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Maximum Benefit (maximum + benefit)
Selected AbstractsFatigue behaviour of riveted Glare lap jointsFATIGUE & FRACTURE OF ENGINEERING MATERIALS AND STRUCTURES, Issue 9 2001L. Lazzeri Fibre metal laminates, such as Glare, are a family of materials with very interesting properties for fatigue-critical applications. This article describes the results of a research programme carried out to evaluate the fatigue and damage tolerance characteristics of riveted Glare lap joints, representative of fuselage longitudinal joints. The comparison with the behaviour of metallic joints shows that different contributions are made to the total fatigue life, with the crack propagation life being by far the longer one for the Glare material whereas the crack nucleation life covers almost the entire fatigue life for metallic joints. Design rules should take this peculiar behaviour into consideration, to achieve the maximum benefit in the use of this class of materials in fatigue-critical applications. [source] Ergonomics considerations and management action in the implementation of industrial robotsHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 3 2001Biman Das To obtain maximum benefit from the implementation of industrial robots, it is necessary to identify specific ergonomics problems and provide answers to such problems. Special features of a typical industrial robot are described. Specific ergonomics problems are identified and discussed: sociopsychological factors, systems safety design, communications, training, and workplace design. For the successful implementation of industrial robots, management should take timely action with regard to advanced planning procedures, user involvement plans, communication channels, company labor policies, and continuous training programs. The technological change from conventional to advanced manufacturing, such as industrial robots, must be jointly supported by all levels of management and workers. © 2001 John Wiley & Sons, Inc. [source] A national survey of pharmacist transcribing of discharge prescriptionsINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 2 2003Mrs Rachel J. Hobson teacher-practitioner pharmacist Objective To provide quantitative data on pharmacist discharge prescription transcription service (PDPTS) provision in UK hospitals. Method Postal questionnaire survey of clinical pharmacy managers. Setting Selection criteria included one hospital in each acute trust in the UK. Key findings The response rate was 66% (135/206). In mid-2001, a PDPTS was provided by 49 hospital pharmacy departments (36%). PDPTS was the most common prescribing activity undertaken by pharmacists, followed by a prescription amendment policy (29%), prescribing in pre-admission clinics (18%) and re-writing drug charts (15%). 59 departments (44%) did not undertake any prescribing activity. Of the 86 non-transcribing hospitals, 69% undertook no prescribing activity (range = 0 to 3 prescribing activities). Transcribing hospitals offered a wider range of prescribing activities (range = 1 to 8 prescribing activities). A weak relationship was found between the number of pharmacists employed per hospital and the number of prescribing activities undertaken (correlation coefficient = 0.208, P = 0.018). The most frequently used PDPTS model (78%) involved pharmacists transcribing the discharge prescriptions for their own wards. The number of pharmacists transcribing discharge prescriptions per hospital ranged from 1 to 89 (mean = 8, mode = 2, median = 5, 25% percentile = 2, 75% percentile = 10). The majority of pharmacists (52%) reported writing less than five prescriptions per day; 35% were writing 5,10 prescriptions per day. The most common training requirement for pharmacists to start transcribing was an in-house training programme (55%). The majority of departments (80%) did not re-assess the ability of their pharmacists to transcribe. Conclusion Hospital pharmacy departments in the UK have started to take on prescribing roles, especially transcribing discharge prescriptions. However, it would appear that the majority of the PDPTS schemes are not being run extensively throughout the hospitals. It is of concern that the principles of clinical governance are not being met in terms of training and re-assessment of the pharmacists who are undertaking this service. The reasons why the service has developed in some hospitals and not others are not known. In order to extend this service, funding, resources and skill-mix maximisation need to be considered. This will enable patients to gain the maximum benefit from this service development. [source] Stochastic analysis of crude oil procurement and processing under uncertain demand for bunker fuel oilINTERNATIONAL TRANSACTIONS IN OPERATIONAL RESEARCH, Issue 5 2006Bernardo Zimberg Abstract Bunker fuel oil (ifo), one of the products of petroleum refining, has a strong impact in the production process because it drives the availability of heavy residues that depend on the crude quality. A simplified stochastic model for the Administración Nacional de Combustibles Alcohol y Portland refinery, based on the uncertainty of the demand for ifo, is proposed for comparison with the current approach of deterministic demand. In this model, the benefits of the production process are maximized, taking decisions on the more suitable raw material, intermediate products and final blends in order to fulfill quality and demand requirements of final products. A specific case is analyzed where the maximum benefit is achieved when the most expensive crude quality is purchased, due to a lack of incentive to produce extra amounts of heavy fuel oil that must be exported at a non-attractive price. Results are compared with the solution of a deterministic model with mean demand. In addition, the stochastic model solution depicts how the refinery should operate for each scenario of ifo demand. [source] Effect of cell number on mesenchymal stem cell transplantation in a canine disc degeneration modelJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 10 2010Kenji Serigano Abstract Transplantation of mesenchymal stem cells (MSCs) inhibits the progression of disc degeneration in animal models. We know of no study to determine the optimal number of cells to transplant into the degenerated intervertebral disc (IVD). To determine the optimal donor cell number for maximum benefit, we conducted an in vivo study using a canine disc degeneration model. Autologous MSCs were transplanted into degenerative discs at 105, 106, or 107,cells per disc. The MSC-transplanted discs were evaluated for 12 weeks using plain radiography, magnetic resonance imaging, and gross and microscopic evaluation. Preservation of the disc height, annular structure was seen in MSC-transplantation groups compared to the operated control group with no MSC transplantation. Result of the number of remaining transplanted MSCs, the survival rate of NP cells, and apoptosis of NP cells in transplanted discs showed both structural microenvironment and abundant extracellular matrix maintained in 106 MSCs transplanted disc, while less viable cells were detected in 105 MSCs transplanted and more apoptotic cells in 107 MSCs transplanted discs. The results of this study demonstrate that the number of cells transplanted affects the regenerative capability of MSC transplants in experimentally induced degenerating canine discs. It is suggested that maintenance of extracellular matrix by its production from transplanted cells and/or resident cells is important for checking the progression of structural disruption that leads to disc degeneration. Published by Wiley Periodicals, Inc. J Orthop Res 28:1267,1275, 2010 [source] RT08 Population PK and PK/PD investigations and Monte Carlo simulations for a rational dosage regimenJOURNAL OF VETERINARY PHARMACOLOGY & THERAPEUTICS, Issue 2006P. L. TOUTAIN Objective There are several means whereby dosage schedules for clinical use may be set, some more appropriate and scientific than others! The challenge of the 21st century must be for colleagues in the pharmaceutical industry, those serving registration bodies and academic colleagues to pool their expertise with the objective of designing dosage schedules for clinical use, which are based on the application of sound scientific principles appropriate for each drug class. In this Roundtable Session colleagues of international standing will review (a) pharmacological and other sources of variability in the responses to drugs; (b) the advantages and limitations of pre-clinical studies for dose selection; (c) the roles of population PK and population PK/PD together with Monte Carlo simulations in dosage regimen selection; (d) Bayesian approaches to dosage selection and (e) regulatory guidelines on the type and extent of studies required for selecting dosages. There is no unanimity amongst stakeholders on either the principles or the methods underlying dosage schedule design. Dose titration studies have long been the principal means of fixing doses but PK-PD and population PK-PD studies are now challenging more traditional approaches. The papers and discussion in this Roundtable Session will provide a critical basis for future advances in this crucial area of therapeutic drug usage. Getting the doses right means that the patient will receive maximum benefit, in terms of optimal efficacy with minimal toxicity, and hence correct dosing will contribute enormously to animal welfare. [source] RT09 Bayesian approaches in dosage selectionJOURNAL OF VETERINARY PHARMACOLOGY & THERAPEUTICS, Issue 2006D. CONCORDET Objective There are several means whereby dosage schedules for clinical use may be set, some more appropriate and scientific than others! The challenge of the 21st century must be for colleagues in the pharmaceutical industry, those serving registration bodies and academic colleagues to pool their expertise with the objective of designing dosage schedules for clinical use, which are based on the application of sound scientific principles appropriate for each drug class. In this Roundtable Session colleagues of international standing will review (a) pharmacological and other sources of variability in the responses to drugs; (b) the advantages and limitations of pre-clinical studies for dose selection; (c) the roles of population PK and population PK/PD together with Monte Carlo simulations in dosage regimen selection; (d) Bayesian approaches to dosage selection and (e) regulatory guidelines on the type and extent of studies required for selecting dosages. There is no unanimity amongst stakeholders on either the principles or the methods underlying dosage schedule design. Dose titration studies have long been the principal means of fixing doses but PK-PD and population PK-PD studies are now challenging more traditional approaches. The papers and discussion in this Roundtable Session will provide a critical basis for future advances in this crucial area of therapeutic drug usage. Getting the doses right means that the patient will receive maximum benefit, in terms of optimal efficacy with minimal toxicity, and hence correct dosing will contribute enormously to animal welfare. [source] Intensive insulin treatment in coronary and intensive carePRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 1 2007Dr C Jones MRCP, MB ChB Specialist Registrar Abstract Hyperglycaemia in the setting of acute illness carries a poor prognosis. The first Diabetes and Insulin-Glucose infusion in Acute Myocardial Infarction (DIGAMI) study demonstrated a reduction in total mortality with intravenous insulin to reduce hyperglycaemia followed by multi-dose subcutaneous insulin in diabetic patients following myocardial infarction. Unfortunately, there were several problems with the follow-up DIGAMI-2 study, so that it is not clear if maximum benefit was obtained by intravenous insulin, subcutaneous insulin, or a combination of both. In the surgical intensive care unit (ICU) setting, intensive insulin to restore normoglycaemia reduced total mortality in patients admitted to a surgical ICU who developed hyperglycaemia. In a follow-up study in medical ICU patients the results were disappointing, and there was no overall reduction in mortality. There is a need for a study which would combine these two complementary approaches, examining the possible benefits of using very intensive insulin treatment to achieve normoglycaemia following myocardial infarction in patients with diabetes. Copyright © 2007 John Wiley & Sons. [source] Implementing Evaluation of the Measurement Process in an Automotive Manufacturer: a Case StudyQUALITY AND RELIABILITY ENGINEERING INTERNATIONAL, Issue 5 2003Graeme Knowles Abstract Reducing process variability is presently an area of much interest in manufacturing organizations. Programmes such as Six Sigma robustly link the financial performance of the organization to the degree of variability present in the processes and products of the organization. Data, and hence measurement processes, play an important part in driving such programmes and in making key manufacturing decisions. In many organizations, however, little thought is given to the quality of the data generated by such measurement processes. By using potentially flawed data in making fundamental manufacturing decisions, the quality of the decision-making process is undermined and, potentially, significant costs are incurred. Research in this area is sparse and has concentrated on the technicalities of the methodologies available to assess measurement process capability. Little work has been done on how to operationalize such activities to give maximum benefit. From the perspective of one automotive company, this paper briefly reviews the approaches presently available to assess the quality of data and develops a practical approach, which is based on an existing technical methodology and incorporates simple continuous improvement tools within a framework which facilitates appropriate improvement actions for each process assessed. A case study demonstrates the framework and shows it to be sound, generalizable and highly supportive of continuous improvement goals. Copyright © 2003 John Wiley & Sons, Ltd. [source] Contrasting Functional Performance of Juvenile Salmon Habitat in Recovering Wetlands of the Salmon River Estuary, Oregon, U.S.A.RESTORATION ECOLOGY, Issue 3 2002Ayesha Gray Abstract For an estuarine restoration project to be successful it must reverse anthropogenic effects and restore lost ecosystem functions. Restoration projects that aim to rehabilitate endangered species populations make project success even more important, because if misjudged damage to already weakened populations may result. Determining project success depends on our ability to assess the functional state or "performance" and the trajectory of ecosystem development. Mature system structure is often the desired "end point" of restoration and is assumed to provide maximum benefit for target species; however, few studies have measured linkages between structure and function and possible benefits available from early recovery stages. The Salmon River estuary, Oregon, U.S.A., offers a unique opportunity to simultaneously evaluate several estuarine restoration projects and the response of the marsh community while making comparisons with a concurring undiked portion of the estuary. Dikes installed in three locations in the estuary during the early 1960s were removed in 1978, 1987, and 1996, creating a "space-for-time substitution" chronosequence. Analysis of the marsh community responses enables us to use the development state of the three recovering marshes to determine a trajectory of estuarine recovery over 23 years and to make comparisons with a reference marsh. We assessed the rate and pattern of juvenile salmon habitat development in terms of fish density, available prey resources, and diet composition of wild juvenile Oncorhynchus tshawytscha (chinook salmon). Results from the outmigration of 1998 and 1999 show differences in fish densities, prey resources, and diet composition among the four sites. Peaks in chinook salmon densities were greatest in the reference site in 1998 and in the youngest (1996) site in 1999. The 1996 marsh had higher densities of chironomids (insects; average 864/m2) and lower densities of amphipods (crustaceans; average 8/m3) when compared with the other sites. Fauna differences were reflected in the diets of juvenile chinook with those occupying the 1978 and 1996 marshes based on insects (especially chironomids), whereas those from the 1987 and reference marshes were based on crustaceans (especially amphipods). Tracking the development of recovering emergent marsh ecosystems in the Salmon River estuary reveals significant fish and invertebrate response in the first 2 to 3 years after marsh restoration. This pulse of productivity in newly restored systems is part of the trajectory of development and indicates some level of early functionality and the efficacy of restoring estuarine marshes for juvenile salmon habitat. However, to truly know the benefits consumers experience in recovering systems requires further analysis that we will present in forthcoming publications. [source] Auditory Brainstem Implantation in Patients with Neurofibromatosis Type 2,THE LARYNGOSCOPE, Issue 12 2004Seth J. Kanowitz MD Abstract Objectives: Multichannel auditory brainstem implants (ABI) are currently indicated for patients with neurofibromatosis type II (NF2) and schwannomas involving the internal auditory canal (IAC) or cerebellopontine angle (CPA), regardless of hearing loss (HL). The implant is usually placed in the lateral recess of the fourth ventricle at the time of tumor resection to stimulate the cochlear nucleus. This study aims to review the surgical and audiologic outcomes in 18 patients implanted by our Skull Base Surgery Team from 1994 through 2003. Study Design: A retrospective chart review of 18 patients with ABIs. Methods: We evaluated demographic data including age at implantation, number of tumor resections before implantation, tumor size, surgical approach, and postoperative surgical complications. The ABI auditory results at 1 year were then evaluated for number of functioning electrodes and channels, hours per day of use, nonauditory side effect profile and hearing results. Audiologic data including Monosyllable, Spondee, Trochee test (MTS) Word and Stress scores, Northwestern University Children's Perception of Speech (NU-CHIPS), and auditory sensitivity are reported. Results: No surgical complications caused by ABI implantation were revealed. A probe for lateral recess and cochlear nucleus localization was helpful in several patients. A range of auditory performance is reported, and two patients had no auditory perceptions. Electrode paddle migration occurred in two patients. Patient education and encouragement is very important to obtain maximum benefit. Conclusions: ABIs are safe, do not increase surgical morbidity, and allow most patients to experience improved communication as well as access to environmental sounds. Nonauditory side effects can be minimized by selecting proper stimulation patterns. The ABI continues to be an emerging field for hearing rehabilitation in patients who are deafened by NF2. [source] Impact of introducing a sedation management guideline in intensive careANAESTHESIA, Issue 3 2006C. Adam Summary To ensure that sedative agents in the intensive care unit are used for maximum benefit, a guideline that promotes the accurate and continuous assessment of patients' needs is indicated. This observational 24-month prospective study investigated the effect of introducing a sedation management guideline into a 10-bedded multidisciplinary intensive care unit on length of stay, severity of illness, mortality and the number of bed days provided. Costs for all sedative drugs were calculated as cost per bed day. Intensive care unit mortality remained constant before and after guideline introduction. The length of stay of non-cardiac surgery patients was mean (SD) 4.6 (4.4) and 5.1 (4.3) days, respectively (p = 0.2). Monthly sedative cost before guideline introduction was £6285 compared to £3629 afterwards (p,0.0001), representing a real saving of £63 759 in sedative costs over the 2 years following introduction of the guideline. Guideline-directed management for sedation significantly reduces the cost of sedative drugs per bed day without any negative effect on length of ICU stay and outcome. [source] Acute obstetric emergency drill in England and Wales: a survey of practiceBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 3 2005Elizabeth R. Anderson Multidisciplinary training for obstetric emergencies is an issue of current interest and debate in the UK. This paper presents a survey of current practice in obstetric emergency drill training in England and Wales. A wide range of training methods and opinions about these methods are demonstrated in this survey. There is much interest in improving the management of obstetric emergencies and this is to be encouraged. However, reliable methods to assess and thereby optimise methods are urgently required in order that women and their babies can realise the maximum benefit from these complex interventions. [source] Testing the Long-Term Effects of the Go Sun Smart Worksite Health Communication Campaign: A Group-Randomized Experimental StudyJOURNAL OF COMMUNICATION, Issue 3 2008Peter A. Andersen This study examined the long-term effects of the Go Sun Smart (GSS) campaign, a large-scale health communication intervention designed to promote sun safety to employees at 26 ski areas in western North America. Employees were enrolled in a pair-matched group-randomized pretest,posttest controlled design with 2 follow-up surveys. Half of the ski areas were randomly assigned to implement GSS in the winter. This article reports analyses of a hierarchical linear design with responses from 1,463 employees who completed the second follow-up survey at the end of the following summer (69% of those who completed the first posttest). GSS continued to have positive effects on employees who worked at intervention ski areas into the summer. Employees exposed to GSS reported less sunburning, engaged in more sun safety behaviors, were more aware of the program, and had more discussions of sun safety at home than employees at matched control group resorts. The long-term effects of GSS support recommending that sun protection programs be implemented at workplaces, but such programs should be implemented with high fidelity to achieve maximum benefits. Despite limitations due to nonresponse, geography, measurement, and ethnicity, the hierarchical clustered design improved the internal validity and generalizability of the findings. [source] | ||||||||||||||||