assessed given heterogeneity in study reporting. Time-, phase-, goal-, and precaution-based guidelines were extracted and reported.CONCLUSIONS: The current literature of hip arthroscopy rehabilitation lacks high-quality evidence to support a